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Saddle sore gone bad.. advice needed
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If you think you may have an infection in the taint. go to a doctor immediately ask for bactrum not keflex. I came a bit too close to having a really bad staf infection in an area i didn't want one... the keflex kinda worked but most docs i talk to say bactrum or similar would have been better. i am on bactrum right now for the next month or more..



Here is the story, ill try and be short. small saddle sore went to doc told him to only numb it and drain it give it a steroid injection, (this is my go to it works everytime and fast), he instead cut it out. really small and then burned it to seal it up didn't ask me i was bugged.
Next kept riding but never felt better, so i went to my normal dermatologist a few times for drain and steroid. no big deal but still annoying and small noraml saddle sore but painful. weeks go by i think now we are at week 4 and 3 doctor trips, so i poke it myself to try and relieve the pressure. well that doesnt work because within probably a day or two I now have a huge swollen area my derm is out of the office so my noraml doc gives me a antibiotic, i take it and it keeps me off the bike for 4 days, i take the keflex for 14 days, and near the end of the fourteen days the sore forms a head (i never had a real head before just a bump).
So here we are today I have two weeks or a bit less of weeping out of the wound now with clear or red stuff and recenlty eye buger stuff in tiny amounts, and a 3 inch long tender area that goes bigger and smaller depending on if i just rode 5 hours on gravel or not. really pretty bad, but also something i can almost handle on 2 hour rides. the 5 hour stuff eek that was a bit rough, but hey i can probably do that again too. i am messed up.

So the question for those that have fought this before is can i fight this and keep riding through the pain for another month and probably heal up, or do i absolutely have to stop riding, like of course the doc says... haha lets here your experiences. and yes i keep it clean, all the time, do bag balm, do boil ease, ect.. shorts are clean.. thanks in advance
Last edited by: Cookiebuilder: May 7, 20 8:39
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Re: Saddle sore gone bad.. advice needed [Cookiebuilder] [ In reply to ]
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Cookiebuilder wrote:
a 3 inch long tender area

3 inch long???

Two wheels good. Four wheels bad.
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Re: Saddle sore gone bad.. advice needed [DrTriKat] [ In reply to ]
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yah three inch long and thick pencil size. oh and after a good long ride a bit bigger. haha
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Re: Saddle sore gone bad.. advice needed [Cookiebuilder] [ In reply to ]
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Wow. Just wow. Impressive. Anything larger than an inch should at least be given a nickname.

But joking aside, doesn't sound like that bad boy gonna resolve without medical attention.

If you can find a designated non-Covid urgent care/ER (we have one like that in my neighborhood), you should have it looked at, they usually have ultrasound and that can help identify if there is fluid in there to drain, or if it's a superficial blood clot (thrombophlebitis) or something else.

Two wheels good. Four wheels bad.
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Re: Saddle sore gone bad.. advice needed [Cookiebuilder] [ In reply to ]
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You have Pilonidal Cysts. When most people talk about saddle sores they aren't talking about full on subdermal cysts. I shouldn't say that for sure as I am not a medical doctor but from your description and the doctors behavior its pretty clear.

