Pudendal Nerve Inflammation - Need a NEW Saddle

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Pudendal Nerve Inflammation - Need a NEW Saddle

Postby Prawn » Sun Mar 04, 2012 1:17 pm

Hello all,

I have just ticked over three months of a burning sensation in my "junk". After doctors, specialists, blood tests, MRI's etc it has been chalked up to inflammation of the Pudendal Nerve caused by cycling.

For those unfamiliar with this issue nerves travel down your spine, run through your tail bone, around the edge of your butt crack and out into your "junk". My nerve issue stems from contact points on my bike saddle and compression of the nerve. Like any nerve issue the symptoms include numbness and a burning sensation. For me, because of the location of the nerve i have inflamed it happens the symptoms are felt in my "junk". The upside is that the nerve will heal and once it does i can get back on my Kuota.

Things have really turned a corner and in recent weeks i have had significant improvement. Some days seem better than others but in the last week i have noted an absence of the burning sensation, other days just a slight sensation.

I parked my Kuota as soon as the symptoms started and i have not been on it since. However, since the marked improvement in the last week i have been thinking of a return to cycling at some point in the next month or so. Obviously the saddle will be critical in returning to cycling and not having the pudendal nerve inflammation happen again. A saddle that does not compress/impact the nerves between your “crack” and your “junk” is what i am after. So I want to put it out there and ask for advice from anyone who might have been in this spot previous. What saddle did you get to prevent this from happening again???

In my searching for a saddle I have noted saddles like the ISM Adamo Road, the Selle SLR Super Flow, Selle SLC and the SMP Dynamic. I have also noted things like the Hobson Easy Seat but I want to stay with a more traditional looking saddle.

Anyone got advice on the saddles I mention above?? Anyone recommend something specific in referencing my particular issue??

Appreciate your thoughts and thanks for your help.

Prawn
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by BNA » Sun Mar 04, 2012 1:34 pm

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Re: Pudendal Nerve Inflammation - Need a NEW Saddle

Postby gururug » Sun Mar 04, 2012 1:34 pm

I have one of these;

http://origins.selleroyal.com/Products/AEROYAL

It's possible to arrange it so that you sit on the back piece and there is no pressure at all in the "softer areas".

May not be the style your thinking of although i'd be looking for a saddle that has a raised/defined sitbones area. Possibly a salle SMP, anyone?

Maybe you can fasten some riser material to an existing saddle. Cheap, and you can have any saddle you like.
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Re: Pudendal Nerve Inflammation - Need a NEW Saddle

Postby PawPaw » Sun Mar 04, 2012 3:10 pm

What saddle/s inflamed it in the first place?
How is the bike set up? drop between saddle and bars? tri bars?
How tall are you?
weight? overweight?

All these things effect whether you will have undue pressure on your perineum.
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Re: Pudendal Nerve Inflammation - Need a NEW Saddle

Postby Prawn » Mon Mar 05, 2012 6:53 am

Ok, a little more information for clarification.
I ride a Kuota Kolt set up for road racing. I had a professional bike fit, measured up, my measurements into the computer, bike on the jig etc. Current drop is 80mm.
The saddle i was riding was a San Marco Arami. I had clocked some 20,000km on this saddle.
I am 180cm tall and weigh 68kgs so being over weight is not going to be the issue.
Typically i was clocking about 250kms a week.
Cheers
Prawn
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Re: Pudendal Nerve Inflammation - Need a NEW Saddle

Postby MikeyD360 » Mon Mar 05, 2012 9:30 am

Im a tall fattie (125kg) and my original road saddle on my first ride gave me pudendal nerve bruising that lasted approx 6-8 weeks and resulted in partial numbness of the old fella during this time.
Obviously I needed a new saddle if I was to continue riding and went for a Selle SMP Extra.

Image

It is a little heavy - ~380g I think - however I have had ZERO comfort issues since changing and have all the feeling back :D
I got mine off ebay for around $100 bucks.
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Re: Pudendal Nerve Inflammation - Need a NEW Saddle

Postby wombatK » Mon Mar 05, 2012 9:49 am

That Saddle you've got is 134 mm wide and all the evidence points to you're pudendum taking
the weight and not your sit bones. I'll put money on your bike fit not including a measurement
of your sit bone width.

Some bicycle stores have the Specialized Ass-O-Meter for this. But others don't bother,
because you might baulk at having to add a $100 - $200 for a seat that fits.

You can do something equivalent by sitting your backside on about 1 cm layer of rice spread out in a plastic bag.
Put the rice-ass-o-meter on a low seat or bench so that you make a similar angle between
your torso and upper thigh as you have on the bike. Sit on it then measure the width of the
depression. Odds-on, it's going to be more than 134 mm.

Then go buy a seat that's the right width. If all this measurement is too complicated for you,
just go buy a Brooks B17. They are approx 170 mm wide, and have lots of fan-boys here
because they are a very comfortable saddle.

