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Physio Bike Fit

With a wealth of experience as a physiotherapist and cyclist behind him, Russell Turbill shares how he assesses both the rider and their bike in a Physio Bike Fit, and also some of the recent client problems that have been referred to him this year for help with their bike riding.

Is a Physio Bike fit just for serious cyclists and expensive bikes?

Definitely not. In fact, nearly all of the cyclists we see at the clinic are recreational or amateur riders. Some take their fitness activities seriously, but most are just regular people who would like to ride their bikes without pain getting in the way.

We also see people on all sorts of different bikes too, including road bikes, mountain bikes and hybrids. We have now also started to see people who ride e-bikes, as they become a more popular mode of transport.

Age doesn’t seem to be a barrier either. Over the years we have seen cyclists who vary in age from teenagers to octogenarians. That is one of the great things about bike riding, it is suitable for many different age groups and abilities.

It is not uncommon for the bike shop that sells you the bike, to take some basic measures to ensure that the bike is the right size for you, but this isn’t the same as a bike fit. There are a number of adjustments that can be made to accommodate the different needs of the rider, and these can change over time, especially if an injury or pain presents itself.

A bike fit can be a great way to help improve your comfort  when riding. It can help ensure you and your bike are connected optimally. It can also identify how you can modify the way you are riding to maximise your output and minimise potentially damaging forces and loads.

What happens at a Physio Bike fit appointment?

Prior to the session, we ask you to provide some basic information about your bike, the problems you are experiencing and what you are hoping to get out of the session. This is usually done either via email or phone.

When you attend the session at the clinic, we ask you to bring your bike with you and the clothing you usually wear when you are cycling too. In most cases, it is ideal for us to set up your bike on a stationary trainer and also to ask you to ride it during the assessment a few times. The intensity of the riding is usually low, unless there is a clinical reason that needs you to ride harder.

If you haven’t seen one of the Physios at our clinic recently, the session will typically start with some extra questions about the problems you are having, and how they are affected by riding your bike. We will often then also do some physical tests that look at your range of movement, strength and control of certain movements that relate to cycling and the issues you are having.

The assessment of the bike itself involves looking at the size of the frame, and then a number of measurements of the main areas that can be adjusted which involve the saddle, pedals/cleats and the handlebars. The measurements are documented as a benchmark, so we know the starting set up of the bike, from which we might make changes.

Then we would look at you on the bike, in the usual riding postures you would cycle in. This gives us an opportunity to do a head to toe analysis of your riding style, posture and other factors that might be contributing to your problems. We use tools such as laser levels, spirit levels, tape measures and photo/video analysis in the assessment to ensure we have accurate measurements to work from.

Bike fit

What happens after the assessment?

Based on our understanding of the cause of your problem, we combine our Physio knowledge with our bike knowledge to make recommendations for your bike set up and/or the way that you ride. 

The assessment findings and recommendations are discussed with you at the assessment, and then sent to you via email as a summary after the session. We also arrange a follow up appointment a few weeks later to check in on how things are progressing, as it can take some time for changes to be made safely. 

Can you share some examples of the types of problems people come to you for?

I can think of 3 Physio Bike Fit sessions conducted recently, which were all quite different.

The first involved a gentleman who was returning to road cycling following a significant lumbar disc injury earlier in the year. He was finding that riding was reproducing some of his previous symptoms into his thighs. One of the key findings in this assessment was that the set up of the bike was very aggressive, meaning that the drop in height from the seat to the handlebars was causing him to reach a long way forward and down to rest his hands on the bars. Although this is a very aerodynamic and fast posture to ride in if you are racing, the exaggerated flexed lower back posture was not suitable for his current condition and recovery from his injury.  As such, recommendations were made to raise the handlebars to put the patient’s back in a less aggressive position. Over time, as he recovers, it may be possible to gradually return to the original set up on the bike, if he were to return to a racing environment.

The second example involves a client who rides a more upright style e-bike. She had been recently receiving treatment for a neck issue with one of our physios and in these sessions she mentioned to them that her symptoms were often worsened by riding, which she did several times a week. To complement the physical and exercise treatment she was having with her treating physios, she was also referred for a Physio Bike Fit to see if there was anything that we could change on the bike that would assist her. During this session, we identified that she would benefit from a change in both seat height and handlebar height. This would allow her to adopt a more relaxed posture, and keep her elbows soft, helping to unload the neck on longer rides especially.

The last example involved a patient getting back into riding his mountain bike, who was hoping to ride a couple of times per week on a local bitumen road for fitness. He had suffered  a significant episode of brachialgia (nerve related arm pain) at the beginning of the year, and was worried that riding could re-aggravate his symptoms. Even just short periods of cycling were causing his arm to tingle with pins and needles. We found that his seat height was putting his body in a position that placed extra tension on his nerve roots, and causing him to place increased weight through his hands. Advice was provided around lowering the seat (which was set up too high), exploring alternate bar grips and relaxing his upper body posture when riding. As an aside, we also noticed that his pedaling technique was not ideal and may have contributed to some problems he had in the past with his knees and achilles tendon. 

The above recommendations were all made with collaboration between the rider and their treating physio, to ensure everyone was on board with what needed to be done.

So you can see there are a myriad of ways that a bike Assessment can help you ride more comfortably. 

How to Book

All Physio Bike Fits are conducted by our Senior Physio Russell Turbill at our Malvern clinic, you can book in to see him by:

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