There is no golden bullet here as even surgery to remove a cyst doesn't guarantee another won't come back after more riding. One theory about they form is direct and repetitive trauma while sitting so a 5 hour gravel ride is a pretty good direct cause. Middle aged men also just seems to be more prone to them than other groups. The thing to avoid is trying to drain them yourself as you already found out. They are easily infected and its difficult to drain them yourself in a sterile manner. The second thing you want to avoid is ignoring an infected cyst. You can end up with sepsis and permanent damage if you don't treat the infected area.
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Re: Saddle sore gone bad.. advice needed [scott8888] [ In reply to ]
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a pilonidal cyst is almost always located in the midline by the tailbone, so a position that would not contact the saddle at all (unless you are in the supertuck, it will hit the seatpost.) So i doubt this is a pilonidal unless it is in that position, and if it is, your doctor should have told you what it was because it typically recurs. Problem is saddle sore is a non-medical term which could mean anything from chafing to folliculitis to abscess. this definitely sounds like an abscess, with or without cellulitis. if it has gone on for weeks and is now at least 3 inches, i agree with above , you need to get looked at in an ED or by a surgeon. this may be above the ability of your typical urgent care. based on the size , time frame, and failure of previous treatments this sounds like may be a more complicated abscess, and there are a lot of important structures "down there" so as i said before ED or general surgeon would probably be best.
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Re: Saddle sore gone bad.. advice needed [Cookiebuilder] [ In reply to ]
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Well I am a doctor and I have suffered badly through my last IM training block with saddle sores of various sizes and seriousness.
A few things to clarify....where is this bugger located? Is it freely draining at the moment? How tender is the swelling to touch at the moment?
In terms of whether you can ride on it or not, at the moment I would say that is a big no sorry. Not with how it is presently. Once my nasty ones have been draining nicely then I would ride again but I would often need a few days off it before I could ride.
Antibiotics can be a bit hit and miss with these....often if there is an abscess the antibiotics won't do much except for reduce any surrounding infection, you just really need it to be draining nicely and then it will clear up quickly.
As to why these are happening....I would love to have clear answers....I tried everything to stop mine from coming on without much luck.
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Re: Saddle sore gone bad.. advice needed [Cookiebuilder] [ In reply to ]
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You are ignoring the advice of people who have been to medical school and know this topic very well, and seeking advice from an online forum of athletes. Your behaviors have made this much worse than it needs to be. It sounds like at least an abscess, and very possibly cellulitis. This can be an extremely destructive infection if not attended to quickly (and correctly) and you're currently going in the wrong direction. Some strains of bacteria are quite resistant to antibiotics; fortunately the more common infectious entities can be treated. If you are in or near a metropolitan area, you need to see a wound care specialist. They will likely get a sample of the goo and do a "C&S," which stands for Culture and Sensitivity. This will tell them exactly what bacteria are growing and what antibiotics they are sensitive to. It takes a few days to get the results. Meanwhile, STAY OFF THE BIKE, before you do any more harm. What can you possibly gain by more riding at this point? What you are risking is significant damage to structures you really don't want damaged, any more than they already are.
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Re: Saddle sore gone bad.. advice needed [Amnesia] [ In reply to ]
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it is in the left side crease of the leg and in the center of the whatever you call it area in the middle... i went to urgent care today and they sqoze out puss and gave me a antibiotic again, not keflex, one that hits mrsa too. they took a culture for the lab. it drains free like using maxi pads from my 12 year old daughter haha. aches all day hurts to touch and walk. I am thinking ill not ride till i see good improvement, and then on a saddle that i hack a big chunk out of so nothing puts pressure there.
my brother is a doc in another state so can't see the thing but he thinks the anti biotics are not super helpful either, with the caution that i really don't want a nasty infection down there for obvious reasons..

i was mostly asking the forum to see if people would say they did all this and then still had to get it cut out, or they had it drained in a certain way and did blah blah and it worked ect.
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Re: Saddle sore gone bad.. advice needed [Cookiebuilder] [ In reply to ]
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Cookiebuilder wrote:
it is in the left side crease of the leg and in the center of the whatever you call it area in the middle... i went to urgent care today and they sqoze out puss and gave me a antibiotic again, not keflex, one that hits mrsa too. they took a culture for the lab. it drains free like using maxi pads from my 12 year old daughter haha. aches all day hurts to touch and walk. I am thinking ill not ride till i see good improvement, and then on a saddle that i hack a big chunk out of so nothing puts pressure there.
my brother is a doc in another state so can't see the thing but he thinks the anti biotics are not super helpful either, with the caution that i really don't want a nasty infection down there for obvious reasons..

i was mostly asking the forum to see if people would say they did all this and then still had to get it cut out, or they had it drained in a certain way and did blah blah and it worked ect.

OK that is sounding promising from your side. If it is now freely draining it is likely to self resolve pretty quickly. The antibiotics will help a bit but the key thing is for it to be draining pretty well. I find that once it starts to drain well it only takes 24-36 hours for the pain to really settle down, a few more days for the swelling etc to go and you should be able to be back on the bike once the pain is a lot better. They are friggin sore to squeeze pus/goo out of normally, as long as there is a decent opening it should hopefully drain pretty well. I would definitely avoid seeing a surgeon to have things cut out (I know this from experience, a friend is a general surgeon and cyclist and does not go near them as it can cause all sorts of additional problems), obviously if it needs help with draining then a bigger cut is good, or a formal opening in theatre and drainage there, but I think you are on the right track.

Feel free to message me directly if you want to discuss it further.
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Re: Saddle sore gone bad.. advice needed [Cookiebuilder] [ In reply to ]
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agree with what amnesia wrote. one thing we see a lot of bouncebacks for are an insufficient incision. typically 1/3 -1/2 the length of the fluctuant area. so in your case the incision could possibly be 1-1.5 inches in length. often times when someone goes to "provider" who doesn't perform I&D that often they get a tiny cut or just a needle poke. it drains for a few hours but then seals back up, and the infection re-accumulates. an adequate cut prevents this from happening.
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Re: Saddle sore gone bad.. advice needed [jflan] [ In reply to ]
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One trick I have learnt with these buggers (before they get to this point) is to use corn rings.
I place one with the donut over the pressure pour , and use medical tape to hold it down better.

