How a Proper Bike Fit Can Make Your Pain Disappear

By: Mark Van Thournout

bike fit pain calgary south


Peak Health & Performance is excited to offer BIKE FITTING at our Marda Loop location! Getting a custom bike fit is a great way to help you achieve your cycling goals, whether that’s increased performance, decreased pain, or just enjoying riding more! All of our bike fits are done by our physiotherapist who has a thorough understanding of how your body moves and will work with you on an individualized physical assessment and fit process to address your goals and any roadblocks you are experiencing.

What Can a Bike Fit Help With?

Knee Pain

The occurrence of knee pain in the general population is estimated to be 25% over the course of one’s life – in cyclists, this rises to 50% (Bini, 2011). These injuries tend to be “overuse” injuries – pedaling at 90 rpm for an hour results in 5,400 pedal strokes. Your lower limb alignment is important to consider due to the repetitive nature of cycling. There are three main bike fit interventions that are recommended for alleviating knee pain: saddle height, cleat adjustments, and cadence modifications.

Custom Bike Fit

Low Back Pain

As cycling shoe technology has evolved, low back pain overtook knee pain as the most prevalent issue that cyclists or triathletes complain about (Pruitt, 2001). Managing low back pain in cyclists is all about changing how much forward bending that is needed. This can be done by controlling how far away the handlebars are, altering the height of the handlebars, or considering the overall position of the rider on the bike.

Cycling culture plays a role here as well; much of the pro peloton will ride with their stems as low as possible which is referred to as “slamming the stem”. Lowering the handlebars increases how far you need to bend forward to reach the handlebars. Ignoring the current trend in favour of a higher set stem can help to reduce back pain (Pruitt, 2001).

Hand Numbness/Tingling

Nerve issues in cyclists are quite common and fortunately, there are some easy fixes to reduce the occurrence of nerve-related problems. Increased pressure on your carpal tunnel (typically with straight handlebars) or the pinky-side of your hand (typically with road handlebars) can cause complaints of hand numbness or tingling, particularly on longer rides. Hand numbness is best tackled by addressing saddle tilt, handlebar tilt, and the use of cycling gloves.

What to Expect From a Bike Fit?

1. It’s all about you! Our bike fits are done with you at the center of it all. We’ll start with some detailed questions about your riding history, cycling goals, current fitness, and any pain that you have while riding. These answers will help inform the changes that we make to your bike together. There’s no sense in making someone look like a Tour de France rider when they just want to be comfortable biking around Fish Creek; a good bike fit should be focused around your goals, not someone else’s.

2. Lots of hopping on and off the bike! We’ll make each change one by one, and let you evaluate how each change feels. We’ll also mark the original position and any changes that are made, so that you can always return to previous positions if things change. We can also try out new pieces and parts – we’ve got all the equipment here, all you need to bring is your bike and any parts that you’d like to try out.

3. Forget the formulas. Many online bike fitting guides are very specific about their advice – your knee must bend 30 degrees at the bottom of your pedal stroke, your elbows must be bent 15 degrees, your seat height should be set to exactly 98% of the length of your leg. These can be helpful guidelines to start with, but everyone’s body is different and these types of recommendations are not guarantees for tackling pain on the bike. A professional bike fit with a physiotherapist can help dispel some of these myths and leave you with a tailored fit, based on your exact body type, flexibility, and cycling experience.

How Are We Different?

image6Many bike shops around the city offer bike fitting, each with their own beliefs and method to fitting. Some lean heavily on technology, others take a more manual approach. Our bike fits are done exclusively by physiotherapists with additional training in bike fitting. This means that in addition to a bike fit, you’re getting the attention of an expert in movement systems, flexibility, strength, and injury prevention and rehabilitation. We’re experts in bodies and movement, and not beholden to industry trends or quick fixes.

Some issues are best served with a two-pronged approach: both physiotherapy and bike fitting. For example, a bike fit can address numb or tingling fingers during a ride, but may not consider that the root cause of that numbness is actually a neck issue rather than a wrist/hand problem.

For triathletes, a bike fit can help optimize your aero position, while adding physiotherapy to the mix would address core and back strength to help keep you in that position. Adding physiotherapy to your bike fit adds an additional layer of problem solving to get you back outside and on track for your cycling goals.

Sneaky Signs You Might Need a Bike Fit

Hand position

When you’re out on a long ride, take a look down at where your hands are sitting on your handlebars. Are they snuggled up against the brake hood? Or are they slightly back, leaving a space between your hand and the hood? There are a few problems with that – your bike is going to handle differently, if you hit any bumps in the road, your hands are going to slide forward, and most importantly, it’s hard to reach your brakes from this position.

The easiest fix for this is to fit you with a shorter stem, bringing your handlebars closer to your body and shortening the distance that you need to reach. That way, you can sit in your typical comfortable position, but just a little bit safer on the road.

Custom Bike Fit - Righ and Wrong Hand Position

Chainstay Wear

Take a look at your chainstays on either side, and watch for signs of rubbing. This is a sign that your shoes are allowing too much heel-in, or external rotation at the hip, in physiospeak. It may not be every pedal stroke, but you might notice yourself bumping against the chainstay with your heel as you pull back on your pedal. There are a few tools in the toolbox to fix this.

One is to go the physio route, and get you better at controlling your hip motion and prevent you from clipping the chainstay – this is usually corrected with glute and thigh exercises. There are also changes to your shoe setup that could solve this – either rotating your cleats on your shoes to prevent that heel-in position, or fitting new cleats that allow less float (how much your heel can move side-to-side).

Chainstay Wear

Time in Aero Position

This is specifically for triathletes – pay attention to how long you can maintain your aero position for. Aero is of utmost importance in triathlon, especially in long distance racing.

One culprit behind not being able to hold an aero position is where your bar pads are oriented. Your elbows should be stacked roughly underneath your shoulders. If your elbows are forward from your shoulders, it takes much more core strength to hold that position. Try this at home to simulate the difference – get into a classic plank position, and have your elbows right underneath your shoulders. Now try shifting your elbows forward from your shoulders.

The fix for this can also come from physio, bike fitting, or both. In physio, we would look at core strength and back extensor endurance. The bike fit solution might be to move your bar pads closer to your body, stacking your elbows underneath your shoulders and getting you closer to that classic plank position. Either way, both fixes would help you stay in your aero position for longer and make the most of your watts!

If you experience any of these three issues, a bike fit would be a great solution to help address these and further optimize your position on the bike!

Time in Aero Position - Wrong and Right

Next Steps

The ultimate goal of bike fitting is to get you excited about riding your bike – whether that’s indoor or outdoors, for comfort or for power, or getting set up on a brand new bike! A good bike fit should be tailored to your individual needs and experience, and we’re excited to offer exactly that at Peak. Click here to book your individualized bike fit with our physiotherapist today.


  • References
    Bini, R. R. & Hume, P. A. (2013). Effects of workload and pedalling cadence on knee forces in competitive cyclists. Sports Biomechanics, 12(2), 93-107.
  • Bini, R. R., Hume, P. A., & Croft, J. L. (2011). Effects of bicycle saddle height on knee injury risk and cycling performance. Sports Med, 41(6), 463-476
  • Ericson, M. & Nisell, R. (1897). Patellofemoral joint forces during ergometric cycling.Physical Therapy, 67(9), 1365-1369.
  • Case, C. & Connor, T. (2016 – present). Velo News Fast Talk [Audio podcast].
  • Pruitt, A. L. & Matheny, F. (2001). Andy Pruitt’s medical guide for cyclists. RBR Publishing Company.

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