Cyclists

Cyclists often experience pelvic floor issues such as numbness, pain, and discomfort due to the pressure exerted by bike seats. Pelvic floor physical therapy helps by assessing and addressing these problems through manual therapy, targeted exercises, bike fit advice, and posture correction. This therapy aids in treating current symptoms and provides preventive guidance to maintain pelvic health and enhance cycling performance.

Symptoms

  • Numbness or Pain in the Perineal Area: The pressure from a bike seat can compress nerves and blood vessels in the perineal region (the area between the genitals and anus), leading to numbness or pain.

  • Pudendal Nerve Irritation: Continuous pressure from the saddle can irritate the pudendal nerve, which can cause discomfort or numbness in the genital area.

  • Weakened Pelvic Floor Muscles: Long hours in a static cycling position can lead to weakened pelvic floor muscles, especially if there's a lack of cross-training or compensatory exercises.

  • Overactive or Tight Pelvic Floor Muscles: On the flip side, some cyclists might develop overactivity or tightness in their pelvic floor muscles due to prolonged periods in a seated position and repetitive pedaling motions.

  • Lower Back Pain: Poor cycling posture or a non-ergonomic bike setup can strain the lower back and, subsequently, the pelvic floor muscles.

  • Hip Imbalance or Tightness: Cycling often requires a forward-leaning posture and repetitive hip flexion, which can lead to muscle imbalances or tightness in the hip area, impacting the pelvic floor.

  • Urinary Problems: For some cyclists, the pressure from the saddle may lead to urinary tract discomfort, urinary urgency, or even infections.

  • Sexual Dysfunction: In some cases, particularly with an improper saddle or poor bike fit, male cyclists might experience issues like erectile dysfunction, while female cyclists might experience pain during sexual activity.

How we can help

PTs use manual therapy to relax overactive or tight pelvic floor muscles, reducing pain and discomfort.

  • Scar Tissue Mobilization: For those with scar tissue from surgeries or injuries, PTs can gently manipulate the area to improve flexibility and reduce pain.

  • Trigger Point Release: They can identify and apply pressure to trigger points in the pelvic area, alleviating muscle tension and referred pain.

  • Joint Mobilization: By mobilizing the joints in the pelvic and lower back area, PTs can improve mobility and reduce discomfort related to stiffness or alignment issues.

  • Myofascial Release: This technique helps in releasing tension in the myofascial tissues surrounding the muscles, enhancing flexibility and function.

  • Neuromuscular Techniques: PTs use these methods to improve coordination and strength of the pelvic floor muscles, which can be beneficial for incontinence and sexual dysfunction.

  • Pelvic Alignment Corrections: They can assess and correct misalignments in the pelvic area, which can be a source of pain and functional impairment.

By employing these manual therapy techniques, pelvic floor PTs can provide relief, improve muscular function, and enhance the overall quality of life for cyclists with pelvic floor issues.

What to expect

At your initial appointment, we will start by taking your medical history, followed by a comprehensive musculoskeletal examination of your pelvic area. This will include assessing your posture, joint alignment, any muscle restrictions or trigger points, the health of your connective tissue, and muscular strength. An internal examination is often part of this process, but it's entirely optional and will only be conducted if you feel completely comfortable with it. This exam is much more relaxed and comfortable compared to a typical ob/gyn/urologist visit, and it provides essential information about your pelvic muscle tone, strength, and coordination. If impairments are found during the exam, the physical therapist can treat the problems with manual therapy techniques resulting in pain relief and improved function. Following the exam, we'll discuss our findings with you and outline a personalized treatment plan aimed at achieving the best results. Most patients start feeling better after their first session and see significant improvement by their third visit.

This review is for Dr. Jess Fu. I have seen her three times so far and I feel that she has already helped me tremendously in a variety of issues from neck pain, weak core, pelvic pain and overactive bladder. Prior to seeing her, I had tried other strategies that would only result in flare up of these issues and within 2 weeks of our initial visit I could already see improvement. She is very knowledgeable and spent time to really understand the root cause of these issues. I highly recommend her.

— Jenna N.