Saddle sores almost inevitably occur amongst serious cyclists to varying degrees. If treated proactively, saddles sores should only be a short-lived hiccup. Left unchecked, saddles sores can progress into legitimate medical and/or surgical emergencies requiring prescription medications and painful procedures. Therefore, it is imperative to address these problems head-on when they first arise.
What is a saddle sore?
“Saddle sore” is a nebulous term that mean different things to different people. It can mean anything from a horrible life-threatening infection of the skin and subcutaneous tissues to just feeling bruised from a long hard day in the saddle. For our purposes we will refer to saddles sores as an actual visible lesion of the skin and/or subcutaneous tissues of the area of the body in contact with the bicycle saddle or seat. Saddle sores come in two basic varieties: skin breakdown (e.g. chafing and ulcers) and subcutaneous lesions (e.g. boils, carbuncles, furuncles, abscesses, and other “lumps”).
An ounce of prevention is worth a pound of cure
The best way to combat saddle sores is to not get them in the first place. Here’s a list of 10 things a cyclist can do to prevent saddle sores:
- Bike fit – This is THE SINGLE MOST IMPORTANT measure you can take to prevent saddle sores and general discomfort on the bike. If you are a serious fitness, recreation, or competitive cyclist, you owe it to yourself to pay for a professional fitting session. I nquire at your local bike shop.
- Cycling shorts – There are just a few pieces of equipment in cycling where, relatively speaking, you should spare no expense. Quality bike shorts will have a molded pad (i.e. “chamois pad”) in the crotch area made of COOLMAX or similar polyester-based material. This material is designed to wick away moisture, provide cushion, allow for airflow, and prevent chaffing.
- Saddle – A quality bike saddle or seat is of obvious importance when it comes to the comfort of your posterior. Saddles come in a multitude of shapes, sizes, cushion thickness and type, and construction. Since no two pelvises are the same, try out as many saddles as possible before settling on the right one for you. Many shops have programs where you can test drive multiple saddles before purchasing. Some manufacturers have models of varying widths that can accommodate your specific pelvis measurements (e.g. Body Geometry by Specialized). You might be surprised to find that the cushiest and widest saddles are often the most uncomfortable.
- Skin – Clean and dry is your mantra when not riding. Always try to remove your shorts as soon as possible after riding. Head to the shower as soon as possible too. If you do not have an active sore or chafe, then assure after showering that your crotch is dry before putting on undergarments.
- Undergarments – Between rides, wear lightweight undergarments that allow for maximum airflow and do not promote moisture build-up (cotton is king here).
- Laundry – Do not wear shorts twice without washing them! Cleanliness is important when it comes to preventing saddle sore.
- Unctions and tinctures – Old school riders swear by dousing their most delicate areas with isopropyl alcohol when ramping up early mileage with the thought that this toughens up their skin. If you can withstand the sting, then this will certainly aid in drying your nether regions after a post-ride shower. Beware, it hurts and may not be entirely necessary.
- Inspection – Take a look at your crotch frequently. Look for areas of chafing, redness, and little bumps. You might be surprised by what you find! Some of these spots can be fairly asymptomatic so you’re only going to know that they are there if you look. Pay close attention to “little bumps” as they can grow into large boils and abscesses. The best remedy for these little bumps or chaffed areas is time off the bike or a decrease in mileage. You can also try a variety of ointments available on the market.
- Rest – Just as your body needs rest to accommodate a training load, your crotch needs time away from the bike.
- Chamois cream – Either you use it or you don’t. Most people become habitual users once they try it. Chamois creams were initially created to condition chamois pads when they were made out of actual animal hide. These days, a chamois cream is essentially used to decrease friction between a rider’s skin and chamois pad. Some brands use botanical ingredients to hinder bacterial and fungal growth. It’s these microbes that are the big culprits in non-healing saddle sores. Beware of brands that use mineral oil and silicone as they can breakdown modern chamois pads and clog the airflow properties inherent to the material used in chamois pads
Treatment of saddle sores
Areas of minor skin breakdown can usually be healed rapidly with a short-term decrease in riding volume or, better yet, complete rest. The area of skin breakdown should be cleansed with simple soap and water twice daily. Avoid hydrogen peroxide and isopropyl alcohol as they can inhibit normal wound healing. A topical ointment like Neosporin (or other over the counter triple antibiotic ointment) can speed up the healing process.
Bumps or hard knots under the skin are typically a more serious condition than skin breakdown. Additionally, these lesions can be quite painful. If at all possible, a complete break from riding is the best path to a speedy and uneventful recovery. As above, cleanse the area twice daily. Although ointments can soothe subcutaneous lesions, most do very little to speed the healing process as they cannot penetrate the skin deeply enough to reach the area of concern. For subcutaneous lesions that produce thick drainage and areas associated with fever or intense redness of the skin, see your physician. Antibiotics and surgical drainage of these lesions can be necessary in some cases.
***You should seek medical attention if:
1. You notice an area of intense swelling and redness around ANY saddle sore.
2. You develop a fever associated with a saddle sore
3. Your saddle sore worsens after treating it as above
4. You develop drainage of thick material or pus from a saddle sore
Source by Joshua G. Barton, M.D.