OttawaPhysiotherapy: Reasons for Bike Fittings

At our Westboro physiotherapy location in Ottawa, we provide bike fitting services by one of our physiotherapists.

Bike fitting is very useful in the prevention of possible injuries that might occur during cycling and below are a few examples.

Cycling is seen by some^[who?] to be an inherently high-risk, dangerous activity although use of appropriate safety equipment and obedience of road rules can reduce risk of serious injury. In the UK, fatality rates per mile or kilometre are slightly less than those for walking.^[18] In the US, bicycling fatality rates are less than 2/3 of those walking the same distance.^[19]^[20] For a child cyclist the rate per mile or kilometre travelled is around 55 times that for a child occupant of a car^{[citation needed]}, while the fatality and serious injury rates per hour of travel are just over double for cycling than for walking (due to the reduced travel time), in the UK.^[18] It should be noted that calculated fatality rates based on distance for bicycling (as well as for walking) can have an exceptionally large margin of error, since there are generally no annual registrations or odometers required for bicycles (as there are with motor vehicles), and this means the distance traveled must be estimated.
Most cycle deaths result from a collision with a car or heavy goods vehicle, both motorist and cyclist have been found responsible for collisions ^[21]^[22]^[23] However, a very high proportion of non-fatal injuries to cyclists do not involve any other person or vehicle.
A Danish study in 2000 concluded that "bicycling to work decreased risk of mortality in approximately 40% after multivariate adjustment, including leisure time physical activity".^[24]
Injuries (to cyclists, from cycling) can be divided into two types:

Physical trauma (extrinsic)
Overuse (intrinsic).

Acute physical trauma includes injuries to the head and extremities resulting from falls and collisions. Since a large percentage of the collisions between motor and pedal vehicles occur at night, bicycle lighting is required for safety when bicycling at night.

Bicyclist pedals uphill at the Taroko Gorge in Taiwan

The most common cycling overuse injury occurs in the knees, affecting cyclists at all levels. These are caused by many factors:^[25]

Incorrect bicycle fit or adjustment, particularly the saddle.
Incorrect adjustment of clipless pedals.
Too many hills, or too many miles, too early in the training season.
Poor training preparation for long touring rides.
Selecting too high a gear. A lower gear for uphill climb protects the knees, even though your muscles are well able to handle a higher gear.

Excessive saddle height can cause posterior knee pain, while setting the saddle too low can cause pain in the anterior of the knee. An incorrectly fitted saddle may eventually lead to muscle imbalance. A 25 to 35 degree knee angle is recommended to avoid an overuse injury.^[26]
Overuse injuries, including chronic nerve damage at weight bearing locations, can occur as a result of repeatedly riding a bicycle for extended periods of time. Damage to the ulnar nerve in the palm, carpal tunnel in the wrist, the genitourinary tract^[27] or bicycle seat neuropathy^[28] may result from overuse. Recumbent bicycles are designed on different ergonomic principles and eliminate pressure from the saddle and handlebars, due to the relaxed riding position.
Note that overuse is a relative term, and capacity varies greatly between individuals. Someone starting out in cycling must be careful to increase length and frequency of cycling sessions slowly, starting for example at an hour or two per day, or a hundred miles or kilometers per week. Muscular pain is a normal by-product of the training process, but joint pain and numbness are early signs of overuse injury.
Cycling has been linked to sexual impotence due to pressure on the perineum from the seat, but fitting a proper sized seat prevents this effect.^[29]^[30] In extreme cases, Pudendal Nerve Entrapment can be a source of intractable perineal pain.^[31] Some cyclists with induced pudendal nerve pressure neuropathy gained relief from improvements in saddle position and riding techniques.^[32]
The National Institute for Occupational Safety and Health (NIOSH) has investigated the potential health effects of prolonged bicycling in police bicycle patrol units, including the possibility that some bicycle saddles exert excessive pressure on the urogenital area of cyclists, restricting blood flow to the genitals. NIOSH is investigating whether saddles developed without protruding noses (which remove the pressure from the urogenital area) will alleviate any potential health problems.^[33]
A Spanish study of top triathletes found those who cover more than 186 miles (300 km) a week on their bikes have less than 4% normal looking sperm.^[34]
Despite rumors to the contrary, there is no scientific evidence linking cycling with testicular cancer in men.^[35]