Your testicles can be easily injured because of their location — hanging down outside your body, inside your scrotum, which makes them vulnerable to being injured by a blow or crushing pressure, according to the American Urological Association (AUA). Common symptoms are testicular pain and swelling.
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"One way that you can injure your testicles is by cycling or bike riding," says Ryan Berglund, MD, a urology specialist at the Cleveland Clinic. "Long-distance cyclists and mountain bikers are at higher risk than recreational riders."
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Nerve Injury and Trauma
"The No. 1 cause of pain felt in the testicles after cycling is nerve pain," says Dr. Berglund. "The pain comes from irritation of the pudendal nerve that goes to the scrotum, rather than injury to the testicle itself. This type of pain is more common in long-distance riders due to the riding position and the saddle."
According to Ochsner Health, this type of pain and numbness in the scrotum and groin area is called "cyclist's syndrome" and is pretty common in cyclists and triathletes, affecting about 60 percent of male cyclists. Using a wider saddle and changing to a more upright riding position can help, Ochsner notes. But keep in mind that, if you're having pain now, you may have to decrease your riding time until the pain subsides.
A very bumpy ride or accident could lead to other issues.
"Mountain bikers can cause damage to their testicles from the shock absorbed during biking," Dr. Berglund says. "They may be at higher risk for testicular trauma or testicular torsion."
Testicular trauma can occur if your testicle is crushed or bruised. The covering of the testicle can be torn and blood can leak into the scrotum, notes the AUA. "The scrotum may be swollen and black and blue," adds Dr. Berglund. "If the covering of the testicle is badly torn, the testicle may rupture."
If ultrasound imaging shows a severely damaged testicle, surgery may be needed, according to the AUA. For a less serious injury, the treatment may be pain medication and support of your scrotum with an athletic supporter.
Testicular torsion occurs when the testicle twists and constricts the cord that attaches the testicle to its blood supply inside the scrotum, which can cut off blood supply to the testicle, explains the Cleveland Clinic. "Testicular torsion causes sudden and severe pain," Dr. Berglund says. "It requires immediate medical attention to prevent loss of the testicle."
What About Cancer?
According to the American Cancer Society (ACA), cycling is not included in the risk factors for testicular cancer. ACA says that injury or trauma to the testicle due to similar activities, like horseback riding, do not seem to increase the risk for testicular cancer. Two risk factors for testicular cancer are having an undescended testicle, meaning a testicle that has not moved down into the scrotum, and having a family history of testicular cancer.
"Testicular cancer does not usually cause testicular pain," Dr. Berglund says. "If you find a lump on your testicle, whether it is painful or not, you should let your doctor know. Testicular cancer is the most common cause of a cancerous tumor in men ages 15 to 45."
Other Causes of Testicular Pain
"You may have testicular pain after riding a bike that has nothing to do with cycling," Dr. Berglund says. "A common cause is infection called epididymo-orchitis, which is an infection of your epididymis and testicle."
According to the Urology Care Foundation, infection of the coiled tube where sperm is stored, called the epididymis, and the testicle can occur on one or both testicles. Infection of a testicle, called orchitis, can spread to your scrotum from the urethra, which is the tube that carries urine out of your body from your bladder.
The foundation notes you may also have other symptoms of infection, such as fever, pain when passing urine, a frequent urge to urinate, blood in your urine or pain in other areas of your belly or anus. In this case, antibiotics may be called for.
Infection is a common cause of testicular pain, so let your doctor know if you have any of these signs of infection.
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Is This an Emergency?
- American Urological Association: “What Is Testicular Trauma?”
- Ryan Berglund, MD, urologist, Cleveland Clinic, Ohio
- Ochsner Health: “Cyclist's Syndrome: You Can Prevent Tailbone Injury”
- Cleveland Clinic: “Testicular Pain”
- American Cancer Society: “Risk Factors for Testicular Cancer”
- Urology Care Foundation: “What Are Epididymitis and Orchitis?”