As a child, I remember spending so much time on my bicycle each summer. We lived in a small neighborhood of dead-end roads with very little traffic. Biking around was the joy of summer, unless I had a UTI. (That’s what we thought it was at the time; sometimes it was and sometimes it wasn’t.) Then my bike would stay parked until I felt better, because bike-riding with an aching bladder or pelvic floor just doesn’t go together well.
Bicycling might seem like a thing of the past for many IC patients. However, there are some pelvic floor friendly ways to bicycle. Remember each of us is different and what works for one might not work for another. Give some of these ideas a try and see if bicycle riding could become a great warm weather activity for you once again.
Pick the right seat.
Finding the right bicycle seat (also called a “saddle”) is definitely the first place to start when it comes to pelvic floor friendly ways to bicycle. It’s no surprise to pretty much anyone, let alone those of us with IC and PFD, that traditional, hard bicycle seats with a “nose” certainly aren’t comfortable. You want to pick a seat that fits your body correctly. The seat should support your sit bones.(1)
In general seats with a wide base work best for pelvic floor health. In fact, one of the biggest reasons bicycle seats irritate the pelvic floor is because they compress the region and result in less oxygen getting to your pelvic floor. One study found bike seats without noses only reduced oxygen flow by about 20% while seats with noses reduced oxygen flow by about 82%.(2) That’s certainly a significant difference, so having the right bike seat is important.
Within wide bike seats, there are a variety of options as well. Some seats have a channel or groove down the center of the seat, others have a long slot in the front and many have bases softened by foam or gel.(1) For even more information about the various bike seats available, check out “Bicycle Seats Explained” by Jim Langley. He’s get a helpful chart that includes some neat seat models designed with pelvic floor health in mind.
If even a wide bike seat is uncomfortable for you, consider trying a recumbent bicycle instead that has a full seat on it to offer complete support.
Adjust the seat correctly.
No matter what kind of seat you have or want to try, be sure it is correctly adjusted before deciding whether it’s right for you. For example, if you feel uncomfortable rubbing or numbness while riding, then tilt the front of your seat down just a little bit at a time to see if you can find the right angle and fit.(3)
Position the handlebars well.
It may not seem like handle bars play a role in pelvic floor friendly ways to bicycle, but they do. The biggest issue is if the handlebars are too low. While lowered handlebars can help with speed and wind resistance, they don’t do any favors to your pelvic floor. This is especially true for women. Lower handle bars result in a pelvic tilt that makes pelvic floor muscles tighten.(4) This pelvic tilt also results in even less oxygen getting to the pelvic floor.(2)
Don’t overlook the importance of the handlebar position on your pelvic floor. Researchers found that the way your seat and bike fit have significant impact on the pelvic floor in terms of pressure and sensation.(5) Make sure your handlebars are high enough that you don’t have to lean over or at least not much.
Wear the right clothes.
Clothes that have seams in the crotch area can put additional pressure on your pelvic floor. So look for pants or shorts that are seamless. Bicycling shorts usually have padding in the back as well to help. Serious riders also don’t wear underwear with their bike shorts to avoid pressure even from underwear seams. Be sure to always wear clean bicycle shorts then immediately change out of them and shower when you’re finished bicycling.(1)
When you are ready to start riding, start slowly. Riding too much, too fast is asking for trouble even without pelvic floor dysfunction. Let your body have a chance to recover in between biking times, and use light gears for low intensity.(3) You want to see how your body and pelvic floor will react to bicycling before you push too hard. Definitely pay attention to what your body is telling you and take breaks as needed.
Ride on flat, smooth terrain.
If you are riding on a stationary bike, then you don’t have to worry about terrain. But if you’re hitting the road or a trail on your bicycle, considering the terrain is important to help avoid flaring your pelvic floor. Bumps and uneven terrain can cause additional vibrations, cause you to shift your body weight while riding and can even result in increased pelvic floor trauma or damage over time.(2) Riding on a smooth surface is best.
Stay hydrated and have a bathroom plan.
Staying hydrated is obviously important for overall health when exercising, but it’s especially important for IC patients in order to keep our urine diluted and less acidic. Be sure to stay hydrated with water as you exercise. And, obviously, being well hydrated means you’re going to need bathroom breaks. Plan your bicycle trips, particularly as you are first trying out biking again, with bathroom access in mind. Go for a short ride in your neighborhood or along a paved bike trail you know has bathrooms nearby.
Stand sometimes up as you ride.
Another pelvic floor friendly way to bicycle is to stand up about for 30 to 60 seconds every 10 minutes of riding. Changing your position and getting off the bike seat reduces compression in your pelvic floor and allows more oxygen to get to the area.(2) It’s a simple shift that can make a difference in whether you can ride a bicycle without flaring your pelvic floor.
Stretch before and after your ride.
Your pelvic floor is a set of muscles and just like the other muscles in your body, they need to warm up and cool down. You want to release areas holding tension. Utilize stretches for your hips and pelvic floor to help loosen them up both before and after riding. The ICN has multiple resources for pelvic floor physical therapy and stretches.
Consider a suspension seatpost.
If you are bicycling on-road, consider getting a suspension seatpost to help absorb the shock and vibrations your bicycle encounters. They’re a relatively inexpensive way to reduce the vibrations and stress on your pelvic floor. Suspension seatposts soften your ride, which is always a good thing. A couple of different types are available that can help you have a smoother bike ride. Find more details here.
- Langley J. Bicycle Seats Explained.
- Buonomo K. As the Bicycle Turns: Cycling and the Pelvic Floor. Pelvic Health and Rehabilitation Center. June 20, 2019.
- Body Gears Physical Therapy. Enjoy Cycling While Protecting Your Pelvic Floor Health.
- Kegel8. Do You Need to Change the Way You Cycle?. May 2, 2019.
- Connell K. Cycling & Pelvic Health: Learn to Protect Yourself. Urogynecology University of Colorado. May 22, 2013.