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Saulicz M, Saulicz A, Saulicz E. Self-Assessment of Lower Urinary Tract Condition in Female Competitive Cyclists. Healthcare (Basel) 2024; 12:1163. [PMID: 38921278 PMCID: PMC11202815 DOI: 10.3390/healthcare12121163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2024] [Revised: 05/25/2024] [Accepted: 06/04/2024] [Indexed: 06/27/2024] Open
Abstract
During cycling, prolonged compression by the bicycle saddle on the anatomical structures located in the perineum area occurs. An additional factor that may have a negative impact on organs located in the pelvic area may be a prolonged sitting position resulting in increased intraabdominal pressure. This situation has the potential to adversely affect pelvic floor function. Therefore, the aim of this study was to assess the incidence of lower urinary tract symptoms (LUTSs) in female competitive road cyclists and cross-country cyclists. The study included 76 female competitive road cyclists and cross-country cyclists and 76 women not practising competitive sport. The Core Lower Urinary Tract Symptom Score (CLSS) questionnaire was used to assess the lower urinary tract condition. Female competitive cyclists had a statistically significantly higher LUTSs score (95% CI: 3.12-4.2 vs. 2.31-3.16; p < 0.05) compared to women not practising competitive sports. Female cyclists had a statistically significantly higher overall CLSS score (95% CI: 3.99-5.61 vs. 2.79-3.97; p < 0.05). Female cyclists had a statistically significantly higher incidence and severity of urinary frequency (p < 0.05 and p < 0.02), urge (p < 0.001 and p < 0.02) and stress incontinence (p < 0.001 and p < 0.001), and pain in the bladder (p < 0.01 and p < 0.01), while physically inactive women recorded a statistically higher incidence of slow urinary stream (p < 0.01 and p < 0.04). A statistically significant association was recorded between the years of cycling and the number of hours per week spent on training and the number of symptoms and their severity. The number of natural births experienced by women involved in competitive cycling significantly affects the severity of LUT symptoms. Compared to women not practising competitive sports, competitive female cyclists are found to have a higher prevalence of LUTSs and a greater degree of severity. LUTSs in competitive female cyclists are negatively influenced by years of competitive career and weekly number of training hours and the number of natural births experienced.
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Affiliation(s)
- Mariola Saulicz
- Institute of Physiotherapy and Health Sciences, The Jerzy Kukuczka Academy of Physical Education, 40-065 Katowice, Poland
| | - Aleksandra Saulicz
- School of Public Health & Social Work, Queensland University of Technology (QUT), Kelvin Grove, QLD 4059, Australia
| | - Edward Saulicz
- Institute of Physiotherapy and Health Sciences, The Jerzy Kukuczka Academy of Physical Education, 40-065 Katowice, Poland
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Vicari DSS, Patti A, Giustino V, Figlioli F, Alamia G, Palma A, Bianco A. Saddle Pressures Factors in Road and Off-Road Cyclists of Both Genders: A Narrative Review. J Funct Morphol Kinesiol 2023; 8:71. [PMID: 37367235 DOI: 10.3390/jfmk8020071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Revised: 05/19/2023] [Accepted: 05/21/2023] [Indexed: 06/28/2023] Open
Abstract
The contact point of the pelvis with the saddle of the bicycle could generate abnormal pressure, which could lead to injuries to the perineum in cyclists. The aim of this review was to summarize in a narrative way the current literature on the saddle pressures and to present the factors that influence saddle pressures in order to prevent injury risk in road and off-road cyclists of both genders. We searched the PubMed database to identify English-language sources, using the following terms: "saddle pressures", "pressure mapping", "saddle design" AND "cycling". We also searched the bibliographies of the retrieved articles. Saddle pressures are influenced by factors such as sitting time on the bike, pedaling intensity, pedaling frequency, trunk and hand position, handlebars position, saddle design, saddle height, padded shorts, and gender. The jolts of the perineum on the saddle, especially on mountain bikes, generate intermittent pressures, which represent a risk factor for various pathologies of the urogenital system. This review highlights the importance of considering these factors that influence saddle pressures in order to prevent urogenital system injuries in cyclists.
