Strategies for decreasing the risk of saddle sores focus on a) decreasing initial tissue injury as well as b) minimizing the concentration of local skin bacteria.

Saddle sores fall into one of three types.

• Chafing - the most common. Really a superficial skin rash caused by the constant chaffing of your shorts/saddle.
• Bruising - a more severe injury of the tissue with bleeding into the subcutaneous (below the skin) layer.
• A tender subcutaneous nodule - The result of a deeper infection which results from bacteria accessing the subcutaneous tissue via the base of a hair follicle or a sebaceous gland. The pressure injury to the follicle or sebaceous gland allows this to happen.

1. Clothing/Equipment.
• Consider a smoother chamois. For recreational riders or mountain bikers, shorts with a one-piece liner or a liner carefully chosen for flat seams. It may take experimenting with shorts brands or chamois types to find the model that works best. Women often do better with shorts designed specifically for their anatomy and that have a liner with no center seam.

• The saddle. Excessively wide saddles rub your inner thighs. Narrow saddles don't provide enough support for your sit bones -- your weight is then shifted to the surrounding soft tissue which can quickly become bruised and irritated. Thickly padded saddles are another problem as they can press upward between your sit bones, causing uncomfortable numbing pressure. The best choice for any individual rider can only be found through trial and error.

2. Riding routine
• Get out of your sweaty shorts as soon as possible after a ride. Shower or clean up with soap and water. Dry well and put on loose-fitting clothing which will allow your skin to dry. The dry skin will be much less susceptible to a bacterial infection in any injured tissue..

• Wash your bike shorts after every ride - they are a great place for bacteria to hibernate between rides. And if you were sweating heavily, it gets rid of any salt crystals that might aggravate tissue abrasion on your next ride.

• Consider minor modifications in your riding style. Stand more frequently. It will take a conscious effort at first to remember, but it will take pressure off the ischial tuberosities (sit bones) where they contact the saddle. Get in the habit of standing for 15-20 seconds every five to ten minutes using natural opportunities such as short hills, rough pavement or accelerating from stop signs.

  Or a slight change in your position on the saddle. Try sitting a bit further back on the climbs so your sit bones get maximum support from the wider area of the saddle taking pressure off your perineum. Any shift in position will give pressure points a break.

• Gradually increasing (versus a rapid ramp up) the length of training rides will help acclimate the skin and tissue in the buttock area.

3. Bike adjustments.
• Consider a bike fit. If your seat is too high, as an example, your hips will rock to a greater degree on each pedal stroke, increasing in the risk of skin abrasion.

  Occasionally a rider will complain of unilateral (one side) abrasions or saddle sores. This could indicate a leg length discrepancy. If it's several millimeters or more, it could help to use a shim under the short legs cleat). Another solution I have heard (anecdote coming) is a slight reorientation of the nose of the saddle to one side or another.

4. Topical agents.

These creams and ointments work by decreasing friction, providing a barrier to prevent maceration (injury to moisture soften skin), and decreasing the bacteria levels on the skin of those pesky bacteria.

• Skin barrier/friction reduction. These products prevent damp shorts from adhering to the skin aggravating any abrading effect. In addition they provide a moisture barrier. Moisture alone, without the physical pressure injury, decreases the barrier to a secondary bacterial infection.

  All these products have their proponents. For example, Pete Penseyres, the legendary two-time Race Across America winner and a former world-record holder is a believer in Bag Balm. If anyone should have the experience to make a recommendation, it would be someone who has spend hundreds of hours in the saddle and ridden 3,000-plus miles in eight days.

  A light coating of inexpensive petroleum jelly will do the job just as well as a commercial product such as Chamois BUTT'r or Bag Balm. But in the end it comes down to personal preference. Just apply to the skin before putting on your shorts. This works much better than trying to smear it directly on the chamois.

• Then there are the antibacterial products which cut down the concentration of skin bacteria. Less bacteria equal less opportunity for an infection even with skin abrasion. My favorite is OTC Neosporin Ointment. The product warnings list "possible skin allergy" so if you try it, be sensitive to the possibility that a rash not responding to simple measures could be from the neosporin.

  One friend who races swears by Noxzema. It not provides a lubricant/barrier effect, but also has a mild anti bacterial benefit.

  And I've read recommendations to use Preparation H Medicated Wipes with aloe and witch hazel as soon as you get off your bike. It cleans the area as well as eliminating a significant number of skin bacteria.

What do I do? First, I spend a bit more on my bike shorts. Riding 4 or 5 times a week justifies (for me) the cost of a top end product. Prorated per mile, it is just a few pennies more. Having tried almost every possible combination of butt butters and cremes, I've had the most success applying a base layer of neosporin to the sit bone (ischial tuberosity) area followed by Bag Balm or Chamois Butter to provide a barrier. Even riding 4 or 5 times a week, that has kept me saddle sore free for several years.

If You Do Get a Saddle Sore

• Medicate it. Besides keeping it clean, treat it with an over-the-counter acne gel containing 10% benzoyl peroxide. Perhaps even more effective is the topical prescription product called Emgel (erythromycin). If a sore is getting out of control, ask your doctor about a course of oral antibiotics.

• Rest it. As you medicate a troublesome sore, take some time off the bike to help it heal. It's far better to lose three days now than a week or more after infection sets in. If you continue to ride on an open sore it may eventually form a cyst that requires surgery.

If You Must Continue Riding

Sometimes you can't take time off. For instance, you may be on a tour or at a cycling camp.

• Change your shorts or saddle. Your problems are probably isolated in one small area -- a boil or abrasion. Changing your saddle and/or shorts can reduce pressure on the sore and lessen pain.

• Use a heavier lube. If you're getting irritated, apply extra lube or switch to a more viscous one. Many long-distance riders swear by Bag Balm, which was originally made for sore cow udders but is now available in most pharmacies.

• Numb it. OTC pain reducers and anti-inflammatories, such as ibuprofen, can help. In extreme cases, pro team physicians will use a topical anesthetic on riders so they can finish a stage race. It's not recommended for recreational riders because when you're numb, you can ride yourself into greater damage.

• Try Preparation H ointment. No, not for that reason. Prep H works on saddle sores because it shrinks swollen tissue and soothes pain. Apply it five minutes before slathering on your chamois cream and putting on your shorts. Also try a dab on sores after rides to dull discomfort.

• Get a donut. In the foot-care section of drug stores, you'll find donut-shaped foam pads in several diameters. They're made for corns but can help you ride more comfortably with a saddle sore, too. Simply place it with the sore in the center of the cutout to relieve direct pressure. The adhesive backing will keep it in place.




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Cycling Performance Tips
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