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> During cycling, repetitive impacts generate extreme perineal pressure leading to increased friction in the pudendal canal and compression from the surrounding muscular (levator ani, obtruator internus, and piriformis) and ligaments structures (sacrospinous and sacrotuberous).2,10,11
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>This constant pressure can lead to loss of gliding of the PN putting it at risk for entrapment.2,10,11 Also, the biomechanical position adapted while cycling, forward lean posture with arms on the aerobars of the bike, further increases the compression in the perineal region due to pressure from the nose of the saddle.2,10,11
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>This chronic perineal microtrauma results in the pathophysiological changes mentioned above.2
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