Thirsty (for knowledge) Thursday: Getting a "Medical" Bike Fit

I just came across this interesting article written by the owner of BeginnerTriathlete.com (where I've been tracking my miles since 2009). The article is called "The day my bike went to the doctor," and it's about being an aging triathlete (hmm... familiar!) working to have a physical therapist fit her to her bike. That's an intriguing thought to me as someone who really listens and does his PT "prescribed" exercises.

Here's some of what she wrote in her article:

On a Tuesday morning, I wheeled my Felt DA through the lobby, past the lab services and neurology departments, past obstetrics, and back to the physical therapy department. Were the other patients staring at me? Sure.

Having paid cash for a certified bike fit at a triathlon store a number of years ago, I had some idea of what to expect, but I was pleasantly surprised at how much more I received at the physical therapist, covered by my insurance:

• Evaluation and objective measurement of hip flexibility and hamstring flexibility on an exam table (I didn't get that at the bike store!)

• Multiple measurements of the same angle (knee flexion angle at the top of the pedal stroke, for example) to eliminate measurement errors

• A check of the "float" in my pedals, to allow my knees some movement as my foot (and shoe and cleat and pedal) move through the pedal stroke

• Knowledge of which parts of the knee (outside, inside, front of patella) would be tight or painful as a result of various bike geometry problems

I feel like I've had the 3rd point covered in my "non-medical" bike fits in the past, but not nearly as much detail in the other 3 points.

Then she writes about HOW she got her medical bike fit, and you'll have to check out the article for that info. It took her almost 3 months to get it all set up, so it could be a process you start shortly to take care of mid-winter and be ready for the 2022 season.

She also noted something I hadn't thought of before during either of my fittings. She said "I wore the normal triathlon shorts I wear most frequently. She advised me that the padding in bike shorts can make a difference of a half a centimeter or so, which is a big difference." That's an obvious point that I've overlooked. I think I've worn my "best" bike shorts to my fittings, and not the ones that I actually use on a day-to-day basis.

In the end, here's what she learned:

I'm always looking for imbalances or explanations, because I have two symmetrical sides of my body, but they don't hurt the same. So something must be going on.

For me, the area where the doctor found my measurements were most outside of the recommended range was at the top of the pedal stroke. My knee was too flexed. That seemed like it would impact both knees equally, but as we talked about it, I realized that I ALWAYS coast with my left pedal down. Which means I always start up against a lot of resistance with my right foot at the top of the pedal stroke, pushing hard, putting pressure on my right knee. We raised my seat 1.5 cm (which is a LOT! I think I may not have tightened it enough and perhaps it slipped down over time). The 1.5 cm adjustment resulted in 8 fewer degrees of knee flexion at the top of the pedal stroke. It also put me in the proper range for my knee being aligned with the pedal spindle. I had anticipated it would make the 90-degree angle at my elbow higher, since moving the seat up on a tri bike also moves it back a little. But my elbows stayed exactly as far in front of my shoulders as they had been. The drop from my seat to the aerobars increased, of course, by the amount we raised the seat. However my reach distance (seat to elbows) only increased by 0.5 cm.

Of course this is all specific to me, and would be completely different for someone else. But it's helpful to share. If you submit to a bike fitting like this, you'll receive different adjustments, different advice, different recommendations, and a different outcome. I was relieved she didn't recommend a different bike altogether.

For more "Thirsty Thursday" posts that highlight workouts, body science, and all kinds of interesting information, CLICK HERE. As always, check back for some "Friday Funnies" tomorrow!