Cycling Weekly – August 22, 2019

48 | August 22, 2019 | Cycling Weekly

this feature, he suggested I include

“medical advice from a doctor who has

looked specifically into saddle-related

problems.” But alas, that was a bit like

ask ing for bike-fits to be free on the

NHS or a Netherlands-grade cycling

infrastructure for the UK.

I’m going to speak at a British Medical

Lymphodoema (swelling) conference

in October and scout out some genuine

experts in these problems, but until

then, my specialists are people who live

it: professional cyclists who have gone

through their own saddle-wars, and

R& D engineers who have spent years

looking into the possible causes of such

horrendous saddle injuries. From skin,

hair, saddle-covers, bike-fits to pelvic-

specific contours and personalised

chamois, the theories and possible

solutions are endless.

A re you a specialist in dermatology,

plastic surgery, urology, a chamois-

designer, biomechanical-bike-fitter,

engineer or pro cyclist with a contract that

permits data sharing? Then we need you.

It starts with the skin

My dermatologist is Emily Nelson of the

British Cycling female team pursuit

team, who knows exactly what to buy

over the counter in Boots: pharmacy-

grade Doublebase as chamois cream,

Adex cream if you’re a bit sore, Diprobase

for general moisturising and Dermal 500

for the shower. Beware any ‘hygiene’

products — they are unnecessary and

damage your natural defences. Emily

knows her stuff, and so I have high

hopes for any new recruits to the British

Cycling programme.

Whether you’re man, woman or

machine, you need to lube-up. Your

bike needs WD40 and you need the

human equivalent, namely chamois

cream. Did you ever want to know why

I don’t have a vulva, is this for me?

YES! This far-from-exhaustive list

of saddle-related ailments can be

experienced by any rider

Infection: My swelling was never

accompanied by infection. Chamois

cream and washing controls infection

risk, but there is a genetic component

too. Everyone’s skin has a coating of

good bacteria fighting off the bad; if you

get more infections, it may be (ironically)

because you’re killing too many of the

good bacteria. Don’t put plasters on

infections, don’t overuse antibiotics,

and take some rest. If it’s not visible

externally, it’s probably not an infection.

Swelling: Female anatomy is especially

good at responding to trauma (blame

childbirth!), which means tissues can

overreact and swell more than necessary.

Necrotic fat: In response to chronic

impact, the body often creates a

protective fat-cushion (medical name:

necrotic fat) under the skin. It occurs

in people with Type 1 diabetes who

inject themselves with insulin every

day. I joke to my team-mates that the

surgery I had was a designer vagina —

but actually it was nothing of the sort.

It was the removal of a huge internal

and external fat lump. Surgery is not

always the best option — there can be

many complications, it is dangerous

and the healing takes a long time. I am

significantly more comfortable now and

experience less swelling, so for me it was

the right option, but not one I took lightly.

Then again, they removed 200g — good

marginal gain!

Ulceration: Ulceration is a process by

which the body gets rid of the necrotic

fat, essentially sloughing off the skin

to push out the waste tissue. This is

end-stage skin death and leaves you

the most open to infection, and is the

most painful. Rest is the only option.

Numbness or erectile dysfunction:

If you’re a male cyclist and you’ve

been experiencing erectile dysfunction,

you’ll need to consult a urology and

sexual health specialist. Most likely,

your nemesis will turn out to be pressure.

Soft saddles like the Power Mimic can

help but it’s not only about the shape,

but also about firmness.

FITNESS

CHECKING THE FLESH

How serious is my saddle sore?

In action at the 2018 Paracycling

World Championship time trial