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Tri-bike fit, neutral spine, and cervical extension
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OK, at the risk of revealing my status as a tired old fart with neck/back issues, I am going to finally ask some (hopefully penetrating and illuminating) questions about conventional wisdom and bike fit that I've been dying to ask for a long time.

First of all, I want to put my assumptions up front:

1) All my training on road/tri bikes has to be done in city, from my front door (I am averse to loading a bike into a motorized vehicle to take it somewhere to train for both philosophical and practical reasons, and I prefer to live in an urban area for reasons unrelated to sport); I *will* cart my bike to races). Thus, there is traffic, cars, stoplights, buses, pedestrians, etc. during parts of my training rides. Usually my ride consists of riding through more traffic-dense regions to get the the less-congested regions where I'll be trying to get into a steady-state hammer.

Therefore, I need to be able to see in front of me. Actually, I need to during races, too, come to think of it.

2) It is not healthy to ride with significant amounts of cervical extension for long periods of time. Personally, I can't do it subsequent to an April 2000 bike vs. car where I rammed my face into a Mercedes, but my coach/trainer, who has done RAAM, and knows a lot of the old ultra-marathoners, makes the statement that a 'lot of us used aerobars in the 80s, then got sore necks and quit'.

Now, I think I get most of the biomechanical rationale for the fit philosophy espoused on this site, and evidently (with the FIST system) these fitting methods are being exported pretty widely.

BUT, I find that personally many of the dictates as to fit don't seem to work for me. After I first developed pain in the upperback/neck, I thought I was done riding upright bikes. But I found a physical therapist who specializes in bike fit. She found that all my bikes had too SHORT a cockpit, that I was riding with a 'hump' in my lower back (I have an exceptionally long torso/short legs compared to normal; 5' 10" tall with a 30" inseam) which forced greater cervical extension to compensate. Except for one - I bought a Colnago C40 from BicycleworldUSA in SoCal - the dealer did a custom fit with a longer top tube than normal - it's a 55cm bike with a 55cm top tube (or 55.5 cm depending on how you measure it; it's come to my attention there is no standard for measuring top tube lengths), and, because of the shallow head tube angle (71.7), it's considered appropriate to ride with a longish stem, in my case, 12.5 cm exactly. With the saddle in a relatively 'neutral' position on the rails, I get pain with either 120 or 130mm stems - 125 does the trick perfectly.

It took months of retraining to get me to be able to relearn how to position myself, and now I have a roadbike setup geometry that works for me - I successfully did double centuries and an ultra-marathon mountain pass one day event last year and was able to manage the neck issues.

But, based on reading this site, I STILL thought when I added aerobars, I needed to shorten up the cockpit, etc. When I wanted to add clipons to my working roadbike setup, I thought I'd add 'shorties' per the conventional wisdom.

It turns out this didn't work for me. The only way I can get maintain aero position with a flat back (and therefore no neck pain) for any length of time is to extend out - I need an upper arm angle slightly greater than 90 degrees to reinforce the stretching out. I turns out a medium pair of Syntace C2's added to my existing long top tube setup works.

Now, I note that Dan consistently talks about getting the bars LOW enough, and that is part of the whole fit process, and it seems like it's part of the whole equation with steep seat tube angles, and the idea that the rider is 'rotated forward' from roadbike standards so as to maintain the same hip angle when bars are lower. So, I can see that I am not that low (head tube on my road bike is average height).

So maybe my higher bars explain why I need the longer cockpit as opposed to conventional wisdom.

But if that's so, then I still don't understand how folks can see traffic without craning their necks. Sorry if this isdumb , but does everybody just train in rural areas (I know Dan does, so this explains this), or what? Or are y'all just younger and healthier than I am, and can tolerate craning your neck until you get to a part where you can assume the position and hammer? Do you not use the aero position until you get to an unpopulated area? If I did that, I wouldn't ever be in aero position.

When I look at the amount of bar drop that the pros use in the grand tour time-trials, I can see there's no way I could tolerate that position unless I was (just like them) on a course with no one else with me up to a minute up the road, so I could just put my head down.

But aren't most triathletes age-group amateurs, with day-jobs and living in cities with traffic in their training ride areas? If the FIST method of fitting is for folks like this, how is this supposed to work? Do we do all our training on our Computrainers or something?

