Hi guys, long time lurker, recent poster. I'm a sports Physio by trade and am struggling to work out a bike fit problem that I have.
I ride an Orbea Liege Euro with a 51.5cm top tube. I ride about 100-200km a week, and I am having a slow build up of tension in my left glute max. It forms a big knot in the muscle and then gives me back spasm on that side. I have had a Retul bike fit done a long time ago when I first bought the bike (18 months ago) and this problem has been happening for about 12 months now. I've had some colleagues look at me and I am quite symmetrical in terms of leg length and flexibility in the hips, as well as outright gluteal power and such, so we're not sure why I'm only getting it on my left leg, but it's definately the cycling which causes it. I can fix it temporarily by working on the muscle manually but it comes back when I ride.
I have attached a picture of my bike setup. You can see how high the seat has to be, and the spacing on the stem is massive. My measurements are unusual - I am 175cm tall but I have a 90cm inseam (very long legs!). So I need a short top tube length for my upper body, but a larger frame to suit my legs. I have pushed the seat right forwards so that I'm not reaching for the pedals as much and this has helped the glute a fair bit, but not fully. It's a tricky problem - hoping to hear from some of the bike fit people out there to figure out what I should do - someone suggested going to a more relaxed geometry bike like a Giant Defy to fix the issue, another suggested a custom frame might be the only option given my unusual measurements. What do you guys think?
Custom frame. I'm 191.5 with a 94'ish inseam (can't remember exactly), so not as bad as you, but I run a stack of spacers under the stem, and now use 'flipped' offset seatposts to get the saddle far enough forwards. My old fit (saddle further back) had been looked at by Steve Hogg, and he was happy with how I had set my bike up, but I'm now 3cm further forwards after struggling with back pain earlier this year.
Just for fun, run your numbers through the 'competetive cyclist' fit calculator and see what it comes up with.
I ride, therefore I am.
...real cyclists don't have squeaky chains...
Get your physio colleagues to clear your lumbar spine, especially with firm unilateral PAs, and do a sustained slump test, with overpressure++.
Sounds like a mild (L) posterolateral L4 or 5 disc herniation, or less likely, a congenital predisposition to lumbar spinal stenosis.
How long can you do the plank for and do you get back pain with it?
What's your hip extensor flexibility like?
What's the drop in cm's between saddle and stem? I can't see your picture.
Yeah we've been there and done that. Neural length is identical, range is identical everywhere. Had three guys look at it LOL. Next step is to MR the spine to have a look if it's some really low-level neural irritation, but if I can fix it with a different bike fit I would be happier.
Interestingly I get paraspinal spasm (flashes in and out of spasm) the day after a ride usually, when I'm just standing still. Dry needling the big glute max trigger point immediately stops the back pain - so we think it's a thoraco-lumbar fascia/neural tethering issue coming from the glute and affecting the spine, rather than the other way around. It's a weird one for sure.
I'm a machine with core strength - I can plank longer than a piece of 2x4. Can't seem to find any assymmetry in the power or flexibility levels anywhere, except when I have the glute trigger - then it just feels tight and restricted until it's gone again.
twizzle - will do that calc. Looks helpful.
Have you had someone look at you on the bike (apart from retul fit).
do you drop one or both hips whilst riding?
how stable is your pelvis on the bike?
how do you "present" whilst riding under load? do you rock, are you completely stable. do you drop both heels? one heel? not at all?
the static bike measurements mean nothing....
I've had three or four of my cycling buddies look at me and they couldn't see anything major, but then again they're not professionals. I am very stable though, no rocking - I tend to be very solid on the saddle with no wobbling which is a good thing I guess. The Retul fit is dynamic but not much load unfortunately - should have been done with a load on a mag trainer or something I reckon.
One thing I have noticed is I tend to "push" more with my left calf through the bottom of the stroke, in other words I seem to engage my left calf to take some load, I assume this is probably because my glute is disengaging as it gets painful and tight and the trigger point forms up, and I'm trying to compensate for it.
- a slump test should have cleared you of tethering issues, from cranium to toes.
