Perineum pain advice

[Conabike]

Hello everyone, I used to enjoy cycle touring in my late teens/early 20s and have more recently been keen to get back into it - now aged 29. I cycled for 5 days in Spain November last year, on a bike that probably wasn’t a good fit. I finished the cycle and 24hrs later suddenly had an intense aching feeling up my legs and then developed pretty severe perineum pain which lasted about a week, sitting down was uncomfortable. Unusual I never experienced pain when actually on the bike. About 3 weeks later I had a 45 minutes cycle session on a fitness bike in the gym (I live in London and don’t cycle in town), cue pain again for 3 days. After that I’ve been off the bike for months. Went to another gym bike session today and whilst not in pain I definitely feel a tingling/numbness down there again, even after such a long break. Went to docs after Spain and they weren’t very useful, prostate not enlarged apparently and just suggested rest.

Already got another cycle tour planned for beginning of July which I’m really excited for and want to start training (more hills involved this time!). I’m at a bit of a loss on what to do next other than get a proper fitting bike and look at a cut out saddle...Need to be careful as ball and chain wants children in near(ish) future. Any thoughts or advice? Apart from a few big tours (3 weeks) I’m not much of an experienced/avid cyclist in the day to day.

Thanks for any advice in advance.

[Paulatic]

Selle SMP totally removes that pain IME.

[531colin]

Well, I'm sadder and a bit wiser after reading what they have to say here https://www.niddk.nih.gov/health-information/urologic-diseases/perineal-injury-males about chronic perineal injury and cycling.
There are, of course, several confounding factors, first of these is are you using the word "perineum" in the same strict sense that they are?
Secondly, I think they are unduly pessimistic about the "damage" which can be done by cycling....they infer that chronic perineal damage is just about unavoidable if you cycle regularly....this is of course not the case if your bike is set up properly so that your weight is on your bum bones, ischial tuberosity if you want to give it its proper title. (google it)...there is also an "ischial tuberosity pain syndrome"...wouldn't you know it!
If you think you have damage which has persisted from an original injury last year, you are going to have to go back to the medics.

[Audax67]

If you sit with your perineum too far forward the nose of your saddle presses straight up onto the urethra and the pubic nerve and arteries. Crushing any of these is a very bad idea. Years ago I read of one bloke whose marriage nearly collapsed because crushing collapsed something else, for months.

Anyway, a decent bike fit and the right saddle should get you sitting on your sit bones and the damage will cease. However, while the first can be acquired for mere money, the right saddle is a different kettle of fish.

Many of my friends ride on SMP saddles and love them. I don't, because my legs differ in length by 11 mm so that, on a plastic saddle, all the weight is on my left sit-bone. I use a Selle Anatomica X, a saddle with a supple leather top that adapts to leg-length as you ride. They're pricey enough but you can get serviceable grade B stock at around half price. I've done some pretty long rides on one without posterior damage.

[steady eddy]

+1 for the Selle SMP - comfortable if a tad wide for a bike with a low front end - but they do a narrower version and very reasonably priced.I am reshaping mine by tightly binding the front with rope when I don't use it - so far that has worked well!
A swap from a Brooks was a revelation in terms of comfort.

[shobo]

I echo audax67.
do NOT take perineum pain at all lightly. STOP, change how you are sitting.
My experience: day 3 of LEJOG got a saddle sore due to 'bad' shorts. Adapted by almost subconsciously moving my bum forward on the saddle. Day 6, I had to pull out, difficulty passing water. Day after, medical emergency, catheter fitted. DO NOT RISK THAT - there could be life changing effects !!
I think I may be lucky, but it is still early in my recovery to be sure.
As someone else said, fit a Selle SMP (there are others) with a cut out.
But whatever you do, if you get pain there, STOP immediately and re-evaluate !! Go back to square one with your best solution, and gradually work up the mileage. Take a month out if you have to !!

[NUKe]

There are many reasons for pain. So first of I would say
1. See your doctor and get it checked.
2. Get a bike fit, but make sure it’s someone who understands fitting fully and not just able to fit racing cycles. So you probably want a cycling physio rather than a bike fitter. They will be able to help with position and suggest suitable saddles.

[Sweep]

Important topic and I second all the advice about checking things with the medics, but I note that the OP hasn't been active since the beginning of May.

I suppose they could be looking at responses without logging in - not sure how the system works.

[geomannie]

Another +1 for Selle SMP.

[LittleGreyCat]

No mention of padded shorts, I note.
Are we all assuming that these are being worn?

[geomannie]

No mention of padded shorts, I note.
Are we all assuming that these are being worn?

No. With a Selle SMP I find that it gives me all the padding I need. In fact, padding makes me seriously uncomfortable.