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9.30 Saddle Sores


This article is from the Bicycles FAQ, by Mike Iglesias with numerous contributions by others.

9.30 Saddle Sores

From: greenla@umich.edu (Lee Green MD MPH)

> I think I'm developing a couple of saddle sores. I'm curious as to an
> effective treatment for them, and effective preventative measures I can

It recurs intermittently here. Lots of comments about keeping clean to
keep the bugs at bay, all to the good.

However, there is more to saddle sores than infection. Skin has several
defenses against bacterial invasion, all of which must fail before
infection occurs.

Abrasion breaks the physical barrier, and preventing it is the reason for
good bike shorts. Lubrication is sometimes helpful too. I recommend not
Vaseline but Desitin. Yup, the diaper rash stuff. Some advocate bag balm
(there seems to be a whole cult of folk medicine around bag balm,
actually) but I'd say best avoid it: it softens skin, which is just what
you don't want.

The point that most posters here seem to miss is probably the most
important though: tissue ischemia. That is, the skin and subcutaneous fat
between your bones and the saddle get compressed. Blood doesn't flow
through them much. Low blood flow is "ischemia", meaning not much oxygen,
nutrients, antibodies, white blood cells, and other good things delivered
to the area.

Ischemic tissue is highly susceptible to infection, heals poorly, and can
break down and form a sore just from ischemia, without any infection at
all. It's similar to the pressure sores that nursing home patients

Keep clean, use lubricants if they seem to help, but especially wear good
bike shorts, *make sure your saddle fits properly*, and *get off the
saddle often to allow blood flow through the tissues.*

There is more to saddle sores if you're interested in a lot of technical
detail regarding oxygen tension, shear forces, etc but e-mail me if you
want the gory details.


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