WEBVTT 00:00:00.495 --> 00:00:02.076 Made a fancy new intro. 00:00:02.177 --> 00:00:03.097 Let's hit that intro. 00:00:08.603 --> 00:00:10.426 How official do we look after that? 00:00:10.445 --> 00:00:12.829 The sound effect and the graphic, Eric? 00:00:13.330 --> 00:00:13.890 So pro. 00:00:14.271 --> 00:00:15.192 It's awesome. 00:00:15.492 --> 00:00:16.112 I love it. 00:00:17.134 --> 00:00:17.493 It's great. 00:00:18.515 --> 00:00:20.437 Eric Moen back on orthostatic with us. 00:00:20.457 --> 00:00:21.318 Thanks for the time, Eric. 00:00:22.111 --> 00:00:23.132 You are so welcome. 00:00:23.652 --> 00:00:26.975 It's just really a pleasure to be here. 00:00:27.175 --> 00:00:29.937 What's your 15-second superhero backstory? 00:00:29.957 --> 00:00:30.077 I mean, 00:00:30.117 --> 00:00:32.237 you've got the bicycle in the background. 00:00:32.357 --> 00:00:33.558 You're a physical therapist. 00:00:33.618 --> 00:00:34.378 I see a bike. 00:00:34.899 --> 00:00:35.659 What should people know? 00:00:38.621 --> 00:00:39.881 Well, I don't know. 00:00:39.902 --> 00:00:40.783 I've been riding bikes for 00:00:40.823 --> 00:00:45.365 all my life and bike as 00:00:45.445 --> 00:00:46.646 part of clinical practice 00:00:46.665 --> 00:00:48.728 has really been there since 00:00:48.768 --> 00:00:50.548 day one when it wasn't really a thing. 00:00:50.609 --> 00:00:50.929 And so 00:00:51.838 --> 00:00:55.299 Uh, I'll say, uh, that I'm, 00:00:55.521 --> 00:00:58.582 I'm one of the earlier people to adopt, 00:00:59.103 --> 00:01:01.344 uh, clinical bike work or bringing, uh, 00:01:01.945 --> 00:01:03.125 bicycles to the clinic. 00:01:03.206 --> 00:01:07.608 And, and, uh, I have a sorted past of, uh, 00:01:08.448 --> 00:01:09.510 just lifetime cyclist, 00:01:09.530 --> 00:01:11.932 recreational cyclist, also licensed racer, 00:01:11.971 --> 00:01:13.653 licensed coach, um, 00:01:14.772 --> 00:01:17.496 educator and bike or bicycle 00:01:17.557 --> 00:01:18.177 clinical work. 00:01:19.018 --> 00:01:20.781 And currently I'm working 00:01:20.820 --> 00:01:22.602 with paracycling at the 00:01:22.623 --> 00:01:23.823 international level where 00:01:23.843 --> 00:01:26.186 I'm head of paracycling 00:01:26.227 --> 00:01:27.808 classification for the UCI, 00:01:27.849 --> 00:01:29.691 which is the International Cycling Union. 00:01:30.640 --> 00:01:33.201 Did you, was this in the, was this in the, 00:01:34.001 --> 00:01:35.343 in the cards when you started? 00:01:35.403 --> 00:01:35.584 Like, 00:01:35.644 --> 00:01:37.305 did you ever expect any of this cool 00:01:37.344 --> 00:01:38.045 stuff to happen? 00:01:38.084 --> 00:01:38.546 Or it's like, 00:01:38.665 --> 00:01:39.626 it's one of those fun things 00:01:39.646 --> 00:01:40.507 that happened along the way. 00:01:40.546 --> 00:01:41.207 Like all the different 00:01:41.227 --> 00:01:43.368 places that cycling and like, 00:01:43.409 --> 00:01:43.748 I love that. 00:01:43.808 --> 00:01:44.010 Yes. 00:01:44.250 --> 00:01:44.810 And right. 00:01:44.849 --> 00:01:46.510 That's the one rule. 00:01:46.531 --> 00:01:46.671 Yes. 00:01:46.730 --> 00:01:48.393 And you just, yes. 00:01:48.492 --> 00:01:49.293 And did your career. 00:01:49.332 --> 00:01:50.414 You're like, I'm a cyclist. 00:01:50.634 --> 00:01:50.774 Okay. 00:01:50.793 --> 00:01:51.515 I'm going to be a PT. 00:01:51.534 --> 00:01:52.756 Like, Ooh, what would happen if I, yes. 00:01:52.876 --> 00:01:54.057 And did this, like, did, 00:01:54.197 --> 00:01:55.257 was this in a plan or is 00:01:55.298 --> 00:01:56.858 this happy accidents along the way? 00:01:58.000 --> 00:01:58.379 You know, 00:01:59.676 --> 00:02:03.177 I have to say that I had 00:02:03.257 --> 00:02:06.058 early visions of doing bike stuff, 00:02:06.097 --> 00:02:08.938 and really a lot of what my 00:02:09.139 --> 00:02:10.679 early interactions of 00:02:10.739 --> 00:02:12.319 clinical bike work were 00:02:12.780 --> 00:02:13.699 actually more centered 00:02:13.740 --> 00:02:16.260 around me trying to figure 00:02:16.341 --> 00:02:19.021 out how I could participate 00:02:19.042 --> 00:02:20.961 at a higher level in cycling, 00:02:20.981 --> 00:02:23.663 because I have, we'll say, orthopedic 00:02:24.478 --> 00:02:26.919 Uh, dysfunction, uh, in a lower extremity, 00:02:27.280 --> 00:02:28.181 which actually, 00:02:28.561 --> 00:02:29.401 interestingly enough 00:02:29.461 --> 00:02:31.143 qualifies me for paracycling. 00:02:31.163 --> 00:02:33.344 So I could be a paracyclist 00:02:33.384 --> 00:02:35.747 because of my impairment, but at the time, 00:02:35.766 --> 00:02:36.146 you know, 00:02:36.426 --> 00:02:38.127 it was really not well known 00:02:38.168 --> 00:02:39.770 around the United States, uh, 00:02:39.990 --> 00:02:41.031 what paracycling was. 00:02:41.070 --> 00:02:41.390 So I was, 00:02:41.510 --> 00:02:42.812 I was just trying to keep up with 00:02:42.852 --> 00:02:45.554 the people with two normal legs, uh, 00:02:45.693 --> 00:02:47.354 which created a need for me 00:02:47.395 --> 00:02:49.257 to figure out how to, how to. 00:02:50.443 --> 00:02:51.943 change or alter my equipment 00:02:52.625 --> 00:02:55.025 to get best medical advantage. 00:02:55.465 --> 00:02:56.844 And so at the time, 00:02:56.884 --> 00:02:57.765 there really weren't many 00:02:57.806 --> 00:03:00.725 people doing it at all. 00:03:00.906 --> 00:03:01.567 Or if they were, 00:03:01.627 --> 00:03:03.326 they were in a very distant place, 00:03:03.447 --> 00:03:04.986 or maybe they weren't able 00:03:05.026 --> 00:03:06.728 to answer my questions or 00:03:07.647 --> 00:03:08.927 creatively problem solve 00:03:08.967 --> 00:03:10.068 with me for my issues. 00:03:10.147 --> 00:03:11.109 And so I was just like, 00:03:11.528 --> 00:03:12.149 out of the heck with it. 00:03:12.188 --> 00:03:13.788 I'm going to do it myself. 00:03:14.949 --> 00:03:16.050 I've got an inquisitive brain. 00:03:17.368 --> 00:03:18.270 I know how to research. 00:03:18.930 --> 00:03:20.610 I've got my physical therapy background. 00:03:20.651 --> 00:03:21.111 And, you know, 00:03:21.132 --> 00:03:21.972 I was talking to someone 00:03:21.991 --> 00:03:23.873 about this the other day, like as a youth, 00:03:23.913 --> 00:03:24.313 you kind of, 00:03:24.713 --> 00:03:26.216 you kind of get inklings of 00:03:26.276 --> 00:03:27.896 what people are going to do. 00:03:28.437 --> 00:03:30.318 Like, like for, for example, 00:03:30.338 --> 00:03:31.740 like my daughter, you know, 00:03:31.800 --> 00:03:32.719 she's always been a runner, 00:03:33.181 --> 00:03:34.140 but she's a runner. 00:03:34.602 --> 00:03:36.043 And so like, for me, 00:03:36.122 --> 00:03:38.664 I was always studying movement, motion, 00:03:40.186 --> 00:03:40.366 like, 00:03:40.969 --> 00:03:41.770 coaching skills. 00:03:41.811 --> 00:03:43.032 I remember tearing articles 00:03:43.111 --> 00:03:45.432 out of magazines about like certain, uh, 00:03:45.612 --> 00:03:46.454 sport technique. 00:03:47.235 --> 00:03:48.074 Uh, so there, 00:03:48.134 --> 00:03:49.216 there was always that kind of 00:03:49.276 --> 00:03:50.456 interest in biomechanics 00:03:50.516 --> 00:03:52.638 and biomechanical function, uh, 00:03:52.778 --> 00:03:54.580 pedagogy or learning a sports skill. 