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American Physical Therapy Association

Proper Bike Fit and Bike-Related Injury Prevention are Focus of National Physical Therapy Month this October

Alexandria, Virginia
Proper Bike Fit and Bike-Related Injury Prevention are Focus of National Physical Therapy Month this October

Physical Therapists Offer Tips on How Poor Bike Fit Can Contribute to Pain and Injury Risk

For the estimated 85 million weekend bicycle enthusiasts and competitive riders in the United States, the risk of a bicycle-related injury may increase with an ill-fitting bicycle, says the American Physical Therapy Association (APTA). APTA will make bike fit the focus of National Physical Therapy Month this October, encouraging members to demonstrate how proper bike fit can minimize discomfort and help prevent pain and injury.

APTA member Erik Moen, PT, CSCS, a Seattle-based "Elite Level" coach through the United States Cycling Federation, says, "The first thing I ask any patient complaining of bicycling-related pain is to bring the bicycle in to check for a proper fit. In most instances, a poor bike fit is at the root of their problem."

Moen, who races on the road, in cyclocross, and in a cycling arena called a velodrome, says that the most common bike fit errors include saddle heights that are either too high or too low, handlebar reach that is either too long or too short, and misalignments of the pedal and shoe. He recommends that cyclists do the following to ensure that they have proper bike fit:

Saddle. Be sure that the saddle is level. If you are sliding too far forward from a forward-tilting saddle, too much weight is being placed on your hands, arms, and lower back. If the seat is tilted backwards, you may place undue strain on your lower back and possibly experience saddle-related pain. A physical therapist can measure proper saddle height by measuring knee angle at the most extended position of the knee in common pedaling.

The saddle also should be a comfortable distance from the handlebars. If it is too close, extra weight will be placed on the mid-back and arms; too far away and extra strain may be placed on the lower back and neck.

Handlebars. Handlebar position will affect hand, shoulder, neck, and back comfort. The higher the handlebars, the more weight will be placed on the saddle. Generally, taller riders should have lower handlebars in relation to the height of the saddle. According to Moen, "Proper handlebar position allows for shoulders to roughly make a 90 degree angle between the humerus and trunk." Trunk angle for the road bike cyclist is 25-35 degrees and for comfort/recreational riding is 35-90 degrees. Moen notes that riders should re-examine their bicycle fit after bad falls or crashes, due to possible re-orientation of handlebars, brakehoods, cleats, or the saddle.

Knee to Pedal. A physical therapist also can measure the angle of the knee to the pedal. The closer the angle is to 35 degrees, the better function the cyclist will have and with less stress on the knee. For the road cyclist, the angle should be 30-35 degrees. The recreatioinal cyclist should have a 35-45 degree angle.

Foot to Pedal. The ball of the foot should be positioned over the pedal spindle for the best leverage, comfort, and efficiency, Moen notes. A stiff-soled shoe is best for comfort and performance.

"Pedaling is a skilled activity that requires aerobic conditioning," Moen says. "You should make it your goal to work toward pedaling at 80-90 revolutions per minute (advanced at 90-105 rpm). Pedaling at this rate will lessen your chance of injury."

Physical Condition
"Good flexibility of the hamstrings, quadriceps, and gluteal muscles is crucial because these muscles generate the majority of the pedaling force and must ideally move through the pedal-stroke in 80-90 revolutions per minute." He adds, "Proper stretching, balance, and flexibility exercises help with coordination of cycling-related skills such as breaking and cornering." Moen also cautions that changes in riders' strength and flexibility affect the ability to attain certain positions on the bicycle and also may require them to re-examine their bike fit.

Moen points to bicycle accessories on the market  such as softer handlebar tape, shock absorbers for the seat post and front fork, cut-out saddles, and wider tires  that help to bring comfort to the sport. "Cycling should be about enjoyment, not pain," concludes Moen. "Proper bicycle fit will minimize discomfort and possible overuse injury, maximize economy, and ensure safe bicycle operation. Proper bicycle fit will make your ride a lot more pleasurable."

An interactive consumer tip sheet for both recreational and road cyclists, featuring high-res color photos illustrating proper bike fit, tips for avoiding bike-related injuries, and exercises for cyclists can be found on this link.


Postural Tips

  • Change hand position on the handlebars frequently for upper body comfort.
  • Keep a controlled but relaxed grip of the handlebars.
  • When pedaling, your knee should be slightly bent at the bottom of the pedal stroke. Avoid rocking your hips while pedaling.

Common Bicycling Pains

  • Anterior (Front) Knee Pain. Possible causes are having a saddle that is too low, pedaling at a low cadence (speed), using your quadriceps muscles too much in pedaling, misaligned bicycle cleat for those who use clipless pedals, and muscle imbalance in your legs (strong quadriceps and weak hamstrings).
  • Neck Pain. Possible causes include poor handlebar or saddle position. A poorly placed handlebar might be too low, at too great a reach, or at too short a reach. A saddle with excessive downward tilt can be a source of neck pain.
  • Lower Back Pain. Possible causes include inflexible hamstrings, low cadence, using your quadriceps muscles too much in pedaling, poor back strength, and too-long or too-low handlebars.
  • Hamstring Tendinitis. Possible causes are inflexible hamstrings, high saddle, misaligned bicycle cleat, and poor hamstring strength.
  • Hand Numbness or Pain. Possible causes are short-reach handlebars, poorly placed brake levers, and a downward tilt of the saddle.
  • Foot Numbness or Pain. Possible causes are using quadriceps muscles too much in pedaling, low cadence, faulty foot mechanics, and misaligned bicycle cleat for those who use clipless pedals.
  • Ilio-Tibial Band Tendinitis. Possible causes are too-high saddle, leg length difference, and misaligned bicycle cleat for those who use clipless pedals.

The American Physical Therapy Association (APTA) is a national professional organization representing nearly 65,000 members. Its goal is to foster advancements in physical therapy practice, research, and education. To find a physical therapist in your area, click on "Find a PT" on APTA's home page. For more information about APTA and physical therapy, please visit


American Physical Therapy Association

More from American Physical Therapy Association:
Proper Bike Fit and Bike-Related Injury Prevention are Focus of National Physical Therapy Month this October



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