Keen cyclist? Read about our new Bike Fit service!

With Richmond Park and the Surrey Hills almost on our doorstep it’s not surprising that cycling has become such a popular sport in this area.

Cycling places unique demands on the body and, here at Physio on the River, we frequently assess and manage people with problems related to cycling. These include aches and pains caused by cycling and the way the bike fits the person, as well as movement issues and physical problems with their body that impedes their cycling – and often both at the same time!

Therefore, it is entirely appropriate that we are now able to offer a comprehensive ‘Bike Fit Assessment‘ by a Physiotherapist to ensure optimal performance, manage any individual musculoskeletal imbalances in the body, minimise injury risk and keep you pedalling joyously!

One of our team of Physios, Richard Game, is a keen cyclist and loves treating cycling injuries. He is also trained in carrying out Bike Fit Assessments. Read more about how Richard can help and the value of having a thorough Bike Fit.

10 most common cycling aches and pains

  1. Neck pain – whether you are on a road bike, mountain bike or a hybrid, your neck has to be unnaturally extended for long period of time in order to see the road ahead. This commonly causes neck pain and sometimes neck related headaches
  2. Hand pain – too much pressure on your hands (usually because of incorrect bike set up) can cause hand pain. Also pressure on the nerve can lead to finger tingling and weakness (a temporary nerve palsy)
  3. Forearm pain – this can be from over gripping the handlebars or incorrect set up causing too much load on the forearms
  4. Lower back pain – it’s not hard to see how flexing the back in an unnatural position for hours at a time can cause lower back pain! Correct bike set up can help to alleviate this.
  5. Hip pain – cycling involves an awful lot of repetition in a very static posture. Tightness across the front of the hips can pose a risk to developing hip pain
  6. Knee pain – incorrect alignment of the knee when cycling (allowing it to drift inwards or outwards) can provoke knee pain
  7. Ankle pain – the position of the foot on the pedal and the cleats can alter the alignment and loading through the ankle
  8. Foot numbness – pressure through the foot and toes can lead to numbness of the foot
  9. Saddle soreness – we’ve all experienced that I’m sure – but the position of the saddle in relation to handlebars and pedals can contribute more or less to this soreness
  10. AC joint soreness – the AC joint is a small joint that sits just above the main shoulder joint. It takes a lot of load transferred up from the arms and into the upper body. It too can get sore and lessening the load with correct bike set up can help to lessen the pain

So you can see that there are quite a few aches and pains that can develop and getting your bike fitted to you correctly can go a long way to alleviating the stresses through the various parts of your body.

What is the advantage of a Physiotherapist carrying out your bike fit assessment?

As Physios we can not only assess how the bike is set up correctly for you but we can also look at how well your physical make-up works on the bike! Not everyone is totally symmetrical and cyclists often carry old injuries and imbalances in their body. We have the background knowledge of the human body to assess what needs to be fixed in your skeleton and movement system for a more comfortable ride. So Physios can look at how well the bike fits you and how you fit the bike!

What is a bike fit assessment?

Bike fitting aims to maximise rider comfort. A well fitted rider should be able to sustain a relaxed position on the bike with minimal effort, without causing strain and overloading tissues.

Bike Seat position IS NOT a normal sitting position but on a bike! It’s an entirely different posture.

The key to a successful bike fitting is that the rider is relaxed, their posture is optimal, weight is distributed evenly and comfortably, the joints are extended optimally to produce power and the foot is stable.

What can you expect from your bike fit assessment?

Bike Turbo Trainer

A bike fitting will take approximately 75 minutes. You should attend wearing cycling clothing, the footwear you cycle in (cycle shoes with cleats if used) and of course, bring your bike!

You will have your bike connected to a turbo machine and expect to be riding for up to 25-30 minutes on and off whilst we carry out the assessment.

We may occasionally make recommendations on changes to components such as saddles, stems and handlebars and, as necessary, can help you to source them (though for most this shouldn’t be necessary).

We charge £180 for our new bike fit service.

Next steps…….

If you would like more information and a chat with our cycling physio guru Richard Game just:

  • call 0203 916 0286
  • contact us by email here

5 ways to improve your cycling

Cycling has never been more popular. You only have to cast a quick glance along the roads and tow paths in Barnes to see how it appeals to adults and children alike.

This month, we give you 5 top tips to improve your cycling and look at the effect cycling can have on your knees. Enjoy reading!

 1. Cadencepedalling cyclist


For fitness and efficiency, keep the pedals turning at about 70-80 revolutions per minute. This may seem harder work at first, but if you do this you will start to use your gears to maintain a good power output consistently.