00:03:55.600 --> 00:03:58.443 So it really, it all kind of fits in, 00:03:58.462 --> 00:03:59.543 I guess the, 00:03:59.682 --> 00:04:01.384 was it incidental just kind 00:04:01.425 --> 00:04:02.906 of did it kind of fall upon me? 00:04:03.086 --> 00:04:03.765 You know, I think, 00:04:04.287 --> 00:04:06.307 I think we make our luck so to speak. 00:04:06.407 --> 00:04:07.688 And so a lot of, uh, 00:04:08.189 --> 00:04:09.991 a lot of the work that I've done, 00:04:10.676 --> 00:04:12.176 has created opportunities 00:04:12.978 --> 00:04:15.997 and it's hard work. 00:04:16.497 --> 00:04:17.218 It's not like, oh, 00:04:17.238 --> 00:04:18.218 I just get lucky and 00:04:18.879 --> 00:04:20.158 something gets thrown into my lap. 00:04:20.199 --> 00:04:21.379 I mean, that happens to people, 00:04:21.480 --> 00:04:24.639 but I'd like to say the 00:04:24.680 --> 00:04:25.740 hard work I've done and the 00:04:26.240 --> 00:04:27.180 good work I've done has 00:04:27.240 --> 00:04:28.161 helped create these 00:04:28.201 --> 00:04:29.682 situations where I've just 00:04:29.701 --> 00:04:30.482 kind of moved along. 00:04:31.007 --> 00:04:32.327 It's such a shock, right? 00:04:32.387 --> 00:04:33.689 We get really good at things 00:04:33.709 --> 00:04:36.050 that we're excited about working hard on. 00:04:36.750 --> 00:04:37.831 And it's, of course, not luck. 00:04:37.911 --> 00:04:40.653 It's because you've decided, I like this. 00:04:40.694 --> 00:04:42.654 This is worth working hard on. 00:04:43.036 --> 00:04:43.836 And then you put a lot more 00:04:43.875 --> 00:04:44.656 time into that. 00:04:44.836 --> 00:04:46.598 And then suddenly you stop 00:04:46.637 --> 00:04:48.079 and look back and you're like, wow, 00:04:48.360 --> 00:04:49.339 look how far I've gone. 00:04:49.360 --> 00:04:50.261 I've learned a lot. 00:04:50.461 --> 00:04:51.401 How can I apply this? 00:04:52.101 --> 00:04:52.322 Yeah. 00:04:52.382 --> 00:04:53.502 You know, frankly, 00:04:53.603 --> 00:04:57.646 for this whole bike niche genre thing, 00:04:57.745 --> 00:04:58.447 for me, it's like, 00:04:58.925 --> 00:04:59.944 It's dessert all day. 00:05:00.084 --> 00:05:05.447 So it's not drudgery like this week. 00:05:06.226 --> 00:05:06.826 Right now, I mean, 00:05:06.846 --> 00:05:08.187 the peak of my season 00:05:08.208 --> 00:05:10.048 because everybody's riding bikes. 00:05:10.088 --> 00:05:11.588 They've got events and 00:05:11.949 --> 00:05:13.069 they're getting new equipment. 00:05:13.129 --> 00:05:15.250 And so I've got I have a 00:05:15.310 --> 00:05:18.471 really onerous schedule that I've thrown. 00:05:18.930 --> 00:05:22.211 I've made this problem, but, you know, 00:05:22.612 --> 00:05:22.771 like. 00:05:23.242 --> 00:05:25.524 last night I saw people till 10 PM. 00:05:25.843 --> 00:05:28.504 And so, you know, I had a 7 AM start and I, 00:05:28.745 --> 00:05:29.846 I ended up seeing people 00:05:29.886 --> 00:05:31.107 till about 10 last night. 00:05:31.166 --> 00:05:32.687 And so it was, it was a, 00:05:32.887 --> 00:05:34.028 it has kind of been that 00:05:34.067 --> 00:05:35.168 way for the last month. 00:05:35.228 --> 00:05:38.629 And so it's been it's been, but it's like, 00:05:38.750 --> 00:05:39.410 it's one of those things 00:05:39.449 --> 00:05:41.771 like it's good fun. 00:05:41.831 --> 00:05:42.651 It's not drudgery. 00:05:42.692 --> 00:05:43.612 It's not like I'm like 00:05:44.012 --> 00:05:45.333 burned out because you know, 00:05:45.612 --> 00:05:48.053 this work task really stinks. 00:05:48.254 --> 00:05:49.735 And so it's just like a, 00:05:50.423 --> 00:05:51.584 If they're willing to come that late, 00:05:51.625 --> 00:05:52.045 I'll see them. 00:05:52.084 --> 00:05:53.925 Cause I don't mind doing this stuff. 00:05:54.266 --> 00:05:55.447 Cause this is the time of year. 00:05:56.187 --> 00:05:56.507 And that's, 00:05:56.747 --> 00:05:58.490 that's something that a reason 00:05:58.509 --> 00:05:59.550 we're doing sort of this 00:06:00.031 --> 00:06:00.870 and you're kicking off sort 00:06:00.891 --> 00:06:02.192 of a mini series that we're 00:06:02.232 --> 00:06:02.892 doing with a bunch of 00:06:02.932 --> 00:06:03.812 different physical 00:06:03.853 --> 00:06:05.454 therapists who are yes. 00:06:05.634 --> 00:06:06.675 And maybe that's the name. 00:06:06.694 --> 00:06:07.776 Maybe that's what we'll call the series. 00:06:07.815 --> 00:06:07.995 Yes. 00:06:08.115 --> 00:06:08.817 And PT, 00:06:08.857 --> 00:06:10.637 which is you take this background 00:06:10.658 --> 00:06:11.439 and you put it together 00:06:11.478 --> 00:06:12.178 with something you're 00:06:12.218 --> 00:06:14.461 passionate about that other 00:06:14.500 --> 00:06:15.502 people in the public too. 00:06:15.622 --> 00:06:16.903 And you get to, you get the, 00:06:17.202 --> 00:06:18.043 something that is greater 00:06:18.083 --> 00:06:19.223 than the sum of the greater 00:06:19.244 --> 00:06:19.985 than the sum of the parts. 00:06:20.444 --> 00:06:22.865 right that's really pretty 00:06:22.966 --> 00:06:24.127 awesome jimmy you know the 00:06:24.166 --> 00:06:28.870 yes and is um is taking the 00:06:28.930 --> 00:06:30.350 opportunity to go just a 00:06:30.370 --> 00:06:31.451 little bit further than 00:06:31.531 --> 00:06:33.012 just kind of your typical 00:06:33.072 --> 00:06:34.072 circumstances there are 00:06:34.093 --> 00:06:35.413 people who like to just 00:06:35.473 --> 00:06:36.915 clock in and clock out and 00:06:36.935 --> 00:06:38.915 I respect that but uh I 00:06:38.956 --> 00:06:39.815 don't know it's so much 00:06:39.875 --> 00:06:41.156 more exciting when you take 00:06:41.216 --> 00:06:44.098 that yes and step really so i 00:06:45.093 --> 00:06:45.394 Brilliant. 00:06:45.915 --> 00:06:46.735 Well, let's get into it. 00:06:47.314 --> 00:06:48.935 So this is really designed 00:06:49.036 --> 00:06:50.637 for the physical therapist 00:06:50.677 --> 00:06:51.598 who maybe didn't grow up 00:06:51.637 --> 00:06:52.858 with a cycling background, 00:06:53.119 --> 00:06:54.100 but they're seeing people 00:06:54.160 --> 00:06:56.762 in clinic and maybe they 00:06:56.822 --> 00:06:57.682 feel they have this sort of 00:06:57.762 --> 00:06:58.502 feeling in their gut. 00:06:58.603 --> 00:06:59.903 I know I had it when I was 00:06:59.963 --> 00:07:00.863 working with someone who 00:07:00.903 --> 00:07:01.605 maybe I didn't know 00:07:01.785 --> 00:07:03.105 everything about their sport, 00:07:03.365 --> 00:07:04.365 but I wanted to know. 00:07:04.646 --> 00:07:05.526 So this is sort of like the 00:07:05.627 --> 00:07:07.608 introductory guide with, hey, 00:07:07.908 --> 00:07:08.668 you got a patient on your 00:07:08.689 --> 00:07:09.449 schedule tomorrow. 00:07:09.951 --> 00:07:10.653 they've mentioned in their 00:07:10.673 --> 00:07:11.918 intake form cycling, 00:07:12.218 --> 00:07:13.382 or maybe they're coming back again, 00:07:13.543 --> 00:07:14.908 or you're seeing a patient 00:07:14.947 --> 00:07:15.850 from one of your colleagues, 00:07:16.576 --> 00:07:17.357 The information that we're 00:07:17.377 --> 00:07:18.858 going to give is really 00:07:18.918 --> 00:07:19.999 introductory but can take 00:07:20.019 --> 00:07:20.699 you the long way. 00:07:20.860 --> 00:07:21.940 You're going to get the most 00:07:22.100 --> 00:07:24.362 miles per gallon of information. 