Boulder Physical Therapy & Custom Bike Fitting | Neuromuscular Strategies

Bike Fit Boulder

What Is Bike Fitting?

Bike Fits are unique to the individual. Some of us have short legs and long torsos or the opposite. Ultimately a bike fit should create a balanced position. A bike is amazing in it’s mechanical design, in that it is two connected triangles moving on two wheels. Your flexibility, strength, and proprioception all come into play with a proper fit. At our clinic in Boulder, a bike fit involves movement screen to help determine your mobility and stability. A lot of time is spent adjusting your shoes and cleats as this is the interface of you to the bike. We then look at saddle position and height, along with stem length, handle bars and if the type of saddle you are riding is appropriate. If you are thinking of buying a bike consider a consultation regarding size. Bike company size charts are generic and you might fit into a medium in one brand, but be a large in another brand. Call 720-352-0678 for any questions and we can get you started to riding more comfortably, without pain and improve your efficiency.

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Features of bike fitting include:

  1. Proper bike fit: A professional bike fitting can help adjust the bike to fit the unique body measurements and riding style of the cyclist.

  2. Comfort: With a properly fitted bike, cyclists can enjoy greater ride comfort, reducing the risk of injury and discomfort.

  3. Improved Performance: Proper bike fit can also help cyclists to improve their performance by optimizing their position on the bike, reducing drag, and improving efficiency.

  4. Injury Prevention: A professional bike fitting can identify potential injury-causing factors and help cyclists to correct them before they cause problems.

  5. Customization: Every cyclist is unique, and a bike fitting can help customize the bike to fit the individual’s needs and preferences. 

Benefits of bike fitting include:

  1. Improved Comfort: A proper bike fit can help cyclists to ride more comfortably for longer periods of time.

  2. Increased Efficiency: With proper bike fit, cyclists can optimize their position on the bike, reduce drag and improve efficiency.

  3. Injury Prevention: By addressing potential injury-causing factors, a professional bike fitting can help prevent injuries.

  4. Better Performance: By optimizing bike fit, cyclists can improve their performance and speed.

  5. Customization: A professional bike fitting can customize the bike to fit the individual’s needs and preferences, creating a more enjoyable riding experience.

My name is Mike Kohm PT, BS and I have taken over 50 physical therapy courses in my career and have 30 years of clinical physical therapy experience. My path has been a bit eclectic, a yoga certification, teaching trigger point dry needling for Kinetacore (click here) and obtaining a functional movement certification (click here).


Mountain biker after bike fitting Boulder Colorad

If I had a mantra concerning a treatment philosophy,

“don’t treat pain.”

Bike Fitting as part of my physical therapy career began as the physical therapist who performed bike fits in our clinic was leaving. I had been through a few bike fits for my cyclocross bike and a mountain bike and was impressed that a few tweaks really improved my comfort level. I expressed interest in learning fits and sat in on a few and was given “Andy Pruitt’s Complete Medical Guide for Cyclists.” I read that cover to cover several times, asked far too many questions and picked up Paul Swifts “BIKEFIT” guide. Essentially I was thrown to the wolves. A lot more questions began to come up, as my skill set improved, so did the challenges! My search lead me Steve Hogg’s website and his articles. (click here)

My company  is a reflection of the education, clinical experience and the influence of many fine “movement specialists.” My experience as a bike fitter leans toward the realm of “medical bike fits” or simply, pain on the bike. I have also fitted local professional racers, teenagers, and weekend warriors.

As a bike fitter, I often get asked about my career path. It all started 24 years ago when I was working at a local bike shop, “The High Wheeler,” to earn a Kinesiology degree at the University of Colorado/Boulder. At the time, bike fitting was just a “Fit Kit” and I observed riders who were having pain on the bike get a lot more comfortable and efficient. I went on to study physical therapy and began to work in orthopedics, taking courses in manual therapy along the way.

