Pelvic Pain and Spinning

Sore or Painful Private Parts Post Your “Soul Cycle?”: Understanding Proper Bike Set Up for Pelvic Health

700 400 Spring Forward Physical Therapy *** Physical Therapist Midtown & Financial District

With the rise of boutique cycle studios popping up across NYC such as Soul Cycle, Flywheel, and Peloton, spinning has taken off as a popular exercise. People flock to these spin classes for the great music, the amazing cardiac and strengthening workout, and the camaraderie.

Cycling can be a great low impact cardio exercise for many people. However, when proper bike fitting is not considered, you may be putting a nerve called you pudendal nerve at risk. If your perineal area, vagina, or penis/scrotum is starting to hurt, especially after your cycling classes, this could be  a sign of a irritation to your pudendal nerve. Your pudendal nerve is a nerve that runs through your pelvis and has three branches: inferior rectal, perineal, and dorsal branch to the clitoris or penis. Irritation to this nerve can cause pain and burning with sitting that is often relieved when lying down. However, functionally this is not ideal because the majority of us need to sit at some point in our day ranging from work to social interactions. The good news is there is preventative measures you can take, so you can continue to enjoy your fun hour of cycling.

If you have pain in your perineal area post cycling that begins to linger:

  1. Stop cycling temporarily
  2. Consider seeing a pelvic floor physical therapist for an evaluation to determine if you pudendal nerve may be playing a role in your pain
  3. Follow your pelvic floor physical therapist’s treatment plan that they will cater to you
  4. If it is determined your pudendal nerve is irritated you may want to avoid lateral band walks, deep squats, and intense hamstring stretching.
  5. When ready to return to cycling, make sure you have a proper bike fitting and seat assessment

If you don’t have pain in your perineal area during or post cycling but would like to prevent it, consider the following proper bike fitting principals and consider seeing a bike fitting specialist:

Handlebars The higher the handlebars, the more pressure will be placed on your perineum in the saddle. Too high of handlebars can be irritating to pudendal nerve problems. The shoulders should make a 90 degree angle to the humerus and trunk.
Seat The seat must be level and not faulty or wobbly. It should not be too close that you are straining your arms or too far that you are straining your back. There are special types of seats that can be purchased with cutouts to take pressure off the perineal area. Consider the saddle width when deciding on a seat to make sure it fully supports your pelvis so abnormal pressure is not placed on certain areas. Wider seats will generally produce less pressure globally.
Seat Height and Pedals Optimal knee angles are about 35 degrees to limit knee strain.
Pedals The ball of the foot should be positioned over the pedal. Shoes with a rigid midfoot are preferred.

Additional Tips:

  1. During the cycling class if you begin feeling discomfort sitting in the saddle consider switching to third position more (butt off the saddle and posture forward)
  2. Try and limit excessive bouncing of your hips that will put strain on your pelvic ligaments. Excessive bouncing may indicate your resistance is too light or your resistance is too heavy that you compensating.
  3. Pace yourself. Trying to keep up with the competitive nature of the class may cause you to lose form and put excess strain on your body. Form over speed first.
  4. Practicing diaphragmatic breathing with focus on the inhalation lying down can help with relaxation of the pelvic floor muscles if you are experiencing pain.
  5. Avoid “over googling” things like pudendal nerve entrapment because most cases are an irritation to the pudendal nerve, and pudendal nerve entrapment is actually very rare and often confused with pudendal neuralgia.

Example of a Seat with a Specialized Cutout:

Bike Seat Cutout

References:

Erik Moen PT, CSCS. Physical Therapist Offer Tips For Proper Bike Fit. American Physical Therapy Association. May 13, 2009. http://www.apta.org/Media/Releases/Consumer/2009/5/13/

Andrea Wood, PT, DPT, PRPC

Knowledge is power, empower yourself for your health

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