Saddle comfort uncensored: ‘I went under the knife to stay pain-free’

After months of grinning-and-bearing the agony of severe saddle sores, Paralympic cyclist Hannah Dines ended up under the surgeon’s knife

“Like your guns, saddles should be smooth and hard,” decrees Rule 61 of the famously machismo-drenched manifesto. Apparently it’s a sin to have more than three millimetres of padding, and switching saddles is uncool because “a hardman would instead cut a hole in it to relieve pressure on the delicate area.”

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Think again, lads, because you’re wrong. Very wrong. And I should know — because I took Jens Voigt’s ‘shut up legs’ principle and applied it to my saddle sores. From months of riding in an aggressive position on an aggressive saddle, I ended up with labial swelling caused by impact injury which got so bad I had to have surgery. From my hospital bed, I wrote an article for The Guardian that got far more attention than was comfortable for a girl who generally spends her time seeking out quiet country lanes.

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My saddle sores story was for several days the most read article on The Guardian’s Lifestyle page, getting hundreds of shares and comments. I had written it not just for fellow cyclists but also for the medical community who might then be able to prevent experiences like mine (which included an incorrect cancer diagnosis). The response was enormous; it began raining saddles – hallelujah – as well as silicon saddle covers and bibshorts, not to mention the dozens of emails from men and women who’d been through similar.

Since going under the knife and telling all about it, I have won a Paracycling World Cup bronze medal and am back to full training. When the fitness editor of Cycling Weekly asked me to write 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 asking for bike-fits to be free on the NHS or a Netherlands-grade cycling infrastructure for the UK.

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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.

Are 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.

Hannah Dines at the 2018 Paracycling World Championships (Simon Wilkinson/SWpix.com)

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 slugs and snails produce slime? It’s so they don’t get cut to shreds over pieces of sharp ground and rub off all their skin. Same with you, my friend. Be more slug! You need a lubricant that is not rapidly absorbed and which is non-perfumed and kind to skin.

The Paracycling physio is Katie Flatters, who is also head of saddle comfort. While guesting at the Paracycling World Champs last year, I quickly realised that Katie was the capable one who isn’t afraid to call a labia a labia – and most importantly doesn’t beat around the bush. Naturally I asked her about pubic hair. “Keep it because it protects. Trim rather than shave. If you must remove it, laser treatment is better than waxing.”

Emily has worked with a laser hair removal clinic to understand exactly what and how the procedure works. Like me, she has a biomedical science degree and keeps abreast of recent research. Laser removal of hair is costly and painful, but it kills the hair follicle, minimising the risk of infection; hair cannot regrow to become a point of abrasion.

Hair is the first point of antibacterial resistance: it keeps bacteria and sweat away from the vulnerable skin. And unlike lube, it’s completely free. Of course, personal choice is protected; Emily makes sure her riders can style it out any way they choose — while being well informed.

I fell in love with the BBC presenter Shari Vahl, who interviewed me after my article was published. She was captivating, interesting, and her statement glasses and cherry-pattern rockabilly dress were perfectly coordinated. More importantly, she told me she had started cycling in her 40s to gain some fitness and accidentally became a long-distance tourer — and she swore by her gel saddle cover.

Among the companies that got in touch, Gelovations in Britain uses medical-grade silicon, while the crowd-funded Ultrapedic in the USA makes bespoke covers of “auto-conforming inter-locking gel springs” – both are wonderful, especially on long rides. Pellitec offers anti-chafe blister pads
that contain silipos, a very thin type of silicon that can be stuck in shoes or on saddles to combat specific areas of chafing – perhaps the perfect compromise, more discreet than a gel saddle cover but offering extra protection where it really matters.

Fit for comfort

Ultra racer Jasmijn Muller has had two surgeries very similar to mine, and has recovered from both to keep winning the horrendously long races she loves. Her advice? Get a bike-fit with pressure-mapping: “You can spend all the money in the world and buy all the wonder creams you like, but with a bad bike-fit you will always continue to have issues. We are all a bit wonky after all, be that in leg length differences, muscle imbalance or oddly shaped labia.”

My medical team at the Scottish Institute of Sport paid for my bike-fit – I’m the first to admit, fitting can be costly. But as Muller points out: “It will save you a lot of money on discarded saddles in the long run.”

