University of Virginia

Clinical Bike Fit

Jay Dicharry, MPT
University of Virginia
Center for Endurance Sport
Dept of Physical Medicine and Rehab
University of Virginia
 University of Virginia

Quick tip for patients ! Seat height

•!level pelvis
•!crank arm parallel to
the seat tube
•!Heel on pedal
•!Knee should be straight
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Quick tip for patients ! Seat height

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Anterior knee pain?

Raise seat to minimize excessive
compressive forces on patella
femoral joint

Lateral Knee pain?

Lower seat to avoid friction of
the Illiotibial band across the
femoral condyle
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For more information:

“Bike Right, Bike Fit!” -APTA

The End!
……..or is it the beginning!
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•!Aim to be efficient
•!Course demands play a role in their position
•!Individual factors affect fit
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Bike Fit for the clinician…… today and beyond

1.! How do I use their body in front of me today?

!!fit bike to rider
a)! Our evaluation defines constraints of each individual
b)! Apply these limits in ROM and stability to that day’s fit

2. What needs to be altered to be able to seek desired position?

!!fit rider to bike
!!Identify issues in ROM, stability, and technique that need to
be addressed to reach desired position – clinical experience
guides this just as it does in any functional training

Make the bike reflective of the rider

Proper bike fit is a process
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Why doesn’t
every cyclist
look like one
of these two
guys?

Endless supply of resources

flexibility
Event specific fit stability
Daily optimization of position
Technique They are different than you!

They have a closed course with a pace car in front of them and a coach in their
ear piece telling them How many feet till the next turn - and you don’t
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You must go down and

forward for better time trial
and triathlon performance.
The wind tunnel numbers don’t
lie.

Busted
Reason
1.! it IS possible to get almost as aero as standard draft legal
positions using an ITU legal position if you manipulate the body
correctly.

2. Going forward and up will help to " drag, but when does the
change in joint angles result in a " power output?
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You run faster off the bike leg if you

are in a forward, aero position.

Inconclusive
Reason
1.! For every study I’ve read that says one thing, another study says
another. Hard to control.

2. do me a favor and tell the ITU guys and gals (who are in restricted
positions) that sorry, they can’t run a sub-30 min 10K Off the bike.
Guess what - they are!!!
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So how do we begin the fit process?

Key Principles:
1.! Accommodate for structure, work to improve dynamic limitations
2.! Orient the rider in the correct location above the bottom bracket and
contact points
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Case Study: Rider X

Top 10 VA state TT championships
Goal: win state TT
5 yrs riding history - 3 yr focus on TT
Mild/moderate low back pain after 30 min on TT bike

Musculoskeletal Exam Highlights:

Severe limited lumbar flexion, severe hip flexor limitation, severe
hamstring restriction bilaterally, protracted shoulders

•!Fit emphasis on rolling the hips forward to minimize strain on lumbar spine
and open the hip angle throughout the stroke
•!Location over the bottom bracket established through course profiles and
soft tissue and stability limitations
•!Exercises given to increase hamstring and hip flexor mobility and increase
scapular stability to prevent excessive protraction in aerobars
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Results:
Back pain reduced following fit to complete resolution in 3 weeks
Over the course of the year, rider saw significant improvements in power and placing
at races: VA state TT champ, Top 5 @ Nats

Verdict: he is pleased - calls me constantly, thinks fit is a big part of his success

Fast forward….Rider finishes residency and is now making a salary

Goes to wind tunnel for analysis
Engineer in tunnel says “You won the state TT in that position?!?!? - we can do
better!!!”
Engineer does NOT perform or take into consideration any biomechanical
analysis that is unique to the rider, but improves drag by 32%. Both depart
happily.

Rider calls me after 3 months of trying to adapt to this position:

1.! Back pain has returned.
2.! Power outputs on all workouts have objectively reduced 40-50 watts at all
given intensity. Power outputs remain normal on his road bike.
3.! Has not placed in top 10 in any race since he altered position.
……………. Do you think Rider X reached the tipping point???
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So how do we begin the fit process?

