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Professional fit doesn't seem to be working. What next?

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Professional fit doesn't seem to be working. What next?

Old 05-29-14, 05:03 AM
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Professional fit doesn't seem to be working. What next?

So I finally caved and did a professional fit seeing as how this was always the de facto response to almost any question about comfort and pain relief on a bike. I believe it has helped a tad but I'm still having issues with my feet, knees, and back. Since I began to bike (3 years ago) I have had the following either treated or diagnosed by someone in the medical field (in other words, these aren't the musings of a hypochondriac):

flat feet and plantar fasci - I've tried different inserts and had spacers put on per the professional fit but I'm still having numbness and pain. The pain is similar to plantar fasciitis I had about 5 years ago which was resolved over time.

diastasis recti (abdominal muscle separation) - This one was a shock especially given it's supposed to mostly be a symptom pregnant women have. After a particularly grueling ride, there was a physical therapist giving post-ride massages and body work. I told her of my back pain and she proceeded to do some manipulations and told me this was my issue. She then had me lay on my back and do a partial crunch. I was then directed to feel the actual space between my abs just below my belly button. She said this leads or is a symptom of a soft core which puts pressure on my back.

herniated disc - This did not require surgery but I think the remnants of the issue might still remain as I end up with lower back pain about 30 minutes into every ride.

si joint dysfunction - I have a feeling that this is my main issue. I can feel it in the bump to the left of my spine in my lower back. Both the physical therapist (above) and a chiro said that this was a big issue with my back pain. PT said it was due to it being too loose; chiro said something about imbalances (big shock) and glute or hamstring tightness. Nevertheless, I do distinctly recall feeling pretty good after getting it popped by the chiro. Problem is, I don't have the time or really the money to have someone pop my back once a week. Plus, that doesn't seem like a long term solution.

BTW, the fitter told me that my hamstrings were abnormally tight but my hips were abnormally loose.

Sorry about all the info. I felt it pertinent to the question as to what the next step would be. The ortho that I visited wasn't much help. If it was just a knee issue or just a back issue, then I would visit a different ortho but I believe I have a bunch of minor issues which are adding up to misery.
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Old 05-29-14, 05:37 AM
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Looks like your next step is a recumbent!
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Old 05-29-14, 05:41 AM
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Doesn't sound like a cycling issue. You need to get your body right before you can do long and/or difficult rides. Nobody here is really going to be able to help. You need medical professionals for that.
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Old 05-29-14, 06:16 AM
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The purpose of a professional or proper bike fitting is to keep the cycling activity from damaging or causing discomfort to a healthy body. Fitting the bike cannot be expected to correct or even reduce the aggravation of physical problems you already have and that are sensitive to any activity.
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Old 05-29-14, 06:28 AM
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Originally Posted by rpenmanparker
The purpose of a professional or proper bike fitting is to keep the cycling activity from damaging or causing discomfort to a healthy body. Fitting the bike cannot be expected to correct or even reduce the aggravation of physical problems you already have and that are sensitive to any activity.
^^^ True.

OP...did you have the same body issues before you had your pro fitting? Or did your issues manifest more profoundly after the fitting? Generally a fitter is sensitive to any issues you have going in and adjustments are made accordingly. For example, even though I am fit and lean, a good fitter isn't going to put in the same position as a pro rider because I am 60 years old. If I ride say Cancellara's bike...we are close to the same size and weight, its gonna hurt real bad. So I can't ride any text book fit formula without pain...I had to find my best fit myself through trial and error. The better you understand your body as it relates to bike fit the farther along you will be to tune your fit.
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Old 05-29-14, 07:49 AM
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Sounds like physiotherapy is in order for the OP. Sometimes the body needs to be fixed before any fit can work.
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Old 05-29-14, 07:55 AM
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OTOH, sometimes a fitter ain't fit to fit either!

I've seen a couple of really bad bicycle sales people attempting to conduct fittings and they clearly did not know what they were doing.
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Old 05-29-14, 07:55 AM
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I agree that it's hard to tell if your discomfort is from riding or from not recovering/easing into positions etc.

It's very, very easy to chase position all over the place.

A good friend of mine has a particularly vexing habit of exercising in spite of injury. Said friend is always injured but never stops and wonders why the injuries don't heal. Runner and cyclist so one of the problems is if the injury is caused by one then the person does the other, but the injury still affects the other as well, just not as much.

