Risk factors that research has found to lead to these issues include:

• Poor bike fit and too low handlebars
• Minimal position changes/staying on the seat too long
• Increased body weight

Handlebars

When your handlebars are too low, your body will tilt forward at the pelvis to grip the handlebars.  This anterior (forward) tilt of the pelvis causes increased pressure through the nerves, arteries, and veins of the pelvic floor.

Position Changes
Sitting on the bike seat too long keeps compression through these important structures which leads to nerve and blood flow issues.  One study found that when your heart rate reaches 60-65% of your ‘Max Heart Rate’ the penile oxygen is decreased up to 84% within 20 minutes of sustained sitting. Ouch!

Body Weight
For people looking to their Peloton workouts for weight loss, this is probably one of the most frustrating risk factors.  I hear this from patients frequently: “it hurts to workout, but I need to workout to lose weight so my body doesn’t hurt”. It's a vicious cycle. So take this risk factor with a grain of salt and focus on the changes you can make to relieve the compression on your pelvic floor. 

How do I fix it??

• Watch your posture!
• Make sure your handlebars are higher than your seat so you don’t lean forward and compress the nerves, arteries, and veins.
• Stand Up!
• Give your pelvic floor a 30-60 second break every 10 minutes of cycling.
• Your Seat Matters!
• Try a wider seat to better distribute pressure and weight, wear padded shorts or try a seat cushion.  Peloton even has a recommendation for a cushioned Schwinn seat for their bikes.
• Cross Train!
• Try running, swimming, yoga, or some of the other classes Peloton has to offer so your pelvic floor gets a break from sitting. 

But what if I'm pregnant?

You are in luck!  The American College of Obstetrics and Gynecologists (ACOG) recommends stationary bike riding as a form of exercise for pregnant people. 

Things to keep in mind:

• Stay hydrated
• Do not allow yourself to overheat
• You may need to stay seated in the 3rd trimester due to change in center of gravity from your growing baby
• Listen to your body! You will know what is too much.

Try using the Borg Exertion Scale to monitor the intensity of your ride.  ACOG recommends staying between 13 to 14 or 'somewhat hard'. You can also try the “talk test.” If you can carry on a conversation while you are exercising then you are likely not over-exerting. 

Stationary bikes have been around for a long time and with their boost in popularity from COVID and Peloton they are likely not going away anytime soon. Do not be afraid of your bike, just be smart about using it. 

In review:

• keep your handlebars higher than your bike seat
• don’t lean forward
• give your pelvic floor a 30-60 second rest every 10 minutes during your ride

Tldr: if you have pain, numbness, tingling, urine leakage, swelling in your genitals from riding a stationary bike, you need to see a pelvic floor physical therapist ASAP!

Where to find treatment in Maryland

At Pelvic Pride Physical Therapy & Wellness, we specialize in the treatment of ALL pelvic floor conditions, including pelvic pain, so you are in the right place! We are conveniently located in the Federal Hill neighborhood in Baltimore MD. Fill out our contact form & our Patient Care Specialist will reach out to you ASAP!

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