Infographic. Getting to the bottom of saddle sores: an infographic.

Napier, Daniel Nicholas; Rankin, Alan; Heron, Neil

Abstract

Saddle sores are skin lesions that affect the area of skin in contact with the bicycle saddle and can prove troublesome for cyclists.1 Friction and compression of the skin can lead to chafing,2 redness and infections such as folliculitis and furunculitis.1 Chronic saddle sores can develop into larger lesions with an elastic consistency and normal overlying skin.3 Saddle sores can prove troublesome for cyclists, causing pain and altered movement, reducing performance or necessitating time off the bike.1 While being reportedly common1 and despite the problems saddle sores cause in cyclists at both the elite and recreational level, this issue is underrepresented in scientific literature. The cultural sensitivity of this topic due to the body area it affects can make it difficult for cyclists to have open dialogue about the issue with healthcare providers.

A scoping review was undertaken to identify and map existing evidence on the definition, prevalence, prevention and management of saddle sores in cycling, identifying research gaps.4 This infographic aims to raise awareness surrounding saddle sores among cyclists and clinicians, representing the key concepts. Preventative strategies identified in studies, which target the risk factors and mechanisms underlying saddle sore development have been outlined. Preventative strategies that reduce pressure include a reduction in cycling intensity or distance, increasing handlebar height, modifying saddle design and wearing a chamois pad.1 4 Saddle-perineal friction can be reduced by optimising seat and perineal hygiene and grooming, not wearing underwear beneath cycling shorts and using chamois cream.1 4 If saddle sores have developed, they can be managed based on size, severity and duration. Small saddle sores in the acute phase can be managed using conservative measures such as increased padding or hot and cold compresses, while medical interventions are reserved for cases requiring urgent treatment or that have severe symptoms.1 Medical treatments can include antibacterial or steroid creams applied topically or injecting steroid into the saddle sore.5 Surgical excision or drainage can be used to treat larger, chronic saddle sores where symptoms indicate although in practice this is rare.5 However, this scoping review found that there is limited empirical evidence within scientific research that demonstrates the effectiveness of these strategies in managing or preventing saddle sores or potential side effects.4 It is proposed that specific randomised controlled trials are conducted in the future to address these research gaps and optimise treatment,4 improving outcomes for cyclists.

• Journal Article Type: Article
• Acceptance Date: Apr 16, 2023
• Online Publication Date: Jul 10, 2023
• Deposit Date: Oct 6, 2023
• Journal: British journal of sports medicine
• Print ISSN: 0306-3674
• Electronic ISSN: 1473-0480
• Publisher: BMJ Publishing Group
• Peer Reviewed: Peer Reviewed
• Pages: bjsports-2023-106911
• DOI: https://doi.org/10.1136/bjsports-2023-106911
• Keywords: Sports medicine, Sporting injuries