"Competitive cyclists in search of marginal gains should be comprehensively screened for anatomical and biomechanical abnormalities before Bike fit or positional set-up. Efficient, injury-free cycling is reliant on pedaling symmetry, which is reliant on efficient lower-limb biomechanics, correct foot function, and a stable, level pelvis. The structure and function of the foot dictate how effectively pedal forces are transmitted via the foot/pedal Interface down to the cranks, and potentially how deleterious forces are transmitted up the kinetic chain, creating pelvic disruption. Leg length inequality must be clearly differentiated into anatomical and functional and then addressed appropriately to achieve a successful outcome. Biomechanical problems can be addressed successfully only if they are recognized and diagnosed. Ideally, the screening process should involve a sports medicine therapist with specialist knowledge of cycling biomechanics and foot function. In competition, marginal gains can represent the difference between success and failure."  Nick Dinsdale

Read the quote again. In all the research we have done this fit expert stands out as a leader in the field of "research based cyclist fitting, based on anatomical and biomechanical performance".

Interested in Reading More ?
1. The benefits of anatomical and biomechanical screening of competitive cyclists
By Nick Dinsdale BSc (Hons), MSc, MSS T and Nicola Dinsdale BSc (Hons), MSST

2. Bike fit guidelines
Nick Dinsdale BSc (Hons), MSc, MSST, Nicola Dinsdale BSc (Hons), MSST
Graduate Sports Therapists Nick and Nicola Dinsdale, father and daughter team, run NJD Sports Injury Clinic in Clitheroe, Lancs. UK. The family clinic is recognized for its strong evidence based approach to the management of sports related musculoskeletal injuries and its keen interest in working with competitive cyclists. Patients include professional cyclists, in addition to British Cycling officials.
NJD Sports Injury Clinic has extensively researched into cycling biomechanics and how lower limb / foot biomechanics can impact on cycling performance. These findings, combined with our own published research, enable us to optimize our Bike fit. To keep abreast of new research and technology, we frequently work with, and liaise with, various Universities in cycling related matters.
  • METHOD NO. 1 - So what is wrong with ball of the foot over the pedal axle (hereafter referred to as BOFOPA)?
  • METHOD NO. 2 - Here's another thought experiment. Most (I hope all) would agree that it is a good idea to spread the pedaling pressure on the foot-over the largest area to lessen the likelihood of hotspots or pain developing. If you agree with that, why is the focus of the literature on BOFOPA?
  • METHOD No 3. - Here we enter a whole new world, that of Midfoot cleat position. Midfoot cleat position is when the cleat is positioned so that the Tarsometatarsal (TMT) joints are over the centre of the pedal axle. The TMT joints are the joints between the two rows of bones drawn on the foot below.

4. Cleat Positioning
by: Aram Goganian on January 4, 2011
Basic variables that professional bike fit specialists can change to correct potential problems:
  • Fore/Aft Adjustment of the Cleat
  • Left/Right Adjustment of the Cleat
  • Rotational/Float Adjustment of the Cleat
  • Wedge Adjustment of the Cleat