Connor is a full-time physiotherapist and
a n e l i te l eve l a g e g ro u p t r i a t h l ete. H e
w o r ke d i n a b i ke s h o p w h i l s t a t u n i v e r s i t y,
i g n i t i n g a l o v e f o r b i ke f i t t i n g . T h i s p a s s i o n
h a s o n l y ex p a n d e d a s a p rofessi o n a l ,
utilising his skills and knowledge as a
physiotherapist in conjunction with his
own impressive experiences in cycling
and triathlon, to begin treating patients
w i t h c y c l i n g - r e l a t e d i s s u e s t h r o u g h b i ke
f i tt i n g a n d c u sto m i se d re h a b p ro g ra m s.
He shares his recent experience travelling
t o A m s t e r d a m t o u n d e r t a ke A u s t r a l i a n
p h y s i o t h e r a p i s t Pa u l V i s e n t i n i ’s “ S c i e n c e
of Cycling” course as part of his
ongoing development as a dedicated
physiotherapist.
W
hat is bike fitting, and why is it so important?
Essentially to “fit a bike” involves matching a person’s
equipment to their own personal capabilities with the
goal of improving performance, comfort, efficiency
and reducing injury rates. As a physiotherapist, my goal is to create
the perfect symphony between a clinical, biomechanical and
aerodynamic approach. This requires an in-depth approach that
incorporates body assessment including mobility and strength,
an on-bike assessment, hands-on therapy and where required, a
supplementary exercise program. This is then assessed through
dynamic analysis – looking at power and heart rate while riding
in their initial position and the final position to see if there is a
measureable change.
Rewind to July and my eagerness for learning lead me to
Amsterdam, where 12 physiotherapists convened to learn more
about the art of bike fitting, cyclist assessment, treatment and
rehabilitation from Paul Visentini. Also attending were a number
of highly skilled physiotherapists, PhD candidates, pro cyclists
Niki Terpstra’s physiotherapist, and a bike fitter for a number of
professional teams working out of Geneva. I saw this as a great
opportunity to not only learn the evidence behind our treatment
methods, but also gain some experiential knowledge from these
great minds.
The three-day intensive course was truly a valuable experience
to learn more about motor patterns, strength training and how
the bike can be modified in so many ways to make the body
more comfortable, efficient and aerodynamic. My main lessons in
relation to evidence (disclaimer – this doesn’t include experiential
evidence, purely what the research currently shows):
•
Most cycling injuries are related to the lower back BUT
the knee is the area which causes the most time off
the bike
•
There is moderate evidence for a link between saddle
height and knee pain (i.e. saddle too low can cause knee
pain), and minimal evidence for saddle fore/aft in knee
pain (i.e. position of saddle in relation to the bottom
bracket)
•
68.7% of cyclists surveyed in one study (Dahlquist, 2015)
had pain while cycling, and 65.1% of those had that
injury for longer than 1 year
•
There is also moderate evidence for a link between
increased lower back flexion (i.e. larger drop to the
handlebars) and lower back pain
An interesting take home point from the course was there was
only moderate evidence for supporting the many expensive bike
fitting machines and the parameters these machines work off
and significantly helping with pain/injury. Alternatively, there is
great evidence for professional bike fitting with positive outcomes
and pain relief. So regardless of the methods used, whether it be
the $20,000 machines or a windtrainer, the message to coaches
and athletes alike is to ensure the fitter is experienced and
knowledgeable in the bike fitting; it is both an art and a science.
These outcomes emphasise the need to analyse the body more
than the bike, looking at strength, mobility, muscle activation
and kinematics. This is where health professionals become key.
I certainly am biased towards physiotherapists, but have met
myotherapists, osteopaths, sports scientists and biomechanists
who also perform fantastic bike fits. If you are experiencing pain,
why not seek someone who is an expert in pain relief?
For coaches/athletes, here are some quick evidence-based things
to look out for which might be contributing to your pain:
•
•
•
Back pain: too much lumbar flexion i.e. bending too far,
reaching too far to the handlebars
Knee pain: saddle too low
Saddle pain: cut out in the saddle to assist with relief of
anterior perineal structures
and some experiential-based (those garnered from the groups
years in the industry) things to look out for:
•
•
•
•
Foot pain: is there a rigid base in the shoe? Is cleat
position correct/even?
Toe numbness: cleat position is critical, saddle fore/aft
also a factor
Hand numbness: bars too low
Neck pain: reaching too far or too low
Since arriving back in Australia I find myself assessing everyone’s
position now whenever I am riding past! My new focus is to help
my clients by focussing on helping the body be comfortable in
the position it wants to be in on the bike, rather than making a
body suit a position it is not used to. Comfort is a huge player in
speed. As a triathlete, I have had comfort-related bike fits and also
have had aerodynamic-related bike fits myself, but a combination
of these leads to the most ideal outcome. Aerodynamics are
important (everyone wants to go faster), but comfort is also key in
maintaining the perfect time trial position for 20, 40, 90 or
180 kilometres.
TOP TIPS FOR CYCLING COMFORTABLY:
1.
Make sure you are riding the right size bike –
collaboration between your physiotherapist/allied health
professional and local bike shop can make sure your dream bike is
the right size.
2.
Relax! The main thing I see contributing to people’s pain
is that they are too tense on the road. 70% of the pressure should
be going through your feet, 20% through the saddle and 10%
through your hands, so relax your upper body.
3.
Make sure that not ALL of your riding is hard – 90% of
your riding should be easy and long, with the remaining 10%
being hard work. Monitor your load levels.
4.
Make sure your body stays ‘fit’ for your dream bike
– maintain condition by doing the rehab/prehab/recovery and
training specifically set by your health professional and/or coach.
5.
Recovery is key – post ride, ensure you have had enough
nutrition and fluids on board, stretch/foam roll (for pain relief, not
injury management) and continue with your conditioning work. As
they say, it’s not all about the bike!
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