VARIOUS CYCLING TIPS FOR PT’S AND THEIR PATIENTS:

• When choosing a road bike, there should be 1-2 inches clearance between the top of the top tube and the crotch.  For mountain bikes, this distance should be 2-4 inches.  If going with a smaller frame size, this distance may need to increase to 3-6 inches.
• Studies have indicated that oxygen consumption while riding is minimized at a saddle height that is approximately 100% of trochanter height, or 106-109% of pubic symphysis height.  One method to measure is to have the patient put a book between their thighs, with the edge of the book riding against the pubic symphysis.  Mark the wall where the edge of the book hits the wall, and measure to the floor from this line.  Multiply this distance by 1.09 to obtain your seat height. (Make sure the cyclist is wearing the shoes she/he will be wearing to ride with)
• Another method to determine seat height is to adjust until the knee is only slightly flexed when the pedal is at the lowest point (6 o’clock position).  For mountain bikes, the seat needs to be lowered for off road riding to increase control and power.  For those with no history of knee pain, the angle of the knee is permitted to be up to 25-30 degrees.
• To adjust saddle fore and aft position, do the following:  Have the patient sit on the bike with someone balancing it for them.  Have one foot at the 3 o’clock position and the leg you will use for reference at the 9 o’clock position.  A plumb line from the tibial tuberosity should pass right through the axis of the pedal/end of the crank arm.  For a mountain bike, this line should fall 1cm behind the end of the crank arm.  Some triatheletes prefer to have their knee as much as 2-3 inches in front, which requires a steeper tube angle on the frame than is found on most standard bikes.
• A slight tilt forward on the saddle can reduce perineum pressure, but may cause undue muscular tension as the rider tries to avoid slipping forward.  Instead, use a seat with a relief cutout as discussed in an update a couple of days ago.
• Handlebar position can be adjusted in different ways depending on the patient’s condition and needs.  When in a comfortable riding position, a line dropped from the nose should hit the middle of the stem. 
• The height of the bars should be 1-2 inches below the saddle for a short rider, and as much as 4 inches for a tall rider.  The stem needs to be raised for those complaining of cyclist’s palsy.  Also, have them wear padded gloves.
• A standard crank arm length of 170mm can be used for persons between 5’5” and 6’ tall.  Cyclists under 5’ should use a 160mm crank arm, while tall riders from 6’-6’2” should try a 172.5mm crank arm.
• A short rider using too long of a crank arm may end up with excessive knee and hip flexion, and thus injury, regardless of the seat position.
• Long crank arms are good for pushing large gears and climbing at lower RPM’s, while short cranks are good for high RPM’s and lower gears.  If the crank arm is changed, saddle position and handlebar position may also need adjusted.
• If possible, lube the chain 24 hours before riding, to allow carrier medium to evaporate, thus reducing dirt buildup
• Choose a saddle that is designed for either a male or female, and try in store before you buy.
• Avoid riding on busy streets with a lot of trees, as it has been discovered that the overhanging limbs can trap carbon dioxide/monoxide
• Change hand positions often to avoid handlebar palsy, and move your neck in a flexed position as you ride.
• Maintain lordosis if riding in an upright position to reduce stress to posterior tissues
• Raise handlebars if cervical degenerative conditions occur, where excessive extension is causing pain into the scapular area or arm.
• A good pre-ride meal could be rice pudding (212 calories), yogurt (114 per cup), oatmeal (145 per cup).  Pasta is also an option to carbo load the week before a big ride, and if you ride 1 hour per day, your daily calories should come 60% from carbos, while a person riding 2 or more hours per day needs 70 carbo calorie intake.
• Conserve energy and change position while occasionally standing during an uphill ride
• Don’t ride in the low position going up hills as it will compress the diaphragm and reduce breathing efficiency and capability.
• Take a 1-foot ruler to your chain to determine if it is worn by doing this:  Place the beginning mark on the ruler at the center of any rivet.  The 12-inch mark should be in the center of another rivet for a new chain, and will fall an eighth of an inch or more short of the rivet on a worn chain.
• Stretch during riding by taking one foot off the pedal and extending the leg, while tilting the body in the opposite direction