00:07:24.382 --> 00:07:25.362 You're going to be really efficient. 00:07:26.384 --> 00:07:27.665 So let's kick it off with this. 00:07:28.125 --> 00:07:28.966 Most common. 00:07:29.887 --> 00:07:31.088 What are some of the most 00:07:31.187 --> 00:07:32.949 common orthopedic injuries 00:07:32.990 --> 00:07:34.490 that we're going to expect 00:07:34.531 --> 00:07:35.331 from somebody who 00:07:35.692 --> 00:07:37.713 self-identifies as a cyclist? 00:07:37.754 --> 00:07:39.355 Meaning either they dug the 00:07:39.394 --> 00:07:41.536 bike out of the garage this year and, 00:07:41.596 --> 00:07:42.877 dang it, this year I'm going to do it. 00:07:42.898 --> 00:07:43.879 I'm going to be a cyclist. 00:07:44.079 --> 00:07:45.480 Or they've been riding for a long time. 00:07:46.225 --> 00:07:46.425 Well, 00:07:46.726 --> 00:07:48.708 the most common thing is usually 00:07:48.747 --> 00:07:50.149 around the knee and it's 00:07:50.189 --> 00:07:51.771 most oftentimes the front of the knee. 00:07:51.831 --> 00:07:53.713 It's most oftentimes, uh, 00:07:53.892 --> 00:07:54.774 irregular compression 00:07:54.793 --> 00:07:56.875 around the patella femoral joint, uh, 00:07:57.096 --> 00:07:58.858 that that's really the most common. 00:07:58.898 --> 00:08:01.480 And then probably the second, um, 00:08:02.682 --> 00:08:04.903 most common is we'd say low 00:08:04.944 --> 00:08:07.346 back pain or pain around the back. 00:08:07.386 --> 00:08:08.225 And that's more just 00:08:08.365 --> 00:08:10.187 postural stresses and strains. 00:08:10.908 --> 00:08:12.850 There's certainly positions 00:08:12.910 --> 00:08:13.971 and functions on the bike, 00:08:14.031 --> 00:08:15.612 which will set that, that off. 00:08:15.692 --> 00:08:16.291 Also, you know, 00:08:16.593 --> 00:08:17.632 I think the other thing to 00:08:17.733 --> 00:08:19.214 understand is that bicycling, 00:08:20.254 --> 00:08:21.636 bicycling is not walking, you know, 00:08:21.656 --> 00:08:23.257 we're the human body. 00:08:23.677 --> 00:08:25.559 We walk, we run, we hunt and gather, 00:08:26.319 --> 00:08:27.000 not on a bike. 00:08:27.261 --> 00:08:28.382 And so bicycles were, 00:08:28.781 --> 00:08:29.923 were born around the 1800s. 00:08:29.942 --> 00:08:30.083 And so, 00:08:32.216 --> 00:08:33.238 There's something that takes 00:08:33.658 --> 00:08:35.239 specific adaptation to. 00:08:35.740 --> 00:08:36.440 And so when you have a 00:08:36.480 --> 00:08:37.961 person with strong 00:08:38.000 --> 00:08:39.423 motivation and excitement 00:08:39.503 --> 00:08:40.783 to get on the bike, 00:08:41.604 --> 00:08:42.565 they're probably not going 00:08:42.605 --> 00:08:44.125 to have the strength, 00:08:44.145 --> 00:08:46.788 the coordination to just 00:08:46.847 --> 00:08:48.929 jump on a bike that's maybe 00:08:48.990 --> 00:08:51.071 not well positioned for them. 00:08:52.684 --> 00:08:54.767 Oftentimes back and neck pain come around. 00:08:54.787 --> 00:08:55.547 Uh, 00:08:55.947 --> 00:08:58.168 and then also it's really kind of 00:08:58.208 --> 00:09:00.230 around the contact points after that. 00:09:00.291 --> 00:09:02.231 So it's like hand pain, hand numbness, 00:09:02.692 --> 00:09:03.972 foot pain, foot numbness. 00:09:04.774 --> 00:09:05.214 Um, those, 00:09:05.374 --> 00:09:06.815 those are really the common things. 00:09:06.875 --> 00:09:09.397 Also we, we, the, the unspoken, the, 00:09:09.797 --> 00:09:11.278 the not often, well, more, 00:09:11.458 --> 00:09:13.279 more commonly talked about, uh, 00:09:13.379 --> 00:09:15.961 are the saddle discomforts, uh, pain, 00:09:16.022 --> 00:09:18.903 numbness, my butt hurts. 00:09:20.466 --> 00:09:22.008 And this was one of those 00:09:22.148 --> 00:09:23.488 aha moments I had as a PT 00:09:23.548 --> 00:09:25.668 student when someone framed it this way. 00:09:25.808 --> 00:09:26.830 And then I took this thing 00:09:26.850 --> 00:09:27.909 that they taught me and I 00:09:27.950 --> 00:09:28.870 sort of put it in a lot of 00:09:28.890 --> 00:09:31.272 different places, which is, Hey, as a, 00:09:31.532 --> 00:09:33.432 as a cycling physical 00:09:33.452 --> 00:09:34.192 therapist or a physical 00:09:34.212 --> 00:09:35.514 therapist who works with cyclists, 00:09:36.760 --> 00:09:36.921 Um, 00:09:37.221 --> 00:09:39.121 they framed it as my job was to move 00:09:39.182 --> 00:09:41.703 the bike to be comfortable for the human, 00:09:42.124 --> 00:09:44.004 not to tell the human to be 00:09:44.044 --> 00:09:45.566 comfortable for the, for the bike. 00:09:45.586 --> 00:09:46.625 So essentially adapt the 00:09:46.686 --> 00:09:47.706 bike as much as you could. 00:09:47.746 --> 00:09:49.168 So the human could be 00:09:49.268 --> 00:09:50.548 optimized on that or to 00:09:50.587 --> 00:09:52.129 reduce the pain of discomfort. 00:09:52.668 --> 00:09:54.230 And that led me to my first, um, 00:09:54.711 --> 00:09:56.071 aha moment or my second aha moment, 00:09:56.110 --> 00:09:58.533 which was I bought my first bike on eBay. 00:09:58.572 --> 00:09:59.312 Cause I was dang it. 00:09:59.332 --> 00:10:00.253 I'm going to be a cyclist. 00:10:00.332 --> 00:10:00.754 And I did. 00:10:01.692 --> 00:10:02.494 And then this is two, 00:10:02.533 --> 00:10:03.874 three years into me riding a bike. 00:10:04.235 --> 00:10:06.615 It was a bike with aero bars 00:10:07.297 --> 00:10:08.216 and I was riding them and 00:10:08.236 --> 00:10:09.817 this is for the podcast, sorry, 00:10:09.837 --> 00:10:10.479 the YouTube viewers. 00:10:10.759 --> 00:10:11.739 I was riding them and I 00:10:11.818 --> 00:10:13.360 didn't realize that the handles, 00:10:13.399 --> 00:10:14.681 the extended arms. 00:10:14.841 --> 00:10:15.061 Yes. 00:10:16.301 --> 00:10:17.922 They telescoped and they 00:10:17.942 --> 00:10:19.423 were telescoped all the way 00:10:19.643 --> 00:10:21.124 in and my arms were longer. 00:10:21.163 --> 00:10:22.144 So I was riding with my 00:10:22.245 --> 00:10:23.566 wrists completely flexed to 00:10:23.605 --> 00:10:24.726 change the gears. 00:10:25.067 --> 00:10:25.706 And someone said, 00:10:26.006 --> 00:10:27.048 that's an interesting position. 00:10:27.087 --> 00:10:27.889 Why do you ride like that? 00:10:27.908 --> 00:10:28.428 And I said, well, 00:10:28.609 --> 00:10:29.750 it's because my arms are longer. 00:10:29.769 --> 00:10:30.429 And they said, you know, 00:10:30.450 --> 00:10:31.291 that little screw right 00:10:31.331 --> 00:10:32.711 there loosens and you can 00:10:33.251 --> 00:10:34.352 shoot those things in and out. 00:10:34.513 --> 00:10:35.894 And I remember the entire 00:10:35.933 --> 00:10:37.455 ride just thinking how 00:10:37.634 --> 00:10:39.275 smart I thought I was 10 00:10:39.275 --> 00:10:40.557 minutes before and how dumb 00:10:40.616 --> 00:10:41.456 I now realized I was. 00:10:41.517 --> 00:10:42.658 I never thought about it. 00:10:43.562 --> 00:10:43.961 But when I, 00:10:44.142 --> 00:10:45.482 when you now look at a bike and you go, 00:10:45.663 --> 00:10:46.744 Oh, all these, well, 00:10:46.903 --> 00:10:47.585 a lot of the different 00:10:47.625 --> 00:10:49.625 parts can be moved. 