Joined: 06 Oct 2003
|Posted: Mon Apr 16, 2007 8:52 pm GMT +0000 Post subject: saddle sore to staph infection
I just had a saddle sore turn into an abscess larger than a quarter within 2 days. I used hot baths and compresses over the weekend and then went to my GP and got it lanced today. He then put a drain in it that he plans to remove on Wednesday. I cannot describe the pain.
From the google searching I just did and from past experience, I'm certain that it was staph and would bet a dollar that the culture will come back as CAMRSA (Community Acquired Methicilin-Resistant Staph Areus, i.e.: evil superbug from hell). Apparrently it's becoming extremely frequent in athletes.
My questions that my family doc couldn't answer are these:
1) Am I likely to heal up in time for the Fort Davis stage race this weekend?
2) Is the cephalexin that he put me on likely to hurt my performance if I do race?
To prevent this in the future, I plan to keep my riding clothes in a clean plastic bag within my courrier bag which doubles as my gym bag, work bag and school bag (therefore having lots of opportunity to pick up nasty things). I also plan to clean myself with baby wipes before putting chamois lube and shorts on. If you think this would be adequate or have any other suggestions, maybe these would be good behaviors to encourage to our comrades. No one wants this stuff. It's awful.
|The Bike Doc
Joined: 08 May 2003
Location: Corpus Christi and Warda, Texas
|Posted: Tue Apr 17, 2007 6:25 pm GMT +0000 Post subject:
To answer your questions first:
1. You will be pushing it to make the Davis Mountains race in a well healed state.
2. If the bacteria that are growing from the abscess are sensative to cephalexin, you will benefit from being on it. If they are resistant to it there is not any benefit. Check with your doctor to see if cultures were done and if so what the results were. It is not likely the antibiotics will hurt your performance. What will HURT your perfomance will be an un-healed abscess. It often takes 2-3 weeks for them to heal adequately.
Here is a copy of an article I wrote on managing saddles sores.
The Bike Doc
Paul K. Nolan, M.D.
Back in the Saddle Again: Saddle Sores Prevention and Treatment
Saddle sores can be an uncomfortable deterrent to bicycle riding. They often develop in areas where excessive pressure, chaffing or rubbing occurs between skin and saddle or areas where the skin rubs against itself. They can range from an uncomfortable chaffing to boils or abscesses with surrounding skin infection. Saddle sores can hit seasoned pros and recreational riders alike.
Having been inflicted with these maladies, I've had first rump experience to test treatment and prevention modalities. Their best management is prevention which hinges on a good saddle and appropriate bike shorts. A well made saddle is not excessively wide, provides easy movement of the thighs without chaffing and padding to pressure areas But what about those fanny hugging, anatomy revealing lycra bike shorts?! Having once been a hold out against lycra bike shorts (I didn't want to be seen riding around in a pair of colored underwear) I have discovered the functional benefits of the form fitting material. Saddle sores often can develop in areas where loose fitting clothing can bunch up and rub against the skin. A well made pair of lycra shorts with smooth seams and a moisture absorbing rump pad is well worth the investment in preventing saddle sores.
In our hot and sometimes humid Texas weather additional measures are necessary to prevent the chaffing and rubbing due to sweat build up. An inner pair of form fittings boxer briefs or an unpadded pair of lycra shorts beneath the padded lycra shorts as well as a body powder such as Mexana or Ammens in the groin and rump area helps to absorb moisture and provide a surface that can slide easily between the skin and saddle. This works in the same way as wearing two pair of socks and using foot powder to prevent blisters when wearing athletic shoes for running or hiking boots. Having at least two pair of lycra bike shorts and liner shorts allows the rider to alternate between them so that a pair can always be clean and dry.
What should a rider do if saddle sores develop? If the sores are only areas of chaffing with redness, a brief detour out of the saddle and using the above described shorts combination when back in the saddle again may be all that is necessary. When extra protection is needed such as when a die hard bicyclist like myself cannot get out of the saddle, a small application of a heavy salve such as Corona Ointment or Bag Balm (found in your local feed stores) to the chaffed areas covered with an application of body powder and the double shorting can help return the rider to the saddle sooner. However, if there are signs of infection such as spreading redness, local warmth, boil formation or increased swelling, the rider has to get out of the saddle and get to a doctor for further evaluation and treatment. A course of antibiotics may be required for an infection, an incision and drainage may be required for boils or abscesses and mandatory time out of the saddle must be taken. Once these areas have healed a return to the saddle can then be pursued. The rider should avoid returning to long distance bike riding initially, but instead start with short rides and gradually building back up to longer distances to allow the rump to toughen up.
Another saddle sore related problem can result from excessive compression of the perineal nerve which runs just under the bottom of the symphysis pubis, the base of the pelvic bone. This is manifested by numbness in the penile or external vaginal areas thus the oft referred to slang amongst long distance cyclist of the "DDD" or the "Dreaded Dead Dingus". Again the best treatment is prevention. A well made saddle with a padded nose that has been positioned properly is critical. Saddle height should not be set so high that the riders pelvis rocks side to side to maintain peddle contact. The saddle tilt should be parallel to the ground or with the nose angled only slightly downward 1 or 2 degrees from level. Try the saddle in the level position first if it has been ridden with the nose elevated, then if this does not prevent the numbness try lowering the nose slightly. Avoid excessive downward tilting of the saddle nose as this can place too much weight on the rider's hands and cause nerve compression in the wrist leading to pain and numbness in the hand and fingers. Also the afore mentioned padded lycra shorts are helpful in preventing the "DDD". A check with your bike mechanic or a more experienced rider for saddle adjustment or recommendations may also be helpful. Following these tips can help get you back in the saddle again.
Another trick to get you back in the saddle for road riding sooner is to switch to a recumbent road bike. There are several FAST models out there to chose from and are comprably priced to high end road bikes. Check out www.bentrideronline.com to get some ideas. Check out this article I wrote. http://www.bikeroute.com/Recumbents/BentMedBenefits.php
Paul K. Nolan, MD
AKA: The Bike Doc