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When is it a bit more than Saddle Soreness? Cyclists Syndrome!

By September 8, 2014June 10th, 2025Uncategorised

When is it a bit more than Saddle Soreness?  Cyclists Syndrome!

Cyclists Syndrome from cycling

It’s normal to feel a bit sore after getting back in the saddle—especially if you’ve had some time off the bike. But what if you’re cycling regularly and start to notice persistent pain, numbness, or discomfort that doesn’t go away?

This might be more than just typical saddle soreness. It could be Cyclist’s Syndrome, medically known as Pudendal Neuralgia.

What Is Cyclist’s Syndrome (Pudendal Neuralgia)?

Cyclist’s Syndrome refers to a condition where the Pudendal Nerve, which runs through the pelvis and supplies the genital area, rectum, and pelvic floor, becomes irritated or compressed. This can occur due to prolonged pressure from a bike saddle or muscle tightness in the pelvic region.

Common symptoms include:

  • Burning, pain, or numbness in the perineal (crutch) area

  • Symptoms appearing 12–24 hours after a ride

  • Changes in bladder or bowel frequency or control

  • In some cases, erectile dysfunction

Because the symptoms affect sensitive areas, many people delay seeking help—despite the fact that this condition is more common among cyclists than you might think.

What Causes Pudendal Neuralgia in Cyclists?

The condition is often caused by direct pressure on the Pudendal Nerve from prolonged time in the saddle or by compression from tight pelvic muscles, such as the gluteals or deep hip rotators. These issues can gradually build over time with repetitive cycling, especially if your bike setup isn’t optimal.

What Should You Do If You Suspect Cyclist’s Syndrome?

If you’re experiencing persistent perineal pain or any changes in urinary or bowel function, the first step is to consult a urologist to rule out other underlying medical conditions.

Once you’ve been cleared of any medical issues, a physiotherapist at MGS Physiotherapy can help address the cycling-related aspects of your symptoms.

How Can Physiotherapy Help Cyclist’s Syndrome?

At MGS Physio, we offer a range of strategies to help manage and resolve Pudendal Neuralgia:

  • Bike setup and ergonomic advice to reduce saddle pressure on the nerve

  • Seat recommendations to improve weight distribution and comfort

  • Activity planning to adjust riding frequency and duration safely

  • Targeted exercises to address pelvic muscle imbalances and release tight gluteal or pelvic floor muscles

If conservative treatment doesn’t provide sufficient relief or symptoms are severe, surgical options to decompress the nerve may be explored with your medical team.

Don’t Ignore the Symptoms

If you’re noticing unusual or persistent symptoms after cycling, don’t ignore them. While Cyclist’s Syndrome can be uncomfortable to talk about, early intervention can make a big difference in your comfort, performance, and quality of life.

If you’re unsure whether your saddle soreness is something more, reach out to our team at MGS Physiotherapy for a confidential and supportive assessment.

Frequently Asked Questions – Cyclist’s Syndrome

1. What is Cyclist’s Syndrome?
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Cyclist’s Syndrome is the common term for Pudendal Neuralgia—a condition where the pudendal nerve becomes compressed or irritated, often due to prolonged saddle pressure during cycling. It can cause pain, burning, or numbness in the perineal (crutch) area, and in some cases, changes in bladder, bowel, or sexual function.
2. How do I know if my symptoms are more than just saddle soreness?
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If symptoms like burning, numbness, or pelvic pain persist beyond typical post-ride soreness—especially if they appear 12–24 hours after cycling—you may be experiencing Cyclist’s Syndrome. It’s also important to take note of any urinary, bowel, or sexual changes and seek medical advice.
3. What causes Pudendal Neuralgia in cyclists?
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It’s typically caused by prolonged compression of the pudendal nerve from sitting on a narrow or poorly fitted bike saddle, or from tightness in pelvic muscles that the nerve passes through. Repeated stress on the nerve can lead to chronic symptoms.
4. Is Cyclist’s Syndrome permanent?
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Not necessarily. With early intervention and appropriate treatment, many people recover well. Physiotherapy, bike adjustments, activity modification, and pelvic muscle release can all help. In severe cases, medical or surgical options may be required.
5. Should I stop cycling if I have Pudendal Neuralgia?
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Not always. With the right treatment and changes to your setup or riding habits, many people can continue cycling. Your physiotherapist can guide you on safe riding frequency, position adjustments, and recovery strategies.
6. What can a physiotherapist do to help?
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At MGS Physiotherapy, we assess your posture, muscle balance, and bike ergonomics. We provide saddle and setup advice, pelvic floor and glute release exercises, and a personalised plan to reduce pressure on the pudendal nerve and manage symptoms.
7. Do I need to see a doctor before seeing a physio?
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If you’re experiencing changes in bladder or bowel habits, or sexual function, we recommend seeing a urologist first to rule out any other medical causes. Once cleared, a physiotherapy assessment can help you manage and treat the cycling-related factors.
8. Is surgery ever required for Cyclist’s Syndrome?
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Surgery is considered a last resort for cases that don’t respond to conservative treatment. Most patients experience improvement with physiotherapy, ergonomic adjustments, and targeted exercises.