Can You Ride A Bike With A Fissure: A doctors advice on getting back in the saddle


An anal fissure can be very painful, but some avid cyclists seem to be able to push through even death itself on their ride day. As a cyclist and doctor I thought that I might be well placed to look into the issue of riding with an anal fissure and seeing if it’s safe to cycle with one.

In general, cycling with an anal fissure is not advised as it can cause worsening pain, impair healing of the fissure or increase the chance of recurrence. You should ensure that you seek medical advice from a practitioner or doctor before restarting cycling with a fissure or even after the fissure has healed.

So cycling with a fissure is not recommended, but why is that? And if a return to cycling has been signed off by your physician, what tips can you use to make your return as easy as possible?

What is an anal fissure?

An anal fissure is a tear in the skin around your anal canal. These are typically very painful but most will heal within two weeks of basic treatment (although some can take much longer).

Before we go any further, I need to be clear. While I am a doctor, an anal fissure should be properly diagnosed by your own physician or doctor. Advise you read over the internet is not a replacement for actual medical advise. There can be many causes of anal pain or rectal bleeding, some of which can be serious and need to be properly checked out.

Before you even think about if you can cycle with an anal fissure, make sure you are doing all the basics as advised by your doctor. Following any dietary changes or hygiene advice they have recommended. Ask your physician about any lifestyle changes you should make.

This is the most important step. Listen to your doctor and give it time to heal. Rushing the stages here can lead to a chronic or recurrent anal fissure (one that does not heal properly or comes back).

Can you cycle with an anal fissure?

Studies done in mountain bikers have shown that long term saddle vibrations that occur in cycling may lead to chronic inflammation and anal fissures. As a result I would not be able to suggest cycling while you have an anal fissure, certainly in the acute stages.

While there have been no direct studies into cycling while you have an anal fissure, it could be suspected that this would impair the healing process, leading to a chronic fissure forming or leading to other complications.

Once the anal fissure has healed, it is possible that cycling will aggravate the area and could lead to recurrence, however this again has not been researched thoroughly.

For all of the above reasons, I can’t advise cycling when you have an anal fissure or even any time after you have been diagnosed unless you specifically discuss this with your medical practitioner. The information this article is based on is very generalised. Each case is specific and by seeking medical attention from a specialist or your family doctor (GP) you will be able to get more personalised advice from someone who has more of an understanding of your specific situation and other medical conditions.

What adjustments could you consider when cycling after an anal fissure?

If your doctor has signed you off for cycling following your anal fissure, there are a few key changes that you can make to make your return easier.

The saddle

First of all, take a look at upgrading your saddle. The saddle is the area of your bike that has direct contact with your bum and so a well fitting and comfortable saddle is key.

You should speak to your local bike shop who will be able to help size you for a proper seat and will even have a few test seats for you to try on your bike before you buy. Once you’ve decided, make sure to ask the shop to install it for you so that they can adjust it to your height while you’re in the shop. Some riders suggest a saddle with a cutout in the middle to reduce pressure.

Quite reasonably, some people presume a wider saddle will be better for cycling after an anal fissure, however the thick padded seats typically don’t work well. For any long distance rides the extra padding will move all of your weight onto the soft tissues of your leg and bum. These areas do not deal well with the extra pressure and so can result in rubbing or chafing.

A well sized and adjusted seat will put the weight on your “sit bones” where you body is designed to carry more weight.

Padded cycling shorts

Apart from a saddle, another key purchase is a good and well fitting pair of cycling shorts. These have extra areas of padding that will keep your pressure areas more protected. You don’t need to buy the most expensive pair of cycling shorts, but it is worth spending a little more on a mid-range pair as these are much more comfortable than the most budget options.

When buying cycling shorts make sure to get one with a “bib” such as this pair from gore wear.

If you are cycling long distances, cycling shorts can be a lifesaver, even if you don’t have any previous issues in that area. I for one wouldn’t leave the house on a cycle without one.

If you are only cycling while commuting, a pair of padded shorts is still worth it. They are lightweight, pack down into a small bag and you can easily change into and out of them in a toilet cubicle.

One final thing that I remind everyone who uses bike shorts, you don’t wear underwear under bike shorts!

Hygiene and creams

It is important to make sure you continue with the hygiene advice you will have been given when you were treating your anal fissure. Making sure that any effected areas remain clean and dry is important to ensure that the chance of fissure recurrence is reduced.

While I don’t personally use it, some riders suggest using Chamois cream when you do ride. This is an anti-bacterial cream that reduces friction. Chamois cream will reduce chafing and keep the area dry, reducing the risk of saddle stores. Some cyclists have suggested using this after an anal fissure to help protect the area however I can’t comment on its use.

Using a recumbent bicycle or feet forward bicycle

Recumbent bikes or feet forward bikes position the rider in a different position to a normal bike. On a recumbent bike you will be sitting in a much more upright but lower position.

This position means that you can sit on a much larger and more supportive chair, making it a common choice among disabled cyclists or those recovering from an injury.

For people recovering from an anal fissure, a recumbent bike can reduce pressure on your anal area and receive pain.

Overall

I hope I’ve made it clear by now, but you shouldn’t cycle with an anal fissure or even afterwards unless you’ve consulted with your doctor.

But once you’ve been advised you are able to cycle, there are a few key steps you can take to make your return easier and more comfortable.

If at any point you feel that your pain is recurring when you start cycling, it is possible that the cycling has exacerbated it and you should seek medical attention.

Mark Holmes

30-year-old doctor with an interest in cycling, bikepacking, and statistics.

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