A painful injury that cyclists sometimes have to deal with is the so-called ‘third ball’. What starts with a small pimple in the buttocks grows into a real egg in no time due to pressure and friction. This makes sitting normally on your saddle virtually impossible. Those who really want to continue cycling often use an anesthetic cream and disinfectant ointment and possibly a special (open) saddle. However, the best treatment still remains surgery to remove all the pus, followed by rest.
What is a third ball?
Cyclists do not only suffer injuries from falls. A painful cycling injury caused by sitting on a saddle for hours on end is the so-called ‘ third ball ‘. In medical terms, this is a pseudocyst with central fibrinoid necrosis (a subcutaneous accumulation of dead cells) around which stiff connective tissue forms and which may cause edema or inflammation. This condition can occur due to friction of the skin of the perineum between the sit bones and the bicycle saddle. The condition usually starts with a furuncle, also called a boil or boil in technical jargon. That little pimple can grow into quite an egg in no time. The necessary friction quickly arises when cycling, but usually only causes problems when you do this for a long period of time. The ‘third ball’ therefore occurs regularly among professional cyclists, but also among people who take long recreational tours on a racing bike.
The third ball in professional cycling
Many cycling professionals have had to deal with this condition during their career. It is said that Laurent Fignon lost the Tour de France in 1989 when he was unable to perform optimally in the final time trial and gave up a few seconds at the last minute to the number two in the rankings, Greg Lemont. Riders such as Joop Zoetemelk, Jan Raas, Erik Dekker, Bram Tankink and Oscar Freire can also talk about it. They have all had to ride the Tour de France with a painful bottom and sometimes even got off because of it. It can actually be seen as the cycling version of RSI, a kind of occupational disease.
Dealing with a third ball
Professionals who get these kinds of problems with their buttocks in the middle of a big round use the strangest remedies to treat it. For example, laser treatment and various types of creams are sometimes used, including udder ointment, anesthetic ointment with lidocaine or disinfectant cream with trouser grease. It is especially important to properly disinfect the skin after a long effort to prevent inflammation.
The only real solution for a third ball is a surgical procedure where the ball is cut open to drain all the pus and remove the dead tissue. Afterwards, one must rest for at least a week.
Prevent third ball
The occurrence of a third ball seems to occur more often with some riders than with others. Various factors play a role in this. For example, it has to do with the thickness of the skin of the perineum and the extent to which someone perspires. The degree of hairiness in that spot can also be a factor. The more hair, the greater the chance that inflammation will occur. The culprit is usually a capillary or hair follicle that becomes inflamed.
The most important factor in preventing a third ball is still good material. This concerns the saddle, clothing and the adjustment of the bicycle. It is important that the saddle shape is properly adjusted to the rider. Some cyclists may benefit from using an open saddle , gel saddle or a saddle specially made for the prevention or use of saddle pain. It is also important to wear good seamless cycling shorts with a chamois. Anyone who goes on long tours without cycling shorts with chamois or pressure-distributing padding is asking for problems.
Finally, the overall condition of the body is a factor. Anyone who sits on a racing bike for a long time must be well trained. If your core muscles are not optimally trained, this can lead to the pelvis tilting forward too much while cycling. This increases the risk of overuse injuries, including the third ball.
