Help me bike commute in Boston without pain!
July 26, 2015 8:30 PM
I have a three mile commute to work. On public transportation it takes 45-60 minutes. On a bike it’s under 20, but I don’t ride every day because biking hurts. Please help me get pointed in the right direction for cycling comfort!
I am 31, male, fit, 5’6”/165 lbs, and a confident urban cyclist, but I can’t seem to escape from saddle discomfort on any kind of bicycle. I have tried bikes from road to fully upright Dutch-style (and Hubway bike-share bikes), and I after some time (from 2-20 minutes, depending on the bike, the saddle, and what I’m wearing) I end up with painful stinging, sometimes followed by numbness, in my most sensitive area. More upright bikes seem better but it’s highly dependent on the fit and saddle. Sometimes the stinging doesn’t come until after riding, and it can last for a day or even several days if I really overdo it. The worst pain seems to come when I quickly spin my legs to get up hills. I try to stand up as much as possible and distribute my weight across the bike when I ride, which definitely helps, but can put stress on my wrists. A urologist I saw basically told me, “bikes are bad for men”, which was not helpful.
I have tried so many saddles I can’t even keep track, including two weird noseless ones (ISM Sport and “Ergo, the Seat”). The noseless ones were some of the worst I’ve tried, and they also transferred so much weight to my wrists that I had pain there. Padded bike shorts don’t seem to help much. I’ve also spent quite a lot of time tweaking saddle height and angle, but unscientifically.
I currently own a Specialized Sirrus, “Small” size frame, but I’m willing to get a new bike. Every other aspect of the bike is secondary to not having pain.
So, my questions are:
1. In a situation like this, is comfort actually achievable on a standard (non-recumbent) bike through fitting and saddle choice?
2. Where around Boston should I go to get a commuter-oriented fitting? The bike shops I’ve been in have all basically said “get a fitting.” One tried to sell me a more expensive one-size-up version of the bike I already have and then get fitted on that. Most of the shops around here seem focused on racing/performance, so I’m not sure how well they would do with me.
3. If a regular bike isn’t going to work for me, can a recumbent actually work for urban riding? What sort of recumbent might work? Where in the area can I try it?
If you’ve gotten this far, I thank you, and I’m looking forward to your advice!
I am 31, male, fit, 5’6”/165 lbs, and a confident urban cyclist, but I can’t seem to escape from saddle discomfort on any kind of bicycle. I have tried bikes from road to fully upright Dutch-style (and Hubway bike-share bikes), and I after some time (from 2-20 minutes, depending on the bike, the saddle, and what I’m wearing) I end up with painful stinging, sometimes followed by numbness, in my most sensitive area. More upright bikes seem better but it’s highly dependent on the fit and saddle. Sometimes the stinging doesn’t come until after riding, and it can last for a day or even several days if I really overdo it. The worst pain seems to come when I quickly spin my legs to get up hills. I try to stand up as much as possible and distribute my weight across the bike when I ride, which definitely helps, but can put stress on my wrists. A urologist I saw basically told me, “bikes are bad for men”, which was not helpful.
I have tried so many saddles I can’t even keep track, including two weird noseless ones (ISM Sport and “Ergo, the Seat”). The noseless ones were some of the worst I’ve tried, and they also transferred so much weight to my wrists that I had pain there. Padded bike shorts don’t seem to help much. I’ve also spent quite a lot of time tweaking saddle height and angle, but unscientifically.
I currently own a Specialized Sirrus, “Small” size frame, but I’m willing to get a new bike. Every other aspect of the bike is secondary to not having pain.
So, my questions are:
1. In a situation like this, is comfort actually achievable on a standard (non-recumbent) bike through fitting and saddle choice?
2. Where around Boston should I go to get a commuter-oriented fitting? The bike shops I’ve been in have all basically said “get a fitting.” One tried to sell me a more expensive one-size-up version of the bike I already have and then get fitted on that. Most of the shops around here seem focused on racing/performance, so I’m not sure how well they would do with me.
3. If a regular bike isn’t going to work for me, can a recumbent actually work for urban riding? What sort of recumbent might work? Where in the area can I try it?
If you’ve gotten this far, I thank you, and I’m looking forward to your advice!