00:10:49.666 --> 00:10:52.027 So the human is actually comfortable. 00:10:52.628 --> 00:10:52.888 Yeah. 00:10:53.488 --> 00:10:53.668 Yeah. 00:10:53.788 --> 00:10:54.849 It really is amazing. 00:10:55.269 --> 00:10:55.830 Um, when, 00:10:56.009 --> 00:10:58.370 when we deal with the human on the bike, 00:10:58.890 --> 00:11:00.672 how many different variables are managing, 00:11:01.493 --> 00:11:07.417 uh, and how much you know about the adapt, 00:11:07.437 --> 00:11:09.518 we'll say adaptive parts and pieces. 00:11:10.754 --> 00:11:11.975 that are out there and 00:11:11.995 --> 00:11:13.794 available to put on a bike 00:11:14.216 --> 00:11:16.155 and the ones that can work 00:11:16.235 --> 00:11:18.037 and can't work and the ones 00:11:18.076 --> 00:11:21.958 that can imply your ability 00:11:22.038 --> 00:11:23.938 to safely ride a bike. 00:11:24.539 --> 00:11:25.700 Because honestly, 00:11:25.720 --> 00:11:26.919 there's some adaptations 00:11:26.940 --> 00:11:28.360 that are just unsafe and 00:11:28.441 --> 00:11:31.601 not appropriate for the 00:11:31.642 --> 00:11:32.722 inclusion to a bike. 00:11:33.302 --> 00:11:34.623 And so we have to be careful of that. 00:11:34.743 --> 00:11:36.344 Just to kind of back up a little bit, 00:11:36.384 --> 00:11:38.725 that whole your aha moment about 00:11:39.835 --> 00:11:41.875 the adaptability of the bike 00:11:41.936 --> 00:11:43.515 and or the adjustability of 00:11:43.556 --> 00:11:45.817 the bike and the adaptation of the body. 00:11:46.777 --> 00:11:48.197 That was kind of first made 00:11:48.278 --> 00:11:52.019 popular by a guy named Andy Pruitt, 00:11:52.578 --> 00:11:53.658 who's done a lot of work, 00:11:54.379 --> 00:11:56.320 early work in this clinical 00:11:56.360 --> 00:11:58.640 scene where kind of was on 00:11:58.681 --> 00:12:00.721 the earlier side of making it popular. 00:12:00.740 --> 00:12:04.842 He would have a slide of of 00:12:04.923 --> 00:12:07.563 this groom with their bike 00:12:08.043 --> 00:12:08.964 on the wedding altar. 00:12:09.874 --> 00:12:10.994 talking about the marriage 00:12:11.094 --> 00:12:13.754 of the body to the bike and 00:12:14.014 --> 00:12:15.414 the bike is adjustable and 00:12:15.434 --> 00:12:17.575 the body is adaptable. 00:12:17.615 --> 00:12:17.995 And so that, 00:12:18.076 --> 00:12:19.456 that really is kind of carried, 00:12:19.836 --> 00:12:22.056 carried out to where you, you know, 00:12:22.076 --> 00:12:25.856 that was probably early nineties that, 00:12:26.236 --> 00:12:27.216 that he had his, 00:12:27.677 --> 00:12:28.977 that was on his slide deck. 00:12:29.057 --> 00:12:30.317 And so it really is, you know, 00:12:30.337 --> 00:12:32.437 that's really an important 00:12:32.498 --> 00:12:34.818 concept that we carry 00:12:34.879 --> 00:12:37.078 forward is the adaptation of 00:12:37.525 --> 00:12:39.366 of the bike position and 00:12:39.667 --> 00:12:41.206 acknowledging that the body 00:12:41.267 --> 00:12:42.548 also has to make some changes. 00:12:43.028 --> 00:12:43.248 Yeah. 00:12:43.528 --> 00:12:44.469 And understanding. 00:12:44.489 --> 00:12:45.208 So you really sort of, 00:12:45.788 --> 00:12:46.590 and for the person who's 00:12:46.629 --> 00:12:47.769 listening to this right now, who's like, 00:12:47.789 --> 00:12:49.311 well, I'm not really a bike expert, 00:12:50.431 --> 00:12:52.111 but you do bring a lot to 00:12:52.131 --> 00:12:53.572 the table as a physical therapist. 00:12:54.011 --> 00:12:55.013 First of all, understanding, 00:12:55.052 --> 00:12:56.634 I'm imagining what's going 00:12:56.734 --> 00:12:58.033 on or why might that happen? 00:12:58.173 --> 00:12:59.575 And then you get to think backwards, 00:12:59.595 --> 00:13:00.215 which is okay. 00:13:00.927 --> 00:13:01.869 how can we, how, 00:13:02.068 --> 00:13:03.389 how can we use what I know 00:13:03.428 --> 00:13:04.649 about biomechanics and what 00:13:04.669 --> 00:13:06.230 I can learn about bicycle 00:13:06.311 --> 00:13:07.552 geometry or bicycle 00:13:07.971 --> 00:13:09.572 mechanics to make this 00:13:09.893 --> 00:13:11.474 activity more enjoyable for 00:13:11.494 --> 00:13:12.014 the person and, 00:13:12.274 --> 00:13:13.975 and be able to do it better, pain-free, 00:13:14.014 --> 00:13:15.076 whatever their issue might be. 00:13:15.495 --> 00:13:16.356 Yeah, a hundred percent. 00:13:16.397 --> 00:13:17.777 You know, the, the physio, 00:13:17.817 --> 00:13:19.057 the physical therapist is 00:13:19.097 --> 00:13:21.438 really uniquely qualified 00:13:21.499 --> 00:13:22.460 to work in this space 00:13:22.519 --> 00:13:24.480 because of what they know about, uh, 00:13:25.041 --> 00:13:27.163 the human anatomy and human biomechanics, 00:13:27.643 --> 00:13:28.763 uh, knee function, uh, 00:13:30.309 --> 00:13:33.972 adaptation to strength, mobility, 00:13:34.933 --> 00:13:37.756 our ability, you know, day in and day out, 00:13:38.096 --> 00:13:39.418 when people talk about, oh, 00:13:39.477 --> 00:13:41.519 my right leg is doing something dorky, 00:13:41.860 --> 00:13:42.120 you know, 00:13:42.259 --> 00:13:43.802 we can look at the bike and try 00:13:43.841 --> 00:13:45.363 to do adaptation bike. 00:13:46.024 --> 00:13:48.004 But if we don't have the perspective of, 00:13:48.405 --> 00:13:51.548 hey, their hip is just crap, you know, 00:13:51.889 --> 00:13:53.169 it has no mobility. 00:13:53.850 --> 00:13:56.011 Closed pack position, I can't even, 00:13:56.072 --> 00:13:56.312 you know, 00:13:58.493 --> 00:13:59.714 That's the bigger picture is 00:13:59.734 --> 00:14:01.413 that they have that limitation, 00:14:01.474 --> 00:14:02.995 impairment, immobility. 00:14:03.995 --> 00:14:06.736 That's the bigger driver of how we take, 00:14:07.417 --> 00:14:09.158 we'd say adaptation or 00:14:09.317 --> 00:14:11.698 adjustment strategies on the bike. 00:14:11.798 --> 00:14:12.679 So it really, 00:14:13.139 --> 00:14:14.340 what we know as physios is 00:14:14.399 --> 00:14:16.100 really super critical 00:14:16.561 --> 00:14:19.702 towards we'd say most efficient, 00:14:19.802 --> 00:14:21.884 effective adaptations to the bike. 00:14:22.705 --> 00:14:24.046 So let's talk about assessment, right? 00:14:24.066 --> 00:14:25.426 That's a PT term. 00:14:25.486 --> 00:14:26.447 That's something PTs are 00:14:26.647 --> 00:14:27.628 pretty familiar with doing. 00:14:28.488 --> 00:14:29.148 What are maybe some 00:14:29.208 --> 00:14:31.129 differences or some 00:14:31.169 --> 00:14:32.350 techniques or tools that 00:14:32.389 --> 00:14:33.610 you might use with a 00:14:33.691 --> 00:14:35.231 cycling athlete that maybe 00:14:35.292 --> 00:14:36.272 someone who hasn't traded a 00:14:36.312 --> 00:14:38.192 cyclist before might not be 00:14:38.212 --> 00:14:39.494 accustomed to or might not think about? 00:14:40.375 --> 00:14:40.595 Well, 00:14:41.534 --> 00:14:43.775 I think when we talk about assessment 00:14:43.836 --> 00:14:44.517 of the cyclist, 00:14:44.697 --> 00:14:46.477 really the important thing 00:14:46.577 --> 00:14:48.918 is to start with the subjective. 