.....by addressing points of contact

1.! Cleat position

2.! Set Seat height

3.! Fore / Aft position

Seat tube
4.! Bar drop Seat tube angle

5.! Bar width

Bottom bracket
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1.! Cleat position

a.!fore/aft b. rotation c. width
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1.! Cleat position

Shim……..to shim or not to shim……and where

Cycling is not running

•!Foot deformation due to " shock is not necessary as part of pedal cycle
•!Structure does influence how the foot interfaces with the shoe foot bed

Cleat wedge Forefoot wedge insole

Ar
•!Alter position of entire foot •!Alter surface contact on foot- proprioception
•!intervention at the ankle •!Possible to alter torsional position of foot
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1.! Cleat position

- foot interface – Step 1 – arch height

Plug the hole

With an insole!

Ar
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1.! Cleat position

- foot interface – Step 2 – forefoot alignment

Fill the gap

Ar
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Knee angles: angle at the knee when

2. Seat Height the pedal is the furthest distance
away from the hip joint
•! this is not always parallel with the
seat tube with some more radical
frame designs
•! 25-40 deg depending on rider
history and ankling pattern
•! Wide range to take into account
what happens under load
•! If Excessive pelvic rock or
excessive toe down, check
pelvis to see if pattern is
acquired or compensatory
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2. Seat Height
•! Observe rider first to check ankle
position - direct effect on knee angle

•! Achieved through measuring knee

angle (angle between greater troch
and fibular maleolus)

•! Using a goniometer, knee flexion

angle should be between 25-40 deg
when the pedal is the furthest distance
from the acetabulum ( parallel to the
seat tube)

•! Mountain bikers can go slightly lower

for lower COG, so try to move seat
back to maintain relative distance from
bottom bracket
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3. Fore / Aft
This can be objectively referenced using either:

a)! the bike (seat tube angle)

•! 1 cm = ~1 deg of STA

b)! the rider (using anatomical landmarks on the

rider’s body).
•! KOPS!

1. Fibular head over pedal spindle

2. Tibial tuberosity over pedal spindle
3. Patella over pedal spindle
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3. Fore / Aft

Rider anterior neutral Rider posterior

Fibular Head Tibial tuberosity Patella

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Fore-aft position
If tibial tubercle is neutral, why would we depart?

•! Anthropometric differences
•! Course profiles
•! Aero goals

If the desire is to go low, you’ve got to get forward,

But you also get closer to the tipping point
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4. Bars
!! Comfort
!! Handling
1.! Bar drop
2.! Bar width

•!Bar height should take constraints

of the rider into the equation
What happens on the way down?
Posterior tilt Can’t
get low

Vertical Middle
road

Anterior tilt Low

long

Ability to roll pelvis limited by:

1.! ROM in hamstrings and L spine
2.! Stabilization

Critical for bar drop & reach!

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J-Bar Test
•!to establish an aerobar drop that is specific to the
dynamic mobility of each rider

•! allows a functional quantification of a rider’s mobility that

is reflective of the amount of soft tissue tension it sees in
a riding position.
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J-Bar Test
Instructions:
a. Have the rider stand against a wall and record their inseam
(cycling shoes on)
b. Rider to places a dowel along the back of the body so that it is
held in contact with the sacrum, thoracic spine, and back of the
head. They will be standing sideways to the wall so that it is on their
right or left.
c. Instruct the rider to bend their knees approximately 30 deg
d. While keeping the knees in their 30 bend, ask the rider to bend
from the hips until the point at which they feel any tension at all in
the hamstrings or low back
 University of Virginia