My husband says that you should look into "prostate relief bike seats" (apparently professional bikers have issues with this) - they have cut outs and gel pads etc. etc. He also suggested a wider seat more typically found on women's bikes might help too. That's all I've got, sorry.
posted by Toddles at 8:55 PM on July 26, 2015
posted by Toddles at 8:55 PM on July 26, 2015
In a situation like this, is comfort actually achievable on a standard (non-recumbent) bike through fitting and saddle choice?
Yes, you should be able to ride three miles, twice a day, for an effectively unlimited time without running into pain. (Exhaustion is a different question).
I try to stand up as much as possible
Don't do this. You should never have to stand up when commuting; it's inefficient and messes with your knees.
and distribute my weight across the bike when I ride, which definitely helps, but can put stress on my wrists
This should be clarified a bit. In an ideally fitted bike, your wrists bear no weight (your legs and seat bones are much better at holding weight). A useful test is to see if you can support yourself on your bike without your hands on the handlebar. You should be able to do that, or else your bike is poorly fitted for your current core strength. As your core strength improves, you'll be able to handle a more aggressive fit (if that's of interest to you).
I end up with painful stinging, sometimes followed by numbness, in my most sensitive area.
At the risk of embarrassment, we'll need to know what your "most sensitive area" is. Are you referring to your perineum? For what it's worth, I've heard from more than a few people that nose-less saddles, counter-intuitively, don't help that much with perineal pain.
Most of the shops around here seem focused on racing/performance, so I’m not sure how well they would do with me.
Somewhat surprisingly, many of the same principles for racing/performance fitting apply for all bicycles. I can't make any particular suggestion for Boston, but I've found that triathlete-specific shops tend to have the best fitters for some reason or another (possibly because they have to fit to a wide variety of bikes as used by beginner to advanced triathletes).
Before that, however, I would suggest checking that your saddle is perfectly level. It's quite uncommon for a non-level saddle to be ideal for riders, and it's a common mistake made by beginner riders. Further, I'd check that you are distributing your weight across the entire length of the saddle. I have a bad habit of moving my weight forward, which tends to put pressure around the perineal region. This might mean moving your saddle forward.
posted by saeculorum at 9:01 PM on July 26, 2015
Yes, you should be able to ride three miles, twice a day, for an effectively unlimited time without running into pain. (Exhaustion is a different question).
I try to stand up as much as possible
Don't do this. You should never have to stand up when commuting; it's inefficient and messes with your knees.
and distribute my weight across the bike when I ride, which definitely helps, but can put stress on my wrists
This should be clarified a bit. In an ideally fitted bike, your wrists bear no weight (your legs and seat bones are much better at holding weight). A useful test is to see if you can support yourself on your bike without your hands on the handlebar. You should be able to do that, or else your bike is poorly fitted for your current core strength. As your core strength improves, you'll be able to handle a more aggressive fit (if that's of interest to you).
I end up with painful stinging, sometimes followed by numbness, in my most sensitive area.
At the risk of embarrassment, we'll need to know what your "most sensitive area" is. Are you referring to your perineum? For what it's worth, I've heard from more than a few people that nose-less saddles, counter-intuitively, don't help that much with perineal pain.
Most of the shops around here seem focused on racing/performance, so I’m not sure how well they would do with me.
Somewhat surprisingly, many of the same principles for racing/performance fitting apply for all bicycles. I can't make any particular suggestion for Boston, but I've found that triathlete-specific shops tend to have the best fitters for some reason or another (possibly because they have to fit to a wide variety of bikes as used by beginner to advanced triathletes).
Before that, however, I would suggest checking that your saddle is perfectly level. It's quite uncommon for a non-level saddle to be ideal for riders, and it's a common mistake made by beginner riders. Further, I'd check that you are distributing your weight across the entire length of the saddle. I have a bad habit of moving my weight forward, which tends to put pressure around the perineal region. This might mean moving your saddle forward.
posted by saeculorum at 9:01 PM on July 26, 2015
Are you making sure that your weight is on your "sit-bones" and not on the soft tissue in between? This might require, counter-intuitively, putting your weight farther back upon the seat than you are used to doing. I do have a seat with a cut - out, but I regularly ride my upright bike for half an hour to two plus hours without ever having tingling/numbness. The first few days you ride in this fashion your sit-bones feel bruised but the pain goes away.
posted by GregorWill at 9:12 PM on July 26, 2015
posted by GregorWill at 9:12 PM on July 26, 2015
This should be clarified a bit. In an ideally fitted bike, your wrists bear no weight (your legs and seat bones are much better at holding weight).
