Skip to main content

Bike fit analysis: With Gale Anderson and Liz Gilbert

Last Saturday, Gale Anderson and Liz Gilbert, physical therapists from Therapeutic Associates, Mt. Spokane Physical Therapy, spent a part of their Saturday with me to analyze my position and body mechanics on my bike. For the last couple of months, I have been working through rehabilitation for unremitting knee pain, and I wanted to rule out any kind of alignment on the bike that may be causing or exacerbating the discomfort I feel in my knee.

Upon arriving, Liz helped me set up my bike on the trainer, and I proceeded to warm up until Gale arrived. Once he pulled out his measuring tool—a device physical therapists like to call a goniometer—he took measurements from the side: shoulder-to-trunk and knee-to-hip angles, among others. Liz set up a laser beam in front of me that spanned the distance from the middle of my cleat to my knee so they could videotape the amount of deviation from that beam through each pedal stroke. When the video was delayed and replayed, my right knee tended to cross midline far more than my left one did. This surprised us all, considering I have sought Gale’s help for the last 2 months to address left knee pain.

Gale had me increase my resistance to see how my form changed. Under a greater load to push during both seated and standing positions, he and Liz observed even greater deviation of my right knee, as it tended to almost hit my top tube.

Several reasons may explain why my right knee tends to fall more medially than my left. First, it could simply be the way I’m structurally made. In this case, Gale could make some adjustments on the bike to better tailor my body position. Second, my hip abductors could stand to use some strengthening. In all honesty, many runners and cyclists struggle with knee, sciatic, and back pain as a result of weak hip abductors. This essential muscle group works to control hip movement by acting as important stabilizers, especially upon footfall while running. In cycling (and running) weak hips oftentimes cause the knees to fall inward and create increased strain on soft tissue structures found in the medial knee.

The third reason could be related to foot pronation. Gale had me stand in front of him to assess how much the arches along the medial borders of my feet fell toward the ground. While foot pronation in certain parts of the gait cycle (especially footfall in running) is normal, the small intrinsic muscles of the feet must contract adequately during the push-off phase of gait (or the downward pedal stroke during cycling) to prevent poor body alignment higher up the kinetic chain (i.e. the ankle, knee, and hip).

My right arch fell closer to the ground during standing than my left one did, suggesting its weakness may be contributing to the poor alignment of my right knee, which may mean my left knee could be compensating for my right, hence a potential reason for left knee pain. I can blame my knee pain on one or several reasons. Yet you’ll soon frustrate yourself to no end, and you’ll realize what makes the work of a physical therapist so challenging. You can go around in circles to try to find the answer or reason for an injury, but you’ll soon realize how every joint, every muscle attached to each joint, and every movement you make impacts every other joint and every other muscle attached to each and every other joint. (In school they taught us the benefits of “stress management.”)

While not the ultimate solution, Gale unscrewed the cleats on the bottom of my cycling shoes and inserted a plastic wedge whose medial surface (the side that goes under my big toe) is slightly thicker than the lateral one. If nothing else, it will encourage me to shift some weight toward the lateral side of my foot in an effort to minimize the amount of downward motion that occurs in my medial arch. (Balance exercises on a Bosu ball, Dynadisk, or foam mat might be better alternatives for a long-term solution in an effort to strengthen the muscles in my feet and lower legs.

Gale and Liz don’t consider what they do a typical “bike fit.” While they can analyze the fit and take the measurements, Gale admits he doesn’t have all the tools needed to make the big adjustments he can suggest his patient make. What he can do, however, is use his extensive knowledge of anatomy and biomechanics to tweak a cyclist’s position on the bike in an effort to remediate a nagging pain or discomfort experienced on and/or off the bike. He can also assess how someone rides to determine what personalized adjustments he might need to make for his patient.

You can visit Mt. Spokane Physical Therapy’s website HERE


Popular posts from this blog

How strong are your feet?

Who knew my first post in 2020 would be about the work I'm doing on my feet. Not just any work, but the work required to make them strong enough to propel me to faster running paces, the work to make them durable enough to heal up some old injuries and prevent new ones from taking hold. Jay Dicharry , a Physical Therapist and researcher in Bend, OR, says that almost all ankle, foot, and lower leg injuries can be attributed to faulty foot mechanics and a weak foot core.  I listened to him speak on a podcast called Trail Runner Nation today, and all the advice he provided me during my two personal visits with him last year rushed back in a torrent of memory. It seems fitting that his reminders would hit me like a hammer over my head when I consider the nagging foot pain that has cropped up again over the past couple of weeks. I'm going back to my toe yoga, short foot exercises, and working hard to build up the strength in my foot intrinsic muscles. Meanwhile, here's a b

My opinion...For what it's worth

My first Half Ironman 70.3 turned into Boise 29.3. I may be the only one to say that I respect the officials' judgment call on this one, because apparently, a few of my triathlete comrades lack sufficient brains themselves. The comments I'm reading on Facebook leave me pretty disturbed. Let me just put this out there: I entered this sport because it looked tough and challenging. It pushes anyone who enters these races to their ultimate limits and requires a demanding amount of time to complete the training necessary to succeed. I entered this sport because of the people. Healthy, smart, fit, inspiring, motivating. I can't think of a single person who has questioned my ability to participate in this sport. I entered this sport because anyone can do it. I passed people younger and older than me, some as old as 74. I watched one woman hobble along the run course, surely just on her first lap. She looked like her knees were going to cave in. Yet she was running. I did not ent

It is finished

As with everything in life, nothing stays the same. Change is inevitable. It does not always mean it's a turn for the worst. In my case, I think this is a change for the better. As of 2021, I am closing the door on racing triathlon and rekindling my investment in the doctorate degree I worked for in Physical therapy. Thankfully, making money again has felt much more productive than losing it in the pursuit of professional triathlon. Thankfully, my body has responded positively to a slackened training schedule. Thankfully, my head is clearer for the release in pressure to perform.  I needed a new pursuit, a new challenge, a new endeavor. Raising and showing my dogs has helped me slow down, challenged me to learn and communicate differently, and taught me that physical fitness can still be achieved to a lesser, healthier extent.  It has worked so well that I'm also going back to doing what I loved to do 10 years ago. Pursuing a more simple lifestyle (outside of work, of course) a