bike fit
DESCRIPTION
Bike Fit. Marc Silberman, M.D. Gillette, NJ. Supplies. Bicycle trainer Stadiometer or measuring tape Text book Measuring tape Goniometer Plumb line Allen wrench set Video Camera, Tripod, Computer/TV. Pro Bike Fit. - PowerPoint PPT PresentationTRANSCRIPT
![Page 1: Bike Fit](https://reader035.vdocuments.us/reader035/viewer/2022062720/56813438550346895d9b2bad/html5/thumbnails/1.jpg)
Bike Fit
Marc Silberman, M.D. Gillette, NJ
![Page 2: Bike Fit](https://reader035.vdocuments.us/reader035/viewer/2022062720/56813438550346895d9b2bad/html5/thumbnails/2.jpg)
Supplies
• Bicycle trainer
• Stadiometer or measuring tape
• Text book
• Measuring tape
• Goniometer
• Plumb line
• Allen wrench set
• Video Camera, Tripod, Computer/TV
![Page 3: Bike Fit](https://reader035.vdocuments.us/reader035/viewer/2022062720/56813438550346895d9b2bad/html5/thumbnails/3.jpg)
![Page 4: Bike Fit](https://reader035.vdocuments.us/reader035/viewer/2022062720/56813438550346895d9b2bad/html5/thumbnails/4.jpg)
Pro Bike Fit
Fabian Cancellara, Andy Pruit, Scott Holz, Bobby Julich
![Page 5: Bike Fit](https://reader035.vdocuments.us/reader035/viewer/2022062720/56813438550346895d9b2bad/html5/thumbnails/5.jpg)
Bicycle Exam
![Page 6: Bike Fit](https://reader035.vdocuments.us/reader035/viewer/2022062720/56813438550346895d9b2bad/html5/thumbnails/6.jpg)
Balance
• Comfort• Safety• Injury Prevention• Peak Performance
• Aerobic efficiency versus aerodynamics
Superman Position
![Page 7: Bike Fit](https://reader035.vdocuments.us/reader035/viewer/2022062720/56813438550346895d9b2bad/html5/thumbnails/7.jpg)
Bicycle Anatomy
Seat tube
Top tube
Seat tube angle72 - 74°
![Page 8: Bike Fit](https://reader035.vdocuments.us/reader035/viewer/2022062720/56813438550346895d9b2bad/html5/thumbnails/8.jpg)
Crankset and Chainrings
53
39
Rider Height
60-64 inches165–167.5mm
65-72 inches170mm
72-74 inches172.5mm
74-76 inches175mm ER Burke
![Page 9: Bike Fit](https://reader035.vdocuments.us/reader035/viewer/2022062720/56813438550346895d9b2bad/html5/thumbnails/9.jpg)
Cycling Clock Diagram
Broker and Gregor 1996
Myth: Clipless pedalsallow the rider to pull upduring steady state
US National Rider300W and 90RPM
The limb is lifted butNot as fast as the pedalIs rising
![Page 10: Bike Fit](https://reader035.vdocuments.us/reader035/viewer/2022062720/56813438550346895d9b2bad/html5/thumbnails/10.jpg)
Order of Fit
1. Foot-Cleat-Pedal Interface
2. Pelvis-Saddle InterfaceSaddle HeightSaddle Tilt and Fore-AftRe-check Saddle Height
3. Hands-Handlebar InterfaceHeight, Reach, and Tilt 1
2
3
![Page 11: Bike Fit](https://reader035.vdocuments.us/reader035/viewer/2022062720/56813438550346895d9b2bad/html5/thumbnails/11.jpg)
1. Foot-Cleat-Pedal
• Ball of the foot is over the pedal spindle
• 1st metatarsal head
![Page 12: Bike Fit](https://reader035.vdocuments.us/reader035/viewer/2022062720/56813438550346895d9b2bad/html5/thumbnails/12.jpg)
2. Saddle Height
![Page 13: Bike Fit](https://reader035.vdocuments.us/reader035/viewer/2022062720/56813438550346895d9b2bad/html5/thumbnails/13.jpg)
Saddle Height
Most important bicycle position setting
• Inseam measurement method (LeMond)– Saddle Height = 0.883 X inseam in cm
• Knee angle measurement (Pruitt, Burke)– 25 to 30 degrees knee flexion at 6 o’clock position
• Heel to back of pedal method– Leg almost fully extended with no hip rocking
![Page 14: Bike Fit](https://reader035.vdocuments.us/reader035/viewer/2022062720/56813438550346895d9b2bad/html5/thumbnails/14.jpg)
Lemond-Guimard Method.
