TIBCO Pro Team's Physiotherapy & Bike Fit

In February, TIBCO Professional Cycling visited Revolutions in Fitness for a day of Cycling Analysis and Physical Therapy.

TIBCO Pro Cycling with Curtis Cramblett, Jeanette Krogstad, and Jennifer Sheppard from Revolutions in Fitness

Curtis assessing Emma Grant's cycling position.

Jen checking Emma's pedaling dynamics.

Curtis measures Sara Clafferty.

Jeanette checking pelvic stability and flexibility

Physiotherapy is an integral part of bike fit.

The Revolutions in Fitness physiotherapy and fit team.

Bike Fit for Kids: At-Home and Professional

Does your kid need a bicycle fitting, or cycling position optimization?
Probably not. 
If your child is under 13 years old and only riding around the block or possibly back and forth to school, then a professional fitting is certainly not necessary. However, some basics can help your child be more efficient and comfortable and stay healthy on the bike.
When the saddle position is correct, your child will pedal more efficiently with more ease and comfort.
A good estimate for seat height (A in the diagram to the right) is approximately ½ inch less than your kid’s

·       A good estimate for seat height (A) is approximately 
½ inch less than your kid’s inseam.

·       Next, put the nose of the saddle approximately 1 ½ to 
3 inches behind the center of the bottom bracket (B).

·       Once the saddle is in the right position, get the 
handlebars about level with the saddle (D = 0), and 
adjust the reach (C) so that when your kid grabs the 
handlebars, he or she is not locking out his or her 
elbows.

inseam.  You can measure inseam length yourself, or you might already know it from the child’s pant length size. Seat height is measured from the center of the bottom bracket (the axle where the crank arms go through) to the top of the saddle in line with the frame of the bike.
Next put the nose of the saddle approximately 1 ½ to 3 inches behind the center of the bottom bracket (B). You can use a plumb line going straight down from the nose of the saddle to measure this distance accurately.
Proper handlebar position will minimize strain for your son or daughter's neck, upper back, and shoulders.
Once the saddle is in the right position, set the handlebars up by adjusting the stem so your child does not have to reach too far or down. Get the handlebars about level with the saddle (D = 0), and adjust the reach (C) so that when your kid grabs the handlebars, he or she is not locking out his or her elbows.
These basics will keep most kids comfortable and efficient on their bikes. If your child is riding a bit more intensively, consider bringing him or her in for a professional bike fit. Many of the kids we work with for cycling position optimization are 13 years or older and are riding more than 7 to 10 hours per week. These kids can be riding for fun or even considering racing. A professional bike fit will help keep your child efficient, comfortable, and injury-free throughout a lifetime of dedicated cycling.

Revolutions in Fitness provides cycling position optimization for dedicated
junior riders, like these members of the San Jose Bicycle Club.

In case you decide that a professional cycling position optimization is right for a child you know, we are offering a 50% DISCOUNT on bike fit for children now through the end of the year. Great for last minute stocking stuffers! Email or call to order: office@revolutionsinfitness.com / (650) 260-4743

Revolutions’ PT, Mark McMahon authors an interesting article about hip health and the practice of yoga to lessen the pain and tension of certain yoga poses.

Solving the hip yoga puzzle the FMT way

by  Mark McMahon, DPT, OMT

Yoga Instructor in the Iyengar tradition

This NY Times article by William Broad puts the spotlight on the potential risks of yoga practice, especially regarding  women’s hip health. The author uses primarily anecdotal evidence from respected orthopedists and yoga teachers to show an apparent recent trend of hip injury among women yoga practitioners. The doctors theorize that some yoga poses which emphasize fully folding or twisting the hip joint, along with women’s natural flexibility toward these poses, contribute to pinching and unnecessary degeneration of the tissues around the hip. After describing the problem, the experts make some common sense suggestions: practice gently, avoid poses where the hip is fully folded, and don’t push through pain. This is sound advice, given that a primary principle of yoga practice is to cultivate nonviolence.