00:14:49.198 --> 00:14:51.039 And so the subjective piece of it, 00:14:51.100 --> 00:14:52.061 you know, I spend... 00:14:54.149 --> 00:14:54.789 I spend some, 00:14:56.171 --> 00:14:57.731 I'll say my practice right 00:14:57.772 --> 00:14:59.452 now is cash-based. 00:14:59.552 --> 00:15:02.514 So I'm not like, oh gosh, 00:15:02.554 --> 00:15:03.416 I got to get this person 00:15:03.475 --> 00:15:05.277 out of here in 20 minutes sort of thing. 00:15:05.376 --> 00:15:07.738 So I take the time to ask 00:15:07.778 --> 00:15:09.899 questions because if I can 00:15:09.980 --> 00:15:11.000 ask some good questions, 00:15:11.860 --> 00:15:12.660 they're going to tell me 00:15:12.701 --> 00:15:13.802 what their problem is. 00:15:14.341 --> 00:15:15.722 And I think that's the 00:15:15.783 --> 00:15:16.864 challenge with today's 00:15:16.923 --> 00:15:18.904 healthcare delivery is we've lost that 00:15:19.849 --> 00:15:21.890 connection and ability to 00:15:22.010 --> 00:15:25.192 ask good questions of our patients, 00:15:25.232 --> 00:15:25.673 clients. 00:15:25.793 --> 00:15:27.174 And so when, 00:15:28.975 --> 00:15:30.836 so it starts there and it 00:15:30.996 --> 00:15:34.039 starts with asking good 00:15:34.299 --> 00:15:35.980 questions around how 00:15:36.020 --> 00:15:37.241 they're using their equipment, 00:15:38.403 --> 00:15:39.243 when they started, 00:15:39.302 --> 00:15:41.164 what's their development as a cyclist, 00:15:42.966 --> 00:15:45.548 what's their, you know, 00:15:46.232 --> 00:15:47.993 Have they had any bike crashes? 00:15:48.933 --> 00:15:49.173 You know, 00:15:49.274 --> 00:15:51.374 just sorts of like how they developed it. 00:15:51.653 --> 00:15:53.995 Are there pains only related to the bike? 00:15:54.414 --> 00:15:55.914 Do they have pains with other things? 00:15:56.335 --> 00:15:58.596 Do they have any past medical history? 00:15:59.255 --> 00:16:01.155 And so really that's 00:16:01.216 --> 00:16:02.817 probably the most critical thing. 00:16:02.856 --> 00:16:04.297 And then really when we talk 00:16:04.336 --> 00:16:06.937 about working with cyclists, 00:16:07.357 --> 00:16:08.618 the piece that sometimes 00:16:08.677 --> 00:16:10.177 the physio may not have is 00:16:10.217 --> 00:16:12.558 the ability to evaluate the 00:16:12.599 --> 00:16:13.719 person with their equipment. 00:16:14.897 --> 00:16:16.097 which is critical to me. 00:16:16.138 --> 00:16:19.198 It's like, if you have, we're physios, 00:16:19.259 --> 00:16:20.620 we watch people walk, right? 00:16:20.700 --> 00:16:22.260 So we watch them walk in. 00:16:22.660 --> 00:16:24.302 That tells a lot about who they are, 00:16:24.361 --> 00:16:25.022 what they do, 00:16:26.023 --> 00:16:27.504 what their impairments might be. 00:16:27.884 --> 00:16:28.683 If we have a runner, 00:16:28.724 --> 00:16:30.164 we watch them run on the treadmill. 00:16:31.025 --> 00:16:32.125 Why wouldn't we watch a 00:16:32.166 --> 00:16:32.947 person on the bike? 00:16:32.966 --> 00:16:34.006 So really when we talk about 00:16:34.027 --> 00:16:35.528 the assessment of 00:16:36.072 --> 00:16:36.932 a bicyclist, 00:16:37.011 --> 00:16:38.352 we have to look at them with 00:16:38.393 --> 00:16:40.673 their equipment and on the bike, 00:16:40.693 --> 00:16:42.174 if we're going to truly treat them. 00:16:42.195 --> 00:16:44.515 And what I tell physios, 00:16:44.556 --> 00:16:46.115 physical therapists is that 00:16:47.096 --> 00:16:48.157 if we're able to see them 00:16:48.177 --> 00:16:49.638 with their equipment and 00:16:49.778 --> 00:16:50.998 have like reasonable 00:16:51.317 --> 00:16:52.999 physical examination with them, 00:16:54.440 --> 00:16:55.919 we can come to resolution 00:16:55.980 --> 00:16:57.260 pretty quickly with regards 00:16:57.360 --> 00:16:59.261 to their problems and 00:16:59.302 --> 00:17:00.422 issues around the bike. 00:17:01.121 --> 00:17:02.423 I often tell this story like, 00:17:03.163 --> 00:17:05.526 Uh, the typical deal is, uh, 00:17:05.826 --> 00:17:07.727 a person may come in to a 00:17:07.787 --> 00:17:08.768 physio office and they get 00:17:08.867 --> 00:17:11.630 treated for knee pain for the bike. 00:17:11.750 --> 00:17:12.089 And, you know, 00:17:12.109 --> 00:17:14.612 they go through the different exercises. 00:17:14.672 --> 00:17:15.192 They're like, oh, 00:17:15.211 --> 00:17:17.012 you've got a weak glute medius. 00:17:17.053 --> 00:17:17.354 You know, 00:17:17.854 --> 00:17:19.634 I'll say every cyclist has a weak 00:17:19.654 --> 00:17:20.635 glute medius and it has 00:17:20.756 --> 00:17:22.037 nothing to do with their knee pain, 00:17:22.557 --> 00:17:23.478 but the, um, 00:17:24.057 --> 00:17:25.038 when you get them on their 00:17:25.078 --> 00:17:26.059 bike and you see that their 00:17:26.119 --> 00:17:28.480 cleat position is totally off. 00:17:29.001 --> 00:17:31.063 If all I do is change the cleat position. 00:17:31.990 --> 00:17:33.290 their knee is magically fine. 00:17:34.092 --> 00:17:38.012 And so it takes one visit to appropriately, 00:17:38.073 --> 00:17:40.173 effectively intervene for 00:17:40.193 --> 00:17:41.453 this person and then back 00:17:41.534 --> 00:17:42.334 out riding their bike, 00:17:42.374 --> 00:17:43.255 just happy and healthy. 00:17:44.095 --> 00:17:46.655 And so really then the 00:17:46.695 --> 00:17:48.155 evaluative tools around the 00:17:48.195 --> 00:17:49.656 bicycle are very simple, 00:17:50.957 --> 00:17:51.936 simple goniometer, 00:17:52.136 --> 00:17:53.458 gravity-based tools like 00:17:54.097 --> 00:17:56.058 levels and plumb bobs. 00:17:56.398 --> 00:17:57.838 There's lots of fancy tools 00:17:57.878 --> 00:17:59.680 that a person can use in evaluation, 00:17:59.700 --> 00:18:00.160 but really, 00:18:01.172 --> 00:18:04.335 for the, for most people, um, 00:18:05.234 --> 00:18:08.057 those fancy tools, they kind of, 00:18:08.999 --> 00:18:10.339 they can lead you asunder 00:18:10.380 --> 00:18:13.561 and they're full of, uh, error sources. 00:18:13.622 --> 00:18:15.943 So I would say for the vast 00:18:16.023 --> 00:18:17.424 majority of people using 00:18:17.445 --> 00:18:18.686 the simple tools and 00:18:18.707 --> 00:18:21.088 understanding good questions, 00:18:21.788 --> 00:18:23.150 good understanding of the 00:18:23.210 --> 00:18:26.452 physicality of your cyclists, um, you can, 00:18:26.692 --> 00:18:28.253 you can treat them very 00:18:28.334 --> 00:18:29.895 well and get great outcomes. 00:18:30.623 --> 00:18:30.823 Yeah. 00:18:31.502 --> 00:18:32.982 So even something as simple as a, 00:18:33.103 --> 00:18:34.144 as a bike trainer that you 00:18:34.183 --> 00:18:35.644 can put that human on and get, 00:18:35.884 --> 00:18:37.384 get them in the, in the cycling motion, 00:18:37.423 --> 00:18:39.525 that's, that's, that's low hanging fruit. 00:18:39.585 --> 00:18:39.744 Yeah. 00:18:39.785 --> 00:18:40.825 There it is right there. 00:18:41.365 --> 00:18:41.724 Yeah. 00:18:41.845 --> 00:18:43.266 I set this up in the background, 00:18:43.306 --> 00:18:43.986 but this is just, 00:18:44.645 --> 00:18:45.925 this is just a bike set up 00:18:46.006 --> 00:18:46.645 on the trainer. 