Body and the Bike: Fitting for Health, Fitting For Performance

Barrett Ford is an avid cyclist. During the spring and summer months especially, you may find the owner of Step & Spine Physical Therapy (Sisters and Redmond) among hundreds in Central Oregon taking on the challenges of long uphill stretches on their road bikes or enjoying the fat-tire thrills of downhill singletrack.

The allure of cycling in such a beautiful region is difficult to ignore. And from a purely physical standpoint, Ford contends, cycling is considered by many the cream of the crop in outdoor exercise.

“It’s a super alternative to the compression of running and other high-impact sports and activities,” he said. “Cycling can provide you with an amazing aerobic workout, but without beating up your joints.”

But Ford cautions that cycling, while low-impact, can lend itself to different problems – carpal tunnel, shoulder, neck, low back, elbow, and knee issues – all associated with an improper bike fit.

“I’d say that about half the people I see when I’m riding have an improper fit,” he said. “What I mean by this isn’t simply that their bikes are too large or too small for their bodies, but that the placement of their seat, their handlebars, and their pedals and cleats aren’t properly adjusted to accommodate the size, flexibility, strength, and movement deficiencies of their bodies.”

On an improperly fitted bike, these deficiencies can manifest themselves as pain, numbness, low endurance, and a general reduction of performance.

“If you’re experiences any of these symptoms when you ride an hour or less, you may need a little tweak in your bike or yourself,” Ford said. “A good bike fit takes into considering both the bike and the body, then works to adjust each in order to maximize comfort as well as performance.”

Triangle of Pressure Points

When riding a bicycle, a person experiences three main points of pressure: on the seat, on the feet and on the hands – a triangle of pressure points. One of the goals of bike fitting, Ford says, it to achieve a comfortable level of equilibrium between the three.

Many common musculoskeletal issues that may arise while cycling, therefore, can be attributed to issues that upset this equilibrium – issues with the bike (e.g., the seat’s too high) and issues with the body (e.g., tightness and inflexibility in the hamstrings).

Some common issues associated with cycling, and possible causes, include:

• Carpal Tunnel Discomfort: This is caused when too much pressure is placed in the hands and arms, often attributed to a seat that’s set too high or handlebars that are turned too low.
• Neck/Shoulder Tightness and Pain: Often resulting from tightness and inflexibilities from previous injuries, neck and shoulder discomfort may also be attributed to a high seat and low handlebars.
• Low-Back Pain: Experiencing low-back pain on your bike is a sign of inflexibility in your hamstrings, which can put strain on your back. This can be aggravated by a high saddle or by simply not moving or breaking from an aerodynamic cycling position for long periods of time.
• Knee Pain: This is a sign that your seat may be too high or too low. A seat that’s too high can cause your knees to overextend while pedaling, putting pressure on the knee ligaments as well as the Achilles tendon. T much knee compression is caused by a seat that’s too low, forcing the joint to deviate unnaturally inward or outward.
• Foot Numbness/Tingling: This can be a sign of a few different issues, from incorrect cleat placement and wearing the wrong-sized shoes to an issue up the musculoskeletal chain.

The Process of Fitting

According to Ford, bike fitting should become a seasonal routine for cycling enthusiasts of all levels. If you get a new bike, proper fitting is a must – that’s a no-brainer. But Ford points out that while we may stick with the same bicycle for several seasons, our bodies never stay the same.

“Just because you were fitted three years ago doesn’t mean your body and your bike fit well together today,” he said. “Sometimes as we become more active, our pains and flexibilities change for the better or for worse.”

Look for the tell-tale signs of an improper bike fit, such as the pain and numbness issues described above. If any of these issues arise, it’s time for a thorough bike-fitting assessment from a physical therapist and movement specialist like Ford. Such an assessment should include:

1. Medical History Evaluation: When did the pain start? Did it involve an injury? Was it related to cycling? The answers to these and other questions are relevant in addressing movement deficiencies and evaluating risk of future pain or injury.
2. Flexibility Testing: Simple stretching the measurement thereof will determine flexibility levels and limitations which, if not considered during the fit, could lead to additional leg and back strain.
3. Cycling Motion Testing/Analysis: An analysis of your body’s motion during a ride will expose additional adjustment requirements necessary to allow you to ride comfortably for 45 to 60 minutes.

Such a thorough fitting, Ford says, not only helps with pain and injury prevention, but also performance. “The right fit allows you to use your hamstrings and quads equally,” he said.

If you’re experiencing pain or discomfort while riding your bike or you desire increased cycling performance, call Ford at Step & Spine Physical Therapy at 541-588-6848 (Sisters) or 541-504-5363 (Redmond) to receive a professional bike fitting analysis.