J-Bar Test
Instructions:
a. Have the rider stand in bare feet against a wall and record their
inseam (in shoes)
b. Rider to places a dowel along the back of the body so that it is
held in contact with the sacrum, thoracic spine, and back of the
head. They will be standing sideways to the wall so that it is on their
right or left.
c. Instruct the rider to bend their knees approximately 30 deg
d. While keeping the knees in their 30 bend, ask the rider to bend
from the hips until the point at which they feel any tension at all in
the hamstrings or low back
 University of Virginia

J-Bar Test
Instructions:
a. Have the rider stand in bare feet against a wall and record their
inseam (in shoes)
b. Rider to places a dowel along the back of the body so that it is
held in contact with the sacrum, thoracic spine, and back of the
head. They will be standing sideways to the wall so that it is on their
right or left.
c. Instruct the rider to bend their knees approximately 30 deg
d. While keeping the knees in their 30 bend, ask the rider to bend
from the hips until the point at which they feel any tension at all in
the hamstrings or low back
 University of Virginia

J-Bar Test
Instructions:
a. Have the rider stand in bare feet against a wall and record their
inseam (in shoes)
b. Rider to places a dowel along the back of the body so that it is
held in contact with the sacrum, thoracic spine, and back of the
head. They will be standing sideways to the wall so that it is on their
right or left.
c. Instruct the rider to bend their knees approximately 30 deg
d. While keeping the knees in their 30 bend, ask the rider to bend
from the hips until the point at which they feel any tension at all in
the hamstrings or low back. Measure the height of the elbow above
the ground. This will serve as the High Point.
 University of Virginia

J-Bar Test
Instructions:
a. Have the rider stand in bare feet against a wall and record their
inseam (in shoes)
b. Rider to places a dowel along the back of the body so that it is
held in contact with the sacrum, thoracic spine, and back of the
head. They will be standing sideways to the wall so that it is on their
right or left.
c. Instruct the rider to bend their knees approximately 30 deg
High
d. While keeping the knees in their 30 bend, ask the rider to bend
Point from the hips until the point at which they feel any tension at all in
the hamstrings or low back. Measure the height of the elbow above
the ground. This will serve as the High Point.
 University of Virginia

J-Bar Test
e. Once this measure is recorded, ask them to
continue flexing from the hip to the point where they
feel a light to moderate stretch in the hamstrings.
Again the height of this position above the ground is
recorded as the Low Point.

f. Plug numbers into the following formula:

Inseam – High Point = high point from which we begin
bar drop from saddle
Inseam - Low Point = lowest point that bars can be
below saddle based on their flexibility

Where to place bars in the range is now a combintion

of evaluation, time in aero position, and goals.
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J-Bar Test
e. Once this measure is recorded, ask them to
continue flexing from the hip to the point where they
feel a light to moderate stretch in the hamstrings.
Again the height of this position above the ground is
recorded as the Low Point.

f. Plug numbers into the following formula:

Inseam – High Point = high point from which we begin
bar drop from saddle
Low Inseam - Low Point = lowest point that bars can be
Point below saddle based on their flexibility

Where to place bars in the range is now a combintion

of evaluation, time in aero position, and goals.
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J-Bar Test
f. Formula:
Inseam – High Point = high point from which we begin
bar drop from saddle
Inseam - Low Point = lowest point that bars can be
below saddle based on their flexibility

Example:
82 cm inseam
High Point = 84 cm ; Low Point = 74 cm

82inseam – 84 high = +2 cm ! bar 2cm above seat

82inseam – 74 low = -6 cm ! bar 6cm below seat

Where to place bars in the range is now a combintion

of evaluation, time in aero position, and goals.
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Bar Fore/aft and Tilt

•! Shoulder is perpendicular (approximately 90 Degrees) to the torso.
•! The elbow pads should be adjusted 2-4in distal to the elbow.
•! Excessive reach for the bars (flexing the shoulder) will increase muscle
activity in the upper body ! plank

Tilt -
bars up helps aerodynamic drag but limits
the amount the rider can pull on the bars
when climbing.
•!Too high of a tilt also tends to put too
much weight on the elbows
•!Too low of a tilt will create additional
upper body strain.

