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

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Presentation on theme: "Bike Fit Marc Silberman, M.D. Gillette, NJ."— Presentation transcript:

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

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


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

5 Bicycle Exam

6 Balance Comfort Safety Injury Prevention Peak Performance
Aerobic efficiency versus aerodynamics Superman Position

7 Bicycle Anatomy Seat tube Top tube Seat tube angle °

8 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

9 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

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 2 3 1

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

12 2. Saddle Height

13 Saddle Height Most important bicycle position setting
Inseam measurement method (LeMond) Saddle Height = 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

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

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

16 Saddle Height Fabian Cancellara and Andy Pruitt

17 3. Saddle Fore-Aft-Tilt Tilt Fore-Aft

18 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.

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

20 Frank Schleck TT Position Raised Goal: more power

21 4. Stem Height 1 to 3 inches

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

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

24 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.

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


27 Contact Overuse Neuropathy Saddle Sore Morton’s Neuroma

28 ‘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

29 ‘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

30 ‘Morton’s Neuroma’ Medical Treatment
Cortisone Massage Shoe inserts Surgery

31 Saddle Sores Moisture + Pressure + Friction Chafing Ulceration
Folliculitis Abcess Subcutaneous nodules

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 Don’t sit around in your kit after riding Emollients

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

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

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

36 Hand Neuropathy Medical Treatment
Massage Cortisone Night splint Surgery

37 Bursitis Greater Troch Pre-patella and MCL bursa Ischial Tuberosity

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

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

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

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

42 Most Common Patella Femoral ITB Patella Tendon

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

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

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

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

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

48 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

49 Strain Cervical Thoracic Lumbar

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


52 Training Periods of Pros
10% 5% 15% 15% % in Zone 3 > 90% HRmax % in Zone 2 70 – 90% HRmax % in Zone 1 < 70% HRmax 0% 10% 75% 80% 90% Rest Pre-Season Competition

53 Training Stimulus Performance Training Volume/Intensity

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 Record at Mt. Evans set a month after a rider had taken 10 days off bike

55 Laws of Training The race is won in the off season
Train frequently, all year round Start gradually and gently Build a big base Go hard on the hard days, easy on the easy days Do not overtrain Avoid monotony Train with others Keep a logbook Take a break at the end of a season, stay active One can look at lactate, watts, speed, intervals, daily workouts but if you don’t see the bigger picture you will never understand training – these are so simple too understand but so difficult to follow – keep a copy on the refridge Adapted from Tim Noakes in the Lore of Running

56 Marc Silberman, M.D.

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