Archive for “knee pain”

How A Bike Fit Can Address Aches And Pains

Posted in Bike Fitting with tags , , , , , , , , , , , , , on June 19, 2012 by hypercatracing

Photos provided by Victor Wang Studios (

No matter the distance you ride, you should be comfortable on your bike. If you experience pain in your neck, back, or knees – or have saddle sores or numbness – your bicycle probably doesn’t fit you properly.

The 3 key areas that an experienced and qualified bike fitter will address during a fitting are feet, seat, and hands – the areas where the rider makes contact with the bike. There are a number of issues that will affect the physical relationship of rider and bike. For example, your body may be asymmetric (one leg or arm slightly longer or shorter than the other), and even the slightest imbalance can lead to pain. While it used to be true that addressing these asymmetries meant a bit of trial and error, the properly outfitted modern fit-studio has the tools (like Retul, 360 degree viewing, wedges, shims, and 2D and 3D video with motion capture), and most importantly, the experience to address the most common issues with more precision providing greater long-term results. Finally, in addition to addressing any pain or discomfort, a bike fitting will also improve your pedaling efficiency and aerodynamics, actually making you faster.

Let’s first talk about proper vs. improper positioning of the feet, seat, and hands, and how this may cause pain or discomfort for the rider.


In general, cleats should be positioned for a neutral foot. The cleat should be under the ball of the foot, and oriented so that your toe and heel point forward and in-line with the frame. The position of your cleat can have a direct effect on knee alignment, and if there is any pain in the knee a fitter should be consulted to have your positions assessed.

Shoes should be snug, but not tight. They should fit like a sock, conforming to the foot shape while able to expand a little without constriction. The arch should match your natural arch and prevent your foot from rolling inward. This fit can be achieved with insoles, inserts, or arch supports.

Pedals should be of a width (stance) that allows the foot to rest directly on top of the pedal and be fully supported.


Your bike seat should be level to support your full body weight and allow you to move around on the seat when necessary. Too much upward tilt can result in pressure points. Too much downward tilt can make you slide forward while riding and put extra pressure on your arms, hands, and knees, which can lead to injury. To adjust the seat height, wear your biking shoes and riding shorts and place your heels on the pedals. As you pedal backwards, your knees should fully extend in the down position. If your hips rock side to side the seat is too high. When you move your foot into the proper pedaling position, with the balls of your feet over the pedal, you should have a slight bend in your knees.

You can also adjust the seat forward and backward (fore and aft position). With your feet on the pedals so that the crank arms are parallel with the ground, the neutral position will put your forward knee (patella tendon) directly over the pedal axle (often referred to as KOPS).

Keep in mind that issues like saddle sores can be alleviated through proper positioning, but may also be an issue with the saddle shape, clothing or another issue. These can and should be addressed in a fitting session.


The location of your handlebars can cause multiple issues. Handlebars may be too high, low, close, or far away. If so, you can have pain, strain, soreness, excessive tightness (or all of the above) in the neck, shoulder, back, and hands.

Unlike a saddle, there is no hard and fast “rule” that tells you where to set the handlebars up, as too many variables are employed in the final location. Variables like frame geometry, usages, style of bike, experience of rider, flexibility, components, and so on all play a part in the final handlebar location. The one constant is that the handlebar’s position should be properly set up relative to the saddle, and this must be addressed first no matter which bike we are talking about.

A generic rule of thumb to cover multiple bike styles and handlebar configurations is that a proper reach (distance to the handlebar from the seat) allows you to comfortably use all the positions the handlebars provide, and to comfortably bend your elbows while riding. To properly support your upper body, the handlebars must also be the proper width for your shoulders and placed at an appropriate height. Too high and you will increase lower back issues, too low and neck/shoulder issues will arise. For all bikes, handlebars come in a variety of shapes and sizes, and a good bike fitter will have multiple varieties to test in order to determine your appropriate shape.

Now let’s talk about some common aches and pains that cyclists have, and how these may be addressed by a bike fit or technique.

Knee pain is most commonly associated with saddle position. A saddle that is too high or low, too far forward or back, can cause issues. Improper bike shoe or cleat position can also cause knee pain.

  • A seat that is too high will cause hip rocking and pain in the back of the knee.
  • A seat that is too low or too far forward may cause pain in the front of the knee.
  • Improper foot position on the pedal (or improper cleat alignment) can cause pain on the inside or outside of your knees.

