Raceplan Coaching & Racing: Those darn saddle sores

A client recently commented on how her saddle sores have impacted her her training and racing and I thought this will make a good topic for the group.

Truth is, if you ride a bike long enough, you'll get them. I remember the first time I battled them. It was during training for the the 1993 Canadian Ironman. I followed the advice of a friend I was training with and smeared Noxema in my shorts during training. Come to find out that Noxema, or any other oil based cream for that matter, either works well or doesn't at all. In my case, it did not work at all. The oils in the cream clogged up my sweat pours and, to keep it as short as possible for obvious reasons, I showed up to the race with at least 11 saddles sores, the largest the size of a nickel. I remember how painful it was for me to sit in the airplane and wondering how I was going to ride 112 miles with my butt in the condition it was in.

My saddle sores were so bad that I had to visit the emergency the day before the race and get some medical advice as to how to best manage the pain and potential physiological issues that may result from racing on them. The nice doctor's words were "well, I'm not going to tell you not to race because obviously you've sacrificed a lot and are here. The only thing I can do is to help make you as comfortable as possible." With that, he gave me a copious amount of topical numbing cream and two syringes of Novocain. The instructions: if the pain gets too bad during the ride, pull over, apply the numbing cream and shoot yourself in the ass with Novocain.

I came really, really close to pulling over, but chose not to. Needless to say, my bike time was an hour slower than anticipated, but I gladly gave up the bike and had a stellar run as a result of being forced to be conservative on the bike.

With that, I vowed to learn as much as I can about saddle sore and am sharing for others to benefit from. Saddle sores are usually associated with:

Chafing: The constant rubbing against the saddle caused from the normal cycling motion can cause chafing of the groin and inner thighs. This is why you want to buy as thin a saddle as will support you (by the Ischia tuberosities - your "sit bones") and why cyclists usually wear good quality, skin tight cycling shorts.
Boils and "in-grown hairs": Both of these are from bacterial infections. "In-grown hairs," or folliculitis, is not such a problem, occurs frequently where you have a lot of rubbing and a lot of hair in tight clothing, and tend to heal on their own without causing pain. On the other hand, boils, or furuncle, which look a lot like acne are from bacterial infections, and can become large, hard, and really, really hurt! You really don't want to get a boil in the wrong place, or your bike won't seem so friendly to you anymore! If this is a frequent problem, ask your physician about preventative treatment with anti-bacterial ointments. The important lesson here is to always wear clean shorts, and to get out of your cycling clothes as soon as you can after a ride.
Sore Backside: This is when the flesh that you're sitting on becomes red, inflamed, and sore. Here it's important to check the fit of the bike, and to check that the saddle is both level and wide enough to hold you up by the pointy extrusions on your rear-end that actually make contact with the padded, back part of the saddle. Women should definitely get a saddle that is built for their wider pelvises.
Skin Ulceration: Basically, this is rubbing the skin off, causing a crater-like lesion. Ouch! If you ride a long tour - 100+ miles/day for five days or more, you are a candidate to develop an ulceration. This definitely should not be ignored, and you should seek medical treatment. If you ride on it untreated, you are at serious risk of getting a much worse skin infection.

Lessons learned:

1. most obvious: hygiene. spending unnecessary shammy time, especially after working out/racing. Get out of those things fast. If you can't shower, carry Purell-type antibacterial gel with you and rub some down south to kill any residue. some women have problems with that stuff because of the alcohol, which may cause a bladder infection. Other options include baby wipes, the unscented ones. others have had good success with liquid acidophilus...yes, the same kind you drink. You can use it topically as well. The point is that you've got to keep that area clean and dry.

2. clothing: some shammys are better than others. I understand you may not have much choice with your team kit, but during the off season, you've got to train in the best shorts available, keep them clean and use plenty of shammy cream (I've found the Assos for winter time because of the menthol action and/or Shammy Butter for summer time to be best)

3. your fit: being positioned properly on the bike is also important. Be stretched out too far or not far enough will put pressure on your sensitive parts and cause rubbing, which will in turn cause the above problems.

4. quality of saddle: saddles break down after a while and pressure points will develop. kind of like an old couch. I make a habit of changing my saddle at least every 18 months.

5. keeping it clean, let the healing begin: I normally scrub the area in the shower pretty well with a good quality soap and clean wash towel. When needed, after drying I apply a bit of antibacterial gel and let air dry. I then apply either Neosporin with pain killer or Desitin (for baby rash) to micro-areas that need it most. Then I wear loose clothing and let mother nature do its thing.

Well that's about it. Your comments/input is welcome as always. Keep the pictures to yourself!