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Clinical Bike Fitting - The New Frontier (the director's cut)

First appeared in SPIN ASIA 50

· bike fit,Physiotherapy,Clinical Bike Fit

this was first written for SPIN ASIA issue 50, but after I had sent the final draft to the editors.... well I made some changes to improve it. That's why its a directors cut... the original article can stand alone, but this enhances it.

Everyone has heard of ergonomics, especially in the workplace where we sit at our desks for 8-10 hours a day. Well Bike Fitting is somewhat similar when you break it down back to basics, it is ergonomics for your cycling position. So think about this.. when you buy that Herman Miller chair and set it up right out of the box you still need to make adjustments to the set it up to suit your body so that it is fit for purpose. There is no use having such an expensive ergonomic chair when it’s not adjusted to your body correctly. Just as buying the latest Cervélo / Pinarello / Specialized / (insert name here) and expecting it to perform optimally without any consideration of your position. As such BIKE FITTING was born.

From humble beginnings of frame builders fitting riders for custom frames, bike fitting has grown into a multimillion dollar business in its own right with fit bikes and motion capture now being the norm and not something just for elite riders. With all the technology now available it can get quite overwhelming and confusing. Just remember that the technology and equipment are just tools that the bike fitter have but the fundamentals of bike fitting remain the same. To adjust the bike to suit the rider and their goals, style, fitness and mobility

Now that you have your head around the concept of BIKE FITTING, how about this.. That latest Herman Miller chair you’ve just adjusted to your “perfect position” will not rehabilitate your bad back for you, it merely facilitates your compromised position so that you can function in comfort while sitting at your desk. Everyone’s body is unique with varying potential. Some of us have longer limbs / body / shorter arms or vice versa, some have previous surgeries or injuries that have affected mobility. A mere ankle sprain can be a condition that is magnified on a bike when we clock the mileage that we do and test our body’s endurance in the pursuit or fitness and athleticism.

In cycling is that what you really want? To be functioning in comfort while riding your bike? Or do you want to get the most performance out of your bike and your body?

What if the problem is not the bike, but your body?

Over the years we have all put on weight / had crashes / sprained ankles / hurt our backs / grown older / exercised less / lost flexibility which deep down we all know are limiting our performance or comfort in some way. This is where the concept of the CLINICAL BIKE FIT fills the gap of overcoming the limitations within ourselves specifically in relation to cycling.

Why do so many cyclists neglect their own bodies while spending thousands of dollars chasing marginal gains in upgrades for their bikes?

All bike fits be it from a bike shop or an independent bike fitter should include an interview to determine your cycling goals, riding style, identify prior injuries, highlight pain or discomfort felt when riding, and other pertinent information. After the interview, there is an assessment both on and off the bike to determine your body type and physical limitations. In a CLINICAL BIKE FIT it is during this functional assessment that encumbrances can be identified and pathologies facilitated through physiotherapy prior to the start of the on-bike analysis. At times the bike needs adjustments and other times it is the body that needs adjusting. When the bike fitter teams up with a physiotherapist to determine the best fit, the body and bike can work as efficiently as possible.

If a traditional bike fit is fitting the bike to the body, a clinical bike fit also fits the body to the bike.

The clinical bike fitting goes above and beyond what is provided at most bike fitters and bike shops. Bike shops and bike fitters make adjustments to the bike based on a what they can observe and measure but only a physiotherapist is able to perform a detailed orthopaedic evaluation of the cyclist and determine what their strengths, weaknesses, and limitations are. Based on this information, the physiotherapist will then treat and prescribe exercises to for the cyclist to specifically target their body’s weaknesses.

The cyclists’ deadly trifecta:

  1. Tight Hip Flexors \ Glute Weakness
  2. Lower Back Stiffness
  3. Stiff Neck

If you are seasoned cyclist, chances are that you will be suffering from at least one these three common problems, but how do they affect performance?

Tight Hip Flexors / Glute Weakness

In the typical road position, you are crouched forward over the bars which causes your hips to never actually go into full extension. The more you ride the more you overwork your hip flexors which causes them to tighten and shorten. This not only puts you at risk for back and knee pain, but also prevents you from fully using your glutes and putting full force into each pedal stroke. This is especially so if your body is not accustomed to pedaling with a solid core.

Lower Back Stiffness / Weak Core

The bane of a bike fitter, the high/low position of high saddle and low bars are often the culprit but also age / flexibility / posture / lifestyle are big contributing factors. The long and low handlebar position relative to the saddle puts stress onto the lower back which over the course of the many hours impedes your performance on the bike. Pedaling may start at your legs, but the real power comes from a strong core, pelvic stability and a flexible spine as it stabilises the rider. By improving your core strength, you can increase your power output in each pedal stroke and with a flexible spine you will be able to maintain a more aero position

Neck Pain

Constantly craning your neck to look up the road or a long/low handlebar position can be triggers of neck pain in cyclists but not necessarily the root cause. Ergonomics at work, constantly looking down at your phone, posture and lifestyle are the most common causes of neck stiffness and degeneration so trying to keep your neck and upper back as relaxed as possible on the bike is the aim here.

How can a Clinical Bike Fit help these issues?

During the clinical bike fit process these issues and others can be identified accurately, treated and exercises taught to prevent them creeping back in the future.

Once you have identified your weaknesses, you have something to focus on that will directly improve your cycling. If you are looking to increase your comfort / power / efficiency, eliminate your weaknesses and the rest will follow.

Steps for a Clinical Bike Fit:

Bike Fit – Initial position on the bike

Video is taken from all sides (front/back/left/right), initial motion capture readings are taken and bike is measured to establish the baseline position of the rider

Physiotherapy – Initial evaluation of the cyclist

Physiotherapist evaluates the rider in motion on the bike to observe any encumbrances that the rider may have that is limiting their performance specifically for cycling. Special tests are performed as well as a comprehensive physical evaluation to determine any weaknesses that the rider may have.

Physiotherapy – Treatment of cyclist

Physiotherapist treats the rider for what was observed in the evaluation.

Physiotherapy – Education and Explanation of Future Exercises

Exercises are taught to help the rider strengthen and maintain the areas of weakness.

Physiotherapy - On bike reassessment

Physiotherapist re-tests the rider dynamically on the bike after the treatment is complete.

Physiotherapist and Bike Fitter collaboration

Together they discuss the what the rider needs and the goals of the bike fit. The physiotherapist may have specific requirements for the rider to address their individual needs to discuss and at times have a compromise needs to happen to accommodate an individual’s mechanics and performance needs.

Bike Fit- 3D Motion Capture Session

Bike fitter completes fit per their regular protocols and within the parameters set by the physiotherapist

Bike Fit – Final position on the bike

Video is taken from all sides, final motion capture readings are taken and bike is measured to establish the final position of the rider

Bike Fit – Reporting

Full report is sent detailing all the final measurements of the bike, information on the position of the rider and a summary of what was accomplished in the session and any exercises needed to maintain and improve the rider’s physical condition.

Now the cyclist needs to maintain physical mobility to compliment the new fit with exercise.

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Be informed and stay safe on the road

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