Question from Thomas L.: My riding position is sporty, with a significant saddle cant. I tend to ride in a sporty manner with frequent pedalling. In my opinion, the seat adjustment is right. However, I have a strong feeling of pressure on the inside of my thighs, just before the widest point. Otherwise, there are no problems with pressure in the pubic or ischial area. The feeling of pressure disappears after about 30 minutes of riding, but returns after about five hours on long rides. Trying out lots of different saddles is expensive. Do you have any tips or experience?
Answer from Dr Stefan Staudte: It is not possible to reliably assess the exact anatomical location of your problem from a distance. The described pressure on the inside of the legs fits well with an overload and compression syndrome of the adductors. Their attachment points are located on the inside of the pelvic bone, in the area of the lower pubic bone and ischial branches and ischial tuberosities. You should try to change something about the way you ride your bike.
Here are four tips: Due to the high saddle cant, the pelvis tilts forwards and puts unfavourable lateral pressure on the seat and pubic bone branches at the transition to the saddle nose. Your saddle may be too wide or too hard at this point. If your legs are in the vertical axis when pedalling, or perhaps turned in towards the centre ("knock-knees"), this could also reduce the space between your legs. Seat pads in your cycling shorts can also add to the pressure. It would be best to assess all aspects together with a specialist. You may also need a cycling training programme in which you modify your leg position and power delivery with a view to the symptoms.