Sorry if I'm being obtuse, but I really don't get it. I have evolved to a fit, over time, that allows me to ride without pain, still see traffic, get down fairly low, and deliver reasonable amounts of power. I'm sensitive to this fit to within a few millimeters, as in, if I vary anything at all, I start getting into painful trouble. And I'm utterly unable to reconcile what I've learned and developed with the stuff on this site, mostly for the reasons listed above.

So, am I just a fringe case, or am I missing something? Does the fit philosophy as esposed by FIST assume that the rider is healthy/youthful enough to tolerate a certain amount of unnatural/unhealthy positioning (let's face it, there's nothing natural about a good aero position), and a certain amount of cervical extension in order to achieve better performance?

Lastly, I note that there was an article a few months back that Dan did where he visited Nytro or someplace undercover to check out their fitting technique. There was a photo of him exiting the shop on his newly fitted test bike. It was interesting to me that he was low, but not *that* low, and he had an utterly straight and flat back in the picture, and he actually appeared to NOT be extending his neck very much; in the picture he appears to be able to see in front of him while maintaining a relatively neutral spinal column (apparently) by virtue of being tilted up JUST enough, and having a totally flat back. I also note that he appears, visually, to be more in the short torso camp (well, at least compared to me, anyway). Not to sure if there's a clue here to resolving the apparent conflicts between what's advocated on the site and my personal experiences, but....anyway.

Any and all words of wisdom appreciated.
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Re: Tri-bike fit, neutral spine, and cervical extension [doncl] [ In reply to ]
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I've voiced my concerns on a number of occassions about people with certain problems not likely to be comfortable in an aggressive riding position. It's fine for a middle aged AG customer with three degenerative discs in the cervical spine to walk into a bike shop and say that he/she wants a P3 and wants to be set up as aero as possible. It's quite likely that the bike fitter can set this person up in this position but can he/she ride comfortably with their neck in extension for a long period of time?
There should be some sort of a basic biomechanical screening process that could be done by pro bike fitters to determine if customers are potential candidates for riding in an agressive aero position.

In my office there are various meters used to measure neck and low back flexibility. These tools could also be used in a bike shop by a knowlegeable individual to measure low back and neck ranges of flexion, extension, rotation, lateral bending. Another meter can measure hip flexion. Some basic methods of assessing short leg syndrome syndrome could be taught. The bike fitter could run a very basic ten minute biomechanical assessment of the customer and would have a reasonable idea of whether or not the customer is likely to be comfortable in an aggressive position or not. For example if the customer clearly demonstrates a lack of flexibility in the lower back or neck, the professional fitter would then consider that a more relaxed position migh be better for the customer.

I don't know if FIST or any of the other methods have a protocol for prescreening customers for their fittings, but it seems like common sense that it would go hand in hand with the actual fitting.

I posted a situation awhile back of a 35 yr old female patient with scoliosis and a Harrington rod in her back. I set her up on both her road bike and P2K. Her biomechanics were very unique with no flexibility between her upper thoracic and upper lumbar spine because of the Harrington rod and her torso shortenned by at least a couple of inches because of the scoliosis. She was definately not a candidate for riding in an aggressive position.

As far as necks are concerned, after looking at neck x-rays for over twenty years, I've noticed a trend wth people with neck complaints. There are exceptions to every rule but neck pain sufferers seem to fall into three stages with neck x-ray evaluation. The first phase is that of an alteration of the normal cervical C curve. Usually it is become strait(hypolordotic) or even reversed in some cases. The second phase shows this same curvature changes but with early disc degeneration and the third stage also shows these curvature changes but now with more advanced disc changes. It seems that the loss of the normal C curve is a precurser for degenerative disc problems, at least IMO. As people progress thru each these stages there also seems to be a loss in neck flexibility. Of course this is a life time progression and doesn't happen over night.

It would appear that these phases of disc wear can be slowed down or stopped if the spinal C curve can be returned to normal. In fact a kinesiology professor has developed a series of exercises that he claims will do eactly this.

Realizing that I'm on a bit of a rant, let it be said that for cyclists with neck problems, riding shouldn't be a problem as long as their bike fit is correct and their position is appropriate.
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Re: Tri-bike fit, neutral spine, and cervical extension [doncl] [ In reply to ]
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I can't really answer all of your questions (becuase I am unqualified) but I can add to the fray with my personal experiences and from looking at pictures people have posted on the site...