Saddle Height = Inseam in cm X .883
Saddle Height
![Page 15: Bike Fit](https://reader035.vdocuments.us/reader035/viewer/2022062720/56813438550346895d9b2bad/html5/thumbnails/15.jpg)
2. Saddle Height
Knee flexed 25-30 degreeswith pedal in 6 o’clockposition.
Photo by Mike Spilker.
![Page 16: Bike Fit](https://reader035.vdocuments.us/reader035/viewer/2022062720/56813438550346895d9b2bad/html5/thumbnails/16.jpg)
Saddle Height
Fabian Cancellara and Andy Pruitt
![Page 17: Bike Fit](https://reader035.vdocuments.us/reader035/viewer/2022062720/56813438550346895d9b2bad/html5/thumbnails/17.jpg)
3. Saddle Fore-Aft-Tilt
Tilt
Fore-Aft
![Page 18: Bike Fit](https://reader035.vdocuments.us/reader035/viewer/2022062720/56813438550346895d9b2bad/html5/thumbnails/18.jpg)
3. Saddle Fore-Aft
When pedal is in the 3 o’clock position, plumb line dropped from inferior pole of patella falls directly over pedal spindle.Bert Webster performing bike fit. Photos by Mike Spilker.
![Page 19: Bike Fit](https://reader035.vdocuments.us/reader035/viewer/2022062720/56813438550346895d9b2bad/html5/thumbnails/19.jpg)
Road vs. Time Trial Position
Steeper Seat TubeMore Forward PositionHigher Saddle
Plumb bob falls overpedal spindle and 1st metatarsal
![Page 20: Bike Fit](https://reader035.vdocuments.us/reader035/viewer/2022062720/56813438550346895d9b2bad/html5/thumbnails/20.jpg)
Frank Schleck
TT Position Raised
Goal: more power
![Page 21: Bike Fit](https://reader035.vdocuments.us/reader035/viewer/2022062720/56813438550346895d9b2bad/html5/thumbnails/21.jpg)
4. Stem Height
1 to 3 inches
![Page 22: Bike Fit](https://reader035.vdocuments.us/reader035/viewer/2022062720/56813438550346895d9b2bad/html5/thumbnails/22.jpg)
4. Stem Height
Stem raised 1cm, rider actually became lower, more aero
![Page 23: Bike Fit](https://reader035.vdocuments.us/reader035/viewer/2022062720/56813438550346895d9b2bad/html5/thumbnails/23.jpg)
4. Stem Extension
Stem Size10 –12 cm
Top Tube
Tops
Hoods
Drops
![Page 24: Bike Fit](https://reader035.vdocuments.us/reader035/viewer/2022062720/56813438550346895d9b2bad/html5/thumbnails/24.jpg)
4. Stem Extension
Torso flexes about 60degrees with the handsin the drops.
Photo by Mike Spilker.
Torso flexes about 45degrees with the handson the hoods.
![Page 25: Bike Fit](https://reader035.vdocuments.us/reader035/viewer/2022062720/56813438550346895d9b2bad/html5/thumbnails/25.jpg)
4. Stem Extension
Andre Steensen, neck and lower back pain, shortened stem 1cm
![Page 26: Bike Fit](https://reader035.vdocuments.us/reader035/viewer/2022062720/56813438550346895d9b2bad/html5/thumbnails/26.jpg)
OVERUSE INJURIES
![Page 27: Bike Fit](https://reader035.vdocuments.us/reader035/viewer/2022062720/56813438550346895d9b2bad/html5/thumbnails/27.jpg)
Contact Overuse
Saddle Sore
Morton’s Neuroma
Neuropathy
![Page 28: Bike Fit](https://reader035.vdocuments.us/reader035/viewer/2022062720/56813438550346895d9b2bad/html5/thumbnails/28.jpg)
‘Morton’s Neuroma’
• Burning pain and numbness
• Impingement of interdigital nerves
• See riders shaking foot out of pedals
• Chronic inflammatory mass
• Between 3rd and 4th metatarsal classically
![Page 29: Bike Fit](https://reader035.vdocuments.us/reader035/viewer/2022062720/56813438550346895d9b2bad/html5/thumbnails/29.jpg)
‘Morton’s Neuroma’ On the Bike Treatment
• Adjust cleat position, usually further back
• Check inside shoe for cleat bolts
• Change shoes to wider toe box
• Shoe inserts may help
![Page 30: Bike Fit](https://reader035.vdocuments.us/reader035/viewer/2022062720/56813438550346895d9b2bad/html5/thumbnails/30.jpg)
‘Morton’s Neuroma’Medical Treatment
• Cortisone
• Massage
• Shoe inserts
• Surgery
![Page 31: Bike Fit](https://reader035.vdocuments.us/reader035/viewer/2022062720/56813438550346895d9b2bad/html5/thumbnails/31.jpg)
