Saddle Sores

author : AMSSM

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While not the most pleasant topic, saddles sores are a common phenomenon within the cycling community. Learn what causes saddle sores and how to prevent them from occurring.

By Rachel Biber, MD

Member AMSSM

While not the most pleasant topic, saddles sores are a common phenomenon within the cycling community. Whether new or old to the sport, it is likely that you have encountered pain in your backside.

What are saddle sores?

First, it is important to clarify some potentially confusing terminology. Saddle sores refer specifically to skin-related disorders of the area of the body in contact with the bicycle seat. In contrast, saddle soreness is the experience of painful “sit bones.” The “sit bones” are the two bony prominences on your backside that come into contact with a chair when sitting. They are the ischial tuberosities of your pelvis. Pain in different parts of your pelvis can also be experienced, particularly with an aggressive aerodynamic position on the bike. Moreover, muscle pain can be part of the cause of saddle soreness. The first ride of the season or a prolonged ride will undoubtedly produce muscle soreness.

Saddle sores do not refer to one specific skin ailment, but rather to a continuum of skin complaints that vary in severity:

1. Chafing
   
   This is the least severe type of saddle sore. It arises from the rubbing of the inner thighs and groin against the saddle. Riding a wider seat tends to amplify body movement on the seat, increasing the risk of chafing with the concurrent increase in friction. This type of skin lesion manifests as a red, inflamed abrasion.
    

2. Furuncles and folliculitis
   
   Folliculitis is an infection at the base of a hair follicle. A furuncle or boil is a localized accumulation of pus with an infected hair follicle. A furuncle can initially look like a pimple. If untreated, furuncles can develop to form abscesses.
    

3. Skin ulceration
   
   A skin ulcer can look like a crater-like lesion. It especially occurs with prolonged rides. If not treated appropriately, it can progress to a severe skin infection such as cellulitis.

How can you prevent saddle sores?

Several strategies can help prevent saddle sores:

1. Saddle type and bike fit
   
   Saddle height and tilt should be adjusted appropriately. A neutral to slight upward seat tilt is recommended for men, whereas, a slight downward tilt is recommended for women. However, slight variations in either direction are common. Bike shops can assist in bike fit with triathlon-specific recommendations. Seat height should be adjusted so that the knee is bent 15-20 degrees with the foot at the bottom of the pedal stroke.
    

2. Bike attire
   
   Quality cycling shorts are integral to preventing saddle sores and should include a chamois. No underwear should ever be worn underneath.
    

3. Hygiene
   
   Cycling shorts should be rinsed or washed after every ride. Cyclists need to keep the groin area clean and dry after each ride.
    

4. Lubricants
   
   The application of a lubricant such as petroleum jelly or triathlon-specific commercial lubricants may help reduce friction and shear.
    

5. Mileage
   
   Gradually increasing mileage or cutting back on time in the saddle not only prevents saddle sores, but also helps heal any persistent saddle sores.

When should you see a doctor if saddle sores occur?

Treatment of mild saddle sores centers around routine skin care, with importance placed on keeping the skin clean and dry when not riding. Unscented lotions can be used for minor lesions. Topical antibiotic creams can prevent infection if chafing or skin ulceration occurs. Warm compresses may help resolve folliculitis or furuncles. Avoid tight clothing to facilitate the resolution of saddle sores.

Medical attention should be sought for any skin lesions that are worsening, particularly if they are increasing in size, warmth, redness and pain, or if they are accompanied by fever. Signs and symptoms such as these of an apparent infection that is not improving should be evaluated by a healthcare professional.

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date: November 3, 2008