Though they are often fodder for jokes, hemorrhoids are no laughing matter. They don't pose a danger, but they are painful. For those who love to bike or who count on a bicycle as a means of transportation, hemorrhoids present a significant tactical problem. It's hard to ride standing up and bicycle saddles can apply significant pressure to areas sensitized by hemorrhoids. If you are prone to hemorrhoids and don't want to give up on biking during flare ups, you will be relieved to know you have options that aren't necessarily a big pain in the you-know-what.
The Back Story
Hemorrhoids develop when veins within or around the anus swell or bulge. The area surrounding the anus is the lowest area within the pulmonary system that moves blood from your liver to your heart, so gravity contributes to the pooling of blood and dilation of veins. Hemorrhoids are usually caused when you have constipation and apply muscular pressure to your bowels. Other factors can increase pressure as well, including sitting for long periods of time on the toilet, obesity, pregnancy, chronic diarrhea, anal sex and heavy lifting. About one-third of Americans develop hemorrhoids. Half of all men will develop hemorrhoids by age 50, reports CBS Money Watch.
Not all hemorrhoids are painful. Hemorrhoids that develop deep inside the anal passageway usually are painless or trigger only mild discomfort. External hemorrhoids that develop on the rim of the anus tend to cause more pain. Usually small, these dark red or purple masses can grow to be the size of a golf ball. Symptoms can include pain, tenderness, discharge of blood or mucous, itching or a lump in the anus. If you develop any of these symptoms, consult with your doctor to make sure to you don't have any other rectal diseases.
Males are at greater risk for hemorrhoids and your risk increases as you age. Riding a bike should not increase your risk of hemorrhoids. Those who are fit and physically active have a lower risk for hemorrhoids. Exercise improves muscle tone and increases blood flow, delivering nutrients and oxygen that decrease inflammation and strengthen rectal veins. Biking, along with other forms of exercise, can actually reduce your chances of developing hemorrhoids.
Once you have hemorrhoids, bicycling can cause discomfort, depending on how large and inflamed the hemorrhoid is and on how you sit on the saddle. If you have a properly sized saddle, you should be sitting on the sitz bones, two aptly-named bones that protrude from the pelvis. These two bones are biologically designed to direct pressure away from your anus and the pudendal nerve that travels between the sitz bones toward the external genitals. When you sit on your bike seat, you should be placing pressure on the sitz bones and not on the fatty tissue, pudental nerve or anus that lie between. Of course, if you have a particularly large or inflamed hemorrhoid, you can have pain even when seated on a regular chair, so your bicycle saddle may also cause discomfort.
What to Do
First off, treat the underlying problem. Speak with your doctor about diet and medicine that can help improve and prevent hemorrhoids. For short distances, try repositioning yourself so you perch more weight forward on your legs and arms. For a longer term solution, try different saddles and seats to find the kind that provides you the greatest comfort. You might think that a heavily padded seat or a gel seat would be most comfortable, but in fact the padding can place additional pressure on the fatty tissue and on sensitive areas. You might be best off finding a firm leather saddle. Alternatively, try a broader seat that gives you a larger space on which to position your perhaps wider-than-usual sitz bones. Also, consider getting a split saddle seat. These bike saddles, available online in many bike shops, have a split down the middle that might help you ride tall in the saddle once again.