Many people who opt for a bike fit do so because they experience pain whilst cycling. An improper riding position can be the cause of many overuse injuries (Callaghan, 2005; Clarsen et al., 2010; Marsden, 2010). Below are some of the common types of pain cyclist's experience, and how we address them:
Foot / Achilles pain - The numbness, aching and often cramping that people experience in their feet or Achilles tendon is typically related their shoe size, position of cleats or height of saddle (Burt, 2014). We can instruct you on the origin of your symptoms and how to manage them, as well as adjusting positioning of your cleats and saddle height as indicated.
Knee pain - The knees are suggested to be the most common site of cycling pain, impacting as much as 60% of cyclists (O’Brien, 1991; Silberman, 2012; Wanich et al.,2007). Alongside arthritic pain, many people experience knee pain in a particular region of their knees. This can be due to a range of factors from saddle height and fore/aft position to cleat position / amount of float surrounding cleats. Knee pain can also be associated with crank length, width of stance on your bike, the shape of your saddle and the angle of your knee (Peveler and Green, 2011). We will strive to locate the source of your pain, which may be multi-factorial in origin, and require several adjustments to alleviate.
Hip pain - The most common of hip pain origins can be related to torso angles and the amount of rocking / bouncing of hips in the saddle as you ride. This can be due to seat height / position, crank length, cleat position or functional limitations such a leg length discrepancy (Burt, 2014). Through correct diagnosis of your pain's origin, we can address any limitations and provide a comfortable seated position to reduce your hip pain and allow you to enjoy your ride.
Lower back pain - Lower back pain is more common in casual riders, and often affiliated with torso and back angles, functional limitations such as leg length discrepancy and the type and tilt angle of the saddle Schulz and Gordon, 2010; Bressel and Larson, 2003; Marsden, 2010). By increasing or decreasing angles based on normal measurements, your personal flexibility and power output ratio, we can help to reduce your lower back pain by decreasing the strain of mechanical and gravitational forces applied to the lower back.
Upper limb / back / shoulder pain - Pain or numbness in the upper extremities is normally related to increased weight bearing through the hands and upper limbs. This may be due to over or under reaching (riding with arms fully locked), hand reach too wide or narrow, or forward rotation of the hoods of the handle bars or saddle (increasing weight bearing through the upper limbs (Patterson et al., 2003; Schwellnus and Derman, 2005). As a rule of thumb, your weight bearing ratio on your bike should be 40% at the handles and 60% at the seat (±5%). By altering your torso and/or hip angles, in addition to addressing functional limitation, we can help to reduce upper limb pain by ensuring an optimal reach, hand placement and weight bearing position on your bike.
The right set-up for your bike is important for all cyclists. Whether you're a casual rider or a top-class athlete, there are many aspects to consider to ensure an efficient and comfortable ride.
Most bike shops will only adjust your bike to suit your current body position, but they will not take in to consideration the adaptability of the human body. At Physioimpulse we consider the biomechanical limitations your body may present as well as the measurements of your bike, establishing an optimal balance between the two in order to ensure a maximally efficient, pain free and sustainable ride (Dinsdale and Dinsdale, 2011).
What common limitations could I have?
Leg length discrepancy -
Studies have shown up to 70% of the population presents with some form of leg length discrepancy, whether its bony or soft-tissue related (Hanada et al. 2001; Kaufman et al. 1996). For many people, this can be a cause of lower back, knee or foot pain and is often overlooked in cycling. If significant, we can often resolve such imbalances through the use of cleat wedges or orthotics, or by addressing related mechanical problems (Dinsdale and Williams, 2010).
Thoracic spine immobility -
In order to sustain a good riding posture, in addition to flexibility, a cyclist requires an adequate amount of spinal mobility (McHardy et al., 2006; Schulz and Gordon, 2010). If your upper back is particularly stiff and rounded, you may struggle to adopt more aerodynamic and comfortable positions from your seat to handlebars. Through manual therapy and a bespoke home exercise programme, we can help to reduce limitations of your spinal movement.
Torso-to-leg ratio -
People come in all different shapes and sizes. This can also effect the set up of your bike position. For example, those with long legs but a short torso may find adopting a dominant riding position more difficult if they can reach the pedals with no problem but not the handle bars. By addressing your flexibility and bike set up, we can provide an optimal balance to match your body type.
Muscular tightness -
Tight muscles are the most common form of functional limitation that can reduce the power of your ride but can also lead to pain. Tightness surrounding the hips can also externally rotate your lower limbs, which can lead to mal-tracking of your knees whilst pedalling and potentially cause knee and ankle pain if not appropriately accounted for. Through manual therapy, and a tailored home exercise programme, we can help to increased your overall flexibility, comfort and power output on your bike (Peveler, 2008).
Arthritis / spinal degeneration -
Many people can source their pain to arthritic or degenerative changes around their joints or spine, particularly as their age increases. Through careful adaptation of the forces applied to specific joints, we can reduce stress on key areas of the body which may normally feel additional strain, whilst also maintaining the power of your ride.
This is a great depiction of muscle use during a pedal revolution. This can be utilised to ensure you work the right muscles during strength and conditioning and stretching programmes!
Here's a stretch for the hip flexors and a great exercise to stretch one glut whilst working the other through balance control.
Physioimpulse Chartered Physiotherapists