Cheers
WombatK

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Re: Pudendal Nerve Inflammation - Need a NEW Saddle

Postby Prawn » Mon Mar 05, 2012 11:23 am

Hi MikeyD360 glad to hear that there are others out there that have bounced back from a similar issue. The SMP saddle is one of the saddles i am looking at. For my weight/size the "Dynaminc" is what i am considering rather than the "Extra" you mention. Glad to hear it is working for you.

Nice pick up WombatK. No, the bike fit i had did not look at the saddle at all. Good piece of advice to look at saddle width as i was more focused on the "cut out" aspect. The Selle Superflow i am looking at comes in a 145mm width and some of the reviews i have read give this wider saddle option a big thumbs up.
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Re: Pudendal Nerve Inflammation - Need a NEW Saddle

Postby petie » Mon Mar 05, 2012 12:23 pm

i think I have a selle italia SLR XC gel flow on my MTB with a cutout. Just happened to be on the bike when i got it but is very comfortable and no issues so far.
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Re: Pudendal Nerve Inflammation - Need a NEW Saddle

Postby PawPaw » Mon Mar 05, 2012 3:18 pm

Prawn, I agree with Wombat that your saddle is most likely not wide enough. The Arami is comparatively thin across the rear, and the sides begin their slope down closer to the centre more than many newer models. This leaves little support for your ischial tuberosities and ischiopubic rami, and subsequently loads your soft tissue. The Specialized range for an average male skeletal frame is 143mm across the rear, and the saddles do not slope down as close to the centreline.

Newer models from many manufacturers have a wider and flatter rear section, then towards the front cut in earlier and sharply, so the thighs don't rub on too wide a nose.

Some other things to consider:
- check your lumbar flexion. If a bit restricted here, you may be tilting your pelvis anteriorally more than optimal, and thereby rolling forwards excessively onto your perineal soft tissue.
- excessive saddle setback may also result in excessive anterior pelvic tilt, so as to reach the bars.
- an excessively long head stem will do the same, as will bars that are rotated too low, or STI levers mounted too low on the bars.

Steve Hogg has written a good article about SMP saddles and general saddle fitting info.
http://www.stevehoggbikefitting.com/blog/2011/09/all-about-smps/
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Re: Pudendal Nerve Inflammation - Need a NEW Saddle

Postby Dobo » Thu Mar 08, 2012 2:56 pm

I suffer from a similar problem too and switched too the Selle smp Extra saddle on my Fuji Altamira as well and after a few minor positioning adjustments I haven't had any issues at all.
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Re: Pudendal Nerve Inflammation - Need a NEW Saddle

Postby scotto » Thu Mar 08, 2012 3:23 pm

+500 votes for selle SMP saddles - the cheapies on ebay are good for my frame (188cm, 94kg)
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Pudendal Nerve Inflammation - Need a NEW Saddle

Postby toolonglegs » Thu Mar 08, 2012 4:35 pm

-500 votes for the SMP's... Torture implement ;-) !.
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Re: Pudendal Nerve Inflammation - Need a NEW Saddle

Postby Prawn » Wed Mar 14, 2012 6:38 am

A follow up question for MikeyD and Dobo.....
The particular issue you guys have had, how did you get yourself back on the bike? Did you actually have a period off the bike? Medically, did you guys see anyone specifically prior to getting back to cycling?
I have been off the bike for just over 3 months while waiting for the nerve to heal. I have significantly improved since the original flare up and hope that within a month i can get back on the bike. I am however worried about a chance of continued issues, or even getting it worse. How did you manage your return? There is bugger all information i can find about the issue and the actual management of the issue to see a return to cycling. Appreciate any advice.
cheers
Prawn
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Re: Pudendal Nerve Inflammation - Need a NEW Saddle

Postby MikeyD360 » Wed Mar 14, 2012 8:34 am

Prawn wrote:A follow up question for MikeyD and Dobo.....
The particular issue you guys have had, how did you get yourself back on the bike? Did you actually have a period off the bike? Medically, did you guys see anyone specifically prior to getting back to cycling?
I have been off the bike for just over 3 months while waiting for the nerve to heal. I have significantly improved since the original flare up and hope that within a month i can get back on the bike. I am however worried about a chance of continued issues, or even getting it worse. How did you manage your return? There is bugger all information i can find about the issue and the actual management of the issue to see a return to cycling. Appreciate any advice.
cheers
Prawn


I did the whole "pretend nothing is wrong" male thing for a week or 2 waiting for it to come good (off the bike of course) and when no improvement I started to get worried and went to the docs... especially after googling gave me some scares :) (hint - dont bother googling any medical condition).
Doctor says just nerve bruising and says it will heal and best to stay off the bike until it does - he couldn't give an accurate timeframe and said anywhere from a few weeks to a few months as nerves are slow to heal.
I stayed off the bike for another week and then after the new saddle came in I though bugger it - I cant go any longer not riding or I will go mad, so just started riding again - short commutes, no weekend rides - and then over the next few weeks the feeling progressively came back. I am very conscious now to get out of the saddle regularly to keep blood flowing and reduce pressure on nerves. No problems since.

