Q: What are the most likely causes of female genital pain while cycling?
Mary Paterson: Saddle comfort can be the deciding factor between an enjoyable ride or a miserable one. It can stop some women from riding their bikes all together, it’s that painful. Why can the saddle be such a “pain in the butt”?
The main reason is that the soft tissue at the front really wasn’t meant to be bear weight. We have sit bones, aka ischial tuberosities, for that job. But on a bike, in a bent-over riding position, your body weight is shared between the 2 sit bones and the pubic bone in the front, which means there is pressure on the soft tissue (the perineum) at the front.
Saddle discomfort is one of the most difficult areas to address in a bike fit. It affects how you sit on your bike and it changes your posture. As a result, it changes all the rest of the angles below and at the front of your bike. The ensuing chain reaction of poor posture to relieve the pressure from an uncomfortable saddle can lead to neck and back pain and can alter how the whole bike feels. To fix the problem often requires trying a number of saddles before completing the bike fit. Or you may have found the “right” saddle but how you sit on the bike is making it uncomfortable.
If your bike is the right size, here are a number of bike fit faults that can cause saddle discomfort:
The most common cause of saddle discomfort is a poor saddle. Some saddles are hard as a rock and some are too cushy. A saddle that is too thick and soft will make you sink down from the weight of your sit bones and cause the middle of the saddle to push up and place more pressure on your soft tissue.
A firmer saddle is usually better, especially for longer rides. A proper woman’s saddle should have good padding for the sit bones and a cut-out or groove in front to provide relief from pressure on the perineum and to improve blood flow. It’s important for the cut-out or groove to extend far enough forward to remove pressure in the correct region. A women-specific saddle is essential for most women. Bikes that are not women specific are equipped with men’s saddles, which were not designed for the female anatomy.
Width is also important. The sit bones should be sitting in the middle of the widest part of the saddle. Specialized and Bontrager both offer saddles in 3 different widths. Specialized has something called the “ass-o-meter”, a simple piece of memory foam that leaves an imprint of your sit bones to determine the correct saddle width. A saddle that is too narrow causes the sit bones to hang off the sides, creating uncomfortable friction at the sit bones where the hamstring tendons attach. If your saddle is too wide, the gel support isn’t where it is needed. Having a choice of saddle width is important for petite women who have narrow pelvises and would normally choose a narrower men’s saddle. Now they can get a women-specific saddle in a narrower width.
Saddle selection is a personal choice. Everyone’s anatomy, weight and style of riding is unique. As a result, one person may love a saddle whereas another will hate it. When buying a saddle, make sure the local bike shop will allow you to return it if you don’t like it. Otherwise, you can spend a lot of money trying to find a saddle that’s “just right”for you.
Here are a few examples of popular women’s saddles that many women find comfortable:
- Specialized Lithium Gel, Sanoma, Jette
- Selle Italia Lady Gel Flow
- Terry Butterfly, Liberator, Damselfly
- Selle SMP
- WTB Deva
Poor Saddle Tilt:
A saddle tilt that is too nose up will put additional pressure on the front soft tissues. This also usually causes a slouched posture on the bike.
A saddle that is too nose down will cause you to slide forward on the saddle and make you sit on the wrong part of the saddle. The sit bones will no longer provide adequate support and more weight will be placed on the hands, causing numbness and hand pain.
The saddle on a road bike should be either level, for a more upright rider, or slightly nose down—just a few degrees down from horizontal—for a more forward riding position. On a time trial bike, the saddle should be more nose down as the pelvis is rotated more forward at the front of the bike. A seat post with adjustable angles allows you to find that ideal tilt. Many posts have saddle clamps with notches that often leave you with the choice of being either too nose up or too nose down.
The Saddle is Too High:
A saddle that is too high will take your weight off the pedals and place more weight on the saddle. It will also cause your hips to rock, causing side to side movement and chafing.
The Saddle is Too Far Back:
Moving the seat forward so that the knees are over the pedal axis, changing the pedaling angle, usually improves saddle comfort.
The Drop Between the Seat and the Handlebars is Too Large:
A more aggressive position at the front of the saddle will put more weight on the hands and the perineum.
The Handlebar Reach is Too Far: Having to stretch too far out at the front reduces support from your arms and places more of your weight on the front of the saddle.
Wear a good pair of cycling shorts with a good quality seamless chamois. As with the saddles, shorts and the thickness of the chamois are a personal choice. The chamois material should wick away moisture. Some have anti-bacterial fibers to reduce bacterial buildup.
Do not wear underwear. Put your shorts on right before you ride to keep them clean and dry. Remove them as soon as the ride is over. Never wear the same pair of shorts 2 days in a row without washing them.
Just as a runner uses vaseline on areas of repeated friction to prevent chafing sores, so cyclists should apply cream to the saddle area. The pedaling motion creates a certain amount of side to side movement on the saddle, which can cause uncomfortable and painful chafing of the soft tissue. It is this friction, more than pressure, that causes saddle sores.
Some sort of cream is a must, especially for long rides and rides on consecutive days. Chamois creams prevent chafing by creating a thin lubricating layer between your shorts and your skin. I use Bag Balm (also used on the udders of milk cows and Shania Twain’s skin) and last year in France rode 6 days in a row without any irritation at all. Other popular creams include Penaten or other diaper rash creams and commercially-made cycling products such as Chamois Butt’r or Bliss.
Get Off the Saddle Regularly:
Every 10 to 15 minutes stand on the pedals to either stretch your back, or use a few pedal strokes to stretch the legs. Just as moving your hands around frequently will prevent numbness and pain, getting off the saddle will relieve constant pressure and improves blood flow. Make sure you stand on or lift yourself up a little from the saddle when you ride over bumps.
Allow Time to Adapt:
The first ride of the season never feels very good. The saddle area needs to get used to that pressure again. Start with short rides and gradually increase your distance and time.
Practice these preventive steps—don’t wait until you are uncomfortable before taking action.
Mary Paterson is a physiotherapist and a certified bike fit professional. An avid road and mountain cyclist, Mary has over 19 years of sports medicine experience. Her business, Bike 2 Body, offers physiotherapy and bike fitting for cyclists.
Mary brings her medical knowledge of sports injuries and biomechanics to the diagnosis and treatment of cycling injuries and applies them to the ideal bike fit.
We want to know what you think! Scroll down to leave a comment.
Like this article? You’ll love getting our free newsletter!