Works a charm, both early in to stop them getting bad, or at the end to get you in the bike without concern for re-injuring.
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Re: Saddle sore gone bad.. advice needed [Cookiebuilder] [ In reply to ]
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Cookiebuilder wrote:
So here we are today I have two weeks or a bit less of weeping out of the wound now with clear or red stuff and recenlty eye buger stuff in tiny amounts, and a 3 inch long tender area that goes bigger and smaller depending on if i just rode 5 hours on gravel or not. really pretty bad, but also something i can almost handle on 2 hour rides. the 5 hour stuff eek that was a bit rough, but hey i can probably do that again too. i am messed up.

Um, maybe take some time off? Like a month and let your body heal itself. Doing 2-5 hour rides and expecting saddle sores to get better isn't very logical. Might want to figure out the cause of the sores also, old/bad shorts, saddle, poor hygiene, etc.
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Re: Saddle sore gone bad.. advice needed [Cookiebuilder] [ In reply to ]
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Here is the secret cure. Ready......wait for it.......BOOM!!!!! (stop riding until you heal)
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Re: Saddle sore gone bad.. advice needed [Cookiebuilder] [ In reply to ]
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Eddie B advised to sit in the sun with your t'aint up. He said it was good to get some sun to toughen the area up. I just liked ending rides by working on my t'aint tan.
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Re: Saddle sore gone bad.. advice needed [Cookiebuilder] [ In reply to ]
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Based on first hand experience, odds are it is MRSA. You need the correct antibiotic based on the culture test results. Once I had the correct antibiotic, I was only off the bike for 5 days.

However, it was misery for 6-8 weeks, as my primary care doc prescribed antibiotics that were ineffective. Once I was able to see my dermatologist (it took several days of pleading my case) she correctly diagnosed the condition and had me promptly on the road to recovery.

Good luck.
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Re: Saddle sore gone bad.. advice needed [Cookiebuilder] [ In reply to ]
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If you wish to keep riding during all of this I suggest you remove the saddle.
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Re: Saddle sore gone bad.. advice needed [Cookiebuilder] [ In reply to ]
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Cookiebuilder wrote:
yah three inch long and thick pencil size. oh and after a good long ride a bit bigger. haha

You sure you are not confusing it with something else?
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Re: Saddle sore gone bad.. advice needed [Muffin top] [ In reply to ]
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😆
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Re: Saddle sore gone bad.. advice needed [Cookiebuilder] [ In reply to ]
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Not what you want to hear but time out of the saddle is probably the solution. I had a saddle sore that turned into a cyst and had to be lopped off. I expected 7-10 days out of saddle but the stitches split, and it was very slow to heal. After 8 or so days I made it 2 minutes before turning around and heading home. Tried after another week and same. Ended up a month off but it healed, and I was able to get back to normal.

Side note: I had occasional issues well after from scar tissue. Whenever it flares up I soak in high concentration epsom salt bath and apply lots of OTC triple antibiotic until it goes away. I also frequently apply lotion to the undercarriage as a preventative measure.
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Re: Saddle sore gone bad.. advice needed [Cookiebuilder] [ In reply to ]
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I developed 2 nasty ones training for IMLP in 2017. Had to be incised and drained with wicking to keep it open for 3 days. I was off the bike a total of 7 days, which was enough for me to be able to resume my long training rides pain free and without reinfection.

I was prescribed topical Mupirocen.
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Re: Saddle sore gone bad.. advice needed [jflan] [ In reply to ]
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DO NOT google pilonidal cyst unless you’ve a very strong stomach...hope you’ve not got one of these but if so rest up and good luck on the recovery.
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Re: Saddle sore gone bad.. advice needed [Cookiebuilder] [ In reply to ]
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Cookiebuilder wrote:
my brother is a doc in another state so can't see the thing but he thinks the anti biotics are not super helpful either, with the caution that i really don't want a nasty infection down there for obvious reasons..

Ever hear of Zoom?

-- Scott
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Re: Saddle sore gone bad.. advice needed [Cookiebuilder] [ In reply to ]
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Update, weeks have gone by and I still have the open hole but it feels like the infection has drained mostly, but i still leak... I went to a new derm, he has me on Bactrum for the next month or so while it seals up and heals.
I think i wish i had been prescribed bactrum (better with msra) and not keflex and i wish they had given me the prescription for a month or more back on infection day one.
I cut a old road saddle and am riding 45 min now.
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Re: Saddle sore gone bad.. advice needed [Cookiebuilder] [ In reply to ]
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This whole ordeal sounds pretty intense and I really hope things are getting better. Have you consider the type of saddle or even the saddle height. When I first started riding I rode with my seat comically high and I gave myself a sore that could draw me to tears if it was even slightly touched. Over the years I have considerably lowered my saddle and utilize chamois cream. I don't have these sores anymore. So your anxiousness to ride is understandable, but you should certainly look to change whatever might have been causing the sore.

Best of luck, I'm sure it's hard to deal with something that just can't seem to heal.

Team Zoot 2023
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