Addressing Pain on the Bike
by Brendan Martin, DPT, PT, FAFS
With the recent boom in the number of people taking up cycling, we have quite a few members of our community complaining of aches and pains after riding. Particularly with longer or harder rides, small adjustments can make a major difference in comfort, efficiency, and power on the bike.
Here are six things to consider when dealing with the aches & pains of cycling:
1) The wrong size frame: While it’s tempting to grab a second hand bike at a great price, a new rider should be sure that they’re buying a bike that fits their body. Too small, and a rider will be scrunched up on the bike and unable to evenly distribute their weight. Further, taking deep breaths while you’re crumpled up into a ball will be a challenge. Lastly, when our muscles are over-shortened, we aren’t able to access our optimum level of efficiency or power due to something called a length-tension relationship.
On the other side of the spectrum, and the more common error in my experience, is buying too big of a bike (my first bike is a size too big for me, and I had to chop the seat-post off and buy additional parts to make the handlebars reachable.) If a rider is constantly stretching and reaching to add power to the pedals, they’re potentially going to experience saddle pain, and other pains associated with overstretching for the pedals. Once again, your muscles are not in an optimal length-tension position for maximum efficiency and power (see Training by Power Blog).
Finally, riding a bike with too large of a frame is like trying to steer a massive aircraft carrier versus an agile fighter jet. The latter option is much more enjoyable!!
2) Wrong saddle height: Something as easy as the height of your bike saddle, or seat, can make all the difference in your ride.
- Too high, and your hips will be rocking side to side as you stretch out and reach for the pedals. After a while, the muscles just above our pelvis, the quadratus lumborum (QL), can start to get angry from overuse in an overstretched position. The QL is a common culprit in hip/low back discomfort in both runners and cyclists, and a lot of times it can be remedied with a quick and easy seat adjustment. Additionally, too high of a seat can result in serious sit bone pain, as you will have a lot of pressure focused on a small area. A lower seat will allow you to more evenly distribute your weight across the bike.
- If your saddle is too low, your quads will be working overtime, in a very small range of motion. Your power will be way down, and your quad muscles will be cooked in no time.
Further, you will be sitting straight up; not very aerodynamic, and not very comfortable on the sit bones for much more than a short and leisurely ride.
- Another way you can tell a seat is too low is if the rider’s knees are pointing way out to the sides as they pedal along. (This is best identified from a posterior viewpoint!)
3) Death gripping the handlebars: White knuckling during a long car drive is uncomfortable. The same applies for a long bike ride. Make sure your hands are relaxed, and that your wrist is in a neutral position (i.e. not bent severely in one direction or another. It shouldn’t look like you’re revving a motorcycle engine.) If you’re experiencing hand pain or numbness, the first two things to check are the plane of your wrist and how hard you’re holding the handlebars.
4) Poor trunk posture: You shouldn’t feel as though you’re doing a plank, but you also shouldn’t be slouching on the bike. There’s a happy medium where your body and trunk are able to relax in a neutral plane. If you’re slouching with your shoulders rounded way forward, the only option you will have to look ahead is to hyper-extend your neck (think arching). If you find yourself with a sore neck and shoulders during or after longer rides, you should evaluate the position of your trunk. Improved thoracic (mid and upper back) mobility and posturing will reduce the amount that your neck needs to arch to look ahead, and should alleviate some of your neck & shoulder discomfort.
On the drop bars for a road bike or in aero position for a tri bike, you want to make sure your trunk is long and relaxed, as it’s both easier to breath, and easier to tap into your max power and efficiency. Your hips rolling backward on the seat will generally lead to a low back rounding. Ideally, you are in more of a neutral lumbar spine and pelvis position versus a constantly rounded position.
Seat adjustments forward/back, up/down, and tip can all work to improve pelvis position. Seat position can play into this tendency but also your cycling technique and habits will also play a role. When pedaling hard, you actually want to make sure that you’re in a neutral to slightly anterior pelvic tilt, rather than that aforementioned low back rounding. This allows your most powerful cycling muscles to function in their optimal positions, and alleviates over-lengthening and strain of those QL and lumbar paraspinal muscles (think “low back muscle soreness”).
