Let’s not forget the hazards of sports such as cycling

Over the years doctors have identified dangers in virtually every form of sport, from musculoskeletal disorders to erectile dysfunction

Despite the indubitable benefits of strenuous exercise, fitness enthusiasts are prone to a host of ailments catalogued, without a hint of irony, in the 800-page (!) Oxford Textbook of Sports Medicine: diverse injuries to bone and muscle, debility from over training, susceptibility to viral illnesses and sudden death. Such hazards are an inevitable consequence of the internal dynamic of competitive sport epitomised by the Olympic Motto ‘Citius, Altius, Fortius’ – Faster, Higher, Stronger – where ever more rigorous training schedules have pushed the limits of human performance beyond their natural boundaries.
Over the years doctors have identified dangers in virtually every form of sport including, perhaps surprisingly, cycling. In its early days they were concerned that, as The BMJ put it around a century ago, “the friction produced by the saddle can prompt sexual impulses in women we need not particularise”. And, for good measure, damage to the heart: “Cycling can cause dilation of the heart from thickening of its walls that all should view with apprehension”.
It was eventually conceded that such ‘apprehensions’ were unwarranted but with the burgeoning popularity of cycling its potentially adverse consequences are increasingly recognised – particularly amongst those dubbed pejoratively as Mamils (middle-aged men in Lycra). Most predictably are musculoskeletal, whether traumatic from coming off one’s bike at speed (such as fractures of the wrist and clavicle), “overuse injuries” of the knee and ankle, and “cyclist’s spine” resulting in neck pain and sciatica.
Two novel cycling-related syndromes in particular have been much commented on – both related to pressure of the saddle on the perineum, the region of the body that runs from the anus to the sexual organs. In a survey of male participants in a 350-kilometre cycle race, almost a third subsequently reported numbness of the penis and ‘erectile dysfunction’ lasting up to a week, attributed to prolonged compression of the pudendal nerve and artery.
The prostate gland too is located in close proximity to the perineum whose irritation when cycling can predispose to an inflammatory prostatitis resulting in pain on urination. Reassuringly however, the claim in a study from London’s Kings College a decade ago that cyclists are also at increased risk of prostate cancer – highlighted by Olympic cyclist Sir Chris Hoy’s diagnosis with the condition – turns out to be unfounded.
Finally, and further to the heated spoon remedy for the relief of painful, itchy insect bites, as recently mentioned in this column, several have commented on how a blast of hot air from a hairdryer is similarly beneficial. “Hold the nozzle a little distance from the skin for about 20 seconds” advises one woman, “family members can help when the bite is on a part of the body difficult to access oneself”.
Next a reader describes a comparable manoeuvre for alleviating wasp stings he was introduced to in the Dordogne where it is apparently common practice, even for non-smokers, to keep a pack of cigarettes and matches in the glove department. “When stung a cigarette is lit and held as close to the bite as possible until it has burnt its entire length – the heat generated prevents the venom from spreading”.
Interestingly heat may also counter the chronic itch of skin conditions. “My son, now in his 40s, has suffered from eczema since infancy with the back of his hands particularly badly affected” another reader reports. When the itching is particularly troublesome he has found it can be relieved by immersing his hands in very hot water. A couple of years ago she herself developed a very itchy skin rash eventually diagnosed as “consistent with nodular prurigo”. Prompted by her son’s experience she has found regular hot showers to be similarly efficacious.
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