Saddle Sores
• Moisture + Pressure + Friction
• Chafing
• Ulceration
• Folliculitis
• Abcess
• Subcutaneous nodules
![Page 32: Bike Fit](https://reader035.vdocuments.us/reader035/viewer/2022062720/56813438550346895d9b2bad/html5/thumbnails/32.jpg)
Saddle Sores On the Bike Treatment
• Change saddle
• Cut a hole in the saddle
• Check saddle height and tilt
• Clean chamois, no seams, keep dry
• Don’t sit around in your kit after riding
• Emollients
![Page 33: Bike Fit](https://reader035.vdocuments.us/reader035/viewer/2022062720/56813438550346895d9b2bad/html5/thumbnails/33.jpg)
Saddle SoresMedical Treatment
• Prevention– Keep dry, clean, chamois, avoid shaving high
• Medical Treatment– Warm soaks– Topical cortisone, anti-fungal, anti-bacterial– Oral antibiotics– Surgical incision and drainage– Surgery
![Page 34: Bike Fit](https://reader035.vdocuments.us/reader035/viewer/2022062720/56813438550346895d9b2bad/html5/thumbnails/34.jpg)
Hand Neuropathy
• Cyclist’s Palsy (Ulnar Neuropathy)
• Carpal Tunnel Syndrome
• Worse after long rides
• Worse on rough terrain
• EMG reversible changes
• May become permanent
![Page 35: Bike Fit](https://reader035.vdocuments.us/reader035/viewer/2022062720/56813438550346895d9b2bad/html5/thumbnails/35.jpg)
Hand NeuropathyOn the Bike Treatment
• Relieve pressure
• Pad bars
• New gloves (not gel)
• Reposition often
• Bars too far forward
• Too low
• Too much tilt
![Page 36: Bike Fit](https://reader035.vdocuments.us/reader035/viewer/2022062720/56813438550346895d9b2bad/html5/thumbnails/36.jpg)
Hand NeuropathyMedical Treatment
• Massage
• Cortisone
• Night splint
• Surgery
![Page 37: Bike Fit](https://reader035.vdocuments.us/reader035/viewer/2022062720/56813438550346895d9b2bad/html5/thumbnails/37.jpg)
Bursitis
Pre-patella andMCL bursa
Greater Troch
Ischial Tuberosity
![Page 38: Bike Fit](https://reader035.vdocuments.us/reader035/viewer/2022062720/56813438550346895d9b2bad/html5/thumbnails/38.jpg)
Ischial Tuberosity ‘Bursitis’
• ‘Sits Bones’ sore
• Cold weather, early season, time trialing
• Rest, Massage, Cortisone
• On the Bike:– Change saddle– Check saddle height and tilt– New chamois
![Page 39: Bike Fit](https://reader035.vdocuments.us/reader035/viewer/2022062720/56813438550346895d9b2bad/html5/thumbnails/39.jpg)
Greater Trochanteric ‘Bursitis’
• Proximal ITB Syndrome
• Pain with lying on side at night
• Physical Therapy
• Massage, OMT, Cortisone
• On the bike:– Check saddle height– Check cycling form
![Page 40: Bike Fit](https://reader035.vdocuments.us/reader035/viewer/2022062720/56813438550346895d9b2bad/html5/thumbnails/40.jpg)
Pre-Patellar Bursitis
• Aspiration and fluid analysis• Cortisone• RICE and massage• On the bike:
– Check cleat and position– Check saddle height and fore-aft– Check pedal technique– Check crank arm length
![Page 41: Bike Fit](https://reader035.vdocuments.us/reader035/viewer/2022062720/56813438550346895d9b2bad/html5/thumbnails/41.jpg)
MCL ‘Bursitis’
• Pain and tenderness over MCL• MRI if suspicious for meniscal tear• Massage• Cortisone• On the bike:
– Check cleat– Check saddle height and fore-aft– Check pedal technique
![Page 42: Bike Fit](https://reader035.vdocuments.us/reader035/viewer/2022062720/56813438550346895d9b2bad/html5/thumbnails/42.jpg)
Most Common
ITB
Patella Femoral
Patella Tendon
![Page 43: Bike Fit](https://reader035.vdocuments.us/reader035/viewer/2022062720/56813438550346895d9b2bad/html5/thumbnails/43.jpg)
Patella Femoral Pain Syndrome
• Pain under the patella from excessive load– Hill climb– Wind– Big gear– Time trialing– Weight training
![Page 44: Bike Fit](https://reader035.vdocuments.us/reader035/viewer/2022062720/56813438550346895d9b2bad/html5/thumbnails/44.jpg)
Patella Femoral Pain Syndrome
• Tender patella facets
• Tender patella compression
