Most people are unfamiliar with the Pudendal Nerve and what it does. Those who suffer from “Cyclist’s Syndrome” are often painfully aware of its effect.
The Pudendal Nerve leaves the spinal cord at the level of the sacrum, which is near the tailbone. It takes a twisting path down through the pelvis. It provides sensation to the skin around the anus and perineum, and provides motor control to the urethral and anal sphincter muscles. Due to its location at the bottom of the pelvis, it can become compressed with prolonged sitting. This happens to cyclists and triathletes quite often, due to the amount of time they spend in the bike saddle.
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Symptoms of Pudendal Nerve Entrapment include:
- Pain with urination or bowel movements
- Urinary urgency and frequency
- Pain and/or numbness with prolonged sitting in the perineum, buttocks, inner thigh, groin, or genitalia
- Pain with intercourse in females
- Erectile dysfunction in males
According to a study by Sommer et al in the International Journal of Sports Medicine, 61% of male cyclists suffered from genital numbness. 19% of male cyclists who had a weekly training distance of 400 kilometers or more suffered from erectile dysfunction.
This condition can be prevented by making the following changes:
- Change the design and position of your saddle. A wider saddle with an absent or flexible nose can be obtained and will decrease pressure to the Pudendal Nerve where your pelvis meets the seat. Gel saddles can be helpful, as can tilting the saddle downward.
- Change your riding position. A more upright posture while riding will shift the pressure from the front of the perineum to the ischial tuberosities, or the “sits” bones. Keeping your hip flexors and hamstrings flexible with regular stretching will make this easier.
- Change your riding schedule. Prolonged pressure from sitting in the bike saddle can cause stretching, compression, and decreased blood flow to the Pudendal Nerve. Decreasing your time in the saddle can be done by altering your training schedule, or simply rising out of the saddle for 20-30 seconds every 20 minutes.
For those suffering from Cyclist’s Syndrome, there is help available. Your physician can refer you to a Physical Therapist to treat the pain and muscle dysfunction that often goes along with this painful condition.