Cycling health specialist tackles common comfort questions
I use insoles in my day-to-day shoes and for running, but they don’t seem to work as effectively when I cycle – why not?
Most off-bike (i.e. walking/running) insoles are rear-foot-only – they’re only half an insole. Cycling is a forefoot sport – as we pedal, the force is transmitted through the forefoot to the shoe, then the pedal. A heel-only insole can’t control the forefoot as much as a full-length insole, which is what I recommend for cycling.
I get really tight hip flexors after riding, as well as low back pain. Are these related, and what can I do to alleviate them? Constant treatment does not seem to help.
They are related, yes. We don’t use our hip flexors very much in cycling, but we do sit in the inner range of our hip flexion for hours on end. This is the same as sitting in a very small car for a long drive – when you get out of the car, you feel stiff and sore. It’s the same on your bike: the hip flexor becomes set to its shortened position. It attaches to the bottom three vertebrae of the lumbar spine, and therefore pulls your back into extension. This is the reason for the low back stiffness and sometimes pain. Stretching will help ease it, and manipulating position through shorter cranks, lowering the saddle nose or raising your front end can help open up the hip, which may help.
I’ve noticed that my knees do not go straight up and down when I pedal, and I’m worried, having heard and read some comments that this may cause knee pain or injury. Is this true?
While it would be lovely from a mechanical efficiency point of view if everyone’s knees tracked in a straight line, most do not. It is true that significant lateral (side to side) tracking of your knees may be a sign that your saddle is too low, which can cause knee pain. However, I see lots of cases where the attempt to make the knee track in line, via wedges, etc, leads to worse injury and pain problems. If you don’t have an issue, my recommendation would be to leave your kneetracking alone. It is more often a reflection of your biomechanics and is probably your body’s ‘preferred movement pathway’ – the best way of pedalling for you personally.
I get a saddle sore constantly – always in the same place, and no amount of chamois cream seems to help. Is there a solution?
Human beings are asymmetrical – some more so than others. Bikes, however, are symmetrical. This can cause issues such as ipsilateral or one-sided saddle sores. A very common cause is leg length difference, which causes you to sit over to one side simply to reach the pedal with the shorter leg. This can load one side of the undercarriage more, causing the issue. A twisted pelvis can lead to the same issue. Chamois cream can help reduce frictional issues but it can’t solve increased pressure. Biomechanical interventions are often needed – either leg length build-ups, or decreasing the effect of the asymmetry by reducing crank length.
I have now amassed 10 different saddles for TT racing, and not one has helped solve the problem I have. Help!
I see many, many people in the same situation. Unfortunately, you could have the best saddle in the world for you on your bike, but if it’s not in the right position, it will never work. First of all, make sure you have the right type of saddle – TT split-nose saddles aren’t designed to work as road saddles. Work on the saddle setback, height and tilt, first making small changes while on your turbo. This can help you evaluate the relative comfort of small but important changes. Remember, cushioning and correct support/ shape are far more important than weight.
I have been trying to achieve a good aero position on my road bike by using aero bar clipons, but can never seem to get comfortable. Any tips?
This is like putting lipstick on a pig! In my opinion, you can never get a good aero position on a road bike using clip-on aero bars because the bike isn’t designed for that position. The effective seat tube angle means it’s almost impossible to get your saddle far enough forward to optimally drop your forearms onto the pads. This means your hips become very closed up, so while the frontal area may decrease, the effect on pedalling power and efficiency is far more detrimental. The only way it can work is when the pads and extensions are set very high (a Race Across America-type set-up).
Phil Burt
was head of physiotherapy at British Cycling for 12 years. He now runs his own bike-fitting service: philburtinnovation.co.uk.
Got a question for our medical experts?
Email david.bradford@futurenet.com