Randy Ice PT, CCS offers a mobile bike fitting program that can resolve your pain syndrome and/or optimize your power output where others have failed. He travels all over Southern California to make the process easy for you. Call (760) 484-6369 for more information or an appointment.
The following "Principles of Bike Fitting: What Factors Make For An Optimal Fit" PowerPoint Presentation will take you through the process of achieving an optimal bike fit and the how to's of relieving/preventing cycling biomechanical pain syndromes. The little understood and discussed "Q Factor" as well as the development of Kneesavers™ is also presented.
Despite the fact that the knee joint moves the most during cycling vs other sports, and the most force is created through the knee via the quadriceps muscle, a cycling knee injury is a relatively rare phenomenon. In fact, many athletes in other sports such as football, basketball, soccer, etc. that put a pounding on the knee joint and whose athletes suffer such injuries as torn meniscus (cartilage) and torn anterior cruciate ligaments ( ACL) or medial collateral ligaments ( MCL) are usually rehabed back to health with the use of a cycle ergometer combined with strength training.
The more common cycling knee injury will be repetitive motion problems due to faulty underlying biomechanics that cause an overuse syndrome. These include quadriceps or patellar tendonitis, ilial-tibial band syndrome and rarely hamstring tendonitis. Rarely will there be an injury from cycling be an actual knee joint issue. Even those people with severe degenerative joint disease of the knee joint are usually able to cycle on a bike and benefit from it. There is not the trauma to the joint that there is with weight bearing exercise.
The perfect bike fit for an individual and his/her bike means the marriage of the two is also perfect. This means the various settings of seat height, saddle position, foot/cleat position, toe-in vs toe-out, stem height and/or stem length and Q factor distance must be optimized to the specific individual's unique biomechanics, geometry, flexibility and goals. Foot pronation and/or supination is another often critical fitting factor that is often missed and best fixed by custom made cycling orthotics that are worn in one's everyday shoes as well as in their cycling shoes. Keeping the foot in a neutral position has tremendous benefits for knee function when riding.
The Q factor is an often overlooked factor in bike fitting that when ignored, is a major contributing factor to cycling knee injury. Lateral knee pain is very commonly related to a Q factor that is too narrow as is pain from the foot all the way up to the hip while riding in many cyclists. The Q factor specifically is the distance between the feet when placed on the pedals. Road bikes tend to have a narrower Q factor than mountain bikes due to a narrower bottom bracket. Recumbent cyclists often benefit from a wider Q factor due to the natural "knees out" position one's knees assume when in the sitting position.
When I began bike fitting in the mid-1980's it became apparent to me that there was need to move people's feet apart to a wider position on the pedals for all sorts of reasons including larger body size, larger feet, a toe out gait pattern, bow legged structure and various other biomechanical issues. Often times the problem is on one side only often due to an old fracture with healing of the foot in an outward bound position that the bike must be fixed to accommodate.
In the 1980's when Greg Lemond became a household word due to his success in the Tour de France and widespread publicity, recreational cycling took off in popularity. Our SCOR Cardiac Cycling Club began offering public participation bike rides in Solvang and other regions of Southern California that very quickly grew to include thousands of riders.
Due to my physical therapist status, I began receiving requests to do "bike fittings" for pain syndromes cyclists were having after riding. Some were after only a few miles of riding and others were after Century rides or longer. This lead to my developing a specific protocol of evaluating the cyclist on and off his/her bike that attempted to put all the biomechanical pieces together to optimize cycling biomechanics and relieve biking knee pain syndromes.
Of all the pain syndromes one can develop from cycling, biking knee pain solutions are just as varied. Some are as simple as raising or lowering
the saddle a small amount. Other knee pain problems are more complex and involve correcting foot biomechanics ( usually excessive pronation),
adjusting the cleat toe-in or toe-out/ and/or fore-aft position.
A too narrow Q factor is a fairly common source of knee pain and requires a way of widening the stance on the pedals. This lead to my creating pedal extenders in 1987 to allow for a wider pedal stance. This in turn can allow for more toe-out on the bike as well as help align the foot, tibia and femur in a straight line when observing the cyclist from an anterior-posterior (front-back) view. This alignment is critical to comfortable cycling that can prevent/relieve pain emanating from the foot, ankle, knee or hip.