- downstream dry needling stopping upstream neuros doesn't validate causation.
- again, what's your hip extensor length like, and your saddle stem drop? Have you slammed the stem?
- what's the diff in your anatomical femur and tibia lengths?
Could it be something mechanical, ie. the bike itself?
Perhaps the saddle or bars are slightly off centre?
Or back to physical, are the power outputs of both the legs the same? Single-legged squats could tell you that.
I've just ploughed through the thread.
My take on it.
blah blah blah..... Baum custom Ti frame .....blah blah blah.
Seems like there is a simple resolution to the back pain.
I ride several bicycles, but not at once.
I'm not a doc or anything but i do remember when i was picking up my new roadie a few weeks ago the person at the shop told me a number of things, one of them was infact that i could get back spasms or pain in the gluteus macimus and this could be because of one or two things.
Unfortunately i can't remember exactly what he said for your case but i remember him mentioning something about the saddle (maybe get a new one?), handlebar position, and also the height of your saddle. Like i said it's just bits and pieces in my head so I'd recommend maybe heading down to a good bike shop and having an ask =)
2012 Merida Race Lite 904
Slump test is not 100% accurate. I've seen plenty of known neural disc issues that don't show up on it. A negative test does not clear you of tethering, particularly if it's transient - think piriformis trigger points tensioning up the sciatic nerve for example during heavy activation. I should probably do a slump test immediately after a ride when the glute is sore..... didn't think of that. Could be an on/off trigger point tether.
Hip extensors are identical - I have HEAPS of glute range - that was the first thing I checked. Saddle top to the top of the bars is 10cm drop. The stem is as high as it will go to keep me out of too much flexion, and I'm still more flexed than most of my mates on the bike. Good idea on the femur/tibia lengths - I know the overall length is identical but will check that.
Anyway I didn't expect to fix this issue via the internet if two specialist musculoskeletal physios haven't been able to find anything causative. What I'm more interested in is ideas on how to stop it by changing the bike fit - since I never had this issue before I started cycling. It's a tough ask I guess because we can't figure out which part of the bike fit is causing it, but the people I have spoken to have looked at my measurements (90cm inseam, 175cm total height and have all said I might need a custom frame to stop the glutes shitting themselves by working on stretch. Bloody tricky problem!
One of the specialists I saw brought up the idea of a unilateral sciatic nerve pathway difference - in other words the nerve may be running through a portion of the fascia/glute med/glute max on that side and not on the other, apparently it's quite common on cadaver studies to see anatomical differences like that which are genetic. I thought it was an interesting idea - like how 17% of the population have the nerve passing through the piriformis belly, and I've seen plenty of odd neural issues which appeared to be muscular tethering in the shoulder and neck. I guess not everybody is the same!
Their take on it was to try to get the glute to do less work so that it didn't fatigue as much. Changing its length/tension relationship is the most obvious thing, and due to my bike fit issues the suggestion was to bring the seat forwards so that I'm a little more upright and the glute isn't on stretch when it's trying to generate power. I've done this and the issue did improve significantly (50-60% better, so very noticeable) but the seat can't go any further forwards now, and it's very high due to my long legs!
Drop the seat and move it a bit forward. Unfortunately I dont believe you are as perfect as you are making out, according to you you are the perfect specimen apart from having long legs. Now your looking for silly things like sciatic nerve going through piriformis being the problem. Two things with that what about all the other people that have that and dont have those problems? Even if it was what are you going to do about it get a nerve relocation surgery?
One thing I have been told is dont miss the elephants people go looking for little tiny things when there is something major wrong and they miss that. I can almost guarantee you will have one (or more likely multiple) elephants, flexibility, strength, control or fit is likely to be a problem. As far as fit goes, seat forward and lowered may help if your as far forward as you can get then maybe you need a different seatpost with an offset and reverse it. See what competitive cyclist says with regards to fit, it is a good base.
