Between the Blade Pain

It’s amazing how much money and time many elite and amateur cyclists spend buying and retrofitting racing bikes to conform to their bodies rather than first restoring function to the most critical piece of racing equipment…the rider’s body! When muscle imbalances, faulty movement patterns and joint fixations distort the body’s framework, the cyclist is led on a never-ending journey in search of that perfect bike fit (Fig 1).

My personal mantra ~ fit the body to the bike stupid!


Bad Bodies= Bad Bikes

Bodyworkers and functional movement trainers whose practices cater to amateur and elite cyclists are aware of the clinical and performance advantages gained by restoring mobility, flexibility and stability to the biker’s muscle/joint complex.

It makes sense to get the kinks out before sending the client off for an expensive and sometimes useless bike retrofit. Without adequate hands-on maintenance and functional fine tuning, cyclists often unknowingly reinforce dysfunctional movement patterns ingrained from long-forgotten micro or macro traumatic injuries.

Confusion and controversy over this chicken-or-egg thing is primarily due to lack of understanding of the Law of Cause and Effect. For instance, let’s say a bike shop performs a retrofit and Bob, the cyclist, smilingly pedals away feeling secure and pain-free on his newly reconstructed ‘machine’. Life is good… or is it?

Let’s assume Bob is one of many ‘flexion-addicted’ Americans with a sedentary job that keeps him glued to the computer terminal day-after-day… month-after-month (Fig 2).

Gravitational exposure eventually pulls Bob’s body into a big “C” curve as the hip flexors and hip capsules shorten and tighten. Unfortunately, the brain re-learns this aberrant posture as normal. With each passing day, his office sitting posture slowly morphs into his biking posture (Fig 3).

It makes sense that, in the beginning, Bob’s bike fit should certainly provide him a comfortable, pain-free ride simply because the bike now fits his ‘jacked-up’ body. But soon Bob begins complaining about knee irritation, low back stiffness and an increased frequency of headaches particularly on long bumpy rides.

Bob’s weak links are beginning to surface partly due to lack of shock absorption during sudden impact, i.e., the front wheel bangs into a big ‘chug hole’ or pressure from the saddle flares an old SI joint injury. Because the hip can’t move, shock ascends up through the SI joints and lumbar spine or down to the knees and ankles.

Gray Cook, Michael Boyle, Craig Liebenson, and others, have developed an enticing and, for the most part, logical theoretical ‘joint-by-joint’ approach that explains how this process can be successfully assessed and corrected.


Bodyworkers

The ‘Yin — Yang’ of Muscles & Joints…
biker version

To perform well in such a challenging event, cyclists like Bob would benefit greatly from a manual and movement program that helps maintain optimum intrinsic/extrinsic muscle balance and motor control. Fluid and dynamic body movement primarily relies on the ability of muscles and fascia must to stay strong… yet flexible. Lumbar spine stability relies so much on proper length/strength balance between muscles, ligaments, joint capsules, and thoracolumbar fascia. Traumatic shocks from funky roads or recurring bike injuries eventually produce enough tissue damage to ‘fire’ nociceptors which may result in pain and disability.

To make matters worse, Bob may develop a pain-spasm-pain cycle as loss of hip mobility places extra strain on SI and low back joints. In the presence of joint instability, the brain may decide to ‘splint’ the area with protective muscle guarding. Low back instability that travels through Bob’s thoracolumbar and pectoral fascia and into the upper extremity joints, is met with resistance from habitually locked hands, elbows and arms. Meanwhile, Bob’s lower body–tight hip flexors and all–continue to grind it out on the new bike causing reverberations and compensations to infiltrate the entire system (Fig 4).


Biker

Many flexion-addicted cyclists refuse treatment and then complain about loss of speed, power and efficiency. One of the most common bike positions used by ‘flexiholics’ has the hip flexors locked short causing the pelvic bowl to be drawn too far forward creating a decrease in hip angle (Fig 5).

Soon, mechanical and neurologic stresses ravage their way through the low back, hips, knees and ankles looking for a weak link in the myofascial kinetic chain.


Biker arch back

Riding Postures and Rehab

The first order of business is to mobilize adhesive (motion-restricted) hip flexors and capsules to restore balance (Fig 6A).

Then, apply fast-paced ‘spindle-stim’ maneuvers to help tonify weakened (neurologically inhibited) gluteal muscles (Fig 6B).

Once the therapist manages to increase hip angle and establish proper functional balance and stability, the cyclist is free to decide which type of riding posture he believes suits him best.

Some cyclists prefer a high seat so they can posteriorly rotate the pelvis to increase hip angle.

Other riders find greater mechanical advantage by putting a little curve in the low back, engaging the core, and then slightly backing off the curve to allow a neutral lumbar spine.


anterior hip capsule


spind lestim

Both groups should avoid:

1. Excessive posterior pelvic rotation and exaggerated thoracic kyphosis. This popular riding position places undue stress on the neck, low back ligaments and joint capsules while inhibiting optimum diaphragmatic action.

2. Excessive lumbar lordosis which leaves the spine vulnerable to road shock (Fig 7).


Back Images

Summary

Like many of America’s other popular, but, abnormal, athletic endeavors such as golf, tennis, bowling, etc., cyclists bring with them a complex biomechanical downside that’s often hard to completely fix. Seen primarily in the ‘arched back’ model, the occiput is forced to hyperextend on atlas to level the eyes…a major cause of head and upper neck pain.

The good news is that the human body is both adaptable and dynamic; the bad news is that our biker clients often bring along a lot of baggage including flexion-addicted sitting postures, old injuries, compensations, poor training habits, etc. Once the skilled manual and movement therapist makes therapeutic corrections, the bike can then be retrofitted to conform to the rider’s optimally-functioning body. A properly fitted bike combined with a revitalized and functionally balanced neuromuscular system allows muscles and joints to work at optimal levels of motor unit recruitment and synchronization. As endurance and performance improve, so does the natural love of cycling.

Electrify Practice