Hannah Dines at the UCI Para-Cycling Road World Championship 2015
(Photo by Christopher Lee/Getty Images for British Cycling)

She’s right: the most recent bike-fit I had at Crimson Performance, using their accessible jig, would have cost me no more than a couple of saddles.

Crimson’s lead bike-fitter told me that too many people start out buying lots of different saddles but that’s the wrong approach to take. During a bike-fitting service with pressure-mapping, you can try multiple different saddles and then invest in the right one for you. Critically, it is not just about the saddle but also about the other pressure points — the handlebars and the pedals, and how your weight is carried through these points.

I hope that in the future bike manufacturers or bike shops themselves might offer free bike-fits with any road bike that puts them in an aggressive riding position. If you have saddle discomfort, especially numbness or swelling, you must get your fit professionally assessed.

How to find the right saddle?

I wanted to find a saddle that hadn’t just taken the classic design, cut a triangle out of the middle and slapped on a ‘for women’ badge. Instead, I was looking for a saddle that had been entirely designed specifically for the female form – and I found one.

Specialized drew on feedback from 20 women including Alison Kendrick, another pro cyclist who has had surgery like mine. At the time when the Specialized Power Mimic was sent to me, I couldn’t do more than 15 minutes on any saddle. I was cynical, tired, in pain and facing the fact I might never again be able to train properly despite having had two surgeries. Sitting on it was soft and welcoming, firm and supportive, and it felt like coming home after a long time away – so I cried…and then went for a 2.5-hour ride.

For the first time, I felt my own sit-bones lifting pressure away from the front of my pelvis. Though I still favour putting all my weight on the nose of the saddle, the materials used are so soft it barely matters. It is going to be marketed as a unisex saddle in future, a decision I found puzzling – until I spoke to Grace Metcalf, women’s business manager at Specialized UK, who told me: “The men who have tested the saddle have found it so comfortable it’s become their ‘new favourite’. I don’t think it’ll be long before we start seeing Mimic tech being adopted by our other models of saddle, making it available to riders of all shapes and sizes.”

Saddles are anatomy-specific – not just male/female, but to individual bodies. For example, CW columnist and best friend Katie Archibald swears by ISM. Given our mutual love of rainbow hair dye, puns and halloumi, I was sure that ISM would work for me too. Alas, we are not saddle sisters. Variety of the vulva (and scrotal/perineal area, lads) is something we must all accept; what works for me may not work for you.

The perfect pad

The golden triad of saddle comfort is: bike-fit, saddle and chamois. You need all three to achieve true comfort. Beware the marketing that claims that with the right saddle you need no chamois — it’s a lie. Rapha’s women’s chamois pad and bibshorts (like Specialized’s) have been developed around the standard female cyclist. It took the company three years, and so it shouldn’t have astounded me how well it fitted my body shape first time. I have had issues with chamois pads that have so-called ‘pressure-relieving’ ridges and others that don’t extend far enough out or taper their padding to a thin seamed edge.

Maria Olssen, who led the design, told me that companies can’t claim they developed a product using real female cyclists unless they actually did. She is adamant that design and innovation should be anchored and backed up through research and problem-solving for the end user, rather than a marketing tool, no matter the cost or time taken; her team spent an extra year getting things right.
“The silence says a lot,” she remarked – and I have to agree with her. It is frightening how many companies women-specific saddles are based on a male design, with an added flash of pink, which is just not good enough.

If you’ve let things go on for a long time (as I did) and are seriously sore down there, don’t panic. The problem is that we do generally keep our privates private. Doctors report, study and improve what comes into their clinic, so if you dismiss your saddle injuries, they won’t recognise the importance of the subject.

In general, antibiotics aren’t the answer, and you’ll need to consult a specialist. Always ask your GP to help you find the most suitably qualified prostate/gynaecology/dermatology specialist in your area – but don’t expect them to be experts in cycling-related injuries.

In conclusion, if you’re suffering from saddle discomfort, start with a bike-fit. If you want to keep riding while saving up for a new saddle or chamois, a good gel saddle cover could tide you over, preventing further damage. Change one thing at a time and keep notes. If you’re happy to talk about it and want to swap notes, my email is: hannah2dines@gmail.com.

Written by Hannah Dines

This feature originally appeared in the print edition of Cycling Weekly, on sale in newsagents and supermarkets, priced £3.25.

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