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Affiliation(s)
- Domenico Savio Salvatore Vicari
- Sport and Exercise Sciences Research Unit, Department of Psychology, Educational Science and Human Movement, University of Palermo, 90141 Palermo, Italy
| | - Antonino Patti
- Sport and Exercise Sciences Research Unit, Department of Psychology, Educational Science and Human Movement, University of Palermo, 90141 Palermo, Italy
| | - Valerio Giustino
- Sport and Exercise Sciences Research Unit, Department of Psychology, Educational Science and Human Movement, University of Palermo, 90141 Palermo, Italy
| | - Flavia Figlioli
- Sport and Exercise Sciences Research Unit, Department of Psychology, Educational Science and Human Movement, University of Palermo, 90141 Palermo, Italy
| | - Giuseppe Alamia
- Sport and Exercise Sciences Research Unit, Department of Psychology, Educational Science and Human Movement, University of Palermo, 90141 Palermo, Italy
| | - Antonio Palma
- Sport and Exercise Sciences Research Unit, Department of Psychology, Educational Science and Human Movement, University of Palermo, 90141 Palermo, Italy
- Regional Sports School of CONI Sicilia, 90141 Palermo, Italy
| | - Antonino Bianco
- Sport and Exercise Sciences Research Unit, Department of Psychology, Educational Science and Human Movement, University of Palermo, 90141 Palermo, Italy
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Puleo RM, Barreveld A, Rice S, Althausen Plante AM, Kotler DH. Unique Concerns of the Woman Cyclist. Phys Med Rehabil Clin N Am 2021; 33:61-79. [PMID: 34799003 DOI: 10.1016/j.pmr.2021.08.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Previously a male-dominated activity, female cyclists now make up nearly half of all cyclists in the United States. Although cycling provides a significant number of health benefits, it is an activity that carries risk of injury, both traumatic and nontraumatic. Sex differences are seen in chest trauma and breast injury, as well as pelvic, given the inherent differences in anatomy. Understanding the relationship of the bicycle to the anatomy of the rider can help mitigate risks for injury.
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Affiliation(s)
- Rozanne M Puleo
- Sports Medicine, Lynn Community Health Center, 269 Union Street, Lynn, MA 01902, USA.
| | - Antje Barreveld
- Anesthesiology, Tufts University School of Medicine, Pain Management Services, Newton-Wellesley Hospital, 2014 Washington St, Newton, MA 02462, USA
| | - Sarah Rice
- Athletico Physical Therapy, 2143 W Division St, Chicago IL 60622-3006, USA
| | - Anne M Althausen Plante
- Obstetrics and Gynecology, Harvard Medical School, Massachusetts General Hospital, 55 Fruit St, Boston, MA 02114, USA
| | - Dana H Kotler
- Department of Physical Medicine & Rehabilitation, Harvard Medical School, Spaulding Outpatient Center - Wellesley, 65 Walnut Street, Wellesley, Boston, MA 02481, USA
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Bury K, Leavy JE, Lan C, O'Connor A, Jancey J. A Saddle sores among female competitive cyclists: A systematic scoping review. J Sci Med Sport 2020; 24:357-367. [PMID: 33109466 DOI: 10.1016/j.jsams.2020.10.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Revised: 09/24/2020] [Accepted: 10/12/2020] [Indexed: 10/23/2022]
Abstract
OBJECTIVES Saddle sores are a prominent but an under investigated health issue among female competitive cyclists. To identify and describe existing evidence of the prevalence, prevention and treatment of saddle sores among female competitive cyclists. DESIGN Systematic scoping review and expert consultation. METHODS Primary studies and grey literature investigating saddle sores for competitive female cyclists were identified from six databases which were systematically searched (Medline; PubMed; Scopus; SPORTDiscus; Embase; Advanced Google Scholar) from 1990 onwards. An online survey was distributed to consultants in the female Australian competitive cycling community to obtain information and expert perspectives outside the published literature. RESULTS Of the 401 studies identified, 10 met the inclusion criteria - 4 were case-series, 4 were cross-sectional, and 2 were brief intervention trials. There was limited empirical evidence to determine the prevalence, and identify prevention and treatment approaches for saddle sores. Handlebar positioning relative to the saddle and reducing perineal pressure had some evidence. Saddle sore treatments appear to be limited to antibiotics and surgical intervention when they worsen or become infected. Yet, three-quarters of the consultants (n=16) indicated saddle sores were frequent among female competitive cyclists, identifying prevention and management strategies as topical creams, maintaining good hygiene, wearing appropriate clothing, leg elevation and taking time off the bike. CONCLUSIONS There is limited research investigating the prevalence, prevention and treatment of saddle sores among female competitive cyclists, although it has been described as a common occurrence by those in the cycling community. Research is required to understand its prevalence, along with trials to investigate prevention and management methods, so that evidence informed guidelines and/or protocols can be developed.
