Vail Summit Orthopaedics Blog

Dr. Cunningham gives biking tips on TV8 Interview with Seth Ehrlich from SOS Outreach.

Hand pain or numbness can be prevented by wearing padded cycling gloves that provide cushioning. You should ride with your elbows slightly bent, not straight or locked. Bent elbows will act as shock absorbers and help absorb the bumps in the road. Changing hand positions on the handlebars can also reduce pressure and pain.

Foot pain or numbness is often the result of wearing soft-soled shoes. Special shoes designed for cycling have stiff soles that distribute pressure evenly over the pedal. This also helps you pedal more efficiently. Foot pain can also be caused by using too high a gear, which results in more pressure where the foot meets the pedal.

Back injuries will  haunt many cyclists, which isn’t really surprising given how they’re hunched over their bikes for long periods of time. Posture is everything and it’s important to get this right and not put strain on the lower back.

Neck pain is another common cycling complaint, and is usually the result of riding a bike that is too long or having handlebars that are too low.

Knee pain is a frequent complaint among cyclists. Knee pain is usually associated with a seat position that is too high, too low, too far forward or too far backward.

The frame geometry of women’s specific bikes accommodates for shorter legs and arms.  There are also women-specific saddles that are shorter and wider to accommodate a woman's wider pelvis. Others have a center cutout to relieve pressure on soft tissues.

Remember that it is important to fit the bike to the rider not the other way around. As we age, we are less flexible so you will be more comfortable in a more upright position. Consider a professional bike fit to improve comfort and performance.

Your bike seat should be at a level that supports your full body weight and allows you to move around on the seat. Too much upward tilt can result in pressure points. Too much downward tilt can make you slide forward while riding and put too much pressure on your arms, hands and knees.

To adjust the seat height, place your heels on the pedals and pedal backwards. Your knees should fully extend in the down position. If your hips rock side to side the seat is too high. You should have a slight bend in your knees when your foot is in the proper pedaling position.

• Fore/aft so that the ball of the foot is in line with the pedal spindle
• Side to side so that the 2nd toe is in line with the tibial tuberosity (bump below the kneecap)
• Rotation in foot’s natural position

• Back angle = 45º (smaller angle for more aggressive riding)
• Shoulder to trunk angle = 90º (larger angle for more aggressive riding)
• Elbow angle = 15º to 25º
• Wrists in a neutral position
• Height usually 1-4” below top of saddle
• Width = shoulder tip to shoulder tip in centimeters
• Distance from saddle tip to bars within an inch of elbow tip to middle finger tip

The length of your stem will give you either more reach or more of an upright feel. If the handlebars are too high, too low, too close, or too far away, you may have neck, shoulder, back, and hand pain. You should be able to comfortably use all the positions on the handlebars and bend your elbows while riding.

Adjust your Saddle

• Height so that the knee angle equals 25º - 35º
• A plumb line dropped from the tibial tuberosity (bump below the kneecap) should intersect with the pedal spindle
• Tilt should be level (tip may be slightly lower for more aggressive riding)
• Width so that weight is distributed on the sit bones