Biking Evaluation
1. Why do you Ride?
2. I don't race or compete...why do I need to be evaluated?
3. Who does this evaluation?
4. What else? Physical Therapy & the Cyclist
Articles
1. Resistance Training for Cyclists
2. Biking Injuries: What Comes Around...
1. Why do you Ride?
for fun
for fitness and health
for competition
because my knees hurt from running
because its part of a triathlon
because I like to
Whatever your reason for riding, a cycling evaluation at Body Mechanics can help you enjoy riding a bike more, and maybe make you better at it.
Optimal position on a bicycle is achieved via the interface between the rider, who is somewhat adaptable, and their bicycle, which is somewhat adjustable. Maximum efficiency is achieved when the rider is positioned in a way that allows him or her to deliver all their power into making the pedals go around without wasting energy.
An Integrated Cycling Evaluation starts with a thorough exercise and medical history. A musculoskeletal screening is used to assess flexibility, strength, and balance. Using the rider's own bike and equipment, a riding and fit analysis is completed. Digital video analysis can be used to assess pedaling mechanics, technique, and general fit on the bike.
Following the evaluation, recommendations will be given on how to improve your function or position on your bike. If needed, follow-up visits can be scheduled to check your progress down the road.
2. If I don't race or compete, why do I need to be evaluated on my bike?
You don't need to be a competitive cyclist to be evaluated for your bike fit. Cycling is a very repetitive activity-you don't want to hurt yourself doing it. Make sure you positioned correctly on your bike so you don't risk being sidelined by an injury.
Maybe you have had problems in the past; getting your position checked on the bike is a proactive way to make sure you don't get hurt again.
The Integrated Cycling Evaluation is conducted by Gregg Fuhrman, MPT, OCS, CSCS. Gregg is a licensed physical therapist specializing in orthopedics. He has a Masters Degree in Physical Therapy from Marquette University, and a Bachelors of Science Degree in Exercise Physiology from UW-Milwaukee. Gregg is a consultant with Carmichael Training Systems (www.trainright.com), and is further certified by the National Strength and Conditioning Association. He has been a competitive cyclist for the past 18 years. With his background, Gregg is able to blend his knowledge of human movement with his expertise in cycling to ensure you will be at your best for riding, training, and competing.
Services include:
- Individualized biomechanical evaluation of your fit on your bike.
- Set-up and fitting of new equipment, shoes, and accessories.
- Orthotic evaluation and fabrication.
- Personalized exercise training programs.
- Injury prevention and post injury rehabilitation.
4. What else? Physical Therapy & the cyclist: Injury rehab & conditioning
We can also help you if you are trying to recover from an injury or accident. Have you been battling a sore knee or stiff back after riding? Schedule an appointment with Gregg so that he can help you get back on the road.
Schedule a consultation and let us assist you with your off-season conditioning program to get your body in shape for the upcoming season. Specifically designed exercise programs can be tailor made to fit your goals and needs. Programs can be individualized for recreational riders, competitive road and off-road cyclists.
Biking Injuries
What Comes Around...
PTs must help both on- and off-road cyclists prevent repetitive injuries and lower extremity pain
By Mike Le Postollec
"There aren't many exercises other than cycling where you complete 90 repetitions per minute," noted Gregg Fuhrman, MPT, CSCS, private practice PT at Body Mechanics, a general orthopedic and sports medicine clinic based in Milwaukee. "And if you multiply those repetitions out to a one, two or three hour bike ride, that's a lot of repetitive motion." Fuhrman is also a Certified Cycling Coach with Carmichael Training Systems.
And a lot of potential for injury. Unlike running and other highly repetitive sports, preparing an athlete to meet the physical demands of a road race or mountain biking competition is only half the challenge. PTs who work with this growing population also need to ensure that the bike and additional equipment allows the athlete to maintain a healthy body position and maintain long-term health. Cyclists who aren't in top shape or use equipment that's "off" risk tendonitis, patellofemoral pain and other repetitive stress injuries (RSIs) of the upper and lower extremities.
The Right Fit
For this reason, cyclists at the professional and club levels may visit therapy clinics like Body Mechanics for cycling evaluations before a competition or event. "Some of our clients are RIDERS in the market for a completely new bike, so they want us to give them a few ideas as far as frame size and fit," said Fuhrman. "But the majority are athletes who're changing equipment, whether that's shoe cleats or a more aerodynamic handlebar. [Clients] will bring their new equipment in so we can [assess] the fit and recommend adjustments if necessary."
The main considerations, Fuhrman said, are:
Bike Frame: Obviously, cyclists should clear the top tube by 2-3 inches when standing over the bike. As a general rule, mountain bikes should have a smaller frame than road bikes to allow for jumping and riding on uneven, rocky terrain.
Seat Positioning: Proper seat height for a rider is predominantly a function of their leg length. The seat should be positioned so that the rider's knees are flexed 22° to 30° with the pedal in the lowest position.
