Physical Therapy or Bike Fitting?

Physcial Therapy or Bike Fitting?

Physical therpists are keen to start bike fitting, and many tend to think that they are superior to traditional fitters. Yet nearly 100% of my “Complex Issue” clients see me after months of “unsuccessful” physical therapy without much optimisim for a solution.

Ironically, the majority of these folks required only the most simple adjustments for complete symptom-resolution when cycling. What do I categorize as a “simple” solution? Moving the cleats back to reduce foot numbness or knee strain is probably the most popular, but I’ve seen rotated-saddles, staggered-cleats, handlebars that aren’t straight, two-insoles in one-shoe, etc.

Other cases have required modifying the shoe/pedal interface, stem, saddle, cleats, seat-post offset, saddle-angle, cockpit, etc., with equally positive results.

Physical Therapists typically do not have access to stems, seat-posts, shoes, cleats, pedals, and other components required to conduct professional bike fitting. If a bike can not be properly adjusted using these resources, the problem is shifted to a client’s body, which is frequently not a problem.

How does one discern between a Bike an Body problem?

Simple:

Fit-related symptoms occur only when riding a bicycle, and are entirely resolved with a competent bike-fit.

Body-related symptoms occur on- and off- bike, and are NOT entirely resolved with competent bike fitting, though symptoms might be reduced significantly with accomodating modifications.

Most importantly, do NOT make an appointment for PT when experiencing bike-related symptoms unless he/she is going to watch you ride a bike on an indoor-trainer.  It is impossible to discern the cause of a bike-related issue without inspecting your componentry and position.