• Unable to do one legged squat
• No effusion
![Page 45: Bike Fit](https://reader035.vdocuments.us/reader035/viewer/2022062720/56813438550346895d9b2bad/html5/thumbnails/45.jpg)
Patella Femoral Pain SyndromeTreatment
• Off the Bike– Massage
– Cortisone or viscosupplementation
– Physical Therapy
– Surgery for removal of medial plica
• On the Bike– Check if saddle is too low or forward
– Check if cranks are too long
– Relative rest, supple spinning
![Page 46: Bike Fit](https://reader035.vdocuments.us/reader035/viewer/2022062720/56813438550346895d9b2bad/html5/thumbnails/46.jpg)
ITB Syndrome Distal
• Anterolateral pain
• Burning or snapping
• Climbing, pushing big gears
• Wind
• Stationary Trainer
![Page 47: Bike Fit](https://reader035.vdocuments.us/reader035/viewer/2022062720/56813438550346895d9b2bad/html5/thumbnails/47.jpg)
ITB
• Massage• Assisted Stretching• OMT• Physical Therapy• Leg length evaluation• Address training and
bike fit• Not Rest, NSAIDs,
injection, or surgery
![Page 48: Bike Fit](https://reader035.vdocuments.us/reader035/viewer/2022062720/56813438550346895d9b2bad/html5/thumbnails/48.jpg)
Knee Pain and AdjustmentLocation Cause Solution
Anterior Saddle too low Raise saddleSaddle too far forward Move saddle
back Cranks too long Shorten cranksPosterior Saddle too high Lower saddle
Saddle too far back Move forwardMedial Toes point out Point in
Feet too far apart Move closerTight pedal tension Lower tension
Lateral Toes point in Point outFeet too close Move apart
Arnie Baker 1998 Bicycle Medicine
![Page 49: Bike Fit](https://reader035.vdocuments.us/reader035/viewer/2022062720/56813438550346895d9b2bad/html5/thumbnails/49.jpg)
Strain
CervicalThoracic
Lumbar
![Page 50: Bike Fit](https://reader035.vdocuments.us/reader035/viewer/2022062720/56813438550346895d9b2bad/html5/thumbnails/50.jpg)
Thoracic Strain/Cervical Strain
• Upper trapezius
• Levator scapula
• Trigger points and spasm
• Do not need to be folded in half
• Bars too low or too far forward versussaddle to far back
• Manual Therapy, Strengthening Program Trigger point injections
![Page 51: Bike Fit](https://reader035.vdocuments.us/reader035/viewer/2022062720/56813438550346895d9b2bad/html5/thumbnails/51.jpg)
TRAINING
![Page 52: Bike Fit](https://reader035.vdocuments.us/reader035/viewer/2022062720/56813438550346895d9b2bad/html5/thumbnails/52.jpg)
Training Periods of Pros
0
200
400
600
800
Nov - Dec Dec - Feb Mar - Oct
km/week
90%
0%10%
80%
15%5%
75%
15%10%
% in Zone 3> 90% HRmax
% in Zone 270 – 90% HRmax
% in Zone 1< 70% HRmax
Rest Pre-Season Competition
![Page 53: Bike Fit](https://reader035.vdocuments.us/reader035/viewer/2022062720/56813438550346895d9b2bad/html5/thumbnails/53.jpg)
Training Stimulus
Performance
Training Volume/Intensity
![Page 54: Bike Fit](https://reader035.vdocuments.us/reader035/viewer/2022062720/56813438550346895d9b2bad/html5/thumbnails/54.jpg)
Overtraining
• Cyclists are notorious
• Clinical history is most important
• Many blood tests, not very helpful
• Exclude organic disease
• Profile of Mood States
• Performance Testing Decrement– VO2, Lactate, HR, Watts, RPE relationship
![Page 55: Bike Fit](https://reader035.vdocuments.us/reader035/viewer/2022062720/56813438550346895d9b2bad/html5/thumbnails/55.jpg)
Laws of Training
1. The race is won in the off season2. Train frequently, all year round3. Start gradually and gently4. Build a big base5. Go hard on the hard days, easy on the easy days6. Do not overtrain7. Avoid monotony8. Train with others9. Keep a logbook10. Take a break at the end of a season, stay active
Adapted from Tim Noakes in the Lore of Running
![Page 56: Bike Fit](https://reader035.vdocuments.us/reader035/viewer/2022062720/56813438550346895d9b2bad/html5/thumbnails/56.jpg)
Marc Silberman, M.D. [email protected]