I would definitely recommend ease back into it with short rides and make them progressively longer - and ensure you are 'testing' the sensations after each ride to make sure you arent making anything worse.
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Re: Pudendal Nerve Inflammation - Need a NEW Saddle

Postby Dobo » Wed Mar 14, 2012 2:28 pm

HI Prawn. Luckily for me I noticed the pain and acted straight away before any real damage was done as I had heard about this before from some other riders. I think I took about 2 weeks off the bike for it to settle down and changed the saddle to the SMP Extra and things are right as rain at the moment (touch wood). I do still get the odd twinge on longer rides now and then but 99% of the time it's ok.

Sorry I couldn't be of more help to you but goods luck with it all.

Cheers
Dobo
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Re: Pudendal Nerve Inflammation - Need a NEW Saddle

Postby m@ » Wed Mar 14, 2012 3:14 pm

wombatK wrote:... If all this measurement is too complicated for you,
just go buy a Brooks B17. They are approx 170 mm wide, and have lots of fan-boys here
because they are a very comfortable saddle.

Just my 2c - B17 has caused minor numbness issues for me, moreso than much narrower plastic saddles I've used. I put this down to the saddle's tendency to sag right where you least want it to (under your sit bones) leaving you sitting on a hard ridge down the middle of the saddle. Before someone asks, the saddle was originally horizontal and I've tried raising the nose ;)

Plenty of others are happy with them, but my backside's not a fan.
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Re: Pudendal Nerve Inflammation - Need a NEW Saddle

Postby greyhoundtom » Thu Mar 15, 2012 8:54 am

m@ wrote:Just my 2c - B17 has caused minor numbness issues for me, moreso than much narrower plastic saddles I've used. I put this down to the saddle's tendency to sag right where you least want it to (under your sit bones) leaving you sitting on a hard ridge down the middle of the saddle. Before someone asks, the saddle was originally horizontal and I've tried raising the nose ;)

Plenty of others are happy with them, but my backside's not a fan.

It is exactly those issues that had me sell my B17 to a mate (who is very happy with the saddle) and buy a Specialized Romin Body Geometry saddle, and while there is very little padding and therefore hard to get used to, it is doing the job to date.

The only time I still get some numbness is if I spend a lot of time in the drops, and if I know I will be in the drops for most of the ride, such as a windy day, dropping the nose of the saddle one notch on my seat post solves that problem.
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Re: Pudendal Nerve Inflammation - Need a NEW Saddle

Postby sumgy » Sat Mar 17, 2012 8:45 am

toolonglegs wrote:-500 votes for the SMP's... Torture implement ;-) !.


And I will give it +infinity votes.
The only reason it will be a torture implement is if you dont set it up right.
Needs to be set with the saddle nose only very slightly lower than the back edge.
I find approximately 4 deg's works for me.
Also need to make sure your setback is in the right place vs others which can be a little tricky due to the dropped nose.
Steve Hogg has a good method for doing this on his blog.
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Re: Pudendal Nerve Inflammation - Need a NEW Saddle

Postby Parrott » Sat Mar 17, 2012 7:32 pm

Haven't used an smp, though know a few who have. They don't use them now. Might be worth a try if you are desperate I guess, if you can find a cheap cast off somewhere.
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Re: Pudendal Nerve Inflammation - Need a NEW Saddle

Postby sumgy » Sat Mar 17, 2012 8:56 pm

Parrott wrote:Haven't used an smp, though know a few who have. They don't use them now. Might be worth a try if you are desperate I guess, if you can find a cheap cast off somewhere.


Refer my post above.
And good luck finding a cheap "cast off".
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Re: Pudendal Nerve Inflammation - Need a NEW Saddle

Postby Eugene » Sun Mar 18, 2012 7:25 am

sumgy wrote:
Parrott wrote:Haven't used an smp, though know a few who have. They don't use them now. Might be worth a try if you are desperate I guess, if you can find a cheap cast off somewhere.


Refer my post above.
And good luck finding a cheap "cast off".


+1

I had the same issue with Numbness after a ride any longer than 50km, Selle SMP Evolution fixed it, it took a few small tweaks to get it right, but I will not ride without it now, have done may 90km + rides none stop without numbness or sore butt-ittiss, I am not small by any means still around 100kg, but I was 120kg+ when I started riding and the seat is perfect.
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Re: Pudendal Nerve Inflammation - Need a NEW Saddle

Postby Parrott » Sun Mar 18, 2012 9:33 am

I haven't used one and haven't needed to. I have my flite max set up so its comfortable in the drops as it needs to be. I am a hack level racer so I need all the help I can get and being aero provides some. The two blokes in my old club did not discard them through lack of experimentation, they couldn't get comfortable in the position they need to be.

I look at what works for others who race as that is the type of riding I do.
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