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Saturday, April 24, 2010

I'm back; SI joint Part 2; orthotics and cycling

Sorry again for the long delay -- this is such a busy time of year that I barely have time for anything besides bike fits and designing custom machines (and my family of course). This week, I purposely carved out some down time to catch my breath, and (gasp) even get out for a ride or two.

Of note recently: I had another client this past weekend with a clearly restricted SI joint (this time on the right side) and after a couple of tests, she too benefitted from treating that right side as a short right leg. A 3 mm leg length shim did the trick, and really allowed her mechanics to even out and she was sitting more equally on her seat as well. I will post the Retul files once I doctor them to block out her name, etc.

I've also had further reinforcement of my long held belief that custom orthotics do a very poor job of controlling lower extremity mechanics in cycling. I get a number of clients that have orthotics in their cycling shoes, and I routinely test them on the infrared with the orthotics as normal, and then without orthotics but with cleat wedges/shims as needed. I have never had a pair of orthotics do as good a job at controlling the mechanics as the cleat adjustments.

Part of the reason for this is that most people don't have two sets of orthotics made -- they have one set for walking/running made (because they're expensive). Walking/running orthotics WILL NOT help in cycling. They might not harm anything drastically, but they won't help -- the mechanics of running/walking and cycling have very little to do with one another. You can almost say they are opposite mechanical events of each other. Again, the orthotics may not cause harm, and they may even be more comfortable to the foot itself, because of the support it provides, but I have not found them to correct for much past that.

Even second sets of orthotics made (supposedly) for cycling have faired very poorly. My personal guess on this one is that most people making orthotics are not familiar with the mechanics of cycling. These health care professionals are educated in the context of gait training and evaluation. Walking is studying ad nauseum -- the micro-events that occur to the muscles during swing and stance phase, etc. (And, incidentally, they are often very good at assessing gait.) Some programs do not even spend a lot of time on running. The programs will acknowledge that there are significant differences between walking and running, however they often do not spend a lot of time on it. And cycling? Effectively "none" is my educated guess.

So my advice is to not spend another $200-$500 on cycling orthotics, when $30-$40 (max) of cleat wedges and shims is much more effective.

Anyhow, I will post some files to show this in a little bit, and I am making a concerted effort to post more regularly.

Stay tuned.



  1. That was a really good post. It helped me to make sense of some of the issues with the subject.

  2. Interesting blog. It would be great if you can provide more details about it. Thanks you.
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