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Bike Fit

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.

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Bike Fit

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  1. Bike Fit Marc Silberman, M.D. Gillette, NJ

  2. Supplies • Bicycle trainer • Stadiometer or measuring tape • Text book • Measuring tape • Goniometer • Plumb line • Allen wrench set • Video Camera, Tripod, Computer/TV

  3. Pro Bike Fit Fabian Cancellara, Andy Pruit, Scott Holz, Bobby Julich

  4. Bicycle Exam

  5. Balance • Comfort • Safety • Injury Prevention • Peak Performance • Aerobic efficiency versus aerodynamics Superman Position

  6. Bicycle Anatomy Seat tube Top tube Seat tube angle 72 - 74°

  7. Crankset and Chainrings Rider Height 60-64 inches 165–167.5mm 65-72 inches 170mm 72-74 inches 172.5mm 74-76 inches 175mm ER Burke 39 53

  8. Cycling Clock Diagram 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 Broker and Gregor 1996

  9. 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 2 3 1

  10. 1. Foot-Cleat-Pedal • Ball of the foot is over the pedal spindle • 1st metatarsal head

  11. 2. Saddle Height

  12. 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

  13. Saddle Height Lemond-Guimard Method. Saddle Height = Inseam in cm X .883

  14. 2. Saddle Height Knee flexed 25-30 degrees with pedal in 6 o’clock position. Photo by Mike Spilker.

  15. Saddle Height Fabian Cancellara and Andy Pruitt

  16. 3. Saddle Fore-Aft-Tilt Tilt Fore-Aft

  17. 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.

  18. Road vs. Time Trial Position Plumb bob falls over pedal spindle and 1st metatarsal Steeper Seat Tube More Forward Position Higher Saddle

  19. Frank Schleck TT Position Raised Goal: more power

  20. 4. Stem Height 1 to 3 inches

  21. 4. Stem Height Stem raised 1cm, rider actually became lower, more aero

  22. 4. Stem Extension Stem Size 10 –12 cm Tops Hoods Top Tube Drops

  23. 4. Stem Extension Torso flexes about 60 degrees with the hands in the drops. Torso flexes about 45 degrees with the hands on the hoods. Photo by Mike Spilker.

  24. 4. Stem Extension Andre Steensen, neck and lower back pain, shortened stem 1cm

  25. OVERUSE INJURIES

  26. Contact Overuse Neuropathy Saddle Sore Morton’s Neuroma

  27. ‘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

  28. ‘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

  29. ‘Morton’s Neuroma’Medical Treatment • Cortisone • Massage • Shoe inserts • Surgery

  30. Saddle Sores • Moisture + Pressure + Friction • Chafing • Ulceration • Folliculitis • Abcess • Subcutaneous nodules

  31. 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

  32. 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

  33. Hand Neuropathy • Cyclist’s Palsy (Ulnar Neuropathy) • Carpal Tunnel Syndrome • Worse after long rides • Worse on rough terrain • EMG reversible changes • May become permanent

  34. Hand NeuropathyOn the Bike Treatment • Relieve pressure • Pad bars • New gloves (not gel) • Reposition often • Bars too far forward • Too low • Too much tilt

  35. Hand NeuropathyMedical Treatment • Massage • Cortisone • Night splint • Surgery

  36. Bursitis Greater Troch Pre-patella and MCL bursa Ischial Tuberosity

  37. 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

  38. 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

  39. 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

  40. 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

  41. Most Common Patella Femoral ITB Patella Tendon

  42. Patella Femoral Pain Syndrome • Pain under the patella from excessive load • Hill climb • Wind • Big gear • Time trialing • Weight training

  43. Patella Femoral Pain Syndrome • Tender patella facets • Tender patella compression • Unable to do one legged squat • No effusion

  44. 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

  45. ITB Syndrome Distal • Anterolateral pain • Burning or snapping • Climbing, pushing big gears • Wind • Stationary Trainer

  46. ITB • Massage • Assisted Stretching • OMT • Physical Therapy • Leg length evaluation • Address training and bike fit • Not Rest, NSAIDs, injection, or surgery

  47. Knee Pain and Adjustment Location Cause Solution Anterior Saddle too low Raise saddle Saddle too far forward Move saddle back Cranks too long Shorten cranks Posterior Saddle too high Lower saddle Saddle too far back Move forward Medial Toes point out Point in Feet too far apart Move closer Tight pedal tension Lower tension Lateral Toes point in Point out Feet too close Move apart Arnie Baker 1998 Bicycle Medicine

  48. Strain Cervical Thoracic Lumbar

  49. 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

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