I'm sure it's possible for you to find a good position but you'll need to stabilize your off-the-bike stuff first, then you can work on the on-the-bike stuff. If your off-the-bike issues keep up or keep changing it'll be virtually impossible to fit you (because your optimal fit will be a significantly changing position depending on how your off-the-bike issues are doing).

For what it's worth I have a marginal back (collapse every 5-10 years, "several burst or bulging discs" according to my doc after an MRI), I have tight hamstrings, and I have to be super aware of things that affect my back like taking my wallet out of my back pocket before driving (because the crooked position makes my back feel extremely uncomfortable within a minute or so). On the bike it's like a reprieve, the problems go away. I fit myself but I did that for 15+ years so I've had some experience doing it. I do a lot of checking on the trainer, i.e. in a very controlled environment.

Seated pedaling is the most significant for injury/fit because it's a fixed position. When you stand up you move around a bit and the fit is about where your bars are relative to your cranks, nothing else, no saddle factors. I stand regularly to "reset" my body, but I'm (now) very sensitive to any position changes relative to my saddle.
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Old 05-29-14, 08:38 AM
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Most fitters doing a "pro fit" employ one of the popular fit "systems". These systems are "formula based" with formulas derived from bio-mechanical analysis of statistical norms. That's great if you're a 50th percentile rider, but if you're out on the tails of the bell curve, you need a fitter that can recognize that and address individual needs. Motion capture showing that your knee angle is in the optimal range doesn't help if "optimal" is completely wrong for your body. The farther out you are from the norm, the more your fitter needs to rely on alternate approaches. Many LBS fitters have only limited training/experience beyond using the "system". Given the OP's functional challenges, the fitter may need to deviate a lot from the optimal performance oriented fit.

A two prong approach is probably in order. Prong 1 is to work on addressing the functional issues. Daily stretching, core strength training, and possibly additional medical intervention are probably in order. Prong 2 is to find a fitter that doesn't care about static angles, KOPS, or other such metrics, and can actually cater to your functional limitations.
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Old 05-29-14, 08:39 AM
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I was at the point of scheduling a fit because of bad pain in my knee and hip of my left leg. But instead I Googled a bit and decided to raise my seat to see if that helped. The knee pain went away totally, and the hip pain is about 80% better.
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Old 05-29-14, 09:01 AM
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This demonstrates that you cannot have a rule for everyone. Professional fit is silly.
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Old 05-29-14, 11:46 AM
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Thanks for all the input. To answer some questions...

I had issues before the fit. When getting the fit, I noticed that the fitter seemed perplexed at a couple of things which kind of fits the responses on the tail end of this thread. For example, when walking, my feet collapse quite a bit to the inside. Also, I'm knock-kneed but pedal with my knees outside my frame. (I.E. kind of bow-legged.)
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Old 05-29-14, 12:12 PM
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Physical therapy
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Old 05-29-14, 02:02 PM
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I had an amateur fit done and I am pain free.

Thanks me.
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Old 05-29-14, 02:07 PM
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cycling is good exercise, but it can throw off the balance between your muscles. OP sounds like he probably should talk to a PT, but for the rest of us there are lots of core exercise programs that will help avoid these issues. The foot problems are things that will crop up and have very little to do with cycling.
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Old 05-29-14, 05:16 PM
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Agreed that OP would best be served by talking with a PT or other medical professional. Many common core exercises can exacerbate diastasis recti.
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Old 05-29-14, 05:25 PM
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Try to find a sports medicine specialist, preferably one with some knowledge of cycling. A quick search turned up the Tennessee Sports Medicine Group in Knoxville. Good luck.
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Old 05-29-14, 08:26 PM
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The foot problems might be easy to solve. What kind of pedals and shoes are you wearing? Do you wear your inserts while cycling? I like SPD-SL pedals because they have a nice big platform to spread the force. There are others that do it well, too. Avoid smaller pedals that will concentrate force on a small part of your foot.

Shoes with a very stiff sole should help avoid hot spots too. Also, make sure you're pulling up on your pedals instead of just pushing down.
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Old 05-30-14, 08:41 AM
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Have you gone back for a follow up fit? Many fitters offer free follow up fits to address any issues you may have with the new position. Even the best fitters may not get it perfect the first time.

My fitter will let me come back as many times as I need until I am happy with the results. After my first fit my saddle at the time became uncomfortable, and I was dealing with hand numbness. After a saddle change and a few quick adjustments those problems were solved.
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Old 05-30-14, 01:19 PM
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Thanks again for all the advice. I'm giving TN Sports Med a call next week. My fitter will do another assessment for free after my inherent issues are resolved.
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