Bike modifications and set up issues can change the loads placed on the body, often these changes are carried out with the aim of improving performance. Occasionally, the incorrect set up can be a simple case ofthe bike having just been riddenby a casual cyclist and therefore lacking any conscious set up. Improper fitting of the bike to the individual rider can result not only in poorer performance but also in injury.

There is not one single formula for correct bike set up, instead the cyclists individual anatomical variants, the type of bike, performance strength and weaknesses and strength/flexibility limitations should all be considered in a good bike fit.

A lack of hip flexibility is a reasonably common fault in cyclists, especially those who do jobs that require prolonged sitting. This lack of hip flexibility can commonly lead to a compensatory varus flare (an outward movement) of the knee to allow the rider to achieve the required angle to pedal. The outward flaring of the knee, combined with a fixed cleat position of the foot, means that the loading paths of the knee and foot are no longer aligned (the knee is outside of the foot rather than over the top of it). This not only means that the forces are not transmitted to the pedals in the most effective way, but also does not load the joints in a safe manner. If the cyclist also has some forefront varus (the front of the foot turns out) this will exacerbate this problem. You can check this for yourself by looking down at your feet whilst you stand in a relaxed position – ideally you would see two toes outside of your heel and not more (note; other things can also cause the foot to look excessively turned out).

Corrections of the cyclists' biomechanical faults (e.g. lack of hip flexion) through manual therapy such as chiropractic alongside small modifications to bike set up will bring the knee and ankle joints back in line; improving both strength output and healthy joint movement. An example of one of these corrections would be to widen the cleat position, which will assist in bringing the ankle under the knee. Another alternation would be to tilt the saddle backwards a little, this increases the posterior tilt in the pelvis and reduces the need for hip flexion. This method has the disadvantage of flexing the lumbar spine further and can result in low back pain.

Another area of the body that can become sore whilst riding bicycles are the neck and shoulder regions. Often this occurs if the cyclist is reaching too far for the handle bars or putting too much weight down through the arms. If there is too much tilt forwards on the saddle, this will encourage the rider to slide forwards and they will be required to use the arms to halt their forwards slide; levelling out the saddle will help avoid this. The forward sitting posture (especially if using dropped handle bars) will also place stress on the posterior neck muscles, as the rider uses these to hold their head up and see where they are going. A rehab/prehab programme to make sure these muscles are strong, as well as good upper thoracic flexibility will go a long way in helping take the strain off this area.

In summary, aches and pains are a fairly common occurrence in cyclists but a combination of good bike fit through small modifications to set up, and strength and mobility improvements from a manual therapist like a chiropractor shoulder help to correct these.

Ref: (2014), Aches & Pains

Sarah Dunmall
MChiroProfDip BSc (Hons)