Individual anatomy may also result in knee pain. Cyclists with slight differences in leg length may have knee pain because the seat height is only adjusted for one side. Shoe inserts, wedges, shims or orthotics can address this problem. Another common cause of knee pain is using too high a gear (mashing). Reducing the gear and increasing the cadence will reduce the stress on the knee.

Neck pain is usually the result of riding a bike that is too long, or having handlebars that are too low. Check for signs like high shoulders, straight (not bent) elbows and craning of the neck. Handlebar width also plays a big role. Bars that are too wide will cause pressure in the upper back between the shoulder blades, while bars that are too narrow or extended will cause forward rounding of the shoulders. Tight hamstring and hip flexor muscles may cause neck pain by forcing your spine to round or arch, as well as cause a hyper-extended neck. Improper saddle position can create these problems as well.

Foot pain or numbness is most commonly addressed by proper footwear. Issues such as hot foot, numbness and arch pain can be addressed through cleat positioning, insoles, orthotics, shoe tightness (width or over clamping), and pedal choice. Pedaling technique and gear choice also play a role in foot pressure.

Hand pain or numbness can be alleviated or lessened by wearing padded cycling gloves. Riding with your elbows slightly bent, not straight or locked, is always a key. Bent elbows act as shock absorbers and help absorb the bumps in the road, they also serve to relax the shoulders and neck area. Changing hand positions frequently on the handlebars can also reduce pressure and pain. Finally, check your component positioning. Brake and shift levers should be positioned in comfortable alignment of your wrists, with the proper reach to work the controls.

Understanding that the pain described above is not normal and can be addressed with a proper bike fit is the first step in getting faster on the bike. The old adage of “no pain, no gain” does not apply in the context of bike fit and cycling. Address issues like numbness and pain and you’ll be motivated to ride further – your performances will reflect your hard work!

Philip Casanta (USAC Level II Coach) is the lead bike fitter at Hypercat Racing, based in Ventura, CA. Phil has been helping athletes optimize their bike fits for over 20 years. Phil works extensively with triathlon, time trial, road, mountain and cyclocross athletes. Retul and F.I.S.T certified, Phil’s expertise combines experience with art and science to produce the optimal fit for athletes based on their individual needs, biomechanics and athletic pursuits. Learn more at

This was an article I wrote earlier this year and was originally published on the blogs of Training Peaks and USA Cycling.


Understanding Bike Fit – KOPS (knee over pedal spindle)

Posted in Bike Fitting with tags , , , , , , , , , , on October 27, 2010 by hypercatracing

Over the last 20+ years of performing bike fits, no single bike fitting axiom seems to be more of an issue than the concept of Knee Over Pedal Spindle or (KOPS).   To illustrate a common issue with the concept I offer this rather typical question from a client and my response. 

QuestionI have a somewhat technical bike fitting question.  I have heard from many sources that give the following information: “In proper neutral fore-aft saddle position, with the pedal at 90 degrees [3 O’clock], a plumb line placed on the front edge of the kneecap should fall to the end of the crankarm.”

On the other hand, an equal number of others say that’s just not correct.  I’m more likely to agree that this method is faulty, because people have different femur lengths with regards to their total inseam.  Also, different bikes are made with different seatpost angles.  I find that even if I were to put my seat all the way forward, my knee still wouldn’t be over the spindle! Is there a better rule-of-thumb?

Answer:  This is an excellent question and one that many people have had trouble rectifying when reading from the various sources that offer their opinions. For this discussion we will assume we are discussing a standard road geometry where this type of positioning would apply. Triathlon, Time Trial, and Mountain bikes would only in the rarest of instances match to this discription.

 The exact quote ” in the proper neutral fore-aft saddle position, with the pedal at 90 degrees (3 O’clock), a plumb line placed at the front edge of the kneecap should fall to the end of the crankarm”, is generally incorrect as it assumes too much.  I have seen this description listed in many an article over the years and it is a tough one to justify since the front edge of the knee cap is also not the bio-mechanical marker for the knee.  This position would place the riders knee from 2-5 mm forward of the ball of the foot relative to the common bio marker of the Tibial Tuberosity (TT or bump just below knee cap)depending on cleat position, length of crank arm, etc… , however since they also use the end of crank arm instead of spindle center the general relative distance between TT and pedal spindle is about the same.  In either case the fact still remains, it can be a poor position for delivering effecient power to the pedal, a cause for generating knee strain, vastus medialis soreness, hot spots in the foot and a number of other issues.  It does not mean it is the incorrect final position and can many times be the resulting position, however it is faulty logic to say that every rider should be in this position from the outset.  KOPS is not the ultimate end goal, more over it is on average very close to the final position.