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Affiliation(s)
- Keira Bury
- Collaboration for Evidence, Research and Impact in Public Health, School of Public Health, Curtin University, Australia
| | - Justine E Leavy
- Collaboration for Evidence, Research and Impact in Public Health, School of Public Health, Curtin University, Australia
| | - Charlene Lan
- Collaboration for Evidence, Research and Impact in Public Health, School of Public Health, Curtin University, Australia
| | - Amanda O'Connor
- Amanda O'Connor, National Cycling Centre Western Australia, Australia
| | - Jonine Jancey
- Collaboration for Evidence, Research and Impact in Public Health, School of Public Health, Curtin University, Australia.
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Piazza N, Cerri G, Breda G, Paggiaro A. The effect of a new geometric bicycle saddle on the genital-perineal vascular perfusion of female cyclists. Sci Sports 2020. [DOI: 10.1016/j.scispo.2019.07.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Prevalence, Prevention and Treatment of Saddle Sores among Female Competitive Cyclists: A Scoping Review Protocol. Methods Protoc 2020; 3:mps3010004. [PMID: 31935936 PMCID: PMC7189673 DOI: 10.3390/mps3010004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2019] [Revised: 12/23/2019] [Accepted: 12/23/2019] [Indexed: 11/17/2022] Open
Abstract
Female cyclists are prone to a variety of injuries and illnesses that occur as a result of prolonged contact with a bicycle saddle. Saddle sores are a range of skin ailments on the buttocks, genitals and inner thigh that result from a combination of friction, heat, pressure, moisture and bacteria in the saddle area. Whilst saddle sores are reportedly common, for some cyclists, the condition may cause only mild discomfort. However, for female competitive cyclists, the condition can be an ongoing source of pain and illness affecting participation and performance in the sport. Despite many online sources for health information and products for saddle sores, it is unknown what empirical evidence exists for the prevalence and severity of saddle sores, and for the effectiveness of prevention and treatment methods. This paper outlines the protocol for a scoping review, which aims to describe the empirical evidence for the prevalence, prevention and treatment of saddle sores among female competitive cyclists. Ethics approval has been obtained for this study from Curtin University's Human Research Ethics Committee no: HRE2019-0120. The findings from this study will contribute to the literature for injury in female sport.
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Priego Quesada JI, Kerr ZY, Bertucci WM, Carpes FP. A retrospective international study on factors associated with injury, discomfort and pain perception among cyclists. PLoS One 2019; 14:e0211197. [PMID: 30682136 PMCID: PMC6347182 DOI: 10.1371/journal.pone.0211197] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2018] [Accepted: 01/09/2019] [Indexed: 12/21/2022] Open
Abstract
Although cycling has been associated with overuse/fatigue and acute injuries, there is lack of information regarding associated risk factors and prevention factors. The objective of the study was to determine the factors associated with injury, and perceptions of discomfort and pain in cyclists. A total of 739 cyclists completed an online questionnaire between February and October 2016. The questionnaire acquired information on participant demographics, characteristics related to cycling profile and fitness training, bike components and cycling posture, self-reported perceptions of comfort and pain, and injuries sustained in the last 12 months. Logistic regression models estimated odds ratios (OR) and 95% confidence intervals (95%CI) that examined factors associated with reporting overuse/fatigue injury, acute injury, body discomfort, saddle discomfort, and pain while cycling. Odds of reporting an overuse/fatigue injury increased when the cyclists complemented training with running (OR = 1.74; 95%CI = 1.03–2.91) or swimming (OR = 2.17; 95%CI = 1.19–3.88), and with reported pain while cycling (OR = 1.17; 95%CI = 1.05–3.69) and not cycling (OR = 1.76; 95%CI = 1.07–2.90). Odds of reporting an acute injury increased when biking to work (OR = 1.79; 95%CI = 1.07–2.86), and decreased with increased average cycling speed (1-km/h decrease OR = 0.93; 95%CI = 0.88–0.97), and compared to low-end bike, with the use of mid-range (OR = 0.25; 95%CI = 0.09–0.72) and high-end bike (OR = 0.34; 95%CI = 0.13–0.96). Although body discomfort was only associated with saddle discomfort and the presence of pain during cycling, saddle discomfort was also associated with biking to work (OR = 0.46; 95%CI = 0.22–0.88). Finally, pain perception was associated with a number of factors such as ride to work, core training, cycling experience, saddle discomfort, pain while not cycling. Numerous factors are associated with injury, and perceptions of discomfort and pain in cyclists. Such factors should be considered when developing training routines, bicycle maintenance best practices, and injury prevention programs.
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Affiliation(s)
- Jose Ignacio Priego Quesada
- Research Group in Sports Biomechanics (GIBD), Department of Physical Education and Sports, University of Valencia, Valencia, Spain
- Biophysics and Medical Physics Group, Department of Physiology, University of Valencia, Valencia, Spain
- * E-mail:
| | - Zachary Y. Kerr
- Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America
| | - William M. Bertucci
- Laboratory of Performance, Health, Metrology, and Society (PSMS, EA 7507), UFR STAPS, University of Reims Champagne-Ardenne, Reims, France
| | - Felipe P. Carpes
- Applied Neuromechanics Research Group, Laboratory of Neuromechanics, Federal University of Pampa, Uruguaiana, Brazil
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Larsen AS, Larsen FG, Sørensen FF, Hedegaard M, Støttrup N, Hansen EA, Madeleine P. The effect of saddle nose width and cutout on saddle pressure distribution and perceived discomfort in women during ergometer cycling. APPLIED ERGONOMICS 2018; 70:175-181. [PMID: 29866308 DOI: 10.1016/j.apergo.2018.03.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/15/2017] [Revised: 01/26/2018] [Accepted: 03/05/2018] [Indexed: 06/08/2023]
Abstract
The objectives were 1) to design and produce two novel unpadded bicycle saddles with a wide/medium width and partial nose cutout; 2) to investigate the responses on pressure distribution and perceived discomfort in female cyclists. For comparison, a standard saddle was also tested. Nineteen female cyclists pedaled on an ergometer cycle for 20 min with each saddle in a counterbalanced order. A pressure mat measured saddle interface pressure. Discomfort ratings were collected using a visual analogue scale. Total mean saddle pressure remained similar across saddles. The wide saddle increased anterior and decreased posterior mean saddle pressure as compared with the standard (p < .002) and the medium saddle (p < .001). Significantly increased ischial tuberosity discomfort was found for the novel saddles (p < .001), while crotch discomfort was not significantly different between saddles. The medium width saddle appeared to be the best compromise since increased crotch discomfort was avoided and saddle pressures were redistributed. Such design may be suggested as an alternative to traditional saddles for women reporting discomfort in the perineal region.
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Affiliation(s)
- Anna Sofie Larsen
- Sport Sciences, Department of Health Science and Technology, Aalborg University, Denmark
| | - Frederik G Larsen
- Sport Sciences, Department of Health Science and Technology, Aalborg University, Denmark
| | - Frederik F Sørensen
- Sport Sciences, Department of Health Science and Technology, Aalborg University, Denmark
| | - Mathias Hedegaard
- Sport Sciences, Department of Health Science and Technology, Aalborg University, Denmark
| | - Nicolai Støttrup
- Sport Sciences, Department of Health Science and Technology, Aalborg University, Denmark
| | - Ernst A Hansen
- Sport Sciences, Department of Health Science and Technology, Aalborg University, Denmark
| | - Pascal Madeleine
- Sport Sciences, Department of Health Science and Technology, Aalborg University, Denmark.
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Gaither TW, Awad MA, Murphy GP, Metzler I, Sanford T, Eisenberg ML, Sutcliffe S, Osterberg EC, Breyer BN. Cycling and Female Sexual and Urinary Function: Results From a Large, Multinational, Cross-Sectional Study. J Sex Med 2018; 15:510-518. [DOI: 10.1016/j.jsxm.2018.02.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2017] [Revised: 02/05/2018] [Accepted: 02/11/2018] [Indexed: 10/17/2022]
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Lolis AM, Falsone S, Beric A. Common peripheral nerve injuries in sport: diagnosis and management. HANDBOOK OF CLINICAL NEUROLOGY 2018; 158:401-419. [PMID: 30482369 DOI: 10.1016/b978-0-444-63954-7.00038-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Peripheral nerve injuries are unusual in sport but impact an athlete's safe return to play. Nerve injuries result from either acute trauma (most commonly in contact/collision sports) or from repetitive microtrauma and overuse. Diagnosis of overuse nerve injuries includes nerve localization and surrounding soft-tissue anatomy, and must account for possible causes of repetitive microtrauma, including biomechanics, equipment, training schedule, and recovery. Prognosis is related to the type of nerve injury. Management should not simply be rest and gradual return to sport but should address biomechanical and training predispositions to injury. Understanding the type of injury and the tissues involved will guide appropriate rehabilitation decisions. Recognizing acute care considerations and implementing appropriate strategies can help minimize secondary trauma to an area following acute injury.
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Affiliation(s)
- Athena M Lolis
- Division of Clinical Neurophysiology, Department of Neurology, NYU School of Medicine, New York, NY, United States
| | - Susan Falsone
- Department of Athletic Training, A.T. Still University, Mesa, AZ, United States
| | - Aleksandar Beric
- Division of Clinical Neurophysiology, Department of Neurology, NYU School of Medicine, New York, NY, United States.
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