Cyclist examined by the osteopath before his bike is adjusted

Osteopathy · cycling

Osteopath for cyclists

I am an osteopath (D.O.) and a cyclist. When a cyclist is in pain, I do not choose between treating the body and adjusting the bike: I do both, in the right order, often in the same session. That is what I do for the riders of La Motte-Servolex Cyclisme and for Gustave Blanc, U23 rider with Red Bull-BORA-hansgrohe Rookies.

Consultation · €60 Bike fit

Cyclists’ pain

Where it hurts, and why

A cyclist repeats the same movement 5,000 times an hour. A slightly wrong position becomes a pain. Here are the seven areas I see most at the practice.

Knee

Pain at the front of the kneecap (saddle too low, cleats too far forward), behind the knee (saddle too high), on the outer side (iliotibial band syndrome, cleats toed in, stiff hip).

Low back

Pelvis locked in posterior tilt, lack of hip mobility, handlebar too far away or too low. The pain appears after 1 to 2 hours and gets worse on climbs.

Neck and shoulders

Position too stretched out for your thoracic mobility, handlebar too narrow, head held up for too long on aerobars.

Hands and wrists

Numb fingers (ulnar or median nerve) from too much weight on the front: saddle setback and angle, handlebar height, gloves.

Perineum

Pressure and numbness linked to the saddle and to pelvic tilt, especially in the aero position.

Feet

Burning, tingling, “hot foot”: cleats, shoe tightness, shoe width, metatarsal position.

Achilles tendon and calf

Cleats too far back or too far forward, saddle too high, stiff ankle.

Cleat setup on a cycling shoe, a frequent cause of knee pain

The method

Treat, then adjust, then prevent

ExaminationMobility of the hips, ankles, pelvis and spine. Observation of your pedalling.
TreatmentHands-on techniques to release the restrictions that create the pain or prevent a good position.
SetupImmediate correction of the obvious settings (saddle, cleats), or a full bike fit if the position is the cause.
PreventionTargeted mobility exercises, load management, position follow-up with the FramIQ app.

By discipline

Each discipline has its own pains

Road bike fit

Knee · Lower back · Neck and shoulders · Hands · Perineum

See →

Gravel bike fit

Hands and wrists · Neck · Lower back · Perineum

See →

MTB bike fit

Knee · Hands and forearms · Lower back · Neck

See →

Triathlon and time trial bike fit

Lower back · Perineum · Neck · Shoulders

See →

Getting your e-bike set up: the basic bike fit

Knee · Back and neck · Hands · Saddle

See →

Case studies

Two knee pains, two solutions

Situations seen at the practice, told as they happened. Names and details changed to protect anonymity.

Bike fit · Road cyclist, aged 25 to 30

Knee pain that appeared with a new bike

The situation: Deep pain on the inside of the knee, which appeared gradually when he resumed riding after buying a new bike, even though the shop had set it up. Impossible to do an intensity session: he was stuck in zone 2. He had reduced his training load without improvement, and had hardly dared move the saddle, with no reference point to go on.
What the bike fit showed: After the mobility tests, the measurements and the analysis on the indoor trainer: saddle too low and too far forward. The cranks were also too long for his leg length, which weighs all the more because he pedals at a high cadence.
What we did: Saddle height and setback corrected, shorter cranks, and work on the pedal stroke, in particular the upstroke and downstroke phases of the foot.
The result: Progressive return, then back to the training load originally planned, without pain.

Bike fit · Cyclist, aged 60

A knee that had been holding him back for years

The situation: Knee pain, on the meniscus side, that had always held him back, and chafing in the crotch on the saddle. He had once been told that one leg was longer than the other, and for years he had been compensating with a shim slipped under the shoe, without ever having it checked.
What the bike fit showed: The bike fit confirmed the difference in length between the two legs. The shim under the shoe compensated well when the pedal was at the bottom, but not at the top: at that point, hip flexion became too great. His pelvis was constantly shifting on the saddle to cope, hence the chafing in the crotch.
What we did: Rather than a shim, a crank shortened by 5 mm on the short-leg side, with the saddle position revised accordingly.
The result: No more knee pain, and no more chafing on the saddle: the pelvis stays stable. He concluded himself that it was the best solution he had tried.

Every case is different: these stories illustrate the approach, they do not promise a result.

Reviews

★★★★★

« I went to Gaspard for a bike fit and I was not disappointed! Very calm, composed, attentive, takes his time, excellent advice (a saddle model better suited to my body), ultra-professional equipment. Available afterwards by email or message for questions, very responsive. I went back to see him after the changes he had recommended: there is real follow-up. I highly recommend him, with my eyes closed! »

★★★★★

« Great work by Gaspard! A few hundred kilometres after he reviewed my bike setup and gave me advice on pedalling properly, no more knee or back pain. The way to go if you want to ride for hours without trouble. »

★★★★★

« I went to see Gaspard because I had been suffering from pain in my right knee for over 2 years, especially on the bike. After one osteopathy session and a bike fit, the pain has completely gone. Impressive result, the pleasure of riding back in a single session. Very professional and effective work. I highly recommend him! »

Google rating: 5/5 from 69 reviews · Reviews published on Google and Doctolib. Read all reviews. Quotes translated from French.

FAQ

Cyclists’ questions

Osteopathy or a bike fit: where should I start?

If you have an established pain, start with the osteopathy consultation (€60): I examine, I treat and I look at your bike to see whether the position is the cause. If the position is at fault, the full bike fit follows, or is done straight afterwards.

Does knee pain on the bike always come from the position?

In the vast majority of cases, yes, or from a change of equipment or training volume. The examination distinguishes a postural cause from a tendinopathy or a joint problem that needs imaging.

Do you treat cyclists after a crash?

Yes, after the medical assessment and imaging if needed. Osteopathy supports recovery from the stiffness and compensations that follow a crash, a broken collarbone or a sprain.

Do you work with cycling clubs?

Yes, I follow cyclists and triathletes from clubs in Savoie and Haute-Savoie. Contact me for a “position and pain” workshop at your club.

Pain on the bike? Start with a consultation.

I treat the pain and check your position. Monday to Saturday, 8 am to 8 pm, in Viviers-du-Lac.

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