KOPS is used, even though it has no real biomechanical basis because it does seem to work quite well and is an ideal starting point when setting a bike up from nothing. One of the reasons it works is really very simple. A diamond frame bike could theoretically have a much steeper or shallower seat-tube and be as biomechanically efficient at either extreme, but the inclination of the saddle would have to be tilted up or down and friction would be insufficient to stop you sliding off it. Similarly, the pedal forces in the KOPS position are predominantly upward with a small rearward component. In normal pedalling efforts these will be reacted by gravitational and saddle frictional forces.

If one is to follow strict KOPS rules then the neutral postion the plumb line or laser should generate from the tibial tuberosity to the center of the pedal spindle. This would be at or just behind the ball of the foot (or 5th metatarsal).  This position tends to greatly reduce the strain on the patellar tendon during the donwstroke, specifically when the most force is being generated, on a typical road geometry.  Having the seat too far back tends to over straighten the leg creating essentially a seat that is too high.  From the neutral postion (once found) you can tweak the seat postion forward or back depending on your riding style (high cadence spinner, big ring masher or something inbetween). 

All this is still not much help without taking into account all the other factors that effect a properly positioned knee, but those are for another discussion.  So here is in a nut shell how saddle positioning brakes down: a higher seat assuming nuetral positioning transmits more power, while a lower seat conserves more muscle energy.  The seat height of course also affects the bio mechanics of the knee itself.  The more you bend your knee the greater the stress placed upon the patellar tendon, if the seat is too high then the strain tends to go to the iliotibial band.  Assessment – you feel pain in the front of the knee – raise the seat slightly.  You feel tightness or pain in the back or side of the thigh – lower your seat.  If you have a functional discrepency causing the knees to be two different angles that is where shims, wedges, orthotics or other devices can help.

To further illustrate my point that KOPS is not what we as fitters are actually looking for here is an exerpt from an  article in the mid 90″s by Keith Bontrager.

The KOPS rule seems sensible enough; it puts the knee in line with the pedal at maximum pedaling force, which must help, right? Wrong. The KOPS rule of thumb has no biomechanical basis at all. It is, at best, a coincidental relationship that puts the rider somewhere near his or her correct position. It probably grew out of someone’s observations that may successful riders sit on their bicycles with their knees somewhere over the pedal spindle. In fact, there has been little comprehensive work done in the field of cycling biomechanics that has studied rider position on the bicycle in order to maximize power input or minimize fatigue. Most builders and fitting specialists rely on customer feedback to tell them whether a change in position feels better or worse. This information doesn’t pertain to power output; it is a result of physiological response called perceived exertion, only one of the several important variables that are related to a rider’s muscular effort. In short, there is no scientific evidence to support the KOPS method.

To properly assess these structures in the dynamic environment of pedaling it is advisable too have a profesional bike fit expert work you through the process and make changes based on trained objective experience.  A proper bike fit is the only way to not guess at the proper location for your knee.

It should be noted that this Q and A was from a conversation in 2005.   Today, nearly 6 years later this question still comes up in some form nearly every fitting.  Today we have adopted tools such as Retul to provide true 3D motion capture that is accurate to less than a millimeter in an active dynamic environment.  This allows us too see exactly what is the best relationship of the foot, cleat, pedal, crank length, Femur, Tibia, saddle, saddle position and more in real time to achieve the correct position for the type of rider and type of bike.  Listed below is a quick quide as too some normative standards relative to our prefered standard of (knee forward of foot, where knee = Tibial Tuberosity and Foot = Fifth Metatarsal) for different types of bikes. 

  • Road Bike            (0 mm to -10 mm)
  • TT Bike                 (+50 mm to +100 mm)
  • Tri Bike                (+50 mm to +100 mm)
  • MTB Bike             (-20mm to -10 mm)

Hypercat Racing provides Retul 3D fittings at their by-appointment studio in Ventura, CA

Understanding Bike Fit – Knee Alignment

Posted in Bike Fitting with tags , , , , , , , , , , on October 18, 2010 by hypercatracing

As mentioned in common bike fit issues part 1, knee alignment is very important to a proper and efficient fit.  Poor knee alignment at best is inefficient and does not allow for good power transfer and at worst will cause injuries.  Correct knee alignment is effected by a number of factors, listed are the 3 most common I come across in the studio.

