‘Physio Bikefit’ Case Study

Comfort, Injury Management and Performance

Lower Back Pain in the Recreational Cyclist – a common presentation

54 year old recreational cyclist rides 100km/wk for 5 years

1 year history of right lower back and front of hip pain

HISTORY

Worse after 1 hour of riding especially when riding hard, power, faster rides. Lower back becomes sore then loss of power right side/tight hip

Stopping riding, stretch, roll, hands-on treatment helps short term

Treatment and personal training including squats for 1 year

Bike is 3 years old. Specialised Bikefit 3 yrs ago – client has “fiddled a little” with set-up

BODY

Slightly decreased R hip range of movement

Lower back, pelvis and hip combined function very poor on 1 leg R > L

Evidence of overload/overusing of the front of hip muscles/quadriceps

BODY on BIKE

See excessive lower back flexion (forward bend) in photo

BIKE

Seat too far back 10.5cm behind bottom bracket

Seat height slightly low (video knee angle measure + static calculation)

PRE: lower back flexed, increased hip angle at top of pedal stroke due to aggressive position.

POST: testing of seat up/forward with bars raised (using pads/towels) gives open hip position, less stress to lower back = less pain and better performance for longer. As body improves the bars can be lowered

Summary – Seat too far back and low with bars too aggressive for this body at this point in time. Lower back flexed is a risk factor for back pain and flexed posture overall challenges the back and hip region which leads to the wrong muscles working to produce power. Optimise bike and fix body

BIKE: Seat forward 3 cm and up 1.2 cm. Bars up 1 spacer (to recommended bike shop)

BODY: Continue hands-on treatment for short term benefits BUT needs to improve the ability of the lower back and pelvis to work optimally in a cycling specific way to guarantee long term improvement

TRAINING: Mid-range effort every 2ndday. Cadence 80 RPM max and hills 3-5% good for technique. Use the ankle and think about having a ‘long trunk’ (technique taught)

Re-visit BIKEFIT in 2 months

Body will continue to change and improve over time – “Physio Bikefit” each year