Cycling and Pelvic Floor Dysfunction…
Austin is known to be an active city and we are especially known for our cyclists. While cycling is considered a good form of low impact, cardiovascular exercise, few people consider the impact that it may have on pelvic floor pain and sexual function. There are many potential causes of pelvic floor issues with cycling, including trauma from a fall or trauma involving the crossbar. However, the key factors of cycling that may be discussed during physical therapy are the bicycle seat and rider’s position on the bicycle (forward flexed posture).
Cycling can create neurovascular injuries (injuries to the nerves and blood vessels) of the pelvic floor which has been associated with sexual dysfunction. The injury to the nerves and blood vessels has been linked to the repetitive compression that occurs during cycling. Your ischial tuberosities or “sits bones” (the bones you feel when sitting on a hard chair) elevator your body so that if you are in proper posture your pelvic floor does not receive compression in sitting. However, your bicycle seat fits between your sits bones and applies direct pressure to the pelvic floor muscles, including the nerves and blood vessels. It has also been suggested that pedaling the bicycle creates stretch to the pudendal nerve which innervates the pelvic floor muscles.
What can you do to protect your pelvic floor while cycling? Unfortunately, there is not much research on this topic. However, it has been suggested that use of a wider posterior section of the seat to support the ischial tuberosities will help to alleviate pressure on the pelvic floor muscles, nerves, and vasculature. Other recommended saddles include noseless saddles and moon saddles which will give support to the ischial tuberosities. Since these saddles do not have a nose, it will take the pressure off of the pelvic floor muscles, nerves, and vasculature. If you do have a saddle with a nose, consider taking breaks from the forward flexed position to sit upright on your sits bones to relieve pressure. If you are not training competitively for a cycling competition, cross training such as swimming, walking/running, and elliptical training are also recommended to allow for healing time and reduced strain to the pelvis.