What a difference a lift can make.

More from the pedal freaks….

Yes, we watch folks on bikes too. We look at foot and knee position, smoothness of strike, back position, as well as the spandex. Gait and biomechanics are everywhere and no one is safe from “the gait cam”.

Take a look at this gal and her pedal stroke. The first 9 second portion of the clip shows her pedal stroke with an increased medial migration of her L knee. Notice at about 4 seconds when she increases her cadence, it exaggerate the issue (see out post on that here). What sorts of things could cause that? A few causes are:

  •  Leg length discrepancy
  • Collapsed arch of L foot
  • Poor foot intrinsic strength of L foot
  • Poor eccentric contraction of L posterior gluteus medius complex
  • Weak lower abdominals L > R
  • Decreased ankle rocker of L foot
  • Cleat positioning on L shoe
  • Hip osteoarthritis
  • And the list goes on…

In this particular case, she had an anatomically short leg on the LEFT and weak foot intrinsics. Yes, we know, folks tend to pronate heavier on the LONGER leg side, but this is usually with running, not cycling. It tends (but not always) to be opposite with cycling. We believe this is due to the more rigid lasted cycling shoe and more of a “reach” with the foot on the short leg side.

In the second part of the clip, from 10 seconds to end, we place a 3mm lift on the left. THAT’S IT. Wow! What a difference! Still some oscillation of the knee at the top of her stroke (present on both sides, but more pronounced on the left), but much less. Note also that her body oscillation lessens as well and her stroke is smoother.

The Gait Guys. Not only are we watching how you walk, but also how you ride

Sometimes, you just need to add a little pressure….

Cyclists are no different than runners; often when the effort is increased (or the conditions reproduced), the compensation (or problem) comes out.

Take a good look at this video of a cyclist that presented with right sided knee pain (patello femoral) that begins at about mile 20, especially after a strong climb (approx 1000 feet of vertical over 6 miles through winding terrain).

The first 7 seconds of him are in the middle chain ring, basically “spinning” ; the last portion of the video are of him in a smaller (harder) gear with much greater effort.

Keep in mind, he has a bilateral forefoot varus, internal tibial torsion, L > R and a right anatomically short leg of approximately 5mm. His left cycling insole is posted with a 3mm forefoot valgus post and he has a 3mm sole lift in the right shoe.

Can you see as his effort is increased how he leans to the right at the top of his pedal stroke of the right foot and his right knee moves toward the center bar more on the downstroke? Go ahead, stop it a few time and step through it frame by frame.  The left knee moves inward toward the center bar during the power stroke from the forefoot valgus post.

So what did we do?

·      Worked on pedal stroke. We gave him drills for gluteal (max and medius) engagement on the down stroke (12 o’clock to 6 o’clock) to assist in controlling the excessive internal spin of the right leg. Simple palpation of the muscle that is supposed to be acting is a great start.

·      Did manual facilitation of the glutes and showed him how to do the same

·      Worked on abdominal engagement during the upstroke (the abs should initiate the movement from 6 o’clock to 12 o’clock)

·      Manually stimulated the external oblique’s

·      Placed a (temporary, hopefully) 5mm varus wedge in his right shoe to slow the internal spin of the right lower extremity

·      Taught him about the foot tripod and appropriate engagement of the long extensors; gave him the standing tripod and lift/spread/reach exercise (again to tame internal spin and maintain arch integrity)

Much of what you have been learning (for as long as you have been following us) can be applied not only to gait, but to whenever the foot contacts anything else.

The Gait Guys. Experts in human movement analysis and providing insight into biomechanical faults and their remediation.

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