A bike fit can mean many different things to differet people. Over the years, I have experienced, and seen riders, who have undergone a 'bike fit' in various guises. This can range from someone eye-balling an approximately correct seat height, using a formula to calculate seat height, rules of thumb about bar reach and drop (forearm length + fist for reach and a fist width for drop etc), static or dynamic angle measurement, 3D motion capture, contact point pressure mapping...the list goes on. Regardless of the process or systems used during the fitting there can be short-comings in the outcome if adequate attention is not paid to the rider.
I should also say at this point, I am not writing this blog to put down or cast aspersions on other types of bike fit process. My aim is just to highlight some of the benefits that clinical knowledge and insight can bring to the process.
Many bike fitters may not have a background in biomechanics or sports injuries and so this element of examination / investigation may fall somewhat outside their remit. That is not to say that this will prevent them being able to carry out an excellent bike fit but what it can mean is that in certain cases there will be reasons why the 'normal' solutions to a rider's problems just won't work out.
So what is a Clinical Bike Fit or Clinical Cycling Analysis?
The key point here is that there is a strong clinical focus throughout the whole process. It starts with the initial interview where we can delve into your previous riding history and any injuries or issues that you have had, or are indeed still suffering with. That lays the foundation for being able to set up a structured clinical exam just like what you would have when seeing a physio / osteo / chiro about an injury.
The crucial difference is that we are looking at these problems with a cycling lens - how might they affect your position on the bike, your comfort, and also your performance? It's one thing to know a rider's injury history but it is quite another to be able to fully understand what the implications of these injuries or problems might have.
During this process it is also possible to start to piece together a bespoke rehab programme for any ongoing injury (or pain) or a personalised strength programme to target improved performance on the bike. So once again there is an element of being able to consider the bigger picture of the unique characteristics of each rider before they even sit on the bike.
Does a clinical exam always dictate how a rider will sit on or ride their bike?
In short, no. In bike fitting there are many 'rules' and it is my opinion that any time you try to make a rule in bike fitting the next rider in the door will contradict it. So, no rules! The clinical exam can be considered a reference sheet for the rider so that when we start to assess on the bike we have some context (that does not necessarily mean a complete explanation) for what we are seeing. The benefit of this context is that it can give a clinical bike fitter more options on how they may go about addressing each specific problem.
Consider this example:
A rider's pelvis is dropping down to the right side of the saddle while pedalling. A solution often seen in these cirucmstances is to 'shim' the side that is dropping to try and post it up.
Why might this work? The rider has a shorter right leg and the shim reduces the instability and over-stretch of the shorter leg.
Why might this not work? If the reason for the shift is not due to a leg length discrepancy.
What could a clinical bike fit offer? In this case there was a history of arthritis in the left hip. The clinical exam revealed a reduced range of motion in the left hip and weakness in key muscles that not only generate power but also help to stabilise the leg. On the bike it was considered that the rider had an issue clearing the top of the pedal stroke with the left hip, causing a hitchon the left and the shift to the right.
Primary bike fit considerations?
Consider changes to crank length (shorter, swing, asymmetric).
A more forward saddle position can open up the hip.
Less drop / reach to the front end can also open the hip joint.
What else can a clinical bike fit offer?
Off-bike mobility exercises to see if some improvements can be made to range of motion.
Hands on treatment to mobilise the hip joint, soft tissue techniques to surrounding muscles.
Strength exericses to address the weakness noted in the gluteal muscle groups on the left.
A comprehensive plan for physio follow-up sessions or onward referral to further investigate if needed.
Hopefully this brief example gives an insight into where a clinical bike fit can be helpful in developing a solution to a rider's problems on the bike. At The Bike The Body all our Bike Fit sessions are clinical and physio-led whether it's a Basic of Full Fit. Though we recommend a Full Fit in cases of injuries or ongoing pain on the bike to allow a more in depth assessment.
So if you have been having ongoing pain or niggles on the bike and perhaps you have even had a bike fit then it may be worth considering a Clinical Bike Fit session to try and get to the bottom of the problem both on and off the bike.
If you would like to find out more or have some questions then please email me HERE
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