For those in the know, Paul Swift was a force to be reckoned with while racing road bikes in the 80’s/ early 90’s, and he still is forging the way forward today, albeit, in the budding profession of bike-fitting. The developer of “leWedge”, he has been at the forefront in bike-fitting education, initially to bike shops and wrenches, but now is moving into the clinical education sphere. This weekend, I spend 20 hours with Paul, “Kit” Vogel PT, DPT and 3 other physical therapists, with the goal of perfecting our fitting skills. (and my personal goal of further developing my PhD thesis).
With an average of 7 years of PT and related education, day one skipped over the usual anatomy review, and we got straight into problem solving. Reviewing each other’s positions on the fit-bike, then checking morphology with clinical tests and measures, we quickly refined our processes for problem identification and resolution. New to me was the use of self-leveling lasers, for accurate orientation of KOPS, the much-challenged Knee-Over-Pedal-Spindle reference position. While not so useful in tri-fitting, it is a good starting point for a road and mountain bike fit, as it gives a baseline reference point for the sagittal plane set-up.
A double laser in the frontal plane was useful for getting a visual on the knee-ankle-foot position, and tracking the lower extremity as it connected with the foot-pedal-interface [FPI]. Use of mirrors in front of the rider allowed them to track the changes as we made them, and added to the neuro-motor changes that are ultimately a part of the process. Paul, Kit and I had lengthy and interesting discussions about the role of morphology versus neuro-motor patterning in the bike fit process. Interestingly enough, we have all come from a a mix of the mechano-structural model, to a sensory-neurological model, and continue to develop our fits through different philosophical routes. My current fit processes uses a combination of structural alterations (uses of wedges, shims and alterations in cleat alignment) with a visual re-education and motor patterning (Kinesiotaping, Low-Die taping, SERF bracing, hands-on-neuro-muscular re-education, mirrors, training diaries with reflection and review) in conjunction with a strong basis in exercise physiology (co-ordination of changes with training plan, via exercise physiologist / coach) and connective tissue science (progression of changes relative to client tissue quality, health and injury status).
Paul and Kit quite definitely address some of the FPI gaps left in other bike-fit certification programs, as they have an emphasis on the foot-pedal interface. I left this class with a much clearer picture of their process, and some new equipment: self-leveling lasers and a screw kit. They have taken the time to put together a kit of different screw sizes, lengths, for all the major pedal systems. Marked by brand, size and labeled for cost and re-stock number, this makes the FPI tweaking faster and foolproof. No more guessing whether the cleat bolts are going to be long enough. No more calling the bike shop to be put on a waitlist for hard-to-find tiny bolts and screws. I have been able to further refine my own methodology, as described earlier, and look forward to becoming a better fitter as I continue to do this, in the same way as I have integrated the hundreds of continuing education courses into my PT carer over the past 20 years. Happy days.
We had a long chat over lunch about my methodology section for my dissertation. I am constantly tweaking it as I get more information from the literature, and as I consult the leaders in the respective fields about elements of my proposal. I will be adding in elements of the clinical examination process to further classify my subjects into groups based on morphology, using standing Q angle and non-weight-bearing forefoot-rearfoot alignment. This will allow me to do some fun regression analysis to determine the relative contributions of morphology to different outcomes. Uncharted territory in the physical therapy literature. And pretty much in any sports science literature for that matter. Launching forth into the abyss..There be dragons… Bring ’em on!