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Unusual Saddle Sore - Advice Needed

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Unusual Saddle Sore - Advice Needed

Old 06-13-19, 04:27 PM
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Unusual Saddle Sore - Advice Needed

Ive had a saddle sore right near my groin for nearly 3 months. When it first occurred, I did ride on it for a couple of weeks when I should have stopped but I've been off the bike for over 2 months now. My bike is my sole means of transportation, so this is killing me.

I tried everything for it including hot compresses, epsom salt baths, turmeric, zinc oxide, hemmorhoid cream, witch hazel, hydrogen peroxide, black drawing salve (PRID and ichtyhmmol) and probably a few other things and nothing has helped. It has never come to a head and for the most part was not terribly painful except when I rode on it. About 3 weeks ago I went to urgent care to see if they could lance and drain it but the nurse said it was too hard to lance - she tried but only blood was coming out. She prescribed Doxycycline (an antibiotic) which I took for about a week with no results. I then went another urgent care a week later to see if they were able to drain it but was again told it was too hard to lance and this time was prescribed two antibiotics - Bactrim and Cephalexin. Those are both extremely strong antibiotics but they still didn't help my saddle sore, although it did reduce in size. At this point, it's not terribly large, but it's still there and in my experience, that means I can't bike.

Yesterday, I went to my doctor for his opinion - he checked the sore and said I should be able to bike right now with no problem as he thinks it has mostly healed and that the remaining bump is just scar tissue. Everything I've ever read about saddle sores indicates that the lump (or core) needs to be removed before you can even think of biking again or otherwise it will return. I asked my doctor about the core and whether it still being there could be an issue and he said my body will likely re-absorb it. I think this is possible since in the past, most of my saddle sores just went away with time off the bike - they didn't burst or anything. However, I don't know about the idea of biking while it's still a lump.

I live in Arizona and the summers here are brutal (it's 108 degrees today!) so I may well take the summer off for the most part since I don't want any more trouble down there, but I was thinking that if he thinks it's ok to ride, maybe I will at least take an occasional ride to see how it goes. But I wanted to get some feedback first if possible. Not having seen the sore of course, but based on what I've explained here, do any of you agree or disagree with his diagnosis, or have any additional input?

One other thing that was a little perplexing is - he said that if it returns, he will refer me to an OB/GYN (I'm female of course) and then they can look into removing it. I was confused by this - would an OB/GYN or any specialty doctor really be appropriate for something like this? I know it's in that region but boils can occur anywhere and it seems odd to me that a specialist would need to treat it.

Thanks in advance for any guidance. By the way, I've been biking regularly for nearly 10 years, so I'm no stranger to saddle sores, but in the past they have always gone away within a reasonable amount of time off the bike. This one is behaving a bit differently and has me scratching my head. And in the meantime, I miss biking like it was a dear lost friend and am in agony without it!
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Old 06-13-19, 04:32 PM
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I've had sores that have recedded but the hard lump doesn't go away until the winter and I can keep riding on it. If there isn't active inflammation and it doesn't hurt to the touch use a good cream to stop abrasion, consider new shorts and/or any fit issues with the saddle. Some sores are caused by chafing/movement and some are from excessive pressure. Sounds like you might be on the road to recovery and just start back slow and keep the area clean. Some days I end up taking 4 showers total between commutes to/from work and an evening ride.
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Old 06-13-19, 04:36 PM
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Thanks for your input - this is definitely reassuring to hear!
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Old 06-13-19, 10:54 PM
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If you haven't already done so, try a Lycra fabric covered saddle. Serfas makes these in various styles. I have an older Terry woman's road bike saddle with Lycra over dense foam in the style of a Selle Turbo saddle but with shorter nose; and a Bell comfort hybrid saddle with Lycra over thick but springy foam. Both are very comfortable in hot, sweaty summers, although I no longer use the Terry saddle because the nose was too short -- I tend to ride the nose for some situations and prefer the longer Selle Italia styles.

An alternative would be saddles with larger cutouts for perineum relief. A couple of cycling friends ride Infinity full cutout saddles, but say they aren't necessarily more comfortable. It's a fairly radical saddle, with no support for the sit bones, yet still has support in the perineum area. Seems like a clever solution to a non-existent problem, at least for me. I don't get sore spots on my ischial tuberosities, so cutting out that support wouldn't solve any problems I have. I'd rather have the perineum relief cutouts.