00:18:47.105 --> 00:18:47.846 We level it up. 00:18:48.146 --> 00:18:49.207 And then, you know, I, 00:18:49.346 --> 00:18:51.487 I look at the bike for forensics, uh, 00:18:51.606 --> 00:18:52.606 forensic information, 00:18:52.646 --> 00:18:55.428 like their handlebar position, their, 00:18:55.448 --> 00:18:57.188 you know, their saddle, 00:18:57.228 --> 00:18:58.269 what's your saddle look like? 00:18:58.368 --> 00:18:59.909 Is it, is it roughed up in one area? 00:19:01.152 --> 00:19:01.352 you know, 00:19:01.412 --> 00:19:02.772 it's kind of funny as I'm getting 00:19:03.113 --> 00:19:04.993 on in clinical exam, you know, 00:19:05.013 --> 00:19:06.534 it's just like pattern recognition. 00:19:07.674 --> 00:19:09.414 If what you do in physios, 00:19:09.434 --> 00:19:11.816 you're like a SI specialist, like you say, 00:19:11.855 --> 00:19:13.676 really acts are, are you, 00:19:14.696 --> 00:19:16.137 you see a person walk across the room. 00:19:16.157 --> 00:19:17.258 You're like, Oh, you know, 00:19:18.318 --> 00:19:19.419 there's their problem. 00:19:19.638 --> 00:19:21.079 And so it's kind of at this 00:19:21.140 --> 00:19:23.381 point to where it's kind of 00:19:23.421 --> 00:19:25.102 at this point where I can 00:19:25.142 --> 00:19:25.862 have a bike walk, 00:19:26.142 --> 00:19:27.502 I'll have a bike walk in 00:19:27.522 --> 00:19:28.143 and it'll be like, Oh, 00:19:28.871 --> 00:19:29.411 Don't talk. 00:19:29.451 --> 00:19:30.310 Let me just fix this. 00:19:31.451 --> 00:19:35.031 And I don't exactly do that, 00:19:37.031 --> 00:19:38.373 but there's some things that you're like, 00:19:38.432 --> 00:19:38.952 oh my gosh, 00:19:38.972 --> 00:19:40.452 you've been riding this this way. 00:19:40.913 --> 00:19:42.932 And so if we just do some 00:19:42.972 --> 00:19:44.273 very simple things, 00:19:45.054 --> 00:19:46.594 but it starts with seeing 00:19:46.614 --> 00:19:47.193 their equipment. 00:19:47.874 --> 00:19:49.034 If we see their equipment 00:19:49.473 --> 00:19:50.815 and understand how they're 00:19:50.894 --> 00:19:52.055 interacting with it and how 00:19:52.095 --> 00:19:53.414 they're developing or how 00:19:53.454 --> 00:19:55.035 they're able to hold postures, 00:19:55.075 --> 00:19:57.496 how they're able to move in 00:19:57.536 --> 00:19:58.236 the pedal stroke, 00:19:59.881 --> 00:20:01.042 what gears they're using. 00:20:01.663 --> 00:20:02.825 Those are all super 00:20:02.884 --> 00:20:04.207 important bits of 00:20:04.307 --> 00:20:05.268 information towards 00:20:05.768 --> 00:20:06.930 understanding why they're 00:20:06.970 --> 00:20:08.451 visiting you with their dysfunction. 00:20:08.932 --> 00:20:10.054 You could have saved me a 00:20:10.094 --> 00:20:11.015 lot of time and effort and 00:20:11.055 --> 00:20:12.396 pain when you saw me riding 00:20:12.436 --> 00:20:13.878 like I had T-Rex arms. 00:20:13.939 --> 00:20:14.378 That would have been... 00:20:15.019 --> 00:20:15.881 That would have been a 00:20:16.121 --> 00:20:17.101 Phillips head screwdriver 00:20:17.162 --> 00:20:18.162 in about 30 seconds. 00:20:19.022 --> 00:20:19.702 But you touched on this a 00:20:19.762 --> 00:20:21.324 little bit in terms of 00:20:21.384 --> 00:20:22.785 equipment customization. 00:20:23.665 --> 00:20:23.885 You know, 00:20:24.165 --> 00:20:25.186 what role does equipment 00:20:25.227 --> 00:20:28.068 customization play in 00:20:28.368 --> 00:20:29.289 treating cycling injuries? 00:20:29.349 --> 00:20:30.290 It sounds like, hey, yeah, 00:20:30.310 --> 00:20:31.270 by pointing out that their 00:20:31.310 --> 00:20:32.471 cleat position is actually 00:20:32.511 --> 00:20:33.692 the thing that a little 00:20:33.712 --> 00:20:35.213 modification can go a long way. 00:20:35.874 --> 00:20:36.634 You sort of have to, 00:20:36.674 --> 00:20:37.715 if you're going to continue 00:20:37.736 --> 00:20:38.516 to see these athletes, 00:20:38.536 --> 00:20:39.176 you got to get more 00:20:39.237 --> 00:20:40.416 familiar with what can you 00:20:40.438 --> 00:20:42.479 do from that end, I'm imagining. 00:20:42.798 --> 00:20:43.500 Well, you know, 00:20:43.519 --> 00:20:44.640 I think that's the biggest 00:20:44.680 --> 00:20:45.721 challenge of the physio 00:20:45.740 --> 00:20:46.942 getting going in bike is 00:20:46.981 --> 00:20:48.042 just understanding the 00:20:48.103 --> 00:20:49.483 mechanical aspects of it 00:20:49.503 --> 00:20:50.584 and understanding which 00:20:50.664 --> 00:20:51.984 equipment is safe to use. 00:20:52.025 --> 00:20:54.567 And how do I even turn a screwdriver? 00:20:54.707 --> 00:20:54.946 Sure. 00:20:55.407 --> 00:20:56.288 Cause these are not cheap. 00:20:56.327 --> 00:20:57.068 Just so people know, 00:20:57.128 --> 00:20:58.230 like you start messing 00:20:58.250 --> 00:20:59.309 around with cyclist spikes 00:20:59.570 --> 00:21:00.510 and you're not doing it right. 00:21:00.730 --> 00:21:01.971 They're not going to be happy people. 00:21:02.251 --> 00:21:02.532 Yeah. 00:21:02.593 --> 00:21:03.353 So for example, 00:21:03.393 --> 00:21:04.973 my last two bikes last night, 00:21:05.114 --> 00:21:05.694 one was like a 00:21:08.133 --> 00:21:09.334 $12,000 time trial bike. 00:21:09.413 --> 00:21:10.954 And then the next one was 00:21:10.974 --> 00:21:14.537 like a $12,000 E road bike. 00:21:15.096 --> 00:21:16.877 And so, I mean, there, 00:21:16.958 --> 00:21:18.598 there's a level of match. 00:21:18.759 --> 00:21:21.441 I'll say level of maturation in, in how, 00:21:21.901 --> 00:21:22.481 how you, 00:21:22.741 --> 00:21:24.383 you serve this group and how you 00:21:24.423 --> 00:21:25.804 take care of their equipment, because, 00:21:25.824 --> 00:21:26.463 I mean, you don't want to, 00:21:27.287 --> 00:21:28.586 dork their equipment in your 00:21:28.967 --> 00:21:30.387 office space and then you 00:21:30.407 --> 00:21:31.788 need to also respect that a 00:21:31.847 --> 00:21:33.107 lot of this stuff is very 00:21:33.127 --> 00:21:34.689 it has weird mechanical 00:21:35.229 --> 00:21:36.788 attachments and fixes and 00:21:36.828 --> 00:21:38.089 then also understanding 00:21:38.130 --> 00:21:39.210 your scope of practice like 00:21:40.349 --> 00:21:41.510 can I make this change or 00:21:41.590 --> 00:21:43.770 how do I how do I partner 00:21:43.871 --> 00:21:46.251 with bike shops you know it 00:21:46.311 --> 00:21:47.451 really is no different than 00:21:47.531 --> 00:21:48.432 what we do in clinical 00:21:48.471 --> 00:21:49.633 practice in the sense that 00:21:50.053 --> 00:21:51.113 we have our scopes of 00:21:51.212 --> 00:21:52.633 practice where you know 00:21:52.653 --> 00:21:53.354 there's things that are 00:21:53.394 --> 00:21:54.814 appropriate for us to do and then 00:21:55.215 --> 00:21:56.536 There's, there's, uh, 00:21:56.876 --> 00:22:00.478 times where we need to, uh, refer out for, 00:22:00.498 --> 00:22:00.538 uh, 00:22:01.157 --> 00:22:02.699 further interventions or more 00:22:03.219 --> 00:22:04.699 appropriate interventions. 