2. Saddle heightkneeat25annotated


When at the bottom of a revolution of your pedals, your knee should be bent to 20-30 degrees at the knee (with the knee straight being 0 degrees). This allows you to generate power from all muscles of the lower limb.


3. Fluids


In cycling as with all sports, fluid balance can really affect your performance. Ideally take sips of water every 15 minutes or so, increasing this if you are working harder such as when going up hills.


4. Bib shorts2995


They may look like Gok Wan’s biggest nightmare! But bib shorts are well worth the money spent. They provide enhanced support and allow the cushioned lining of cycle shorts to provide maximum comfort for easier riding.




5. Tyre pressure

It may seem illogical, but a higher pressure means less punctures! In London there are countless ways to puncture tyres. A reinforced tyre (around £25 will get you a good one), inflated to the maximum pressure will reduce punctures as well as enhancing the efficiency and feel of your ride.

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Knee Pain When Cycling – How to Avoid It

Cycling can play havoc with your knees – but can also be avoided. Nip over to our informative blog – Knee Pain When Cycling and How to Avoid It.

Meet The Team!

Richard Game Physiotherapist

Richard Game joined our clinic in 2007. He has many strings to his bow. Before becoming a Physio he studied Sports Science at university and since becoming a Physio he has added a Master’s degree in Pain Management and he is shortly to complete a PhD. He is also trained in the use of acupuncture for pain relief. What little spare time he has he enjoys with his family – wife and three young boys! He is mad about rugby and he’s a keen cyclist.

If you have enjoyed this take a look at our other cycling blogs.

Knee pain when cycling – and how to avoid it

Cycling is a great way to get fit but it isn’t without risk of pain and injury. Apart from the obvious flesh wounds related to falling off your bike, the most common problems are usually felt around the knee.

Read on to learn more about the common causes of cycling knee pain and how to avoid the pitfalls.

Why does knee pain occur when cycling?

Cycling is a repetitive activity so aches and pains are rarely related to cartilage tears or damage to the deep cruciate ligaments inside the knee – but much more likely to be an overuse condition.

Biomechanical stresses through the knee, caused by muscle imbalances or incorrect bike setup, are often at the heart of the problem.

Typical causes of knee pain when cycling

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Pain felt around the front of the knee often arises from the knee cap joint (patella-femoral joint). The knee cap should track nicely in a groove on your thigh bone but is often pulled off course by an imbalance of the muscles controlling it – some may become weak and other muscles may become tight. This can cause the underside of the knee cap to rub against the side of the groove.


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The Ilio-tibial band (ITB) is a very strong, long tendon which runs down the outside of your leg from above your hip joint to below your knee joint. It has attachments to the outer side of the knee cap. It commonly becomes tight in runners and cyclists and this can create an uneven pull on the knee cap.

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The ilio-tibial band can also become sore as it passes across the outside of the knee joint. If you can imagine that on a long ride your knee may perform up to 5,000 revolutions!  As the knee bends and straightens repetitively the ITB can rub on the side of the knee joint and become inflamed.

Those with a tight ITB are often found to be weak in the Gluteus Medius Posterior muscle – a deep buttock muscle that controls the alignment of your leg and stabilises your hip. If this is weak the leg will tend to drift inwards affecting the alignment of the leg.

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Those with a weakness of the inner quads – the vastus medialis muscle can also can also experience pain in the knee. Weakness on this inner side means the knee cap can be pulled more to the outer side.

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It may be hard to believe but altered foot posture (rolling the ankle out or in too much) can also impact the knee.


A scoliosis (curve in the spine) can affect the alignment of the pelvis and this can also affect the working of the knee.

How you can avoid knee pain when cycling

Getting your bike set up correctly is essential. For instance, if the saddle is too low this will increase the bend of your knee. The distance of the saddle from the handlebars can have an impact on the knee angle too.

Sometimes your bike set up can be perfect but a tight hamstring muscle or a small difference in leg length, for example, can affect the biomechanics of your cycling action.

The best treatment for knee pain?

Our team of physios are trained to analyse movement and we specialise in treating all these issues which can lead to knee pain in cycling. We will:

  • Check out your alignment – not just in standing but in your cycling position too
  • Test the length and strength of the muscles so we can identify any muscle imbalances
  • Look to see if any old injuries have left you stiff in any of your leg or back joints
  • Look at the way you move – you may habitually cycle with your knee facing inwards, for example.

If you are suffering knee pain, just pop into the clinic and make an appointment or click here to contact us by phone or email.

If you enjoyed this take a look at our other cycling blogs!

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