A lump in the groin area is known as an ischial hygroma, sometimes referred to as the ‘cyclist’s third testicle’. This is a fluid-filled cyst which is formed under the sitting bones in the tissue between the skin and the bone. A combination of pressure and forces causes the connective tissue to necrose (die) and form a sac-like area that is filled with fluid debris (a cyst). This can eventually enlarge to a few centimetres in size and can become very painful to the touch, making cycling difficult.Further complications could occur through the spread of bacteria to this cyst via the blood. Once infected, a large abscess can form. This is obviously even more painful and can stop the hardest rider in their tracks. Ask Robert Hunter, who had to pull out of the Tour de France while within sight of the Eiffel Tower after having to stand for virtually the whole distance in the final individual time trial.
A small ischial hygroma will settle if rested completely and may never recur. However, if it is well formed and large, the cyst will be walled off and will not disappear with rest. At this point, you will need the help of a general surgeon. They will need to fully excise the cyst to prevent it from recurring. You will then need to rest for two weeks to allow the wound to heal.
Follow these steps to prevent saddle sores to reduce the risk of the painful blight recurring.
Dr Jeroen Swart is a sports physician and exercise physiologist at the Sports Science Institute of South Africa.
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