With the flat back thing...
I have noticed that many people (including myself) obssess over having a flat back... now a flat back can be onbtained by curling your lower back over so that your rib cage is parallel to the ground or you can do it the better way by rotating around your hips so your lower back is in a more neutral position and your upper back is brought down.

In defense of Dan Empfield, if you go to the portion of slowtwitch called bike chooser or something along those lines, you can find specific bike reccomendations for different body types. From my reading he is saying that the shorter cockpit (than a road setup) not an short cockpit in the absolute sense.

If you haev problems craning your neck up maybe you need to be in a less aggressive position, I don't think that there is anyone who would argue that... But there is going to be a range where you are going to be comfortablel craning your neck... to be aero at all costs you would be on one end of that spectrum, comfort at all costs would be on the other end of that spectrum...

I thikn your post definately illuminates the fact that there is no one universally correct fit and that everyones needs and concerns need to be factored in
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Re: Tri-bike fit, neutral spine, and cervical extension [taku] [ In reply to ]
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When you say people obsess over having a 'flat back', what do you mean by that? When I say flat back, I simply mean the back is flat, neutral. It may not be parallel to the ground - in fact one could sit stock upright with a flat back.

I'm no expert, but I don't see too many triathletes with backs parallel to the ground - this sort of handlebar drop seems to be reserved for the pro roadie time trialists. Although I guess there are some triathletes who can maintain that 'parallel to the ground' back for 112 miles; Joe Boness is reputed to be one, I guess.

But I don't (and never have) aspired to that. I still have to be able to see forward without cervical extension. The 'flatter' my back is (as in, no humps in it anywhere; rotated perfectly from the hips), the less cervical extension I have to do, because when you put a hump in your lower back, you have to extend the neck to counter this, just to 'get back to zero', so to speak.

As regards cockpit length, I totally understand what Dan Empfield is saying about shortening it from your road setup. I understand that he's NOT saying that everyone needs a particularly 'short' cockpit, but rather, that a given person's tri-bike fit will have a shorter cockpit than the same person's roadbike fit.

What I was saying is that, while this makes TOTAL sense to me, empirically it doesn't work in my case. It turns out I need the same length cockpit for aero position with full length aerobars as for roadbike position - anything less and I start hunching up my back and getting neck pain. I seem to need to be extended out with my elbows past 90 degrees to ensure that I keep a totally neutral (i.e., 'flat') back.

I suspect that the long and short of this is just that, because of age-related changes to my spine (and possibly exascerbated by my accident), I'm simply a fringe case; sort of 'the exception that proves the rule' sort of thing. Also, my longer-than-normal cockpit may be sort of a necessary compensation for past bad habits that have not totally been erased from muscle memory (I'm theorizing kind of wildly here, to be honest).

What I know for sure is that the only fit that I believe in for me is the one that allows me to ride for long periods without pain. That's the acid test. Any fit that causes extreme pain must be wrong for me, by definition.
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Re: Tri-bike fit, neutral spine, and cervical extension [cerveloguy] [ In reply to ]
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In Reply To:
The bike fitter could run a very basic ten minute biomechanical assessment of the customer and would have a reasonable idea of whether or not the customer is likely to be comfortable in an aggressive position or not. For example if the customer clearly demonstrates a lack of flexibility in the lower back or neck, the professional fitter would then consider that a more relaxed position migh be better for the customer. ...
As far as necks are concerned, ... The first phase is that of an alteration of the normal cervical C curve.... these curvature changes but now with more advanced disc changes. It seems that the loss of the normal C curve is a precurser for degenerative disc problems, at least IMO. As people progress thru each these stages there also seems to be a loss in neck flexibility.
It would appear that these phases of disc wear can be slowed down or stopped if the spinal C curve can be returned to normal. In fact a kinesiology professor has developed a series of exercises that he claims will do eactly this.

Can you provide a link to these exercises? Thanks, don
Last edited by: doncl: Mar 12, 03 19:25
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Re: Tri-bike fit, neutral spine, and cervical extension [doncl] [ In reply to ]
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point taken
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