I would point out modern American life has wreaked havoc on hips, it’s been proven: the US has the highest per capita rate of hip replacement in the world. Sitting, driving, and other sedentary lifestyle issues are probably much worrisome factors in the epidemic than the few overaggressive yoga practitioners! In general, even Mr. Broad acknowledges, yoga probably helps more people maintain joint and body health than get injured doing yoga. So it’s likely that the problem with yoga injuries lies not with the poses themselves, but in how they are (or not!) being instructed.

The primary safeguard from developing an injury in yoga is to find a good teacher and attend classes regularly. A good teacher should be able to give verbal and/or touch cues to guide a student to a proper alignment in a pose. If that’s not possible then they should be able to give a modification which allows the student to experience the essence of the pose with less strain. Classes in which poses move very quickly from one to another, or in which few alignment cues are given, should be considered for advanced practitioners. Instructors who encourage competitive straining or “pushing through the pain” are to be avoided. Finding the right class and intensity level for you is key. Those with significant injuries or other concerns about their musculoskeletal health might do best with private instruction at first from a qualified teacher, before getting into general yoga classes, OR entering into a course of physical therapy with yoga goals in mind.

Here at Revolutions in Fitness we commonly work with all kinds athletes of all levels, with all kinds of goals. Our physical therapists work with the the principles of Functional Manual Therapy (FMT), as taught by the Institute of Physical Art (Gregg and Vicki Johnson, co-founders), in which treatment is guided by the overriding goal of enhancing function through the entire system, not just the injured body part.  Given its central location in the body and how it transmits force from leg to torso and vice versa, a strong, stable hip is key to any athletic pursuit. The hip is just like the shoulder, it has its own "rotator cuff" system which often needs to be strengthened to ensure the health of the joint. Whether you’re walking, running, cycling, or holding a yoga pose, an efficient hip helps. What does efficient mean? According to FMT, an efficient joint has a) good mechanical alignment and mobility, b) sufficient strength, endurance and power for the desired activity and c) good control of movement and position throughout the range of motion of the activity. So in yoga for instance, a very flexible woman may need to be trained to NOT fold the hip all the way during a forward bending pose! This takes strength, control, and awareness. All of these qualities can be assessed, trained and enhanced with the FMT approach in a physical therapy setting.

So if you’re a yogi or yogini and your hip is bugging you, don’t ignore it. Consider a consult with one of our expert PTs to help sort things out. Or if you’re happy with your yoga and just want to keep it that way, we can help you identify and improve weaker areas that can lead to problems in the future. Yoga practice can be a wonderful laboratory for self improvement and integration of body and mind. Wishing you safe movement and happy hips.

NY Times article referenced above: http://www.nytimes.com/2013/11/03/sunday-review/womens-flexibility-is-a-liability-in-yoga.html?_r=0

My Aching Body

By Curtis Cramblett, P.T., CSCS, Expert Level Cycling Coach

If you sat at your computer in a poor ergonomic position for six hours straight, bending and straightening your elbows 300,000 times or more, you’d expect a repetitive strain injury, right? 

Cycling is similar in that it too is a poor ergonomic position with repetitive motions. In a six-hour ride your knees, hips and ankles will bend and straightening approximately 300,000 times. Your neck and back will be in a constant forward position. So if you want to prevent or get rid of aches follow Coach Curtis’s “5 F’s of Training”

1. Bike Fit: Andy Pruitt once said changing the seat height by a mere inch changes the mechanics and muscle actions of every joint in the lower extremity. I find that changing it by 1/16th of an inch can cause or alive pain! For example, if you decrease the seat height you increase the forces on the front of the knee, but if your saddle is too high, forces increase in your hamstrings, low back and hands.

WHAT TO DO: 

Educate yourself on bike fits and make the appropriate changes. If you are doing rides longer than 2 hours or multiple days then I recommend getting a professional bike fit. 

