Why Get a Bike Fit?

A bike fit is one of the best investments you can make to improve your comfort and power on the bike. The most frequent comment people make after their fit is that they wish they had done the fit years ago. The ideal time to get a bike fit done is BEFORE you get a new bike, so you can use the detailed fit data to better inform frame and equipment choices. One of the most frustrating things for an athlete to hear at the conclusion of a fit is that they purchased the wrong size bike.

Medical Bike Fit

Our fitting process includes a detailed history and musculoskeletal exam to uncover your specific positioning needs. By evaluating you both on and off the bike, we gain a detailed understanding about your  functional needs and adjust your position accordingly. Our fitting services is unmatched because it incorporates the perspectives of a physician, coach, and elite athlete.  Cost: $299

Performance Bike Fit

This fit was developed for the rider who wants to optimize his or her position without investing in the full assessment included in the Medical Bike Fit.  The Performance Fit employs the same methodology of the Medical Bike Fit and features a balance and flexibility assessment, Dartfish motion capture system, and provides a discipline-specific position that addresses all contact points.  Cost: $150


Case study: Low back and hip pain

Issue: The athlete was having low back and hip pain while riding, in addition to suffering from chronic saddle sores.

Fit procedure findings: A musculoskeletal exam revealed moderately tight hips, which were limiting hip joint mobility and causing back and hip pain. On the bike, muscle tightness had led to pelvic rotation, crooked posture and inefficient pedal stroke. The left knee tracked very close to the top tube while the right knee tracked away from the bike. Measurements revealed the right knee was 2 cm ahead of the pedal spindle while the left knee was 3 cm behind the pedal spindle for a net right/left difference of 5 cm.

The solution: In addition to making adjustments to the bike, the athlete was treated for hip muscle and joint problems, helping reduce the net right/left difference down to 1.5 cm once the fit was completed. The athlete was also provided rehabilitation exercises to facilitate proper movement and recovery.

Follow up: Hosmer Chiropractic Health provided the athlete several more treatments for hip issues uncovered in the fit process. Over time, the right/left difference was eliminated, pedaling motion became notably more efficient, and the athlete experienced pain-free pedaling.


Your position may only be part of the cause to pain on the bike. In this case, diagnosing and treating hip problems was key to increasing pedaling efficiency and eliminating pain.

Case study: General discomfort

Issue: The athlete was not comfortable on the bike and the left side felt “different” and less smooth than the right.

Fit procedure findings: A musculoskeletal exam revealed that the left leg was approximately 1 cm shorter than the right, and the inequality was found to be anatomical rather than functional. Hosmer Chiropractic Health ordered an x-ray series to determine the origin of the difference and found that it was due to a discrepancy in femur length.

The solution: Based on the x-ray findings, the athlete was fitted for custom orthotics and custom shoes to account for part of the leg length difference. We adjusted the left-side cleat position to make up for the rest of the difference. Hosmer Chiropractic Health also made recommendations for daily footwear to keep the athlete’s pelvis more level while walking and standing.

Follow Up: A final adjustment of the bike position was made once the custom shoes/orthotics were available.


Leg length differences can be anatomical (due to different femur or tibia lengths), functional (due to tight muscles and/or joint restriction) or both. Proper diagnosis and treatment, along with bike position modifications should be done by a medical professional that can manage the unique complexity of each case.

Case Study: Knee pain

Issue: The athlete had history of knee trauma that included a ruptured ACL, and had chronic knee pain with cycling. The pain made it difficult to push on hills or sprint, so racing was not possible.

Fit procedure findings: A musculoskeletal exam revealed significant pronation was putting lateral pressure on the knee both on and off the bike.

The solution: We added orthotics to the athlete’s shoes and adjusted the saddle and cleats to minimize lateral deviation at the knee with cycling. This improved his overall hip/knee/foot alignment. Hosmer Chiropractic Health also ordered custom orthotics for the athlete.

Follow up: Once the custom orthotics were available, we observed the changes to the athlete’s pedaling style and found that the alignment and motion of both legs had improved.  The athlete reported being able to ride again pain free.


The athlete had a medically significant injury history that had a significant impact on the fitting process. Hosmer Chiropractic was able to make recommendations for this complex case that allowed the athlete to resume training and racing without restriction.