Know Your Sore

Needless Anxiety
Even though I am classified as a recreational cyclist (non-competitor) and for that much a spirited club cyclist I have slowly encountered many of the discomforting aspects of cycling. In 2007, I had a serious crash descending Burnt Mountain Road at nearly 40 mph. As a result I had some very serious road rash, a separated shoulder and a lot of equipment damage. I have suffered cramps and heat exhaustion. I have been chased by the wiliest of dogs. I have tweaked my knees and my lower back and now this past couple of weeks a major saddle sore. But what I found out that saddle sore is such a broad term especially when looking around at various web pages. I noticed saddle sores on these pages range from blisters, cysts, swollen glands, pressure sore and infected hair follicles.

The bad thing about having so much information out on the internet as that one can work themselves into an anxiety by self-diagnosis. As I started to read I thought what I had may have been a cyst because it seemed to fit what other cyclists described. I knew mine was not just a blister since it was not an open sore produced by friction. I have had those before and they seem to heal with basic treatment. This past Saturday I felt a tremendous amount of discomfort on the last 30 miles of the 80 mile ride. By the time I got home and into the shower the discomfort was getting worse. While cleaning I felt a bump the size of a peanut (in the shell) on the crease of my right thigh and it was super tender to the touch. That is when I started doing some research as to what it may be and why did it form. I follow the basic rules of cycling hygiene on a post ride or as best as I thought at the time. Finishing a ride I would change to dry clothes and get home as quickly as possible to shower, but perhaps that is not good enough and perhaps there will be moments in cycling when no matter what you do it is still going to happen. However, it still pays to be informed especially since this little bump caused so much discomfort and prevented me from training the past couple of days.

I like being informed and I am glad that we have so much information available to us out on the web, but we have to know that we do not really know most of the sources out on the web and if that particular person has the best information. Again by some of the descriptions I had self-diagnosed the bump as a cyst and by reading how most deal with cysts that caused my anxiety to rise a bit. Sure having to have a cyst surgically removed and the thought of having that private region exposed on the table can cause the anxiety to rise, but it was post removal that caused me the most anxiety because it would require stitches and a few weeks off the bike or training. As time passed in the next couple of days considering that this would impact my training I could no longer deal with the thought and sought counsel with a doctor recommended to me by a cycling friend. The doctor is an avid cyclist himself and cycles a minimum of 200 miles a week. Surely a guy that does that much time on the bike would have encountered this issue not only personally but also with some patients.

 Medical Diagnosis and Treatment
Sure enough as I met with the general practitioner for the first time he was eager to talk about his cycling training and told me that he had a lot of personal experience in the matter. Obviously he needed to look at the bump and immediately he said not to worry it was an infected hair follicle. Whew!! That was an immediate relief of the anxiety of having a surgical removal of a cyst. You see how I needlessly stressed about a self-diagnosis from a lot of so called web doctors? I worked myself into an anxiety for no reason, but I am very grateful to have met not only this doctor, but a doctor that is an avid cyclist. Being that he is an avid cyclist his view then was to get me back to training. The doctor prescribed the antibiotic, Doxcycline Hyclate, the topical Mupirocin to kill bacteria and Lidicaine topical so that I can apply an hour before training so that the area will be numb to discomfort while it is healing. Now I must say since my information is on the internet that do not take this information to be your self-diagnosis. This is exclusive to me as prescribed by my doctor.

Future Prevention
As the good doctor finished up writing the prescription he changed to the topic of chamois crème. He mentioned that over the years he has tried many types of cycling specific crèmes to other items like those for diaper rash, bag balm and other items. I have used a variety myself and recently I had fair luck with Udderly Smooth and Chamois Butt’r, however, as I started to extend my training time and especially those longer days lately extending the miles to 80 I notice that these solutions were not holding up to time, heat and friction. There lies part of the problem. The other could be potentially not cleaning quickly enough. Imagine that on a five plus hour ride with heat, tremendous amount of sweat, friction and a trace of bacteria the environment becomes like one said on a web page, “an incubator for bacteria.” It may not be enough that I change quickly into dry shorts following a ride and long commute home to get cleaned up in the shower. It may be that we need to address that situation much more quickly.

My plan going forward. Again this is what I plan and I will state that I am not a cycling expert nor am I a doctor so take this for what it is, but it is just a plan to be a bit more careful with post ride hygiene. Especially since this small issue with saddle sores can be much larger than we know and can destroy weeks of training. It has also knocked pro cyclist out of the tour.