5) Float and Cleat Position on Bike Shoes: A simple adjustment in cleat position can be the difference maker between optimum power transfer and lower leg pain. Cleats are the “teeth” that clip our shoes/feet into the pedals. “Clipping in” like this is essential for optimizing the transfer of power from our legs into the mechanical energy necessary to propel the bike forward.
Proper cleat fit will leave the rider with some amount of “float,” the ability to wiggle your ankle around a bit while riding. (Imagine having the ability to move your heel side to side just a bit without your foot clicking out of the binding.) If the cleat has zero float, it will leave your foot totally fixed in one rigid position. This leaves no room for mobility, and as you move through the pedal stroke, compensations can occur in different joints up the leg, resulting in unnatural motion at the ankle, knee or even hip. On the other hand, too much float or play lowers the coefficient of power translation by allowing energy to go in different directions aside from strictly into the pedal. It can also allow for sloppy pedal mechanics, another cause of ankle, shin, knee pain. Pedal float is a spectrum between mobility and rigidity; both have their benefits, but the perfect amount of float in your pedal is going to depend on personal preference, terrain you’re riding, and your own level of joint mobility (or lack thereof!) amongst other factors.
Aside from cleat adjustments, different types of pedals have more or less float. For example, Crank Bros egg-beater pedals have a ton of float, which make them great for all the three dimensional movements a mountain-biker or cyclocross rider must go through on one of their rides. The extra motion gives your knee some variability as the rider moves through a variety of terrain, and prevents other joints from picking up the slack (IE – your knee isn’t moving twice as much to make up for a locked foot/ankle.) Conversely, a triathlete riding on a flat, straight course isn’t going to need as much mobility, so they will more likely prefer a Shimano pedal with tighter cleat fit to minimize energy leakage. These are factors that a knowledgeable local bike shop can assist a rider with.
Cleat position is where the “teeth” are placed on the bottom of the shoe and affects how power is applied to the pedal. If your feet or ankles are nicking the crank as you pedal, you may want to move the cleats outward, or laterally, to give a bit more space. If you have a history of achilles injuries you may want to consider moving your cleats backward, or posteriorly, to unload the gastroc-soleus-achilles complex from overloading. Ultimately, though, your personal biomechanics are essential in determining where to place the cleat of your bike shoe, and it is best to consult with a Physical Therapist or expert bike fitter for determining what cleat position best suits you. A whole body evaluation is best, as it takes into account the entire context and all of the factors involved in safely getting as much power as possible into those pedals!
6) Seat Tipping: Bike seats can either sit level (perfectly horizontal,) or have some degree of forward tilt. A slight forward tilt can push your center of gravity forward a bit in order to get it aligned over the pedals (better for power output,) or to help shift a triathlete’s bodyweight forward onto the aerobars. Ultimately, seat tilt is largely a personal preference, and should be adjusted very gradually. I personally like the position a small amount of tilt puts me in on a tri-bike, as I feel that I can push the pedals harder. However, too much forward tilt pushes too much of my weight onto my arms, and results in wrist and shoulder discomfort on long rides.
A mostly level seat allows for more shifting around during long rides, without the seat forcing you forward. A more level seat is a great way to allow for little position adjustments along a ride to avoid having all of your weight on one tiny spot for a long period of time, which as you would expect can result in some serious pain!
As you can see a lot of bike fitting is very personal for each person’s individual anatomy. Additionally, a great bike fit is essential, but it doesn’t always address root issues that may be causing discomfort and inefficiency on the bike. A skilled Physical Therapist can evaluate a cyclist or triathlete both on and off the bike to identify and then address areas of weakness, restricted range of motion, or other muscle imbalances that may result in symptom-generating compensatory patterns. Also, an efficient body on a well-fit bike is also the easiest way to get “free” additional power output (and who doesn’t want that?)
If you think you might be leaving some efficiency/power on the table due to a less than ideal bike position, give us a call to schedule your physical therapy assessment, we can even help evaluate your form on and off the bike!