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?
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.