Evidence and experience
What the evidence and two decades of surgical experience say about cyclist pudendal nerve.
Sustained pressure from a narrow saddle compresses the pudendal nerve against the pelvic bone. Numbness during a ride is an early warning; burning that persists for hours or days afterwards means the nerve has been irritated rather than simply squashed.
Most cases settle with saddle changes, position adjustment and rest. Cases that do not settle after months of sensible modification need a proper nerve assessment rather than more waiting.
We see this pattern in committed amateur athletes across New York and the wider United States, where indoor cycling volume is high year round.
Dr Bollens is a professor of urology, a proctor in pelvic surgery and a published author on pudendal neuralgia.