I trademarked the 20 mm wide pedal extenders as "Kneesavers", although they have been called "Foot Savers" and "Cycling Savers" by many of my customers who found immediate pain relief once installed on their bike. Within a few years I began making larger sized Kneesavers of 25 and 30 mm widths as there are a large number of people who need an even wider Q factor stance. Some very large individuals have had extra long custom made Kneesavers fabricated as their biking knee pain solution. That lead to the making of "Pedal Adapters" that have a 1/2" threaded male end and a 9/16" female end so that serious cyclists, or those who live where it snows or rains a lot can train indoor on a spin trainer or stationary bike utilizing their own pedals and shoes. Clipless pedals that maximize free float are also a frequent need to relieve knee pain.
Got them [Kneesavers™] yesterday, and all I have to say is WOW what a difference.
I also got some Wellgo MG-1 Pedals and I have to say is PERFECT, my big duck feet now fit!!!
With my new handlebar / stem riser I NOW FIT ON THE BIKE!!! This thing LOOKS HUGE!!!
Again thanks and there will be no need to make any changes!!! THEY ARE PERFECT!!!
Due to the repetitive motion aspect of cycling, slight biomechanical imperfections can lead to pain syndromes. A slightly too low saddle, or too narrow Q factor can lead to certain soft tissues (ligaments, tendons or other connective tissue) becoming irritated and inflamed from overuse, not unlike secretaries who develop carpal tunnel syndrome from repetitive typing motion aggravated by sitting in a poor biomechanical position.
Many cyclists complain about cycling knee pain that can be due to a variety of factors. In my experience one of the more common but overlooked factors is the Q factor distance. This is particularly true for those who walk with their feet toed-out (so-called "Duck Foot" gait pattern), those that are larger or have a wide pelvis (women in particular), those with a bowlegged structure which leads to a mal-alignment of the foot, knee and hip and frequently lateral knee pain. Frequently people have a prior traumatic unilateral problem where the foot is now permanently pointed outward after a fracture and/or surgery. The heel(s) constantly rub against the crankarm with each revolution leading to the shoe(s) wearing out sooner in addition to having a knee pain syndrome. Kneesavers help cycling knee pain by widening the Q factor distance.
In the early days, my predecessors recommended adding a washer or two between the pedal and crankarm to widen the Q factor. The obvious limitations are that the distance created can only be 2 - 3 mm and doing so leaves less pedal threads in the crankarm, a potentially somewhat hazardous situation that puts more stress on the remaining threads that are threaded into the crankarm. Kneesavers specifically move the feet significantly wider ( 20 mm at a minimum on each side) and do so in a way that assures all the pedal threads are threaded into the pedal extenders.
Kneesavers are made of stainless steel or Titanium to withstand maximum stress and force put on the pedal, even by large cyclists. One caveat is to avoid using Kneesavers in carbon fiber crankarms if you weigh more than 200 pounds as I am not convinced carbon fiber will be able to withstand those pedal forces created by larger cyclists.
Kneesavers help cycling knee pain and other biomechanical imperfections discussed above by creating the optimal cycling biomechanics so that the threshold of the cycling pain syndrome is pushed essentially eliminated, thus relieving pain. There are MANY testimonials on this website illustrating all the varied applications and relief cyclists have used Kneesavers that show how Kneesavers help cycling knee pain. I have thousand of satisfied customers from all over the world who use them and have done so for over 24 years. They come with a money back guarantee that they will relieve your pain syndrome or your money back. They are made in the USA by a California based machinist who can also custom make any size needed. They also come in 1/2" threads only for use with the native pedals on indoor stationary bikes.
For an in-depth Power Point presentation of all aspects of bike fitting including the Q factor that illustrates all the different cycling pain syndromes and how they are best relieved, see my presentation "The Importance of Proper Q Factor Alignment in Cycling" elsewhere on this website.
P.O. Box 2466
747 S. Mission Rd.
Fallbrook, CA 92028
Phone: 760-484-6369 for out-of-state inquiries or 800-548-4447
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