This month, MOTI Physiotherapy’s Dr. Ari Baquet, PT, DPT, OCS interviewed local bike fit expert, Brian Bonilla of The Cub House bike shop in San Marino, on bike fits from a patient’s perspective. Below is the transcript of that interview, edited where needed for clarity.
Ari Baquet: If a person is having bike-related issues, when is it my body versus when is it my bike? Even on the clinician end that can be pretty hard to tell, some of the time. If somebody were to come in and ask you that question, what would be your thoughts?
Brian Bonilla: I’ll usually ask someone if they have prior injuries or things that give them discomfort off the bike, and see what affects them off the bike. Let’s say their hands keep going to sleep, when generally that doesn’t happen, or they feel a lot of pressure in their perineal area [while riding] whereas sitting on a bench or chair there are no issues, that’s when I’ll think the saddle height might be too high or the handlebars are pushing up against your hands cutting off circulation or creating hand numbness. So it’s more of a person-to-person type of thing. But generally speaking, I’ll ask questions about injuries or discomforts and I’ll go based off of that.
Ari: So it sounds like if it’s something they experience only on the bike but not in other parts of their life, that’s when you wonder if the bike is the problem?
Brian: Yes, that’s how I’d sort it out. And generally, if you’re active on a bike whether you’re recreational or racing, getting a general saddle height is key, to make sure you won’t get discomfort, whether it be knee-wise or low back discomfort.
Ari: If somebody then were to ask, “I just started riding, I don’t think I have any issues, should I get a fit done?”, how would you talk them through that?
Brian: Generally what I would say is if you just got into riding and you think you don’t need a fit done, I would say get something called a “bike sizing”, where you get your saddle height and handlebar in the right place. When you buy something that moves, be it roller blades, or snowboard, or even a bike, it’s like getting something your general size – like a suit – and then getting it tailored to you. You might have a shorter torso and longer legs, so you might need a shorter stem, or vice-versa where you have hardly any inseam and need a low saddle height and further-out handlebars. So I generally tell people getting a bike is like getting a suit. You get your general size, and then the bike would get adjusted to you. Something that took me a long time to learn is that the bike works for you, you don’t work for the bike. So we should be able to manipulate the bike to have as much comfort and not as much discomfort.
Ari: I feel like that’s quote of the day right there.
Brian: Yeah, it was after my coach told me that, where he saw me super-stiff on the bike one day before a race, and told me “Remember, the bike works for you”.
Ari: What are the most common injuries or discomforts you see in either new riders or riders who may have been just a little off in their fit?
Brian: One of the biggest things would be IT bands, where people are really stiff or don’t stretch before riding and might have a saddle height that’s too high, so once they’re riding they’re [effectively] over-stretching. Another major thing where I feel bad for people is if they’re new to the sport, and they just start riding clipped-in (where one’s feet are fixed to the pedals -Ari), and don’t get their cleats set up, it can cause a lot of knee discomfort. Riding with a clipped-in shoe puts your lower extremities in a fixed position, and if you have [trouble with your] knees, it locks it in and doesn’t allow your leg or knee to float around. So that’s one of the biggest issues, is cleat placement, on knee issues and toe numbness as well.
Ari: How does the toe numbness thing tie into cleat placement?
Brian: Toe numbness and cleat placement can work where, let’s say, if the metatarsal of your foot and center of your cleat are badly aligned, it can put more pressure on certain parts of your toes, and can affect blood flow through the foot. From there, when I set up cleats, I make sure everything is neutral for your body and not simply straight for the bike, and also look at how the cleats place relative to the arch of your foot. If it’s too far forward, your arch can collapse and that causes your knees to buckle in toward the frame, which will affect from the foot all the way up the legs. Finding good arch support and setting up cleats properly can affect toe numbness and help all the way up through your knees.
Ari: That makes sense, but I would never have thought of it in terms of a blood flow standpoint. If someone comes to you and you’re seeing them for the first time like a blank slate, broadly speaking what does your assessment consist of?
Brian: Good question. I have them do a couple of stretches before they even hop on the bike, while barefoot. I see how the hip flows in relation to the hip, knee, ankle, and arch of the foot. I try to see what sticks out. For example, when someone does a knee bend, does their hip shoot out to the right? From there, a couple of shoulder stretches, because when on the bike you are kind of stretched out to the handlebars, so I look toward the neck as well to see what it naturally looks like with your arms out. I feel the back as well, and adjust accordingly to that. I have about a ten-step set of things I look at before we hop on the bike.
Ari: How do you tie that into what you’re seeing on the bike? Do you immediately adjust for it, or is it just good context?
Brian: It’s good context. I’ve seen it all the time where people are really stiff and don’t have the most mobility off the bike, but once they’re on the bike, their whole body changes. I’m myself a great example of that. I have the worst posture ever. But once I’m on the bike, I have a nice flat back, and stable hips, but if you see me just standing my shoulders are hunched and I don’t have the nicest gait walking. But on the bike it’s very different.
Ari: Are bike fits something that change over time? Or is it a set-it-and-forget-it kind of thing where once it’s dialed, you’re good?
Brian: I usually tell people to get a fit check-up every six months to a year and a half, just because the body changes dramatically in a month and a half. Where you might not have the most mobility when we meet up the first time, when we do the follow-up, someone might say “Hey Brian, I’ve been stretching more, doing more yoga, and have lost some weight”, that can also affect their ability to get lower and more aggressive on the bike to get more efficient. But if they get a bike fit and then don’t really ride for the first six months, it can be that the handlebar height has to be up a little more since they don’t have the flexibility anymore, and saddle position might have to be lower and further back. So I generally tell people to get a check-up every year.
Ari: What else should I be asking you? What else would you want someone to know?
Brian: Saddle selection. What works for someone won’t work for someone else. Everyone has to feel well-supported without too much pressure in the crotch area, where it’s nice and neutral. If you’re on too wide of a seat you can get saddle sores; if you’re on too narrow of a saddle your hips will be rocking everywhere and you won’t be as stable and efficient. So that’s a key portion. Something else is that sometimes as we do the fit I put wedges and shims inside cleats and shoes, to adjust for leg length discrepancies or arch drop, small things individual to the person.
Ari would like to express his gratitude to Brian for his time and thoughtfulness throughout this interview. Please contact MOTI Physiotherapy or The Cub House with questions.