00:22:04.759 --> 00:22:05.759 And so that's really how 00:22:06.019 --> 00:22:07.099 there's things that I can do. 00:22:07.140 --> 00:22:07.700 You know, I've been, 00:22:08.760 --> 00:22:10.840 I've been wrenching on my bikes for years, 00:22:10.861 --> 00:22:12.362 you know, since I was a little, you know, 00:22:12.382 --> 00:22:13.442 as a little kid, you know, 00:22:13.461 --> 00:22:13.961 I've always been 00:22:14.102 --> 00:22:15.623 mechanically interested in 00:22:15.722 --> 00:22:17.323 turning wrenches on my bicycles. 00:22:17.383 --> 00:22:18.624 And so there's that 00:22:18.683 --> 00:22:20.064 background knowledge that, you know, 00:22:20.744 --> 00:22:22.025 bikes from the, not to 00:22:23.083 --> 00:22:26.164 give away my age, but I'm secure in my age, 00:22:26.204 --> 00:22:27.066 so it's fine. 00:22:27.865 --> 00:22:29.166 But back in the 70s, 00:22:29.227 --> 00:22:29.987 I was tearing apart my 00:22:30.027 --> 00:22:30.867 bikes all the time. 00:22:31.868 --> 00:22:34.089 And the bikes these days are 00:22:34.130 --> 00:22:34.730 very different. 00:22:34.750 --> 00:22:36.191 We've gone to much more 00:22:36.592 --> 00:22:41.213 technically intricate bikes 00:22:41.515 --> 00:22:43.435 that require special attention. 00:22:43.476 --> 00:22:44.777 And so it's not just like, oh, 00:22:44.856 --> 00:22:45.737 I'm going to take a weekend 00:22:45.797 --> 00:22:46.538 course on bikes, 00:22:46.577 --> 00:22:48.118 and then I'm going to be a bike fitter. 00:22:48.159 --> 00:22:48.419 It's like, 00:22:48.907 --> 00:22:50.167 Oh my gosh, I need tools. 00:22:50.228 --> 00:22:50.728 I need to have the 00:22:50.768 --> 00:22:51.588 perspective of how to 00:22:51.648 --> 00:22:53.548 attach these bikes to stand, you know, 00:22:53.588 --> 00:22:54.969 just simply attaching a 00:22:55.009 --> 00:22:56.210 bike to a stand these days. 00:22:56.289 --> 00:22:57.710 It's not easy. 00:22:58.329 --> 00:22:59.450 You know, there's some, 00:22:59.730 --> 00:23:01.131 there's some trickiness to it. 00:23:01.330 --> 00:23:02.851 And so, um, 00:23:03.151 --> 00:23:06.211 so it is this type of practice 00:23:06.271 --> 00:23:07.152 I'll say is not for 00:23:07.251 --> 00:23:09.492 everybody and really almost 00:23:09.573 --> 00:23:11.113 kind of have to have to be 00:23:11.173 --> 00:23:12.913 the triple threat, if you will, 00:23:12.952 --> 00:23:15.574 of clinicians where physio. 00:23:17.070 --> 00:23:18.432 Some bike background 00:23:18.491 --> 00:23:20.874 understanding and then mechanical skills. 00:23:21.433 --> 00:23:22.555 So you really, 00:23:22.755 --> 00:23:24.876 it's just like your example of fixing the, 00:23:25.116 --> 00:23:25.277 you know, 00:23:25.297 --> 00:23:27.618 we talked earlier before the recording, 00:23:27.659 --> 00:23:28.400 you know, you had that, 00:23:28.559 --> 00:23:29.921 that you were out riding 00:23:29.961 --> 00:23:30.642 your bike and you didn't 00:23:30.662 --> 00:23:31.662 know how to fix a flat. 00:23:32.222 --> 00:23:33.423 And it's like, 00:23:34.084 --> 00:23:35.345 if you don't know how to 00:23:35.424 --> 00:23:36.425 turn these wrenches and 00:23:36.465 --> 00:23:37.987 appropriately tension bolts 00:23:38.126 --> 00:23:39.327 to parts and pieces, 00:23:40.528 --> 00:23:43.030 that one exposes you to liability. 00:23:43.510 --> 00:23:46.834 Two, it doesn't help your patient client. 00:23:47.801 --> 00:23:50.384 So it really, you do have to, 00:23:52.585 --> 00:23:53.565 as much as people have 00:23:53.605 --> 00:23:54.645 enthusiasm for this, 00:23:54.685 --> 00:23:56.047 you do have to have some 00:23:56.086 --> 00:23:59.009 base understanding of these things. 00:23:59.669 --> 00:24:02.431 And really when I'm working, you know, 00:24:02.651 --> 00:24:05.132 I pretty much only see bike, you know, 00:24:05.152 --> 00:24:06.813 I have a little tiny bit of 00:24:06.853 --> 00:24:08.394 orthopedic practice these days, 00:24:08.433 --> 00:24:10.134 but it's all bike. 00:24:10.214 --> 00:24:10.575 And so, 00:24:11.855 --> 00:24:13.797 but to have that array of like 00:24:14.416 --> 00:24:16.038 bikes that come in, you know, 00:24:16.097 --> 00:24:16.979 I have like from, 00:24:17.961 --> 00:24:19.301 The seventies bikes all the 00:24:19.342 --> 00:24:20.943 way up to today's bikes, 00:24:21.023 --> 00:24:24.346 which are vastly different, uh, in how we, 00:24:24.626 --> 00:24:27.189 how we can adjust them and adapt them. 00:24:28.442 --> 00:24:29.242 Well, let's talk about this. 00:24:29.282 --> 00:24:30.403 We talked a lot about, you know, 00:24:30.682 --> 00:24:32.263 a little bit about modifications, right? 00:24:32.284 --> 00:24:33.345 A cleat position, 00:24:33.605 --> 00:24:35.066 a saddle height or a saddle 00:24:35.105 --> 00:24:36.426 pitch might change things. 00:24:37.268 --> 00:24:38.468 But let's take the two 00:24:38.868 --> 00:24:40.068 common injuries that you talked about, 00:24:40.108 --> 00:24:41.869 which is anterior knee pain or low back. 00:24:42.530 --> 00:24:43.711 What preventative measures 00:24:44.352 --> 00:24:45.992 typically can cyclists take 00:24:46.113 --> 00:24:48.275 to avoid those common injuries? 00:24:48.434 --> 00:24:49.895 How do you educate your 00:24:49.935 --> 00:24:52.017 cyclist to avoid that 00:24:52.136 --> 00:24:53.617 anterior knee pain or maybe 00:24:53.657 --> 00:24:55.159 that low back issue before 00:24:55.199 --> 00:24:56.019 it becomes something that 00:24:56.038 --> 00:24:56.839 keeps them off the bike? 00:24:57.796 --> 00:24:58.056 Yeah. 00:24:58.096 --> 00:25:00.155 You know, when people progress it, 00:25:00.195 --> 00:25:00.977 so for example, 00:25:01.017 --> 00:25:03.836 if I'm never ridden a bike, 00:25:04.977 --> 00:25:05.757 one of the things, 00:25:06.518 --> 00:25:08.117 the first thing is starting 00:25:08.218 --> 00:25:09.377 out with the right size of 00:25:09.438 --> 00:25:11.637 equipment or the right size of bike. 00:25:11.718 --> 00:25:12.959 And so there's ways of 00:25:13.499 --> 00:25:14.838 acquiring that equipment. 00:25:15.479 --> 00:25:16.038 You know, 00:25:16.118 --> 00:25:18.500 bike shops are great places to 00:25:18.559 --> 00:25:20.819 start to find the right size of bike. 00:25:20.859 --> 00:25:23.119 Sometimes, you know, it doesn't work out, 00:25:23.200 --> 00:25:24.901 but that's, you know, for the most part, 00:25:24.941 --> 00:25:25.840 it generally works out. 00:25:25.901 --> 00:25:26.500 You know, bike shop, 00:25:26.929 --> 00:25:28.169 is pretty darn good about 00:25:28.209 --> 00:25:32.509 getting you the right basic size of bike. 00:25:32.650 --> 00:25:33.789 Then from there, 00:25:34.570 --> 00:25:35.790 it's understanding that 00:25:35.931 --> 00:25:38.371 there will be positional changes. 00:25:38.431 --> 00:25:40.592 So when we look at a person 00:25:40.632 --> 00:25:41.771 who's starting out on bike, 00:25:42.311 --> 00:25:44.251 it starts with kind of 00:25:45.573 --> 00:25:47.553 maybe a basic rudimentary 00:25:47.673 --> 00:25:49.113 bike fit or bike changing 00:25:49.153 --> 00:25:50.314 of the bike position to 00:25:50.394 --> 00:25:52.534 improve their postural 00:25:52.653 --> 00:25:56.575 tolerance and gait function on the bike. 00:25:57.724 --> 00:25:58.944 And that can be, you know, 00:25:59.404 --> 00:26:00.546 I'll say a lot of times 00:26:00.605 --> 00:26:01.846 people these days are doing 00:26:01.885 --> 00:26:02.945 the DIY things. 