Knee pain? Hot foot? Sore neck? Achilles Tendonitis? Back Pain? What do all these things have in common other than ruining your day? I bet your first thought was a poor fitting bike! I’m smart enough to know that other than the title of this post, hardly any of you would have thought about someone’s position on a bike causing pain. Pain on a bicycle may be more common than you think. According to the International Journal of Sports Medicine, 85% of cyclists experience pain or injury while biking. Sure, most of us are not the next Lance Armstrong, but I do believe there is a need for proper fit when even the average Joe is riding his or her bike. An average pace on a bike is 70 pedal rotations per minute, this means on a 30 minute bike ride, you would bend and extend your knee 2,100 times. Think about the potential for an injury if the bike is not fitted properly, even for the casual 30 minute bike ride.
Bike Fit Definition:
Bike fit includes a biomechanical assessment of ones position during simulated biking with appropriate, tailored adaptations of specific components to improve alignment, position, and posturing resulting in decreased compensation and reduction of pain.
My Bike Fit 101
I like to have my patients ride their bike on a trainer for 4-5 minutes before I even start to assess their position. This allows people to settle in and expose potential compensations or errors in mechanics. I look at multiple areas on the bike from foot position on the cleat (pedal) to the angle of your shoulders as your hold onto the handle bars. From this point I assist with adaptations and test our work making additional adaptations as needed.
Bike Fit vs Time
When people have pain during or after a bike ride, this pain does not usually occur overnight. What does this mean - it means that the resolution of such pain will not occur overnight. Following a bike fit adaptation, it may take upwards of weeks to reduce pain. To further elaborate and explain this thought, let’s take a minute to discuss muscular adaptations. Some muscular adaptations that occur with bike riding are great things, such as toned legs. Other adaptations, such as overactive hamstrings, can lead to pain. To be brief, in order to correct overactive hamstrings, muscular adaptations will once again need to occur. To assist with muscular adaptations, we may need to adapt your position on the bike. A new position will change the length tension relationship of your hamstrings thus allowing for optimal function and resulting in less pain as time progresses. Overall, bike fitting is a great first step to assist with muscular adaption, but is this may be only one piece of the puzzle.
Bike Fit and PT
A perfectly fit bike may not always yield pain free riding. Sometimes there are muscular imbalances, postural weakness, and poor proprioception (big word for poor body awareness) that leads to pain. I believe that with any exercise you need to be appropriate for such exercise and that includes riding your bike. You wouldn’t try to do hand stand pushups knowing you’re not even strong enough to hold yourself in a handstand position, yet many people think they can ride their bike miles when it has sat in the garage all winter long without any consequences. This is where physical therapy can come into play. A PT can expose the imbalances related to pain with bike riding and provide significant insight with regards to exercise to get you on the right track. Sometimes a bike fit alone is not enough to resolve your pain, and in summary, physical therapy may be needed even after your bike is properly fit.
I hope that after reading this blog post the phrase “Bike Fit” is on your radar. I believe that there is a place for both the extremes of athletes and the casual rider when it comes to bike fit. It takes a thorough “test and check” model to achieve success when adapting a bike but the benefits of pain free riding speaks for itself. If you are experiencing pain during or after riding your bike I would love to help. Please feel free to reach out to our clinic for more bike fit information and to schedule an appointment today.
Author: Jake Miller PTA