I am trying to hold more of my weight on the pedals and handlebars, and less on the saddle. I have the saddle pretty low (almost certainly too low) to allow this. It's not ideal, but it seems to have helped in the short term.
At the risk of embarrassment, we'll need to know what your "most sensitive area" is.
I figured I would have to clarify. While the pressure is being exerted by the saddle on the perineum (although the sit bones are bearing much of it), the stinging and numbness are in the underside and tip of the penis.
(Additional possibly TMI detail: I have also considered that I may have some kind of weird nerve issue. Not to go into too much detail on my anatomy, but I have noticed since I was young that there is a point in my left buttock, right where the sit bone just happens to hit the saddle, that sometimes causes tingling in my penis when hit just right.)
posted by mamutmamut at 9:26 PM on July 26, 2015
I am trying to hold more of my weight on the pedals and handlebars, and less on the saddle. I have the saddle pretty low (almost certainly too low) to allow this. It's not ideal, but it seems to have helped in the short term.
At the risk of embarrassment, we'll need to know what your "most sensitive area" is.
I figured I would have to clarify. While the pressure is being exerted by the saddle on the perineum (although the sit bones are bearing much of it), the stinging and numbness are in the underside and tip of the penis.
(Additional possibly TMI detail: I have also considered that I may have some kind of weird nerve issue. Not to go into too much detail on my anatomy, but I have noticed since I was young that there is a point in my left buttock, right where the sit bone just happens to hit the saddle, that sometimes causes tingling in my penis when hit just right.)
posted by mamutmamut at 9:26 PM on July 26, 2015
Are you making sure that your weight is on your "sit-bones" and not on the soft tissue in between? This might require, counter-intuitively, putting your weight farther back upon the seat than you are used to doing. I do have a seat with a cut - out, but I regularly ride my upright bike for half an hour to two plus hours without ever having tingling/numbness. The first few days you ride in this fashion your sit-bones feel bruised but the pain goes away
I have been aiming for that - I have had saddles on my old road bike and on my current bike that felt like they were putting weight on the bones with what seemed like surgical precision (e.g. Specialized Ronin), and they also had a cutout. I don't have one of those on now, but I do remember sitting pretty far back on them. Some ideas for why it might not have worked are the nerve thing I mentioned above, or perhaps they were actually ill-fitted?
posted by mamutmamut at 9:30 PM on July 26, 2015
I have been aiming for that - I have had saddles on my old road bike and on my current bike that felt like they were putting weight on the bones with what seemed like surgical precision (e.g. Specialized Ronin), and they also had a cutout. I don't have one of those on now, but I do remember sitting pretty far back on them. Some ideas for why it might not have worked are the nerve thing I mentioned above, or perhaps they were actually ill-fitted?
posted by mamutmamut at 9:30 PM on July 26, 2015
Also, paradoxically, tilting the front of your saddle up can lessen the pressure on your perineum, because you slide back onto the wide part of the saddle where your butt takes the load. I've gone both ways depending which bike and how I'm riding, but don't be afraid to play with moving your saddle off the dead level that your bike mechanic sets it at.
I have also played with those 2 pad saddles (looks like one current generation is the "Hobson Easyseat". We were looking at it for a tandem, and my stoker wiggled way too much on it, but if I were sensitive I might consider it for a short distance commuter.
posted by straw at 9:32 PM on July 26, 2015
I have also played with those 2 pad saddles (looks like one current generation is the "Hobson Easyseat". We were looking at it for a tandem, and my stoker wiggled way too much on it, but if I were sensitive I might consider it for a short distance commuter.
posted by straw at 9:32 PM on July 26, 2015
I wonder if you might have to also rotate your hips backwards slightly -- remove any arch in your back and put your back in a neutral position.
posted by GregorWill at 9:40 PM on July 26, 2015
posted by GregorWill at 9:40 PM on July 26, 2015
Although I do think a bike fitting is something to consider, I think this is now verging into a medical issue to consult with your doctor on. Although perineal pressure can, and does, lead to penile numbness, it tends not to result in pain, and further, it tends to take more than just two minutes to set in. I don't want to speculate further than that, as I'm not familiar with your particular pain from the perspective of bike fitting.
