The mounting benefits of physio-led bike fit

Anyone who follows me on Twitter or Facebook [as I type this is a monumental 123 – God bless you all!] will know that a few days ago I published a rather excited post about an article in CYCLING WEEKLY (14/01/16). It was expressing an opinion that physiotherapy led bike fits may well just be a better choice for those requiring bike fit, especially those in discomfort. We all love a bit of confirmation bias, so I was always going to love this article…right?

   Two very different riding positions from the days before the addition of scientific enquiry into bike fitting. Fausto Coppi and Gino Bartali. Did Coppi used to have neck ache?!


Two very different riding positions from the days before the addition of scientific enquiry into bike fitting. Fausto Coppi and Gino Bartali. Did Coppi used to have neck ache?!

The reason I set up Cycloform was that as a lower limb specialist physiotherapist within a musculoskeletal service I saw a number of cyclists who had failed to improve with first line care, often feeling that the practitioners they were seeing didn’t get why they couldn’t just do less cycling. I saw a trend developing. After consulting with general practice, sometimes before, these troubled souls would often book a bike fit. These, as we know, are commonly undertaken by a local bike shop, a trusted part of the cycling community. I trust the guys at my LBS implicitly. When my bike complains I know that they will sort it out. But if I’m in pain it stands to reason that I see someone who understands me.

Will Andy Murray go to his trusted racket supplier Head when his shoulder hurts?

Should cyclists be guided by branding when choosing someone to facilitate pain free cycling?

Of course there are great fitters using some kit supplied by the big manufacturers, with Trek having their own Precision Fit brand and Retul now owned by Specialized. But lets not conflate kit with the personal expertise of the fitter.

In CYCLING WEEKLY Simon Schofield expresses a number of key benefits to a physio-led fit.

  • It starts with the rider
  • Expertise in diagnosis
  • Expertise in treatment and rehabilitation
  • Identification of limitations of a ‘medical’ nature. This is further broken down to four examples:

1.    Constriction of the iliac artery

2.    Leg length discrepancy

3.    Lower back pain

4.    Knee pain and its myriad of causes.

If you are still with me, you’ve read this far then thanks, I’m about to come to the point of this blog. I understand that CYCLING WEEKLY is written for public consumption, not for nuanced and critical evaluation as if it were a peer reviewed journal. I have nothing but praise for Simon Schofield taking the time to delve into my world of bike fit and write an article about something that I am so passionate about. However I feel something else needs to be added to this article.

As well as the abilities above, the physio-led bike fitter should also have the ability to contextualize the issues that he sees. In the physio world [such a place does exist – its particularly militant on Twitter!] we discuss ad infinitum the pro’s and con’s of ‘diagnosis’. There is a strong argument that says beware of the unintended consequence of the diagnosis you are giving. For example a simple diagnosis of an arthritic knee, wear and tear, without context may lead the receiver of said diagnosis to stop exercising due to fear of further wear, put weight on and hugely reduce their health and quality of life.

Expressing people’s pain as more complex than in fact it is, building up a complicated issue to justify your tag as an expert rarely does anybody any good. Frightening people into seeing experts simply creates patients, not athletes.

I am therefore going to add to the list of benefits to a physio-led bike fit.

  • The ability to place in context issues found within a rider. Within a framework of normal variation and the normality of aging.
  • An ability to spot the things that matter in a presentation and play down the things that do not.

Thanks for reading! 

Simon Smith2 Comments