Yep you're probably right vander, the three musculoskeletal specialist physios that I've seen are almost certainly wrong. It's also quite probable that the computerised fit that I did is completely incorrect as well. It's much more likely to be a super obvious problem than a subtle one, after all I haven't done even the basic things of getting a good bike fit done, or seeing a qualified health practitioner to ascertain if it's a mechanical problem in my body. I thank you for your valuable input.
Jokes aside, thats a good idea about a reversed seatpost - I could probably get a different shaped one (the top portion on mine kicks back where the clamp is, so there's not a massive amount of forwards movement available) that allows more forwards movement of the rails. I'll try that and see what happens. Just to be careful with this though - I want my forward-most portion of my knee to be vertically aligned with the front tip of my toe when the crank is horizontal right? I just don't want to go too far forward and then get knee issues!
Well I saw over 10 doctors and specialist's... they all missed the most obvious of problems... one single muscle playing up. So it does happen.
Still sounds like body mechanical problem to me. I went through 16 months of misery ... sometimes internet diagnosis does work .
No expert by a long way, but reading your posts I take it you are a fit, strong flexible and symmetrical sort of bloke.
I'm not that last bit and if my bikes are set up to be symmetrical it hurts, I have the bars turned by a fraction and the saddle is nearly but not quite fore and aft.
I may be way off base but it is worth checking.
London Boy 29/12/2011
Computerised bike fit, good if you dont have problems but not so if you are having problems, for me they are to cut and dry, most people using things like retul dont actually know much about fitting people. Better off being fit by someone that knows more about it.
About MS specialist physios, I have seen some absolute shockers (including one that teaches occasionally in at UQ), however there are some good ones so its hard to say but as TLL says just cause they have a qualification doesnt make them infallible.
What is was trying to get at is your case doesnt make sense, in the fact that you are amazing at everything but still have these pains. Another thing to consider is what were you like 18months ago when you got the fit, as you get fitter your fit may need to change.
I'm with Vander . My 20 years of musculoskeletal physio practice has taught me many things. Many colleagues who did masters in manips/ms are plain hopeless clinicians. We have physios now doing some crappy 2 year graduate entry course who are often worse.( some are good, but not great)
Don't discount dans input. And remember that common things happen commonly... Etc. too often I see clinicians looking for the most obsure diagnosis and ignoring the obvious.
Ps. Nice work Dan . The profession wil be in good hands
Hold on - aren't we supposed to be asking you the questions then?
Cycle touring blog and tour journals: whispering wheels...
As for bike fit. Give me a 60 year old ex cyclist over a computer any day. I've had both, and an old trackie at dunc gray picks up fit issues from just watching me race that some texta markers, video and goniometer have no answer to. Bike fit can be a bit like physio. As much as we want to be scientific and logical, gut and instinct can be equally as powerful
That's all BS. Just look at a recumbent. Or a TT bike, when ridden with the nose of the saddle on the coccyx.
As for seat posts... Thompson Elite. But get a torque wrench for doing the bolts, they have had a few posts break when people get carried away with bolt tension... and if you reverse it, you may have to remove and turn the top cap as well, it depends on the rail angle of the saddle you use.
Sent from my iThingy...
I ride, therefore I am.
...real cyclists don't have squeaky chains...
Wrong ! That is one of the most vague descriptions of saddle positioning I've ever read. There are far too many variables to consider before assuming a correlation between "knee & tip of toe".
A 100mm drop sounds excessive. If you already have your stem angled up & a large stack height then I would guess your frame is way too small.
Above you have stated two very obvious things.
1. You're trying to force your seat forward without the consideration of axle/cleat positioning.
2. You're still "more flexed" than most of your mates & running a 100mm seat/bar drop.
Also being able to hold a plank means absolutely nothing when it comes to core strength. The "plank" is a very small part of the equation which makes up your overall core stability.
Gas propulsion.......it's natural don't fight it.
I am not a physio, I am a computer programmer by trade. Which is why I would be concerned about your computer bike fit. Computer bike fit will work well for your average person. However, given you unusual body measurement I would not trust a computer program generating values based on average body measurements.
I would use a human bike fitting expert, at least they will think about the problem than using what the average does.
Some experts disagree
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