Many physical therapists will do bike fittings from a more anatomical standpoint than non-medical fitters are familiar with. I believe this would be more appropriate for you. Further, a doctor can prescribe such a fitting, which may be covered or discounted by your medical insurance.
posted by saeculorum at 10:27 PM on July 26, 2015
Many physical therapists will do bike fittings from a more anatomical standpoint than non-medical fitters are familiar with. I believe this would be more appropriate for you. Further, a doctor can prescribe such a fitting, which may be covered or discounted by your medical insurance.
posted by saeculorum at 10:27 PM on July 26, 2015
Would it be possible for you to visit a sports med doctor? I've always had much better luck with sports med practitioners. That's mostly because they don't give the type of answer your urologist did which was essentially, give up riding. Sports docs tend to accept that you're going to do this thing (run, ride, rodeo, whatever) and we need to keep you safe and healthy while doing it.
FWIW - According the the size chart, at 5'6" you could ride either a Specialized S or M Sirrus. I doubt your problem is the frame. A semi-qualified fitter would be able to adjust either frame for you - maybe swapping out stem/post. You don't need to buy a new bike, you need a better fit.
posted by 26.2 at 10:47 PM on July 26, 2015
FWIW - According the the size chart, at 5'6" you could ride either a Specialized S or M Sirrus. I doubt your problem is the frame. A semi-qualified fitter would be able to adjust either frame for you - maybe swapping out stem/post. You don't need to buy a new bike, you need a better fit.
posted by 26.2 at 10:47 PM on July 26, 2015
I am a big fan of Bicycle Belle right on the border between Cambridge/Somerville (a 10 min walk from Porter Square). They focus on comfortable, urban cycling. While a lot of their branding is towards women, a friend who had troubles in the saddle after pregnancy liked them. They might be able to point you in the right direction for help.
posted by troytroy at 2:45 AM on July 27, 2015
posted by troytroy at 2:45 AM on July 27, 2015
Just to cover this - have you looked at what you're wearing? Underwear and trousers specifically, and different consequent arrangements of junk.
but yep, the sit-bone nerve thing does sound absolutely key, especially if it means you're shifting to avoid causing that numbness when you can, which I would end up doing and it'd mess up my riding position completely. Good luck with Dr!
posted by lokta at 3:01 AM on July 27, 2015
but yep, the sit-bone nerve thing does sound absolutely key, especially if it means you're shifting to avoid causing that numbness when you can, which I would end up doing and it'd mess up my riding position completely. Good luck with Dr!
posted by lokta at 3:01 AM on July 27, 2015
With your description of a unilateral pressure point on your buttock, this does sound a lot like pudendal nerve entrapment (although there are other possible causes such as chronic prostatitis). Do you get the symptoms any time except cycling? Any ejaculatory or urinary symptoms? (No need to answer in thread, just things to think about)
I would see if you can be referred to a urologist with an interest in pelvic floor neurophysiology, for a proper diagnosis (this is not general urology). In the meantime I would skip the cycling I'm afraid - if it is pudendal entrapment then unfortunately just changing the saddle won't fix it (obviously some will be better than others, but the underlying problem will still be there).
posted by tinkletown at 8:00 AM on July 27, 2015
I would see if you can be referred to a urologist with an interest in pelvic floor neurophysiology, for a proper diagnosis (this is not general urology). In the meantime I would skip the cycling I'm afraid - if it is pudendal entrapment then unfortunately just changing the saddle won't fix it (obviously some will be better than others, but the underlying problem will still be there).
posted by tinkletown at 8:00 AM on July 27, 2015
Thanks for all the advice. I did once-around with this problem and the medical establishment about six years ago, and came away very frustrated. I'm willing to give it another shot, but I think I would need a starting point. Does anyone have any recommendations for sports medicine docs, physical therapists or urologists who are well-versed in this sort of thing?
posted by mamutmamut at 10:00 AM on July 27, 2015
posted by mamutmamut at 10:00 AM on July 27, 2015
Good advice above. In addition, my $0.02: For shops, I would head you towards Wheelworks -- either in Belmont (main store, on Trapelo Rd, lots of saddles to try) or in Somerville (near Davis).
