REF-1272 · Partin et al., 2012 · The Journal of Sexual Medicine · Paper · PubMed · Free full text

Should I raise my bar for saddle numbness?

Unproven: in 41 competitive women a bar below the saddle went with 3.47 kPa more perineal pressure and less genital sensation, but numbness was as common (63.6% vs 63.2%). Not tested.

Main caveat: Cross-sectional, one 40-60 s pressure recording on a trainer with power not controlled; bar height self-reported, not measured.
limited, mixed evidenceMeasured on trained athletes

Partin and colleagues (Texas A&M, Yale, NIOSH and Albert Einstein College of Medicine) reanalysed the 48 premenopausal competitive women cyclists from their earlier comparison of cyclists and runners — the same 48 women whose saddle designs are analysed in REF-1273.

Each rider brought her own bike and saddle, set as she usually rode, and pedalled at an even cadence on a Minoura MagTurbo trainer while a Novel Pliance pressure map recorded saddle pressure for 40-60 seconds; genital sensation was measured as vibratory thresholds (higher = less sensation) with a Medoc Vibratory Sensory Analyzer 3000 at eight sites supplied by the pudendal nerve.

Handlebar height was taken from the riders' questionnaire: 22 rode with the bar level with the saddle and 19 with it lower (5 with a higher bar and 2 who did not answer were excluded). Women with lower bars had higher mean and peak perineal pressures on bivariate analysis and higher thresholds at the anterior vagina (2.8 vs 2.0 microns) and left labia (3.0 vs 2.0).

Adjusted for age and saddle type, a lower bar went with 3.47 kPa (95% CI 0.24 to 6.70) higher mean perineal pressure; in the sensation model the anterior vaginal threshold was 0.86 microns (0.18 to 1.53) higher.

Total saddle pressure and the other six sensory sites did not differ, and about 63% of riders in both groups reported genital numbness, tingling or pain in the last month. The authors conclude that low handlebars are associated with increased perineal pressure and decreased sensation and that correcting such modifiable risks may protect the pelvic floor.

Our reading: a small, plausible signal on markers, in the same direction as the men's survey (REF-1268: a bar level with or above the saddle went with less numbness), but the symptom riders feel did not differ between the groups, and a single trainer measurement cannot show nerve damage.

Protocol

Design: cross-sectional secondary analysis of the 48 cyclists from Guess et al. 2006 (48 cyclists, 22 runners); IRB-approved; written informed consent. The same 48 women are analysed for saddle design in REF-1273.
Eligibility: premenopausal women cyclists aged 18 or older riding consistently, on average at least 10 miles a week (full text; the abstract adds "4 weeks per month" and "nonpregnant").
Exposure: handlebar height self-reported on a non-validated cycling-history questionnaire as level with, lower than or higher than the saddle; higher (5) and missing (2) excluded a priori; analysed n = 41 (22 level, 19 lower); no significant differences between the 41 and the 7 excluded (data not shown).
Saddle pressure: own bike and saddle on the trainer in the usual position, even self-chosen cadence, 40-60 s at 20 Hz; power output not controlled; mean and peak perineal and total saddle pressures (kPa) analysed with custom Labview software.
Genital sensation: vibratory thresholds in microns by the method of limits at the clitoris, left and right perineum, anterior and posterior vagina, left and right labia and urethra.
Other variables: percentage of time seated, shock absorbers, saddle firmness, staying seated on rough terrain ("rough sit").
Analysis: t-tests, chi-squared or Fisher's exact tests; multivariable linear regression with handlebar level as the predictor, adjusted for age and saddle type (traditional nosed vs cut-out) per the Methods; Stata 11; two-sided p < 0.05.
Riders (Table 1, level vs lower): age 37.8 ± 6.4 vs 34.5 ± 6.5 years; miles a week 95.0 ± 87.1 vs 115.0 ± 64.9; hours a week 7.8 ± 6.1 vs 8.4 ± 4.4; cut-out saddles 38.1% vs 50.0%; time seated 91.6% vs 93.1%; none different.
Funding and interests: the full text's funding field names the National Center for Research Resources (UL1 RR024139); the PubMed and Crossref records add NICHD 5K12HD047018 and the Robert Wood Johnson Foundation. "Conflicts of Interest: None." Four authors were at the National Institute for Occupational Safety and Health (a US government institute) and one lists Alaska Urological Associates, Anchorage, AK; no saddle or bike-fit company is among the authors or funders.