2./3. Fatigue ability (endurance/strength) and Flexibility 

Think Yin and Yang of muscles and joints

Muscles need to be both strong and flexible to allow proper movement and support of the joints in your body. As mentioned above, this is especially important for cyclists because our joints are either stuck in a static position as with the upper extremity or in repetitive motion as in the lower extremity. 

If joints are not flexible AND strong then you’re asking for trouble. What’s more, muscles on either side of the joint need to be balanced. For example, many cyclists have very strong quadriceps muscles (front of the thigh) and relatively weaker hamstring muscles (back of the thigh). This is similar to the unequal guide wires on a tent causing the tent to tip. 

WHAT TO DO:

- Static positions need to be reversed. This means occasionally backward bending when you get off your bike.

- Strengthening and stretching both sides of the body joints. Incorporate pulling and pushing exercises to strengthen the upper body, and hamstring and quadriceps exercises for the lower body. --Use proper pedal mechanics (discussed below).

4. Fitness Progression - Proper progressive training

You might expect an injury if, in one week, you increased weights in the gym by 60%. However, many people think nothing of increasing their longest ride from a 40 mile ride to a 65 mile in one week, the same 60 percent increase. Once our bodies have reached their fitness limits they can only tolerate gradual increases of no greater than 5-10 percent per week of mileage or time increases. Frequent high-intensity rides or long rides with greater than moderate intensity will also lead to injury. 

WHAT TO DO:

- Intense rides (greater than 75 percent of max heart rate) should be limited to one to 2-3 days a week. 

- Gradually progress time spent on the bike and/or mileage in 5 to 10 percent increments per week.

- Every 3-6 weeks decrease your training time by 40-60% to allow your body to regenerate and adapt to training. 

5. Cycling Form - How you pedal counts

Pushing hard gears is analogous to walking up a flight of stairs two or three steps at a time, when you only need to take them one at a time. By selecting easier gears you break up the same amount of work over more pedal strokes, taking a great deal of stress off of your knees. 

WHAT TO DO: 

- You should aim for a cadence (pedal revolutions per minute) of 85 to 95 on a flat road and no less than 70 on a hill. You can achieve this by selecting the proper gear for your ability. However, on a significant hill, this can present a challenge without a triple chain ring on your front gears. 

- Improper pedal form will also cause pain: not pushing and pulling on the pedal. Or if knees are not staying in a straight line when you pedal then your form needs some work. If you notice your knees bowing out or in relative to the top tube of your bike, ouch, this is you. 

- Use all your muscles to propel yourself forward. With proper pedal strokes, both your quadriceps and hamstrings play a part. Imagine your pedal going through a full circle; as your foot moves to the bottom position of the stroke, imagine scraping bubble gum off the bottom of your shoe. Then, pull your knees toward your handlebars as you bring your foot to the top of the stroke. This will take pressure off of the front of your knee and give those tired quadriceps a rest.

- Focus on keeping your knees going straight up and down. This problem is frequently a bike fit issue however. 

6. Fuel and Hydration - Nutrition

Proper fuel, water, and electrolytes will fuel those muscular engines. With out it they will seize up, cramp and sputter. Imagine trying to run an unleaded car on leaded gas. This is what happens when we do not fill a body with what it needs to carry out those long rides.

WHAT TO DO:

- Research suggests 55 to 65 percent of our fuels should be in the form of carbohydrates, mostly complex. Fifteen to thirty percent of our foods should be fats and 10 to 20 percent protein.

- Drink between two and four liters of water a day depending upon your workout intensities. Watch your urine; it should be a light yellow color. Check your weight before and after a ride, it should not change by more than 1 pound if it does replace it with the water you have lost!

