Questionnaire Bicycle Seat Pain

Questionnaire Bicycle Seat Pain
This questionnaire serves the purpose to collect information that will allow us to better understand
the occurrence of sitting bone pain when cycling. Participation is voluntary. Evaluation is performed
exclusively by the two doctors named below, who are involved into competitive cycling for decades
and obliged to maintain confidentiality. Any publication of data will be an anonymous form.

The questionnaire is filled in online or offline, and the completed questionnaire is sent via the user’s
email. Because of this the evaluating doctors will be able to see the sender’s email address. The
doctors respect your privacy. Hence 2 preliminary questions:

I am happy to be contacted regarding medical                 I would like a summary of the results
queries that arise from my questionnaire.                    once the study has been completed.
   Yes                                                          Yes
   No                                                           No

                           Questions can be sent to bsp@sportsmedicalcoaching.com

          Stefanie Mollnhauer                                                  Dr. med. Florian Wenk
            www.pro-formance.de                                             www.sportsmedicalcoaching.com
                                                                                  dr.florianwenk.com

General information
Gender                            Ethnic                                                    Years of Age
   Male
   Female

Height (cm)            Weight (kg) during racing season                Weight (kg) in off-season

Years of experience in competitive cycling

Main focus on                                          Other cycling disciplines participated in
                                                          Road
                                                          Cyclocross
                                                          MTB
                                                          Triathlon
                                                          Other (please specify)

Lifetime kilometres cycled                             Kilometres cycled in the previous year

I suffer(ed) from bicycle seat pain
   No, luckily never (please continue filling in this questionnaire)
   Yes, in the past (please specify)
   Yes, at the moment (please specify)
   Yes, regularly (please specify)

Here, you can voluntarily specify your health problems. To be able to reply, there is a possibility
to provide us your email address (confidential).

Email address (confidential):

Riding style

Preferred cadence (revolutions per minute)              Preferred cadence whilst time trialling
whilst training                                         (resp. self-paced racing)

Do you climb out of the saddle?
   Yes, generally already on short rises
   Yes, on longer climbs from the beginning on
   Yes, on longer climbs in the 2nd half of the climb
   No, not generally
   Other (please specify)

Equipment
Saddle used on road bike (please name brand & type):

Saddle used on MTB (please name brand & type):

Saddle used on TT bike (please name brand & type):

Type of pedal / cleat system:                           Cleat movement:
                                                           fixed cleats
                                                           floating cleats

Preferred brand / type of bike shorts:

Preferred chamois design:                               For female riders only: Using a
   extra-thin (e.g. like in triathlon suits)               special female (slim) chamois
   thin                                                    design
   mid thickness                                           unisex chamois design
   thick

Use of customized insoles

Professional bikefitting performed?                      Bikefitting performed
                                                            without pre-existing bicycle
                                                            seat pain?
                                                            because of bicycle seat pain?

Did the bikefitting include a saddle pressure testing?
   No
   Yes

Did the bikefitting include a foot pressure testing?
   No
   Yes

Did the bikefitting lead to a complete loss of bicycle seat pain?
   Yes.
   Yes, partially. (Please specify below)
   No changes.

Annotations:

Loss of training time because of bicycle seat pain?
   No
   Yes (please specify)

Has the bicycle seat pain been caused by riding a particular type of bike?
   No
   Yes (please specify)

How often do you suffer / have you been suffering from bicycle seat pain (number of times over
how many years)?

How did these present to you (please describe, and if known give diagnoses made)?

How long (how many days) did the complaint last for on each occasion?

How many days in total have you suffered from sitting pain from?

Did you loose training days?
   No
   Yes - please specify how long for on each occasion

How many days in total?

Do you have any underlying medical conditions?
   No
   Yes - please detail

What do you believe is causing these problems?

Primary prevention
What measures for primary prevention do you take?
   Daily washing of bike shorts (hygiene)
   Frequent local disinfection of perineal area
   Chamois cream (please specify brand & type)

Frequent trimming / shaving of local area?
   No
   Trimming
   Shaving (please specify, e.g. complete or partially like iro, perineum only, etc.)

How often do you trim / shave ( e.g. daily, every other day, etc.)?

Therapy
Did you independently treat / self medicate? If yes, what did you try? Please explain.

Did you see a healthcare professional?
   No
   Yes, a physiotherapist.
   Yes, a doctor (General Practicioner).
   Yes, a surgeon.
   Yes, an orthopaedist.
   Yes, other (please specify)

What did they recommend and was this effective?

Did they make any diagnosis, and how did they treat these?

Did they employ any physical treatments?
   No
   Yes (please specify below)

Annotations:

Did they employ any osteopathic or functional orthopaedic treatments?
   No
   Yes (please specify below)

Annotations:

Did you subsequently have a bikefitting?
   No
   Yes (please specify below)

Annotations:

How long did it take for this to make a noticeable difference?

Did you change your riding style?
   No
   Yes, please specify in what way:

Secondary prevention in the future
Once your sitting bone pain had improved, did you take futher measures to prevent recurrence?
   No
   Yes (please specify below)

Annotations:

Have you had further pain since?
   No
   Yes (please specify below)

If yes, of what nature and how severely?

Please submit this PDF file as an email attachment to
bsp@sportsmedicalcoaching.com - Thank you very much!

Feel free to contact us for further questions,                                Email address
or type your questions here:                                                  (confidential):