  1. Cleat position –  The location of the cleat on your shoe will affect your knee tracking.  Cleats have multiple positions: for, aft, side-to-side, rotation (toe in-out, heel in-out) and tilt.  Where your cleat is located on your shoe not only affects the comfort of your foot but also the alignment of the knee as it travels throughout the stroke.  Note: A worn or broken cleat will perform incorrectly and cause the symptoms of poor cleat alignment.
  2. Foot position – Where your foot sits in relation to your hip.  While many times the foot-hip position can be adjusted via the cleat position it is not always the possible, such as when the pedal spindles are too short or the crank width too wide. The hip-foot relationship can also be effected by your stance (distance between feet) on the bike  or the Q-factor (distance between cranks).   A significant discrepancy between the width of your hips and the spacing between your feet when engaged to the pedals will cause the knees to be poorly aligned throughout part or all of your pedal stroke.  Many times an athlete will feel their foot is pushing in or out on your shoe when the hip and foot are out of alignment
  3. Saddle Position – Saddle position directly affects knee tracking.  Having the saddle too low tends to force the knees and foot in at extension (bottom of stroke) and out at flexion (top of stroke), giving the visual impression of looping when looking at the knee from the front.  Saddle too high tends to have the opposite effect. 


  • Other factors – More common contributors to knee alignment: 
    • Pedal choice.  Pedals come in different spindle lengths, width of platform, support and float (ability of the cleat to rotate in the pedal).  Your pedals need to allow for proper foot position relative to your hip. 
    • Shoes.  Shoes need to be supportive and hold the foot in the right position, if they are worn out or incorrectly sized they can cause a misalignment of the cleat position.
    • Insoles.  Some athletes need different support within the shoe to keep the foot aligned.  having the wrong or a worn insole can allow the foot to become misaligned. 
    • Orthotics. Using orthotics made for a different sport will cause issues, it is very rare that orthotics made for running are correct for cycling.  If you need or choose to use custom orthotics it is best to have them specifically made for your cycling. 
    • Wedges. Wedges are used to account for Varus and Valgus foot tilting.  Wedges are a fantastic tool for solving fit issues, however they can also be a problem.  Over wedging is more common that under wedging, however both are a problem.  If the foot is over/ under wedged the cleat and/or whole foot will be misaligned and cause the knee tracking to be affected. In many cases this will cause pain and/ or discomfort and in extreme cases injury.
    • Shims.  Different than wedges a shim is designed to deal with leg length discrepancies (LLD).  LLD’s come in both functional and anatomic.  a functional LLD is generally not fixed by shims, however a true anatomic LLD is.  If not assessed properly placing shims for a functional LLD or the incorrect length for an anatomic LLD will cause issues at the hip that will translate to poor knee tracking. 

Bike Fit 101 – “Quick Fixes”

Posted in Bike Fitting with tags , , , , , , , on April 12, 2010 by hypercatracing

Pain is never normal, but unfortunately it is quite common with cyclists especially from the knee down.  Most pain can be attributed to improper position of the rider and/ or equipment of the rider.  Here are 5 common quick fixes to the most common problem areas I see daily.  This chart is from Paul Swift of Bike Fit Systems, makers of the original Cleat Wedge and something we use and recommend here at HBW. 

  1. Outside of Knee (Lateral) –  Try moving the foot further away from the crank (cleat inside).  Pain to the outside of the knee is often a sign that feet are in a position too narrow for you stance or hip width. 
  2. Inside of Knee (Medial) – Try moving the foot closer to the crank (cleat outside).  Pain to the inside of the knee is a strong indicator that your stance on the bike is too wide.  From the back a rider would look like an A. 
  3. Achilles – Moving the foot forward (cleat backward) will often take stress away from the Achilles.
  4. Arch – Moving the foot backward (cleat forward) will often take stress away from the arch.
  5. Outside of foot – Move the cleat inside to push the foot further away from the crank (move foot toward the pressure area) and/ or use wedges.  This is most commonly seen in feet not being centered on the pedal. 

In all of these cases I recommend seeking a qualified Fit specialist who works with shoe/ pedal interfacing and has the tools to properly assess the problem in a dynamic setting.  Tools I frequently use in my practice may include, wedges, shims, pedal spacers, shoe insoles, lasers, and in some cases changing the model of pedals and/ or shoes.  Too learn more about these tools and techniques or to find a fit specialist visit

It is never acceptable or normal  to ride with pain or discomfort.