For recommended readings and more in depth articles on the subjects mentioned in this article, please visit my website at RevolutionsinFitness.com

Curtis@RevolutionsInFitness.com

www.RevolutionsInFitness.com

w:(408)676-7430 

Licensed Physical Therapist

Personal Trainer

Certified Strength and Conditioning Specialist

USCF, USA Expert Level Cycling Coach

Certified Spinning Instructor

Barefoot Running

Curtis adds his observations on making them jump from shoes, to barefeet.
Something to be careful doing, and do correctly to prevent injuries.

Listen to this audio from Curtis - if you think you want to try the  "Vibram 5 finger" shoes.

<above is Curtis's memo on history, and pro's and con's of trying barefoot or 5 finger shoes.>


Video and information regarding barefoot running -
by Roving Runner; Brian Fidelman.

Follow him as he ran with Christopher McDougall,
author of “Born to Run,”

NYT - Barefoot Running

DOES CRANK LENGTH MATTER?

Does crank arm length matter in a time trial position?
A letter of observation from Curtis Cramblett, PT, CFMT, CSCS, Level II Cycling Coach; after returning from Garmin Team Camp, December 2010. 

I just came back from the Garmin professional cycling team camp in Grand Cayman Islands where some great discussions happened regarding crank length. Research is starting to suggest that changing crank lengths by 2.5-5mm does not change power for endurance athletes. This has also been true in my experience. Athletes, without trying, increase their cadence, making up for the slight loss in leverage. The benefits of shortening up your crank length on a time trial bike, is that as your knee and your hip come over the top of the pedal stroke, your hip and your knee have to bend less. Keeping the angles closer to what they are on your road position, and making it easier to keep the momentum over the top of the stroke. That’s a very good thing if you consider your hip has to bend so much more in a time trial position, while your torso angle comes down, in order to get very aerodynamic. When this drop in torso closes up the hip angle, basically you increase hip bend and the amount of stretch to your hip muscles in the back, including your hamstrings. Additionally this puts the muscles in the front of the hip, the hip flexors, at a much more shortened position and when muscles gets very short, they have a harder time contracting.  

David Zabriski, Curtis Cramblett

Curtis Cramblett, Christian's Van De Velde

In summary, as crank length goes down, we are still trying to figure out how much is still efficient for most people. As crank length goes down the decreased hip and knee bend at the top makes it easier to clear the top of pedal stroke, and thus allows less bumping of your knees into your chest. For most cyclists, a feeling of easier breathing comes with that, keeping them appropriately positioned over the top of the pedal. For those triathletes out there, it also seems to make it easier to then hop off the bike and transition into your run. So there's not enough good research yet, however the cutting edge thought these days, is to consider having 2 different crank lengths; one for your road bike and one for your time trial bike - where the time trial bike is shorter. 

Many will suggest that getting used to one and then switching over to the other is detrimental, because you’re use to a certain pedal circle. However my experience, and other avid cyclists experience, suggests that it’s a lot easier to get used to a smaller circle than it is to get used to a more bent hip angle, closed hip angle and it’s easier to keep your power levels higher with a more open hip angle where you’re fighting this pedal at the top of the stroke. Gives us something to think about, and I would suggest you checkout Slowtwitch.com, look up crank length, there are some nice discussions going on there, and I think you will see a lot more cyclists and triathletes; when in time trial positions, choosing to shorten up their cranks in the next couple years.
— Curtis Cramblett, PT, CFMT, CSCS, Level II Cycling Coach. Revolutions In Fitness.

Work the fuzz out, why we need to keep moving!

Here is an fascinating video which illustrates what happens when we stop moving, from injury or just lack of activity, even sleeping!

Please first listen to below audio introduction (turn your volume up) from Curtis Cramblett, PT, CFMT, CSCS, Level II Cycling Coach, then click the link to the video. Important to learn more about this "loose connective tissue and fascia" before watching. The video includes a Cadaver, a person that passed away & donated their body to science. 

Ready to watch Gil Hedley's, 

"Fascia and stretching: 

THE FUZZ SPEECH" video? click here.