Try padded shorts, or a different brand. I'd suggest the Przewalski shorts or bibs with 3D pads on Amazon, only $15-$25. Outstanding values. The pads are unlike anything else I've tried -- thick, dense, resilient, with excellent wicking but never feel soggy. The surface feels unusually smooth with dimples like a golf ball. I prefer these shorts on my road bike with a firm saddle that has little padding.

If you prefer little or no padding, try Aero Tech Pro with their thin microfiber black and tan pads. It's about as thick as a terrycloth washcloth, yet comfortable. I wear these on one of my road bikes with a thicker padded saddle and more flexible shell.

I use hydrogen peroxide on my shorts pads, then handwash with long soaks in Tide Ultra Stain Release liquid. It's extremely concentrated and a little goes a long way, so it's worth the extra money. A long soak of 20-60 minutes gives the enzymes plenty of time to work, which is the real key to getting fabrics as clean as possible.

BTW, unless you can afford a good dermatologist it can be hard to pinpoint the causes for these problems. I have occasional breakouts from psoriasis and tinea cruris. Lidex gel and miconazole ointments help.

Depending on the location of the sore, it may be possible to combine a non-stick sterile pad with something like Moleskin pads to minimize abrasion and retain the skin medication longer. Alternatively, some folks use Moleskin type pads with cutouts, so the pads don't actually contact the sore spot, but offer a little peripheral padding to relief pressure.
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Old 06-14-19, 03:29 AM
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As someone who has often suffered with saddle sores here's my two cents worth.

First of all, once you're back on your bike make sure you regularly use prophylactic treatment to prevent reoccurence. For me that means thoroughly washing the affected area and then slapping on Sudocrem. You may not be familiar with that but it's what we use on baby's to prevent nappy (diaper) rash. Here's the list of ingredients, in case that's helpful: Liquid Paraffin, Paraffin wax. Beeswax, Microcrystalline wax, Sodium benzoate, Linalyl acetate, Propylene glycol, Citric acid, Butylated hydroxyanisole, Sorbitan sesquioleate.

Secondly, if you do think you have one developing, I've found that slapping on a hydrocolloid dressing protects the area from chafing and promotes healing. They remain on for several days and can be quite painful when you do finally remove them but, for me at least, they are really worth it. Compeed blister hydrocolloid plasters are reasonably cheap and easy to come by.

Finally, make sure you've got a comfortable saddle. Saddles are probably the most individual thing on a bike so asking advice on these boards won't necessarily be that helpful. I've spent a small fortune on saddles over the year (and shorts, for that matter). About the only helpful thing I can tell you is that the most expensive isn't necessarily the best. The two I've had that worked pretty well for me were a Fizik Arione (which, sadly, snapped across the middle recently) and a Fabric Line Shallow.

Best of luck

John
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Old 06-14-19, 05:45 AM
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I did not wade through the earlier responses, so forgive me if someone else has already pointed this out: you should see a dermatologist. Not a general practitioner.
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Old 06-14-19, 11:10 AM
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Originally Posted by canklecat View Post
If you haven't already done so, try a Lycra fabric covered saddle. Serfas makes these in various styles. I have an older Terry woman's road bike saddle with Lycra over dense foam in the style of a Selle Turbo saddle but with shorter nose; and a Bell comfort hybrid saddle with Lycra over thick but springy foam. Both are very comfortable in hot, sweaty summers, although I no longer use the Terry saddle because the nose was too short -- I tend to ride the nose for some situations and prefer the longer Selle Italia styles.

An alternative would be saddles with larger cutouts for perineum relief. A couple of cycling friends ride Infinity full cutout saddles, but say they aren't necessarily more comfortable. It's a fairly radical saddle, with no support for the sit bones, yet still has support in the perineum area. Seems like a clever solution to a non-existent problem, at least for me. I don't get sore spots on my ischial tuberosities, so cutting out that support wouldn't solve any problems I have. I'd rather have the perineum relief cutouts.

Try padded shorts, or a different brand. I'd suggest the Przewalski shorts or bibs with 3D pads on Amazon, only $15-$25. Outstanding values. The pads are unlike anything else I've tried -- thick, dense, resilient, with excellent wicking but never feel soggy. The surface feels unusually smooth with dimples like a golf ball. I prefer these shorts on my road bike with a firm saddle that has little padding.

If you prefer little or no padding, try Aero Tech Pro with their thin microfiber black and tan pads. It's about as thick as a terrycloth washcloth, yet comfortable. I wear these on one of my road bikes with a thicker padded saddle and more flexible shell.

I use hydrogen peroxide on my shorts pads, then handwash with long soaks in Tide Ultra Stain Release liquid. It's extremely concentrated and a little goes a long way, so it's worth the extra money. A long soak of 20-60 minutes gives the enzymes plenty of time to work, which is the real key to getting fabrics as clean as possible.

BTW, unless you can afford a good dermatologist it can be hard to pinpoint the causes for these problems. I have occasional breakouts from psoriasis and tinea cruris. Lidex gel and miconazole ointments help.

Depending on the location of the sore, it may be possible to combine a non-stick sterile pad with something like Moleskin pads to minimize abrasion and retain the skin medication longer. Alternatively, some folks use Moleskin type pads with cutouts, so the pads don't actually contact the sore spot, but offer a little peripheral padding to relief pressure.

Thanks! I have Brooks saddles on both of my bikes. When I first started biking, I had a synthetic saddle and would get saddle sores all the time. Since changing to Brooks saddles, I hadn't gotten a saddle sore in the past 3+ years. I think the Brooks works well for me, although I'm definitely intrigued by the saddles with the cutouts for perineum relief, as that seems like it would solve the issue. I like the moleskin pad idea. Maybe I could still ride if I had one of those on the sore.
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Old 06-14-19, 11:18 AM
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Originally Posted by jgwilliams View Post
As someone who has often suffered with saddle sores here's my two cents worth.

First of all, once you're back on your bike make sure you regularly use prophylactic treatment to prevent reoccurence. For me that means thoroughly washing the affected area and then slapping on Sudocrem. You may not be familiar with that but it's what we use on baby's to prevent nappy (diaper) rash. Here's the list of ingredients, in case that's helpful: Liquid Paraffin, Paraffin wax. Beeswax, Microcrystalline wax, Sodium benzoate, Linalyl acetate, Propylene glycol, Citric acid, Butylated hydroxyanisole, Sorbitan sesquioleate.

Secondly, if you do think you have one developing, I've found that slapping on a hydrocolloid dressing protects the area from chafing and promotes healing. They remain on for several days and can be quite painful when you do finally remove them but, for me at least, they are really worth it. Compeed blister hydrocolloid plasters are reasonably cheap and easy to come by.

Finally, make sure you've got a comfortable saddle. Saddles are probably the most individual thing on a bike so asking advice on these boards won't necessarily be that helpful. I've spent a small fortune on saddles over the year (and shorts, for that matter). About the only helpful thing I can tell you is that the most expensive isn't necessarily the best. The two I've had that worked pretty well for me were a Fizik Arione (which, sadly, snapped across the middle recently) and a Fabric Line Shallow.

Best of luck

John
Thanks! I was unable to find hydrocolloid dressings in a Google search - I wonder if those are only available in the UK. It seems like they keep all the helpful stuff away from the US as I'm always hearing about the cool things available in Europe that we can't get here.

My Brooks saddle had been working great for me for several years as I hadn't gotten a saddle sore in ages, but I may need to re-examine this. I also just recently got new bikes and the bike shop I bought them from was lazy about giving me a proper fit. They just went out of business (big surprise) so I can't go back for a fit check up. I do wonder if the saddle might be too high or too low.

Update: I was able to find hydrocolloid dressing on Amazon. Cool!