•!Good starting point is a slight downward

tilt to spread the weight of the upper body
equally through the forearms and hands
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Bar width
•!“Stacking” the rider over the contact points provides stability, breathing
room, and stable handling.

•!Goal is to maintain shoulder blades flat along the body

Wide
Better breathing
More comfort
More stability

Narrow
Impaired breathing
Compensatory scapula (shoulder blade) position
increasing neck strain
Poor handling (how technical is course?)
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Bar type /bike type influences elbow position and muscular effort
required to hold position

Shoulder angle
Standard
Aerobar + Road bike
= Too flexed
(too far reach)

Shoulder angle
Shorty
Aerobar
+ Road bike = @90 -proper
Weight distribution
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Fit Flowsheet - Assessment

1.! Have rider spin for 4-5 min and settle in on seat position
LISTEN-do you hear a smooth spin or choppy stroke, what does pelvis look
like (wobble or tilt), toe down or heel drop-due to compensation or
correction? Where does knee track over foot when looking from
behind? (knees should follow the structural alignment you saw during
your eval – excess frontal and transverse plane ROM can be
addressed through cueing and therapeutic intervention)
2.! Seat height via knee angle
3.! Fore/aft via KOPS method
4.! Gather info on upper body position
a.! bar drop
b.! shoulder angle
c.! elbow angle
d.! scapular orientation
e.! cervical spine position
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Fit Flowsheet - Intervention

1.! Set cleats according to static evaluation
2.! Instruct on how to sit on bike
a.! changes orientation of hip center to affect all lower body measures
b.! torso length to affect reach and drop
c.! J-Bar test uses the functional relationship of the ROM in the hamstrings
and lumbar spine to help guide expectations. Can be improved, but
be realistic about room for improvement. If they lack ham and/or
lumbar mobility, they have to go up and forward
3. Seat height @ 25 -40 deg knee flexion angle
4.! Set fore/aft according to KOPS - keep height in check
5.! Observe alterations in pedal stroke
6.! Continue to adjust bars according to criteria presented
7.! Adjust for abnormalities using Table 1
8.! Check Table 2 for specific complaints
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Positives of steep
Allows a more aerodynamic position
Necessary for riders with limited mobility – we further compensate their position on the bike due
to their lack of mobility

Negatives of steep
can decrease power production
places increased work demand on the quads
Places additional compressive forces on the patella-femoral joint
Can impair low rpm hill climbing
Can affect bike handling, vision, and safety

Positives of slack
Spreads out the total work demand of lower body muscles more evenly
Allows for more efficient position climbing
More comfortable since there is more room to move around
Puts less restriction on the hip joint (more open throughout the revolution)

Negatives of slack
less aero
rider with limited hamstring/lumbar mobility will not be able to achieve a slacker position without
making interventions to their flexibility and alignment
 Bridge the gap

From the clinic to the bike

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How do I sit on a bike? - Broomstick Drill

•!Rotate through pelvis – not spine

•!Seat tilt can be your friend to cue pelvic tilt
•!Ready Position!
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Posture
If core stability in functional task is so important,
why not do it on the bike?
Left arm off
Right arm off
Left leg off
 Left arm off
Contra-lateral leg off
 Deficient
Force-Couple
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Organization of trunk muscles is impaired in chronic LBP and posture

dysfunction, often the source of poor stabilization of the entire lower
extremity.

Global muscles provide external loading and spinal orientation

Move the bucket around
Local muscles provide segmental control
Increase the segmental stiffness

Progress is made by incorporating functional skill into

light tasks (supine bridges) and progressing to
heavier load functional task (climbing a 14% grade
at 350 watts)

Adding core drills on the bike is an essential to

Ensure that this learned skill transfers into their
Riding position.
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The End……
And the start of the road ahead