Prevention
Perhaps one cannot totally prevent an infected hair follicle, cyst or blister, but we can try.

• Always use clean shorts – I do this for sure and I would suspect most people do this most basic step.
• Use a good lubricant – This is something that one may want to experiment. The Doctor suggested Queen Helene Coco Butter. It is cheap at discount stores or Amazon.com. It has some good reviews on the web and seems to hold up under extended time. I purchased a 15 oz. container for less than $5 and will give a test. (Coach Levi's review)

• Use a sanitary wipe post ride – I purchased a store brand version of Wet One’s for babies. It is not harsh and will help kill bacteria if you have a commute home. I will do a quick wipe of the area before putting on dry shorts.
• Use an anti-bacteria soap – Dial soap is my choice since it is not expensive and it is anti-bacterial

It is important for me to note that saddle sores can occur for various reasons and they may not always be defined by the medical society with such broad terms. It could be a cyst, it could be an infected hair follicle or it could simply be a blister. It may be caused by bacteria or it may be caused by a poor bike fit, cheap cycling shorts or bad saddle fit. Best thing to do is go to your doctor if you have an issue and have it looked at rather than delaying treatment or getting anxious over what it may or may not be. To Know Your Sore see your doctor if it is significant and causing anxiety, discomfort and distracting from enjoying cycling.

10/10/2013 Update

Another sore that I am trying to figure out, but also finding it difficult to find good information is a pressure sore and from the description it sounds much like the type of sore that I have experienced in the past. A friend that is a veteran racer and cycling coach informed me a little more about pressure sores that are caused by poor bike fit, but can also form from being on rough pavement, sitting down hard on the saddle, fabric fold, seams or other issues generated by excess pressure in sensitive areas. A couple weeks ago I was on a short standing climb and remember sitting back down and hit that sensitive crease on the saddle. When I got home I felt a small pea sized hard lump and soreness just like the original problem. If this is a reaction to impact and there is inflammation/swelling and soreness it is much like bumping your noggin on something and getting a lump. Immediately after the post ride shower I used a small thin ice pack that I use treating injuries and wrapped it with a paper towel, placed in the crease of my shorts (not cycling shorts) and left on while uploading my ride data. By that evening the swelling had gone down and the next day I was able to train again. There was some tenderness in that area for a couple of days, but I was just mindful not to impact the area again in how I would sit back down on the saddle, avoided hitting cracks and holes in the pavement that causes jarring to the area and was careful not to rock in the saddle. I still want to learn more about pressure sores to make sure this is what is going on, but it makes sense at the moment.

9/17/2012 Update

Since this post I have had a number of times of friction type saddle sores and at this moment I am treating a couple of blister type sores on each side of my legs at the crease. A few months ago I finally noticed what is causing my trouble. This past weekend I did a 90 mile route on Saturday and another 40 on Sunday, plus a number of hours last week training on rollers. On Saturday I noticed that either the seam at the pad or maybe a slight fold in the material at the crease of the leg and it was a very slight annoyance. Not something that was enough to really stop the bike and make adustments so I kept on, but with that many miles of friction and heat it was enough to open up the skin.

At the end of Saturday's ride I quickly changed to dry clothes and did not hesitate to get into the shower and clean the area with an anti-bacterial soap. As soon as the soap touched the area there was a burning sensation and I knew there was potential trouble brewing. Following Sunday's ride it was a repeat of putting on dry clothes immediately and rushing home to clean with the soap and apply an antibiotic ointment. I keep a bottle of Bactine in my gear bag for road rash or saddle sores and should have applied this. I am sure if I had it would have caused me jump about 6 feet, but I should have done this.

I am glad this is a blister type of saddle sore because it will probably heal in a day or two and it may not impact indoor training this week if I continue to do the home treatment and cleaning. I applied some zinc oxide (commonly used in baby products for diaper rash) this morning after training and it seems to be soothing the discomfort of chafing. An area of chafing or blister type of sore is much better to deal with than having a cyst type that may need medical treatment.

Keep it clean so you can keep training! Best wishes and fast recovery on your issue.



This just part of my collection of Desoto shorts that I keep in circulation. Training consistently it is nice to have clean shorts that you can trust. I consider these shorts to be the best cycling investment that I have made. It allows me to train almost daily and have clean reliable shorts. Of course each of us must find the brand that works for each individual preference.

I doubt that I could hold up for 400 miles and I don't think I will ever try to give that a test.