Handlebar Height: The stem that holds the handlebars should be set slightly lower than the nose of the saddle, based on the rider's needs and the event they'll be competing in.
Fuhrman said that PTs should assess cyclists while they're using bike shoes, pedals, saddles and other accessories that could affect positioning on the bike. "You also need to have clients out on the road riding," he added, "because the riding they do on a stationary bike isn't what they'd encounter on the road or trail, working up hills or into a headwind."
As important as a proper fit is, however, cyclists who aren't in riding shape and those who use bad riding technique still run a risk of injury. For example, one client recently came to Body Mechanics with complaints of knee pain that he thought were the result of poor cleat alignment. After watching this patient ride on a training stand, however, Fuhrman traced the knee pain back to an ankle injury he'd suffered during a mountain bike race. "Because of a severe sprain that [this patient] didn't treat, he had tightness in the subtalar joint that caused an abnormal foot position on the pedal," the PT explained. "With some mobilization and specific stretching activities we were able to treat the patient better than if we immediately started adjusting the bike."
Therapists conducting a cycling evaluation take a thorough history and put patients through many of the same functional tests used by PTs in other settings; for example, watching the patient walk, squat, balance, and transfer from sitting to standing, and checking for signs of scoliosis or other structural dysfunction. Areas that are particularly relevant to cycling include hip flexibility and motion in all planes (flexion, extension, abduction and external rotation), lumbo-pelvic orientation and motion, and ankle dorsiflexion and ROM.
"There's usually less stress on head, neck, wrist and arms, so we're looking more at stability from the spine through the shoulder girdle," Fuhrman added. "If the rider needs to get into an aerodynamic position for a triathlon or a time trial, trunk flexibility and stability become more of an issue than if they're sitting upright on a mountain bike or going for a casual ride."
Biker Training
Based on their findings during the evaluation and the client's individual goals, PTs who also offer coaching services to this population may put together an individualized bike training program. "The training really depends on what the athlete is looking for," said Robert Kopitzke, PT, CPI, Elite USA Cycling Coach. As co-owner of Body Concepts Inc., El Dorado Hills, CA, Kopitzke has experience evaluating and training mountain bikers, road bikers and triathletes. "It could be as specific as writing down a daily workout schedule, or as general as just telling the athlete about exercises they can do at different times of the year."
Although these programs are tailored to the riders needs and may include bike-specific drills, flexibility and weight-training, endurance training is always a key component. For example, the PT/coach may recommend a daily endurance ride that starts with 15 to 20 minutes of warm-up, then an hour and a half of biking at the riders optimal heart rate and cadence. After the ride the biker may go through a 10 to 15 minute "cool down" period, followed by a customized stretching routine performed why the athlete is still warm.
At the same time, coaches often recommend interval work as a way to train riders to tap anaerobic energy stores; in other words, the short duration, high-intensity energy "burst" that allows riders to work up steep hills or bridge a gap between other riders ahead of them in a race. "In elite athletes, about 90 to 92 percent of their maximum heart rate is the point at which they switch from aerobic to anaerobic energy systems," Kopitzke explained. "So once we establish that base we'll have the athlete work on anaerobic training by working in shorter intervals-two minutes down to as short as 10 or 15 seconds-of very high intensity, maximum effort."
Coaches may also decide to pay particular attention to trunk strength. "Cyclists spend a lot of time weight-training in the off season, but most athletes don't spend enough time on the trunk, and core strength is particularly important to mountain biking," said Fuhrman. "cyclists need a strong solid base to transmit stability from their upper extremities on the handlebars to their legs beneath them, because muscle weakness or imbalance in the trunk can lead to back or neck pain."
Developing trunk strength, he said, is usually a matter of activating the abdominal and oblique muscles. With some practice, cyclists can learn to "fire" their trunk muscles while performing squats or lunges, to develop strength and core stability.
A Growing Field
At this point, most PTs' experience with cyclists is limited to treating the occasional cycling-related injury, but therapists could see more of these injuries on a regular basis. Buoyed by coverage of Lance Armstrong's achievements in the Tour de France and a greater interest in mountain biking, all forms of cycling have become much more popular in recent years. Unfortunately, public knowledge about bike safety, proper equipment and conditioning has not grown as quickly as interest in the sport. The result could be an increase in RSIs and traumatic accidents such as fractures and road rash.
For this reason, PTs in the sports medicine and orthopedic fields who learn more about evaluating and training cyclists will be prepared to meet the needs of this growing population. "cycling is still not as mainstream in the U.S. as some other sports but there's a niche aspect to it, with the triathlon, endurance races, mountain biking and recreational biking," Fuhrman said. "PTs already have a good idea of how to analyze human movement, and with cycling you're just applying that to an athlete sitting on a machine. After you learn a little more about the key components of cycling, I think a PT would have a lot to offer."
For more information on bike sports and cyclist training, visit www.trainright.com
Mike Le Postollec is on staff at ADVANCE and can be reached at mlepostollec@merion.com