Saddle sores in elite/professional cyclists with labia/vulvas: Results of a mixed methods survey

Saddle sores (skin and soft tissue cycling-related urogenital overuse injuries) can negatively impact cyclists on and off the bike. Previous research has offered solutions of riding less, using wider saddles, or raising handlebars, which are not realistic for professional cyclists. Our aim was to survey elite and professional road cyclists with labia/vulvas to understand saddle sore epidemiology, impact on cycling careers and life off the bike, and prevention, mitigation, or treatment strategies.

A novel mixed-methods cross sectional survey METHODS: Responses were reported as frequencies or medians with interquartile ranges. Impact of saddle sores was assessed using related samples Wilcoxon signed rank tests.

Of thirty-three eligible cyclists, nearly all had cycling-related pain and abrasions (30/33 = 91%). Eleven (33%) indicated they had a history of or current issues with all queried saddle sore subtypes. Ulcerations and abscesses were most bothersome. Participants reported saddle sores more negatively impacted training than racing. The effectiveness of mitigation strategies varied by participant and injury. 42% reported a prior bike fit that contributed negatively to their saddle health, and 67% felt like their labia "got in the way" while cycling.

In a volunteer sample of elite/professional cyclists, saddle sores were common and had a negative impact on training and racing. This study supports the need for more awareness about saddle sores and for further research on true prevalence and incidence of saddle sores, prevention and treatment strategies, and impact on the health and careers of elite/professional cyclists with vulvas, a unique cohort not previously studied.