Last edited by ciclista_pazza; 06-14-19 at 11:28 AM.
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Old 06-14-19, 11:20 AM
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Originally Posted by Koyote View Post
I did not wade through the earlier responses, so forgive me if someone else has already pointed this out: you should see a dermatologist. Not a general practitioner.
Thanks! I'll make an appointment with a dermatologist if this doesn't clear up soon.
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Old 06-14-19, 12:02 PM
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If the saddle sore is a pimple type, try using Boil Ease. I've tried several treatments and it has worked for that type of saddle sore. I think I got it at Walgreens or CVS.
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Old 06-14-19, 12:08 PM
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Originally Posted by ciclista_pazza View Post
Update: I was able to find hydrocolloid dressing on Amazon. Cool!
Yes, I was going to say that Amazon had it. I'm pretty certain that these are what I've been using, they just aren't referred to as hydrocolloid dressings in the US. Actually Amazon seems to have far more choice in similar products than we get over here.

You may be right about the saddle height needing adjusting - my guess would be down rather than up. But I'd go with very small adjustments over a longish period. Your hips shouldn't rock as you pedal - if they do then drop the saddle a little. I found that 5mm made a lot of difference for me.

I had a Brooks B17 saddle for years and never got on with it. Just goes to show what I said about saddles being very individual.
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Old 06-14-19, 12:22 PM
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I managed skin hygiene with surgeon's scrub and washing 1 of my 3 pair of bike shorts in rotation
starting every day a clean pair. on my several month's long bike tour..

1 dab of polysporin at night , for 1 hot spot .. in 6+ months..









.....
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Old 06-14-19, 12:30 PM
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Originally Posted by jgwilliams View Post
As someone who has often suffered with saddle sores here's my two cents worth.

First of all, once you're back on your bike make sure you regularly use prophylactic treatment to prevent reoccurence. For me that means thoroughly washing the affected area and then slapping on Sudocrem. You may not be familiar with that but it's what we use on baby's to prevent nappy (diaper) rash. Here's the list of ingredients, in case that's helpful: Liquid Paraffin, Paraffin wax. Beeswax, Microcrystalline wax, Sodium benzoate, Linalyl acetate, Propylene glycol, Citric acid, Butylated hydroxyanisole, Sorbitan sesquioleate.

Secondly, if you do think you have one developing, I've found that slapping on a hydrocolloid dressing protects the area from chafing and promotes healing. They remain on for several days and can be quite painful when you do finally remove them but, for me at least, they are really worth it. Compeed blister hydrocolloid plasters are reasonably cheap and easy to come by.

Finally, make sure you've got a comfortable saddle. Saddles are probably the most individual thing on a bike so asking advice on these boards won't necessarily be that helpful. I've spent a small fortune on saddles over the year (and shorts, for that matter). About the only helpful thing I can tell you is that the most expensive isn't necessarily the best. The two I've had that worked pretty well for me were a Fizik Arione (which, sadly, snapped across the middle recently) and a Fabric Line Shallow.

Best of luck

John
One more question about the hydrocolloid dressing - it seems like that would create a moist environment, but I thought the idea was to avoid moisture and keep the area dry, so how would those dressings help the saddle sore issue?
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Old 06-14-19, 12:47 PM
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Originally Posted by ciclista_pazza View Post
One more question about the hydrocolloid dressing - it seems like that would create a moist environment, but I thought the idea was to avoid moisture and keep the area dry, so how would those dressings help the saddle sore issue?
I can't answer that - all I can say is that it seems to work well for me and allows me to continue riding through the issue. There may well be better products out there - if you find something please keep us posted.
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Old 06-14-19, 01:11 PM
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Originally Posted by jgwilliams View Post
I can't answer that - all I can say is that it seems to work well for me and allows me to continue riding through the issue. There may well be better products out there - if you find something please keep us posted.
Thanks! I'm very intrigued about those dressings and I really appreciate you mentioning it as I'd never heard of them before. I've been searching about those dressings this morning and a lot of people are saying they work great for saddle sores, so I think this is a very good idea.
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Old 06-14-19, 02:38 PM
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Liquid Paraffin, Paraffin wax. Beeswax....
That's awfully close to petroleum jelly - mineral oil and wax - which some believe clogs pores and which reportedly can trap bacteria next to skin. Body Glide or Gold Bond Friction Defense may be better choices - no mineral oil. Body Glide lasts a lot longer than the Gold Bond stuff for me. I've been using Body Glide this year, and so far a multi-year saddle sore hasn't surfaced in over 300 miles, mostly in 15-25 mile chunks.

