Important SPINformation

 

How Does Cycling Affect Your Pelvic Floor?

 

Outdoor sport weather is here!  As any fellow George Washington Bridge runner would know, cyclists are out in full force.  Obvious health requirements for all cyclists include wearing a helmet, maintaining adequate hydration, maintaining properly functioning breaks, and using bells and lights to alert surrounding pedestrians.  Today, I have decided to discuss the less known health considerations that all cyclists should know, and with that I bring to you a blog about the effect of cycling on the pelvic floor.

Cycling stresses the pelvic floor muscles and structures unlike any other sport.  Narrow, non-padded seats and crossbars are two big culprits responsible for pelvic floor dysfunction.  Our body was designed for sitting to occur on our ischial tuberosities (aka the “sit bone”), however majority of bicycle seats force its users to sit on the perineum, particularly on the ischiopubic ramus (the segment that connects the pubic bone to the ischial bone of the pelvis.  The increased pressure against the seat of the bicycle in this sensitive area can result in elevated muscle tension, urogenital dysfunction, and compression of nerves and/or blood vessels which supply the penis and testicles (males) and the labia and clitoris (females).  Nerve compression can result in numbness, pain, or a burning sensation.  Blood vessel compression can interfere with circulation, which may manifest as erectile dysfunction in males.  To give you a sense of the amount of pressure placed on the pelvic floor during cycling, consider the following: during blood pressure readings, the cuff is inflated to approximately 120 mm Hg (= 2.32 lb/square inch) to restrict arterial blood flow momentarily.  During cycling, a typical nosed bicycle seat produces 2.90 lb/square inch and may rise to a whopping 5.37 lb/square inch during vigorous activity, more than double the amount required to restrict blood flow during sphygmomanometer usage!  This comparison helps us clearly understand how intense cycling can result in pelvic floor dysfunction.

So what can be done to protect one’s pelvic floor?  For starters, the noseless bicycle seat, also known as an ergonomic cycle seat, helps alleviate perineal pressure.  Many different brands and types are available, and I would recommend sampling from several options in person at a professional bike shop prior to purchasing your most comfortable seat.  Furthermore, a research study published in The Journal of Sexual Medicine (May 2012, link to article) analyzed the effect of handlebar height on perineal and total saddle pressure (measured in kilopascals/kPA).  Forty eight female cyclists who rode a minimum of ten miles/week were included in the study.  Handlebar placement positioned below the saddle was associated with a 3.47-kPA average increase in perineal saddle pressure.  Therefore, raising the handlebars can help decrease perineal pressure and promote improved sitting posture.

In addition, pelvic floor physical therapy, such as the type delivered at Revitalize Physical Therapy, helps to restore normalized muscle tone, eliminate tension, alleviate nerve compression, and improve blood flow.  It would be an honor to help with any of these conditions.  You now have the facts, and knowledge is power!  Take this information and run with it…or cycle with it!  May you have a happy, healthy, energized, and athletic summer!

Transplant-astic

Female infertility is a sensitive issue that affects approximately 48 million women worldwide.  Several factors affects fertility, including genetic factors and various acquired factors (ex. infections, eating disorders, and chemotherapy).  Uterine malformations or fibroids may also interfere with pregnancy.  On rare occasion (approximately 1/ 4,500), women may even be born without a uterus, something which certainly interferes with fertility.
Fortunately, recent research in Sweden by Dr. Mats Brannstrom, Professor of Obstetrics and Gynecology at University of Gothenburg in Sweden resulted in the first successful pregnancy and delivery after uterine transplant (September 2014).  The transplant involved detachment of the womb from the donor, and then a different team of surgeons delicately inserted the uterus and its respective blood vessels into the recipient, a woman who had born without a uterus.

This procedure has not yet been successfully performed in the United States.  Opponents of the surgery claim that this elective surgery, which is not a lifesaving procedure (such as a heart or lung transplant), places both uterine donor and recipient at risk.  Furthermore, as with any organ transplant recipient, the woman is required to take immunosuppressive medication for the duration of the foreign organ remaining in her body.  Therefore, the plan for this surgery is for the uterus to be removed after the woman delivers the amount of desired children in order to allow her to terminate immunosuppressive medication.  However, as the procedure becomes refined and perfected, it will probably become more accepted within the medical community due to the potential benefits.

Furthermore, Brannstrom predicts that within five to ten years, additional medical advances may obviate the need for a uterine donor altogether- namely, that doctors will be able to create a uterus from the woman’s very own cells.  An additional benefit of this type of procedure is that the recipient will not need immunosuppressive medication AT ALL, and there is a decreased risk of organ rejection.  For Brannstrom, the possibilities are endless.  May he have continued success with all his amazing endeavors in order to bring babies and joy into the world.

pregnant woman
Expectant Mother