Key Results

Genital vibratory threshold, microns (bivariate)Bar level, mean (SD)Bar lower, mean (SD)p
Anterior vagina2.0 (0.86)2.8 (1.15)0.02
Left labia2.0 (0.9)3.0 (1.8)0.03
Six other sites——not significant
Multivariable model (n = 38)Bar lower than the seat, coefficient (95% CI)p
Mean perineal saddle pressure, kPa (with age and saddle type; adjusted R² 0.2905)3.47 (0.24, 6.70)0.036
Anterior vaginal threshold, microns (Table 4 lists bar level and age only)0.86 (0.18, 1.53)0.014
Saddle type in the pressure model: a traditional (nosed, no cut-out) saddle went with lower mean perineal pressure than a cut-out, −3.17 kPa (−6.31, −0.04), p = 0.048 — the same direction as REF-1273.
Left labial sensation was non-significantly lower after adjustment (p = 0.07). Total saddle pressure was not associated with bar height.
Symptoms: genital numbness in the last month 63.6% (bar level) vs 63.2% (bar lower), p = 0.98.
Age: in the youngest age group 80% rode with the bar below the saddle, in the oldest 80% with it level; age lost its association with pressure and sensation once bar height was in the model.
Numbers that do not add up: the abstract says the sensation result was adjusted for age and saddle type with P < 0.01, but Table 4 lists only bar level and age and gives p = 0.014; the bivariate perineal pressure values appear only in Figure 1 (an image, not read).

Mechanisms

Measured: a bar below the saddle went with higher perineal (not total) saddle pressure and a higher anterior vaginal vibratory threshold.
Authors' interpretation: a low bar makes the rider lean forward, lowering the trunk angle and tilting the pelvis forward, which moves weight from the sit bones onto the perineum; bar height and a cut-out saddle may add up. They note that their companion analysis found no link between saddle pressure and sensation (REF-1273), so the bar may act on sensation by another route, or the pressure method may be too insensitive.
Inference: younger riders more often had low bars and age and bar height moved together in the models; with 38 riders the two cannot be cleanly separated.
Inference: a single resting sensory test after a short ride cannot show nerve injury, and the threshold difference did not show up as more reported numbness.

Practical Application

Should I raise my bar for saddle numbness? Unproven: in 41 competitive women a bar below the saddle went with 3.47 kPa more perineal pressure and less genital sensation, but numbness was as common (63.6% vs 63.2%). Not tested.
A bar level with the saddle is a low-cost change to try for saddle-area numbness or discomfort. Not from this paper; the base's own practice. The paper links a lower bar to higher perineal pressure and one higher vibratory threshold, not to more numbness (B-, cross-sectional, markers); the men's survey links a bar level with or above the saddle to lower odds of numbness and sores (REF-1268). The authors name the aerodynamic advantage of a lower bar as the trade-off.
Do not promise it will remove the numbness: about 63% of these riders reported numbness, tingling or pain in the last month whatever their bar height.
Saddle choice matters too: in the same women a cut-out saddle went with higher perineal pressure than a solid nosed one (REF-1273).
See a clinician. Not from this paper; the base's own practice: numbness that lasts after rides or keeps returning, persistent labial swelling, or pain with sex goes to a clinician; the assistant does not diagnose.

Limitations

Cross-sectional, one 40-60 s pressure recording on a trainer with power not controlled; bar height self-reported, not measured.
Same sample as [REF-1273]: the two papers are not independent evidence.
Small: 41 analysed, 38 in the models; no power calculation for this subanalysis (the authors' limitation); riders with a bar above the saddle were excluded.
Markers, not symptoms: pressure and vibratory thresholds differed; reported numbness did not; all women had normal sexual function in the original study (the authors' statement).
Selection: the authors note a possible selection bias — women uncomfortable with their body, or without neurological symptoms, may not have been motivated to take part; mostly normal-weight, experienced riders. How the original 48 were recruited is described in the 2006 paper, not here.
Reporting: the abstract and Table 4 disagree on the adjustment and p-value for sensation.
Funding and interests: NIH (NCRR, NICHD) and the Robert Wood Johnson Foundation; no conflicts declared.
How this entry was checked and changed
Why this level

the rubric's B row for a cross-sectional study, lowered one step: the outcomes that differed are markers (perineal saddle pressure in a 40-60 s trainer bout, genital vibratory thresholds), the rider's own symptom (genital numbness in the last month) did not differ, handlebar height was self-reported in two categories, n = 41 (38 in the models) with no power calculation for this subanalysis, and the abstract and Table 4 disagree on the adjustment for genital sensation. Read from the full text (PubMed Central author manuscript, the repository copy listed by OpenAlex; Europe PMC's full-text service returned no copy)

Full text (checked 2026-10-27)
Subanalysis of the cyclists from the original study of female cyclists (n=48) and runners (n=22); 7 subjects (5 with the bar higher than the seat, two without an answer) were excluded a priori, decreasing the sample size from 48 to 41 (full text)
Women who rode with handlebars lower than the seat had a 3.47 kPA increase in mean perineum saddle pressure: coefficient 3.47 (0.24, 6.70), p 0.036, adjusted R2 = 0.2905, N=38 (full text)
Anterior vagina vibratory threshold, bar lower than seat: 0.86(0.18, 1.53), p 0.014, model F(2, 35) with handlebar level and age, N=38 (full text)
Bivariate thresholds, level vs lower: anterior vagina 2.0 (0.86) vs 2.8 (1.15), p 0.02; left labia 2.0 (0.9) vs 3.0 (1.8), p 0.03 (full text)
Numbness in the last month: 63.6% vs 63.2%, p 0.98 (full text)
Traditional saddle in the pressure model: −3.17 (−6.31, −0.04), p 0.048 (full text)
Conflicts of Interest: None; funding field National Center for Research Resources UL1 RR024139 (full text)