My treatment philosophy is simple: “Don’t treat pain.” Often, pain on the bike is caused by poor biomechanics above or below the involved painful area. It can be seemingly unrelated issues like off-set brake levers that twist the torso, causing the pelvis to react and affect the knee. For instance, a local professional uneven bars gymnast came to me with knee pain on the bike.

Bike fitting is not just about aerodynamics; it’s also about a client’s flexibility in their musculoskeletal systems and their “neural dynamics.” I start most fits with a Selective Functional Movement Assessment, address neural dynamics, and review a client’s medical background.

Many riders present themselves in unnecessarily aggressive positions as they age, lacking the neural mobility or flexibility to sit in the same position as when they were 20-25 years old. A pro 1-2 rider with lateral knee pain came to my clinic this spring. She had 2-3 previous fits, several renowned orthopedic consults, and an MRI that showed a frayed lateral meniscus. She was recommended surgery, but she wasn’t sure that it would fix her problem.

After a thorough analysis, I found that she had a compromised femoral nerve glide with an extremely tight lateral quadricep and IT band. Her bike position consisted of a very aggressive position in the cockpit, which in turn shortened her hip flexor and upper quadriceps, restricted her femoral nerve, and tightened her lateral quadricep and Iliotibial band.

We decided to try some trigger point dry needling to release the quadriceps and hip flexors, and her homework was to begin neural mobility training and flexibility. We also lowered the seat, flipped her, shortened her stem, moved her saddle forward, and shimmed her left cleat. After these changes, she was able to begin riding again without pain, and we were both happy that she avoided an unnecessary surgery!

If you are thinking of buying a neighbor’s bike or a bike off of Craigslist, bring it in to make sure it will fit you properly. 45 minutes to an hour up front can save you the headaches of a poor fit.

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Making Bike Fitting More Personal and Effective

Bike fitting is an art, not a science. Many riders are being fit with a “system” that uses a computer, but this often leaves them out of their own fit. The people doing the fits are often trying to fit the rider in their box and are looking at the rider through their computer, not at the bike. Mike Kohm, a physical therapist in Boulder, Colorado, believes the best computers are our brains and observation skills. Here’s what you need to know about bike fitting.

Start with Foot Dynamics and Cleat Placement

Most fits take a minimum of three hours, and initially, a fair amount of time is spent on foot dynamics and cleat placement. Wedges are often used to help align the foot, knee, and hip. The cleat interface is our literal connection to the bike, along with the saddle and brake levers. Bar width is assessed to make sure a person is appropriately fitted.

Measurements and Laser Alignment

Measurements are taken of the trunk flexion, elbow, knee, and cervical position is noted. The intention is not to fit people into a strict set of limits but to objectively measure how a person is fit to the bike. This provides a guide in which to begin the fit. Paul Swift’s suggestion of a laser has become an integral part of the bike fit. The laser helps to see how the femur, patella, tibia, ankle, and foot all line up during the cadence. The laser can be used to align the saddle to the bars.

Clean Up Subtle Asymmetries

Mike Kohm finds that a good bike fit cleans up subtle asymmetries and dials the person into their bike so they are efficient and unloads muscular imbalances. The nervous system readily reacts to both positive and negative influences. When the body falls into a state of imbalance, and then pain it will alter movement. Dysfunction movement patterns can manifest and these can be magnified on the bike.

Asymmetries Become Bigger Problems

Cycling is a repetitive motion event, and subtle imbalances and asymmetries become bigger problems after an hour or two on the bike. Athletes and workers with movement asymmetries are 2-3x more likely to get injured. This is why a proper bike fit is essential.

Personalized Fitting

Mike Kohm believes that people do not fit in a box. Two people with nearly the same build are most likely going to have different positions on their bikes secondary to their neural dynamics, flexibility, core strength, and breathing capacities. Therefore, a personalized approach is the best way to achieve an effective bike fit.

Happy Riding!


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