How a Bike Fit can Address Common Aches and Pains


Photo by Victor Wang Studios (
Photo by Victor Wang Studios (
No matter the distance you ride, you should be comfortable on your bike. If you have neck, back, or knee pain, saddle sores, or numbness; your bicycle probably doesn't fit you properly.
The three key areas that an experienced and qualified bike fitter will address during a fitting session are Feet, Seat, and Hands - the areas where the rider makes contact with the bike.  There are any number of issues that will affect the physical relationship of rider and bike. For example, your body may be asymmetric (one leg or arm slightly longer or shorter than the other). The slightest imbalance can lead to pain. While it used to be true that addressing these asymmetries was a bit of trial and error, the properly outfitted modern fit studio has tools like Retul, 360 degree viewing, wedges, shims, 2D and 3D video and motion capture, and most importantly experience, that enables the qualified fitter to address these most common issues with more precision and greater long term results. Finally, in addition to addressing any pain or discomfort, a bike fitting will also improve your pedaling efficiency and aerodynamics - actually making you faster.
Let’s first talk about proper vs. improper positioning of the Feet, Seat, and Hands; and how that may cause pain or discomfort for the rider.
In general, cleats should be positioned for a neutral foot position. The cleat should be under the ball of the foot, and oriented so that your toe and heel point forward and in-line with the frame. The position of your cleat can have a direct effect on knee alignment, and if there is any pain in the knee a fitter should be consulted to have your positions assessed. 
Shoes should be snug, but not tight. They should fit like a sock, conforming to the foot shape and able to expand a little without constriction. The arch should match your natural arch and not allow your foot to roll inward. This can be achieved with insoles, inserts or arch supports.
Pedals should be of a width (stance) that allows the foot to rest directly on top of the pedal and be fully supported. 
The Saddle
Your bike seat should be level to support your full body weight and allow you to move around on the seat when necessary. Too much upward tilt can result in pressure points. Too much downward tilt can make you slide forward while riding and put extra pressure on your arms, hands and knees, which can lead to injury. To adjust the seat height, wear your biking shoes and riding shorts and place your heels on the pedals. As you pedal backwards, your knees should fully extend in the down position. If your hips rock side to side the seat is too high. Now move your foot into the proper pedaling position, with the balls of your feet over the pedal. You should have a slight bend in your knees.
You can also adjust the seat forward and backward (fore and aft position). With your feet on the pedals so that the crank arms are parallel with the ground, the neutral position will put your forward knee (patellar tendon) directly over the pedal axle (often referred to as KOPS).
Keep in mind that issues like saddle sores can be alleviated through proper positioning, but may also be an issue with the saddle shape, clothing or another issue. These can and should be addressed in a fitting session.
Photo by Victor Wang Studios (
Photo by Victor Wang Studios (

The location of your handlebars can cause multiple issues. Handlebars may be too high, low, close, or far away. If so, you can have pain, strain, soreness, excessive tightness (or all of the above) in the neck, shoulder, back, and hands.
Unlike a saddle, there is no hard and fast “rule” that tells you where to set the handlebars up, as too many variables are employed in the final location. Variables like frame geometry, usages, style of bike, experience of rider, flexibility, components, and so on all play part in the final handlebar location. The one constant is that the handlebars position should be properly set up relative to the saddle, and this must be addressed first no matter which bike we are talking about. 
A generic rule of thumb to cover multiple bike styles and handlebar configurations is that a proper reach (distance to the handlebar from the seat) allows you to comfortably use all the positions the handlebars provide and to comfortably bend your elbows while riding. To properly support your upper body, the handlebars must also be the proper width for your shoulders and placed at an appropriate height.  Too high and you will increase lower back issues, too low and neck/ shoulders will be an issue. For all bikes, handlebars come in a variety of shapes and sizes, and a good bike fitter will have multiple varieties to test in order to determine your appropriate shape. 
Now let’s talk about some common aches and pains that cyclists have, and how these may be addressed by a bike fit or technique.
Knee pain is most commonly associated with saddle position. A saddle that is too high or low, too far forward or back can all cause issues. Improper bike shoe or cleat position can also cause knee pain.
  • A seat that is too high will cause hip rocking and pain in the back of the knee.
  • A seat that is too low or too far forward may cause pain in the front of the knee.
  • Improper foot position on the pedal (or improper cleat alignment) can cause pain on the inside or outside of your knees.
Individual anatomy may also result in knee pain. Cyclists with slight differences in leg length may have knee pain because the seat height is only adjusted for one side. Shoe inserts, wedges, shims or orthotics can address this problem. Another common cause of knee pain is using too high a gear (mashing). Reducing the gear and increasing the cadence will reduce the stress on the knee.  
Neck pain is usually the result of riding a bike that is too long, or having handlebars that are too low. Check for signs like high shoulders, straight (not bent) elbows and craning of the neck. Handlebar width also plays a big role. Bars that are too wide will cause pressure in the upper back between the shoulder blades, while bars that are too narrow or extended will cause forward rounding of the shoulders. Tight hamstring and hip flexor muscles may cause neck pain by forcing your spine to round or arch, as well as cause a hyper extended neck. Improper saddle position can create these problems as well. 
Foot pain or numbness is most commonly addressed by proper footwear. Issues such as hot foot, numbness and arch pain can be addressed through cleat positioning, insoles, orthotics, shoe tightness (width or over clamping), and pedal choice.  Pedaling technique and gear choice also play a role in foot pressure.
Photo by Victor Wang Studios (
Photo by Victor Wang Studios (

Hand pain or numbness can be alleviated or lessened by wearing padded cycling gloves. Riding with your elbows slightly bent, not straight or locked, is always a key. Bent elbows act as shock absorbers and help absorb the bumps in the road, they also serve to relax the shoulders and neck area. Changing hand positions frequently on the handlebars can also reduce pressure and pain. Finally, check your component positioning. Brake and shift levers should be positioned in comfortable alignment of your wrists, with the proper reach to work the controls. 
Understanding that the pain described above is not normal and can be addressed with a proper bike fit is the first step in getting faster on the bike. The old adage of “no pain, no gain” does not apply in the context of bike fit and cycling. Address issues like numbness and pain and you’ll be motivated to ride further - your performances will reflect your hard work!
This article was contributed by TrainingPeaks, the ultimate training and nutrition software for cyclists and endurance athletes. USAC members receive 10% off TrainingPeaks Premium Athlete Software. Learn more here.
Philip Casanta (USAC Level II Coach) is the lead bike fitter at Hypercat Racing, based in Ventura, CA. Phil has been helping athletes optimize their bike fits for over 20 years. Phil works extensively with triathlon, time trial, road, mountain and cyclocross athletes. Retul and F.I.S.T certified, Phil’s expertise combines experience with art and science to produce the optimal fit for athletes based on their individual needs, biomechanics and athletic pursuits. Learn more at

This Article Updated May 31, 2012 @ 10:42 AM For more information contact: