Experience with Pressure "sores"?

Training
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Has anyone experienced pressure sores? Not your typical saddle sore, but an area of skin which seems normal, but a pressure point has built up over time?

I’ve been taking issues for months, which i think started from spending 15-18hrs a week on the trainer during lockdown, when i couldn’t ride outside.

Can’t seem to kick it, and dermatologist doesn’t have any ideas or solutions either. I got a saddle mapping recently, and its definitely right on that area where there is a ‘hot spot’.

2 weeks off and still no improvement. Getting pretty disheartened, thats the longest i’ve been off the bike in over 2 years.

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So you potentially identified a pressure point that matches to your issue. What if any changes were made based on that info?

If you haven’t seen it, here is my thread meant to cover a wide range of saddle related issues, with some suggestions for changes:

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Thanks, yes I have changed my saddle and moved it to get the pressure better distributed, but still experiencing issues

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Same issue inside and outside?

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Yes

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Hard to suggest more. Assuming your pressure mapping lead to a “proper” saddle choice and position, and the issue present inside and outside, leaves maybe clothing that we haven’t mentioned. But my guess is that you have looked into that already.

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I get pressure sores also. The only solution I’ve found is to use a saddle with a lot of padding. Unfortunately, these are harder to find than I’d like. Most newer saddles are pretty hard.

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So pressure sores are a thing? i had convinced myself i made that up…never heard it mentioned before.

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I’m using your term - but that’s what it is. I have sharp sit bones I think. Both my brothers have the same issue. Runs in the family.

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If this article describes your problem, I dealt with it for 10 years before mostly resolving it last year and then found out what the issue was just within the last couple of months:

One year ago I had a bike fit that utilized saddle pressure mapping. Shocker: all of the highest pressure areas lined up exactly with my ‘problem’ areas. The solution is to reduce the peak and average pressures you experience. It is something you’ll have to work through with the fitter and the pressure mapper to see which specific changes have positive vs negative effect. I don’t want to speculate and would ignore people who just say to ‘drop your saddle height.’

For me the fit changes involved moving the saddle back and up, adjusting the saddle tilt and switching to a non-padded leather version of the same saddle (from carbon.). The saddle was the right width for my undercarriage so no changes there. I prefer an unpadded saddle as due to a pelvic asymmetry when I use padded saddles the left side compresses / wears faster than the right which leads to worse problems. We used the pressure mapper after each change and undid some changes after they increased pressure. I had 3 sessions of ~3hrs, ~2.5hrs, and a ~1hr check in. Well worth whatever money I spent on it and I wish I had figured it all out years ago.

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Foam density.

I’m not 100% I understand the issue but, I’m still amazed after decades of serious riding/training, how a pad can affect comfort. The density of the foam is a big part of it for me…

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bibs can all be quite different huh.

It also amazes me at the incompetence of a large portion of the medical profession.

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I experienced the same problem with increased trainer use. I found that by raising my front wheel a few inches I no longer experience the problem. Hope you find a solution!

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Did you find you needed to change the tilt of your saddle at all?

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I didn’t change the tilt of my saddle. I had an old riser block and my decision to use it was done just to mix things up a bit. The resolution of the pressure sores was just a happy accident. It does make me think I may need a proper bike fit/saddle mapping at some point.

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Do you sit squarely on the saddle or do you sit towards one side or the other?

(If you go on a group ride and look at the other riders you’ll find that most riders sit to one side or the other. Often it’s just a centimeter or two and sometimes it’s 3-5+ centimeters. It actually seems rare that someone sits exactly dead center on the saddle.)

I had a problem a couple of years ago when I ramped up my mileage. Basically I was getting a lot of abrasion under my left sit bone area. At first I thought it was a saddle sore or ingrown hair. Then I got tons of swelling and pain in the area after increasing base miles to 13-15 hours per week. The doctor thought I burst a blood vessel in the area.

I recovered from that over a few weeks. After a week I could ride with two pairs of shorts. I played around with many different saddles and rode around on a Selle Anatomica for a long while.

As an experiment I decided to try and force myself to sit squarely on the saddle. This feels super weird to me. If I sit on the saddle normally I’ll settle in at 2cm to the right of center which brings the left closer to the edge of the saddle. I force myself to pick my butt up, move it left, and plant it square. It feels totally weird.

Despite the weird feeling, this has alleviated the pressure spot I used to get on the left. I figure that I have some kind of pelvic asymmetry.

I also started using an SQLabs Active saddle which allows the rear of the saddle to rock back and forth. I think this helps with the asymmetry. I also found that Assos shorts ageed with my behind the best.

I feel like it’s still an ongoing experiment. While working fine, the SQLabs saddle is a flat shaped saddle. Back in the day, I used to always gravitate towards the Selle Italia Turbo which is a very rounded saddle. And I always used to hate hard flat saddles. I do think by sitting centered on the saddle I could probably use any of my old saddles without too much problem.