Depends on where the sore is, but it's best to avoid having seams rub on the sore. It your shorts or saddle rub you there, I recommend you make a change in the cuplrit.

Best of luck.
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Old 06-15-19, 08:18 PM
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I have had plenty of saddle sores. I usually will take a day or two off just to let it settle down a bit. Then, I will use moleskin patches. They come in a pack containing several sheets about 3 in. X 3 in. I just cut them into small squares. They offer some padding. I also will wear two pairs of shorts until it gets better. Finally, I ride my fixed gear a lot during this time. That forces me to stand a lot while climbing.

I will put some Oxy 10 on it at night and keep the area as clean as possible. I have been prescribed antibiotics on occasion . Can't say if they helped or whether it was other things I was doing.
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Old 06-15-19, 10:18 PM
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Originally Posted by ciclista_pazza View Post
Thanks! I'll make an appointment with a dermatologist if this doesn't clear up soon.
You've had a sore for three months in your groin area, and it is putting your summer riding season in jeopardy. It already hasn't cleared up soon. Go see a dermatologist.
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Old 06-15-19, 11:03 PM
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So .. not in Canada where you can ask a Dr Without big insurance co pays .. ready to vote for a change?
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Old 06-16-19, 11:01 PM
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Also, try a soap-free/oil-free acne wash, usually a clear liquid gel with salicylic acid as the active ingredient. Helps. I mostly use it instead of bar soaps or generic body washes.
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Old 06-17-19, 04:17 AM
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I remember reading this article somewhere. Could be here or on Flipboard.

https://www.dailymail.co.uk/health/a...-soreness.html

Other than that, maybe stay off the bike. Take a bus or walk a while.
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Old 06-17-19, 09:04 AM
  #22  
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Originally Posted by canklecat View Post
Also, try a soap-free/oil-free acne wash, usually a clear liquid gel with salicylic acid as the active ingredient. Helps. I mostly use it instead of bar soaps or generic body washes.
Yes, however, I suspect that this may weaken skin and remove protective oils, as that's effectively how it works. Showering with that several times a day to solve a specific issue before a ride a week ago contributed, I think, to a much greater general soreness during and after the subsequent ride beginning almost from the start; granted it was my longest of the season, but only by around 15%. It was successful, in that the trouble spot was okay for the ride, and I didn't develop any new ones, but it seems like it came at a cost. So my new strategy absent an issue is to only do that prophylactically once or twice in days immediately after a lot of time in sweaty shorts, and absent a specific issue not do it in days resting up before a long ride.

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Old 06-17-19, 02:20 PM
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Just a follow-up. I completed my 140 mile ride on Saturday. We had cold, headwinds, heat, rain, clouds, sun, but no locust. Overall it was a great ride, but a very long day in the saddle.

I used Assos Chamois cream at the beginning, Chamois Butt'r at 50 miles, 72 & Assos Chamois cream at 102. I was doing OK until I hit the 118 mile mark. Then it got warm and I can feel my saddles sores starting to bother me. It's Monday and I'm still pretty sore. I used the Specialized Power Expert saddle and I have loved it; however, I think it might be time to experiment with a different saddle. I ordered a Selle Italia SLR Supermax with ti rails. I'll see if a new saddle makes any difference.

Thanks for your advice in this thread.
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Old 06-17-19, 05:32 PM
  #24  
holytrousers
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Dear ciclista_pazza, you said you are no stranger to saddle sores. Have you determined the reason behind them ?
Did tinkering with your saddle height/angle/fore-aft position have any effect on your saddle sores ?
Your saddle might be exerting constant pressure on your groin that is not relieved while you pedal. Try lowering your saddle a couple of millimeters and see what happens.
ps. give vaseline salicilate a try.
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Old 06-18-19, 03:17 AM
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Boils, lumps etc on one side of the groin can quite often be a result of one leg slightly shorter than the other, the boil will appear on the shorter side. A small shim under the cleat will fix this. Ideally you should get measured and a good bike fitter will advise the right depth of shim. Otherwise start with the thinnest under the cleat and go from there.

I suffered from this issue for years until a bike fitter measured me and shimmed one cleat. The issue has never returned.
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