Bike Fit Marc Silberman, M.D. Gillette, NJ Slide 2 Supplies
Bicycle trainer Stadiometer or measuring tape Text book Measuring
tape Goniometer Plumb line Allen wrench set Video Camera, Tripod,
Computer/TV Slide 3 Slide 4 Pro Bike Fit Fabian Cancellara, Andy
Pruit, Scott Holz, Bobby Julich Slide 5 Bicycle Exam Slide 6
Balance Comfort Safety Injury Prevention Peak Performance Aerobic
efficiency versus aerodynamics Superman Position Slide 7 Bicycle
Anatomy Seat tube Top tube Seat tube angle 72 - 74 Slide 8 Crankset
and Chainrings 53 39 Rider Height 60-64 inches 165167.5mm 65-72
inches 170mm 72-74 inches 172.5mm 74-76 inches 175mm ER Burke Slide
9 Cycling Clock Diagram Broker and Gregor 1996 Myth: Clipless
pedals allow the rider to pull up during steady state US National
Rider 300W and 90RPM The limb is lifted but Not as fast as the
pedal Is rising Slide 10 Order of Fit 1. Foot-Cleat-Pedal Interface
2. Pelvis-Saddle Interface Saddle Height Saddle Tilt and Fore-Aft
Re-check Saddle Height 3. Hands-Handlebar Interface Height, Reach,
and Tilt 1 2 3 Slide 11 1. Foot-Cleat-Pedal Ball of the foot is
over the pedal spindle 1 st metatarsal head Slide 12 2. Saddle
Height Slide 13 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 oclock position Heel to back of pedal
method Leg almost fully extended with no hip rocking Slide 14
Lemond-Guimard Method. Saddle Height = Inseam in cm X.883 Saddle
Height Slide 15 2. Saddle Height Knee flexed 25-30 degrees with
pedal in 6 oclock position. Photo by Mike Spilker. Slide 16 Saddle
Height Fabian Cancellara and Andy Pruitt Slide 17 3. Saddle
Fore-Aft-Tilt Tilt Fore-Aft Slide 18 3. Saddle Fore-Aft When pedal
is in the 3 oclock position, plumb line dropped from inferior pole
of patella falls directly over pedal spindle. Bert Webster
performing bike fit. Photos by Mike Spilker. Slide 19 Road vs. Time
Trial Position Steeper Seat Tube More Forward Position Higher
Saddle Plumb bob falls over pedal spindle and 1 st metatarsal Slide
20 Frank Schleck TT Position Raised Goal: more power Slide 21 4.
Stem Height 1 to 3 inches Slide 22 4. Stem Height Stem raised 1cm,
rider actually became lower, more aero Slide 23 4. Stem Extension
Stem Size 10 12 cm Top Tube Tops Hoods Drops Slide 24 4. Stem
Extension Torso flexes about 60 degrees with the hands in the
drops. Photo by Mike Spilker. Torso flexes about 45 degrees with
the hands on the hoods. Slide 25 4. Stem Extension Andre Steensen,
neck and lower back pain, shortened stem 1cm Slide 26 OVERUSE
INJURIES Slide 27 Contact Overuse Saddle Sore Mortons Neuroma
Neuropathy Slide 28 Mortons Neuroma Burning pain and numbness
Impingement of interdigital nerves See riders shaking foot out of
pedals Chronic inflammatory mass Between 3 rd and 4 th metatarsal
classically Slide 29 Mortons 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 Slide 30
Mortons Neuroma Medical Treatment Cortisone Massage Shoe inserts
Surgery Slide 31 Saddle Sores Moisture + Pressure + Friction
Chafing Ulceration Folliculitis Abcess Subcutaneous nodules Slide
32 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 Dont sit around in your kit after riding Emollients Slide
33 Saddle Sores Medical 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 Slide 34 Hand Neuropathy Cyclists
Palsy (Ulnar Neuropathy) Carpal Tunnel Syndrome Worse after long
rides Worse on rough terrain EMG reversible changes May become
permanent Slide 35 Hand Neuropathy On the Bike Treatment Relieve
pressure Pad bars New gloves (not gel) Reposition often Bars too
far forward Too low Too much tilt Slide 36 Hand Neuropathy Medical
Treatment Massage Cortisone Night splint Surgery Slide 37 Bursitis
Pre-patella and MCL bursa Greater Troch Ischial Tuberosity Slide 38
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 Slide 39 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 Slide 40 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 Slide 41 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 Slide 42 Most
Common ITB Patella Femoral Patella Tendon Slide 43 Patella Femoral
Pain Syndrome Pain under the patella from excessive load Hill climb
Wind Big gear Time trialing Weight training Slide 44 Patella
Femoral Pain Syndrome Tender patella facets Tender patella
compression Unable to do one legged squat No effusion Slide 45
Patella Femoral Pain Syndrome Treatment 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
Slide 46 ITB Syndrome Distal Anterolateral pain Burning or snapping
Climbing, pushing big gears Wind Stationary Trainer Slide 47 ITB
Massage Assisted Stretching OMT Physical Therapy Leg length
evaluation Address training and bike fit Not Rest, NSAIDs,
injection, or surgery Slide 48 Knee Pain and Adjustment
LocationCauseSolution AnteriorSaddle too lowRaise saddle Saddle too
far forwardMove saddle back Cranks too longShorten cranks
PosteriorSaddle too highLower saddle Saddle too far backMove
forward MedialToes point outPoint in Feet too far apartMove closer
Tight pedal tensionLower tension LateralToes point inPoint out Feet
too closeMove apart Arnie Baker 1998 Bicycle Medicine Slide 49
Strain Cervical Thoracic Lumbar Slide 50 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
versus saddle to far back Manual Therapy, Strengthening Program
Trigger point injections Slide 51 TRAINING Slide 52 Training
Periods of Pros 90% 0% 10% 80% 15% 5% 75% 15% 10% % in Zone 3 >
90% HRmax % in Zone 2 70 90% HRmax % in Zone 1 < 70% HRmax Rest
Pre-Season Competition Slide 53 Training Stimulus Performance
Training Volume/Intensity Slide 54 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 Slide 55 Laws of Training 1.The race is won in the off
season 2.Train frequently, all year round 3.Start gradually and
gently 4.Build a big base 5.Go hard on the hard days, easy on the
easy days 6.Do not overtrain 7.Avoid monotony 8.Train with others
9.Keep a logbook 10.Take a break at the end of a season, stay
active Adapted from Tim Noakes in the Lore of Running Slide 56 Marc
Silberman, M.D. [email protected]
