Bike Fitting for Injury Prevention

How to Adjust Your Fit and Position for Injury-free Cycling.

By Dr. Paul Abbott Jr. (Vail-Summit Orthopaedics)


More than 1.3 million people are treated for bicycle-related injuries each year. As orthopaedic surgeons, we treat many of these injuries. The most common cycling accidents involve colliding with a car or another bicycle; loss of control; entangling hands, feet or clothing in the bicycle; or feet slipping off the pedals. But injuries can also occur from a bad bike fit.

Cyclists can give themselves the best chance of avoiding injuries by warming up and down thoroughly and stretching as much as possible.

Here are some tips on how to adjust your fit and position for injury-free cycling:

Adjusting the Saddle
Moving your bicycle seat forward and backward adjusts the length between your seat and your handlebars and can help prevent injury. Your bike seat should be level in order to support your full body weight and allow you to move around on the seat. Too much upward tilt can result in pressure points. Too much downward tilt can make you slide forward while riding and put too much pressure on your arms, hands and knees.

To adjust the seat height, place your heels on the pedals and pedal backwards. Your knees should fully extend in the down position. If your hips rock side to side the seat is too high. When you move your foot into the proper pedaling position, with the balls of your feet over the pedal, you'll have a slight bend in your knees.

You can also adjust the seat forward and backward for better comfort. Place your feet on the pedals so the crank arms are parallel with the ground. The proper position will put your forward knee directly over the pedal axle. Drop a plumb line from the patellar tendon (the bump on your leg below the knee cap) to make this adjustment easier to see.

Handlebar Adjustment
The length of your stem will give you either more reach or more of an upright feel. If the handlebars are too high, too low, too close, or too far away, you may have neck, shoulder, back, and hand pain. You should be able to comfortably use all the positions on the handlebars and bend your elbows while riding.

Gender Issues
The frame geometry of women’s specific bikes accommodates for shorter legs and arms. There are also women-specific saddles that are shorter and wider to accommodate a woman's wider pelvis. Others have a center cutout to relieve pressure on soft tissues. Men are at risk for erectile dysfunction with prolonged riding or improper fit. “Urologically correct” seats are available to decrease risk. You should stand on pedals to take weight off this area frequently.


Common Complaints and Possible Solutions:

An ideal bike fit is often a matter of trial and error. The slightest imbalance can lead to pain. Here are some common complaints and possible solutions.

Knee pain is a frequent complaint among cyclists. Knee pain is usually associated with a seat position that is too high or low or far forward or back. An improper cleat position can also cause knee pain.

• A seat that is too high will cause pain in the back of the knee.
  
• A seat too high will also cause your hips to rock side to side, which may cause discomfort.
  
• A seat that is too low or too far forward may cause pain in the front of the knee.
  
• Improper foot position on the pedal, or improper cleat alignment, can cause pain on the inside or outside of your knees.
  
• Individual anatomy may also result in knee pain. Cyclists with slight differences in leg length may have knee pain because the seat height is only adjusted for one side. Shoe inserts or orthotics can help correct this problem.
  
• Another cause of knee pain is using too high a gear. Try to use a gear that allows you to pedal quickly, from 70 to 100 strokes per minute.
  

Back injuries will also haunt many cyclists, which isn’t really surprising given how they’re hunched over their bikes for long periods of time. Posture is everything and it’s important to get this right and not put strain on the lower back.

Neck pain is another common cycling complaint, and is usually the result of riding a bike that is too long or having handlebars that are too low.

Foot pain or numbness is often the result of wearing soft-soled shoes. Special shoes designed for cycling have stiff soles that distribute pressure evenly over the pedal. This also helps you pedal more efficiently. Foot pain can also be caused by using too high a gear, which results in more pressure where the foot meets the pedal.

Hand pain or numbness can be prevented by wearing padded cycling gloves that provide cushioning. You should ride with your elbows slightly bent, not straight or locked. Bent elbows will act as shock absorbers and help absorb the bumps in the road. Changing hand positions on the handlebars can also reduce pressure and pain.


Final note
Remember that it is important to fit the bike to the rider not the other way around. As we age, we are less flexible so you will be more comfortable in a more upright position. Consider a professional bike fit to improve comfort and performance.


Dr. Abbott joined Vail-Smmit Orthopaedics in 1993 and has made the Vail Valley his home. Although he is a surgeon, he believes his most important job is to educate his patients about their problem: What it is, how they got it, how to get rid of it, and how to keep it from coming back. He prides himself on how often he can prevent surgery by the use of physical therapy, judicious use of medicines, and alternative medicine. He looks at surgery as a last resort. If surgery is necessary, however, he possesses excellent skills and has pioneered arthroscopy techniques.