Bike Fit Case Study

Bike Fit Case Study

People often ask how a bike fit with a physical therapist is different from one at a cycling shop.  Clients or prospective clients have stated “I had a bike fit.”  And it is possible your bike was fit to you, but the real question is, were you fit to your bike?

While height is an important component of a bike fit, there are many aspects of a person’s anatomy that can cause a bike to be ill fitted, including, but not limited to: torso length, leg length, arm length, saddle preference or handle bar preference.  Beyond anatomy, we also need to know if a rider is experiencing pain while on the bike or if s/he is riding his/her bike differently because of the pain. Finally, has his/her body experienced any changes since his/her last bike fit?  These are all things that we as physical therapists consider when looking at a bike fit and can talk to the patient about how s/he is experiencing pain and how that effects his/her cycling.

Case Study

Recently, a client came to us with reports of low back pain.  Since the onset of that pain, he has been unable to comfortably ride his mountain bike, road bike, or commuter bike. The client stated he also may have a possible leg length discrepancy.  Bike Fit evaluation revealed that he has an increased trunk angle, and a decreased knee angle, which places him “knee behind pedal” during his cycling stroke.

It appears he has been riding with a saddle height that is too high and aft (behind seat post), which increases the glute and hamstring load with his “knee behind pedal” measurement.  Therefore, he may be placing increased load on his posterior chain (glute and hamstring muscles) and causing increased strain and compression in his lumbar spine.  His leg length discrepancy is also exaggerated by increased saddle height and increased reach to the handle bars. This was evident while evaluating his pedal stroke from the front while using a laser to line up his hip, knee and foot throughout his stroke.  His shorter lower limb was rotating in and out of neutral to accommodate for the increased reach.

We opted to start by only making a couple of key adjustments, including decreasing his saddle height and moving the saddle forward on the seat post.  By decreasing the saddle height and moving the saddle forward it decreased the reach his legs needed and decreased the amount of flexion in his lumbar spine, which provided immediate relief of his low back discomfort. We did not make any changes to his bike fit to account for his leg length discrepancy. He stated he is more aware now of the rotation and compensation on his shorter side and he will try to be cognizant of this while riding.  He is ready to hit the road and enjoy pain free cycling once again.

When was your most recent Bike Fit?  Are you riding pain free? Call today to schedule with Lauren Esmailka, PT, our bike fit specialist.

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Covid-19 Notice

3/27/2020 Covid-19 Notice:

On March 19th, we made the difficult, yet important decision to close both clinics, in order to do our part to flatten the curve. We will reopen the clinics part time on Monday, April 6th, with an emphasis on telemedicine. This will allow us to comply as much as possible with the governor's Stay Home Stay Healthy order if it is extended, while also meeting our obligation as essential infrastructure workers. According to Dr. Matos, an expert in biological surety and the management of select agent programs at federal facilities: "Physical therapists are essential in flattening the curve of the Covid-19 pandemic. They play a key role in keeping people they can help out of doctors' offices and ER's. This will not only free up the medical teams to treat those impacted by Covid-19, but also limit the exposure of those seeking the care of the physical therapist." To that end, we will focus on telemedicine, but also allow for select, necessary in-office treatments for low risk, healthy individuals. This will be a joint determination between you and your PT. Many, if not all of our patients, have come to appreciate the effectiveness and efficiency of the hands-on manual therapy techniques our physical therapists use to help relieve pain and improve function. So, we recognize that a telemedicine visit may not seem as appealing. At this time, telemedicine is the appropriate and safe way to continue your care without further interruption and your physical therapists are prepared to alter their approach in order to still provide effective care.

During our temporary closure, your physical therapists have been on unemployment and not able to contribute to our communities financially as they normally would like to. Getting back to work, providing your care will allow us to resume caring for you and our community. For every telemedicine visit we provide in April, the clinic will donate $5 to the following organizations:

Kelsea Cannon, PT- Westside Baby
Lauren Esmailka, PT- Treehouse
Elizabeth Rogers, PT- Rainier Valley Food Bank

We remain passionate about helping you improve and maintain the function of your movement system so that you can do the activities you love. I remain available for urgent (i.e. post-op care, acute injury, treatment needed to decrease/avoid use of NSAIDs and Opiods) in-clinic treatment and telemedicine treatment from now until April 6th. We invite you to follow/Like our  Facebook page, where I am offering complimentary weekly Pilates mat class on Wednesdays at 7am and foam roller class on Fridays at 7am. All are welcome to participate in these classes or view them anytime on our Facebook page.

Please contact me directly with any questions or concerns. If you are a current patient, you should have received an email from me with scheduling/rescheduling info. Be in touch with your PT to schedule your telemedicine visit. I am available via clinic phone (206-535-7356) and email ( We will update you here and our Facebook page as things change.

We are counting the days until we get to resume our work together both virtually and in the clinic! Thank you for your support of this small, locally-owned physical therapy private practice!

Elizabeth Rogers, PT

Owner, Elizabeth Rogers Pilates & Physical Therapy, PLLC

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