At any shop, you have a nonzero probability of finding some snotty dude who can't be bothered, but I've gotten good, insightful, non-pressure treatment at both of those shops, and I know they both do a decent trade in commuters.
I would say: get a professional fitting. You want a good chunk of an expert's time -- put your money where your mouth is. You'll want to make sure that person is listening to your needs; but bike fitters are actually very trained in what they do, and it is reasonably complicated, not just some dude's opinion or handwaving. So it's worth the money.
posted by Dashy at 12:38 PM on July 27, 2015
At any shop, you have a nonzero probability of finding some snotty dude who can't be bothered, but I've gotten good, insightful, non-pressure treatment at both of those shops, and I know they both do a decent trade in commuters.
I would say: get a professional fitting. You want a good chunk of an expert's time -- put your money where your mouth is. You'll want to make sure that person is listening to your needs; but bike fitters are actually very trained in what they do, and it is reasonably complicated, not just some dude's opinion or handwaving. So it's worth the money.
posted by Dashy at 12:38 PM on July 27, 2015
I don't know someone local to you, but Arnie Baker, MD is probably the alpha dog on this. There aren't a lot of people who are both a doctor and Cat 1 cyclist/national champion. I've met him through Team in Training. He's a good guy and fixture in our local San Diego cycling community. If you have a reason to be in San Diego, he's the person I'd recommend. You could try emailing him to see if he'd consult on your case or recommend someone local.
You might skim the Men's Health section of his book Bicycling Medicine.
posted by 26.2 at 1:14 PM on July 27, 2015
You might skim the Men's Health section of his book Bicycling Medicine.
posted by 26.2 at 1:14 PM on July 27, 2015
For someone of your age/size/weight/fitness it should be perfectly possible to ride a bike painlessly for a routine short bike commute. Millions of similar men all over the world manage to do so. So something's not right with either your body, or your position on the bike, or both. The internet is generally pretty bad at both urology exams or bike fitting. You really need to go and get some non-internet advice. I'd try a bike fitter first because they're generally much cheaper than urologists and it sounds like you've tried that route already.
posted by normy at 3:59 PM on July 27, 2015
posted by normy at 3:59 PM on July 27, 2015
Thanks for all the advice. I'm going to schedule a fitting session with either Boston Sports Medicine or The Cycling PT. If anyone has any other recommendations, speak up!
I didn't know that there were physical therapists that did bike fitting, so the internet came through there. I've had really good luck with PTs in the past for various other issues, so I'm cautiously optimistic it may work out.
If that doesn't work, I'm going to see if I can find a urologist who is actually helpful, because I likely do have something diagnosable that cycling is aggravating. I've had a few minor, possibly related issues but nothing that any doctor said was worrisome, so it may take some effort to find someone who takes me seriously.
Finally, if that doesn't work out, I may end up That Guy who rides a recumbent to work. My commute can be made approx. 75% on paths, so it will probably be awkward but possible. But I'd like to stick with a normal bicycle if possible, because a recumbent just doesn't seem like it would fit into my lifestyle very well (my SO and friends ride around town Copenhagen-style, and it would be great to be able to join them a bit more than I do).
posted by mamutmamut at 6:07 PM on July 27, 2015
I didn't know that there were physical therapists that did bike fitting, so the internet came through there. I've had really good luck with PTs in the past for various other issues, so I'm cautiously optimistic it may work out.
If that doesn't work, I'm going to see if I can find a urologist who is actually helpful, because I likely do have something diagnosable that cycling is aggravating. I've had a few minor, possibly related issues but nothing that any doctor said was worrisome, so it may take some effort to find someone who takes me seriously.
Finally, if that doesn't work out, I may end up That Guy who rides a recumbent to work. My commute can be made approx. 75% on paths, so it will probably be awkward but possible. But I'd like to stick with a normal bicycle if possible, because a recumbent just doesn't seem like it would fit into my lifestyle very well (my SO and friends ride around town Copenhagen-style, and it would be great to be able to join them a bit more than I do).
posted by mamutmamut at 6:07 PM on July 27, 2015
This thread is closed to new comments.
posted by mattbcoset at 8:54 PM on July 26, 2015