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Basic Principles of Bike Fitting: The Role of the Physical Therapist Matthew S. Briggs, PT, DPT, SCS, ATC

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Improving People’s Lives

through innovations in personalized health care

Basic Principles of Bike Fitting:

The Role of the Physical Therapist

Matthew S. Briggs, PT, DPT, SCS, ATC

School of Health & Rehabilitation Sciences, The Ohio State University; OSU Sports Medicine

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OSU Sports Medicine

Objectives

By the end of this presentation you should be

able to:

Describe important, basic bike anatomy

Describe common overuse injuries associated with

cycling

Understand basic principles of bike fitting to avoid

and/or treat cycling injuries & help your patients/clients ride safer

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OSU Sports Medicine

Terms to Know

Saddle

(vs seat)

Reach

:

tip of saddle to center of handlebar

Bottom Bracket

Fore, Aft:

bottom bracket to saddle

Drop

:

saddle to handlebars

The Drops

:

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One position for a

very long time!

 Cervical Extension  Lumbar Flexion

Injury

 Type of cycling  Duration  Intensity  Mechanics  History

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Cycling Injuries

Sport of Repetition -

Overuse

80-90 rpm, 6 hour century ride

32,400 strokes PER LEG

Any minor misfit causes MAJOR problems

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OSU Sports Medicine

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Risk Factors:

Overuse Injury

Males

Miles/Week

Low # of Gears

Less Experience

Females

More training time/year vs. races

Less time stretching

2x risk for

neck/shoulder

(Wilber 1995)

Other considerations:

Poor lumbopelvic/ thoracic muscular endurance

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Neck Injuries

Cervical spine pain

Headaches

Radiculopathy

Positioning / posture

Thoracic musculature weakness

Prolonged extension

Deep cervical muscle weakness

Helmet / glasses fit

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OSU Sports Medicine

Knee Injuries

Anterior Knee Pain

Iliotibial Band Syndrome

 Poor tracking

Proximal stability weakness / lack of control

Overuse / training errors

Bike Fit

Saddle position

Shoe-pedal interplay

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OSU Sports Medicine

Low Back Injuries

Lumbar pain

Increased Pelvic/lumbar extension

Iliopsoas inflexibility

Bike fit

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Hand Injuries

Ulnar nerve

Median nerve

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OSU Sports Medicine

Groin / Pelvis Injuries

Pudendal nerve palsy

Between sacrotuberous & sacrospinous ligaments, at

ischial tuberosity (stretched during pedaling)

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OSU Sports Medicine

Weight Distribution

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Cycling Biomechanics

(and efficiency) Alter with changes to:

Saddle Height

Saddle fore/aft position

Crank Arm Length

Foot Position

Cadence (revolutions / minute)

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Examination: Interview: Cycling History

 Injury history  Events?:

recreational

criterium

century

tours

triathlons

 Shoe / Cleat / Pedal

 Orthotics

 Days / Week cycling

 Weekly Mileage

 Longest recent ride

 Typical speed

 Typical Cadence

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OSU Sports Medicine

Examination: Interview: Cycling History

Type of bike

Type of use

Recreational

Triathlons

Tours

Cyclocross

Track

Mountain

Injury History

Time on Bike

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OSU Sports Medicine

Physical Examination

Functional tests

:

e.g. SFMA, FMS, unilateral testing

Movement patterns

Mobility vs. stability

Leg length

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Make the bike fit the body…

…don’t make the body fit the

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OSU Sports Medicine

Bike Fit Basics:

Necessary Tools

Bike

Trainer

Riser blocks

(towels?)

Goniomete

r

Level

(phone app?)

Plumb line

(tape measure?)

Basic allen wrenches

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Patient/client need to bring anything they would wear on the bike!

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Bike Fit Basics:

Session

At least 1-2 hours long

.5-1 hour evaluation & history

1 hour dynamic bike fit on trainer

Our bodies change so an annual fit

should be part of training

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OSU Sports Medicine

Bike Fit Basics:

Lateral View

 Saddle Fore/Aft

 Cervical Posture (check with cycling glasses/helmet on)

 Spine Posture (neutral spine)

Be sure the bike is level: set level across axels

 Shoulder Angle  Elbow Angle  Wrist Angle  Hip Angle  Knee Ext @ DBC ~30°  Ankling Angle

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Bike Fit Basics:

Saddle Size

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OSU Sports Medicine

Bike Fit Basics:

Saddle Position

Most important variable to get right

Includes height, setback, tilt, and width

Too low

= anterior knee pain

Too high

= pain behind knee

over stretching the hamstrings

Saddle sores & crotch irritation-rocking pelvis

Find balance maximizes patellar fulcrum, while

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Bike Fit Basics:

Saddle Height

Put bike on trainer & pedal for five minutes

This helps you loosen up & find position

Quick & Dirty Check:

Unclip shoes & place heels on the pedals

Pedal slowly & watch knee at bottom of stroke

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OSU Sports Medicine

Bike Fit Basics:

Saddle Set Back

Setback (fore/aft)-you in relation to the bottom

bracket

Determined by femur length

Knee center of rotation (COR) directly over pedal

Long legs should move seat back

Short legs should move seat forward

Correct position: COR over pedal & ischial tubes on

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Why is Set-Back Important?

Put the power of your leg into the pedal at the

point in the crank circle when it does the most

good

To get maximum power the knee should be over

the pedal axel

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OSU Sports Medicine

Bike Fit Basics:

Optimizing Set-Back

 Measure Saddle Fore/Aft:

plumb from knee to front of crank arm

 Seat too Forward:

increased patelofemoral load

 Seat too Aft:

patella becomes an ineffective fulcrum

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Bike Fit Basics:

Saddle Tilt

Tilt- should “almost” always be level

If not something else is most likely wrong with the fit

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OSU Sports Medicine

Bike Fit Basics:

Knee angle

Dead Bottom Center (DBC)

Knee Ext @ DBC

~30°

Changes with load and RPMs

Knee angle vary between

20-40°

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Bike Fit Basics:

Torso Angle

 Most riders are 30-50°

 Euro racers 30-35° on brake hoods

 Old & Young riders 35-45°

 Fitness Enthusiasts 50°

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OSU Sports Medicine

Bike Fit Basics:

Elbow/Wrist Position

Handshaking

position (wrist in neutral)

Adjust hoods to achieve this position

Should be level with top bar

Or adjust so the end of the bar points to the center of the seatstay

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Bike Fit Basics:

Shoe/Cleats

Last aspect to consider

Unless they are new

Can eliminate hip, knee, and foot pain

Ball of foot over pedal axel

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Symptom Likely Cause Try…

Scooting forward on seat Stem may be too long so you pull yourself forward as you ride; saddle nose may be tipped down too much Install a shorter stem; level saddle Scooting back on seat

Stem may be too short so you feel cramped and push yourself back; saddle nose may be tipped back; saddle may be too far forward on the rails

Install a longer stem; level the seat and center it on the rails; move your seat back

Lower back hurts

Stem too low or too long; must strain back to reach bars; or seat may be too high, causing rocking when pedaling

Try raising the stem/handlebars; still hurts? try shorter stem; check and adjust seat height

Neck hurts Stem too low; must crane neck to see Raise the stem/bars

Hands hurt Stem too low; too much weight on hands; saddle may

be pointed down

Raise the stem/bars; level saddle

Front of knee hurts Seat too low and/or too far forward, straining knees Raise seat; may need to move seat further

back as well

Back of knee hurts Seat too high, over-extending leg Lower seat

Numb bum

Too much weight on the seat; may need to slide back a little on the seat. Try to sit such that you feel the weight on your sit bones rather than the front or center of your crotch

Lower handlebar position; check seat height as it may be too high; May need to try another brand of shorts and or seat; lose weight

Achilles tendon hurts

Pedaling too much on your toes; cleats too far forward on your shoes; feet may not be forward enough over the pedal

Keep the balls of your feet over the pedals when you’re pedaling; move cleats back.

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OSU Sports Medicine

Final Thoughts

 Focus on injury prevention, movement dysfunction, & performance.

 Detailed medical history.

 Physical examination = mobility, stability, strength, etc.

 Biomechanical & biometric measurements.

Many different fit systems

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OSU Sports Medicine

Thank you!

Matt Briggs PT, DPT, SCS, ATC

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References

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