00:26:03.006 --> 00:26:03.767 So they're watching a lot of 00:26:03.807 --> 00:26:06.406 YouTube videos or watching this and that. 00:26:06.446 --> 00:26:08.087 And they're like, ah, you know, this is, 00:26:08.127 --> 00:26:08.748 these are the good 00:26:08.788 --> 00:26:09.847 recommendations and things 00:26:09.907 --> 00:26:11.648 to try to try to try to get 00:26:11.709 --> 00:26:12.288 this taken care of, 00:26:12.308 --> 00:26:14.429 but acknowledging that bike 00:26:14.489 --> 00:26:16.630 fit has some or bike positioning. 00:26:16.690 --> 00:26:17.630 I like to call it bike 00:26:17.690 --> 00:26:18.869 positioning has something 00:26:18.910 --> 00:26:20.010 to do with your postural 00:26:20.050 --> 00:26:22.090 tolerance and pedaling function. 00:26:22.931 --> 00:26:25.112 Then it's proper. 00:26:26.448 --> 00:26:28.208 progression of training and 00:26:28.327 --> 00:26:29.108 pedaling skills. 00:26:29.568 --> 00:26:32.409 And it's not just as easy as 00:26:32.469 --> 00:26:33.128 riding a bike. 00:26:33.470 --> 00:26:34.809 And so, as I like to say, 00:26:34.829 --> 00:26:36.970 it's as easy as riding a bike. 00:26:36.990 --> 00:26:38.830 But riding a bike's not that easy. 00:26:38.851 --> 00:26:40.510 I mean, there's a lot of things to go on. 00:26:40.570 --> 00:26:41.851 It's one thing to pedal the bike. 00:26:41.891 --> 00:26:43.092 It's one thing to keep the 00:26:43.112 --> 00:26:45.392 bike upright in all different conditions. 00:26:45.711 --> 00:26:47.972 And that doesn't just happen 00:26:47.992 --> 00:26:49.432 through watching a YouTube video. 00:26:49.653 --> 00:26:50.353 I mean, you have, 00:26:50.553 --> 00:26:51.813 or riding the trainer 00:26:51.853 --> 00:26:54.253 indoors while watching Netflix. 00:26:55.348 --> 00:26:56.589 you have to be outside 00:26:56.650 --> 00:26:57.509 riding your bike and you 00:26:57.549 --> 00:26:58.450 have to go through certain 00:26:58.509 --> 00:26:59.951 progression of skill 00:26:59.990 --> 00:27:01.290 development in order to 00:27:01.332 --> 00:27:02.311 keep the bike upright, 00:27:02.352 --> 00:27:06.594 in order to provide yourself with a good, 00:27:07.074 --> 00:27:09.075 reasonable biomechanical stimulus. 00:27:10.075 --> 00:27:12.855 And so I think acknowledging 00:27:12.895 --> 00:27:13.756 that there's a progression 00:27:13.776 --> 00:27:14.916 and you're not just going to say, oh, 00:27:14.936 --> 00:27:15.817 I'm going to buy a bike and 00:27:15.856 --> 00:27:18.877 do a century drive in a couple of months. 00:27:19.258 --> 00:27:21.638 It's just, I have those people, 00:27:22.480 --> 00:27:22.980 those people, 00:27:23.567 --> 00:27:26.008 buy bikes and try to do like, for example, 00:27:26.189 --> 00:27:27.288 in Seattle or in the 00:27:27.328 --> 00:27:29.309 Pacific Northwest where I'm located, 00:27:29.369 --> 00:27:32.152 we have a, a big bicycle ride, um, 00:27:32.711 --> 00:27:34.953 called Seattle to Portland that in July, 00:27:34.973 --> 00:27:35.493 mid July, 00:27:36.034 --> 00:27:37.935 it's either a one day or a two 00:27:37.976 --> 00:27:40.436 day ride from Seattle to Portland. 00:27:40.797 --> 00:27:42.557 It's 200 miles people. 00:27:42.999 --> 00:27:45.279 There are people who buy new 00:27:45.319 --> 00:27:46.760 bikes and take up cycling 00:27:47.161 --> 00:27:48.662 and start training in March 00:27:49.102 --> 00:27:50.323 for this ride in July. 00:27:52.568 --> 00:27:54.250 it's really tough I mean 00:27:54.349 --> 00:27:55.590 it's it's hard to do 00:27:55.691 --> 00:27:56.811 particularly for people 00:27:56.852 --> 00:27:58.532 without athletic background 00:27:59.012 --> 00:28:00.233 to just pick up equipment 00:28:00.273 --> 00:28:01.713 and do this and so but 00:28:01.733 --> 00:28:02.674 they've watched youtube 00:28:02.714 --> 00:28:03.976 videos and things like that 00:28:04.096 --> 00:28:05.416 which might say oh yeah you 00:28:05.457 --> 00:28:06.656 can do it and here's the 00:28:06.676 --> 00:28:07.557 bike fit you're gonna be 00:28:07.817 --> 00:28:09.939 fine and but physically 00:28:09.979 --> 00:28:10.880 it's really difficult 00:28:11.039 --> 00:28:12.240 difficult with regards to 00:28:12.340 --> 00:28:14.182 adaptation and so you know 00:28:14.201 --> 00:28:16.042 I think again understanding 00:28:16.433 --> 00:28:17.775 That it's a physical task 00:28:17.994 --> 00:28:19.695 that takes adaptation time 00:28:20.256 --> 00:28:21.256 and that the position of 00:28:21.276 --> 00:28:23.336 the bike is super duper important. 00:28:23.778 --> 00:28:24.617 And then after that, I mean, 00:28:24.657 --> 00:28:26.919 there's things like nutrition, uh, like, 00:28:27.179 --> 00:28:30.000 uh, ration, uh, you know, how to fuel, 00:28:30.060 --> 00:28:33.561 how to eat, how to eat well, recovery, uh, 00:28:33.883 --> 00:28:34.923 things like sleeping. 00:28:36.483 --> 00:28:37.903 So there's all these, you know, 00:28:37.964 --> 00:28:38.825 all these different things, 00:28:38.964 --> 00:28:39.825 basic bike skills. 00:28:39.845 --> 00:28:41.205 Like how do I stop safely? 00:28:41.306 --> 00:28:42.666 How do I corner safe? 00:28:42.747 --> 00:28:42.987 Yeah. 00:28:43.547 --> 00:28:45.008 How do I stand up and pedal? 00:28:45.693 --> 00:28:46.654 There's lots of people who 00:28:46.694 --> 00:28:48.076 don't even can't do that, 00:28:48.156 --> 00:28:50.459 can't afraid to take a hand off a bar. 00:28:50.499 --> 00:28:51.900 You know, they're like, oh, you know, 00:28:52.080 --> 00:28:52.721 I can't do it. 00:28:53.122 --> 00:28:53.382 Right. 00:28:53.402 --> 00:28:55.124 So oftentimes, you know, 00:28:55.144 --> 00:28:57.165 there are sports skills 00:28:57.226 --> 00:28:59.788 required to safely use your bike. 00:29:00.328 --> 00:29:03.712 And lots of people don't have them. 00:29:04.032 --> 00:29:05.054 Some of those sports skills 00:29:05.114 --> 00:29:06.796 are limited by the position of the bike, 00:29:06.836 --> 00:29:06.955 too. 00:29:08.476 --> 00:29:08.796 All right. 00:29:09.596 --> 00:29:10.797 So if you were giving advice, 00:29:10.836 --> 00:29:11.798 if someone's still nodding 00:29:11.837 --> 00:29:12.978 along with us and they're saying, 00:29:12.998 --> 00:29:13.278 you know, 00:29:14.078 --> 00:29:15.459 I'd like to get into or 00:29:15.519 --> 00:29:16.259 something I've got on my 00:29:16.299 --> 00:29:17.500 schedule in the next couple of days, 00:29:17.980 --> 00:29:18.961 what advice would you give 00:29:19.040 --> 00:29:19.922 to a physical therapist 00:29:19.942 --> 00:29:21.061 looking to specialize in 00:29:21.102 --> 00:29:22.042 treating cyclists? 00:29:22.462 --> 00:29:23.983 What's the 101? 00:29:24.084 --> 00:29:24.463 Like, okay, 00:29:24.483 --> 00:29:25.503 I've listened to what Eric said. 00:29:25.523 --> 00:29:26.184 I've put some of these 00:29:26.224 --> 00:29:27.125 things into practice. 00:29:27.545 --> 00:29:28.905 What might be the next step 00:29:28.925 --> 00:29:30.386 or the next place that you'd send them? 00:29:32.367 --> 00:29:35.269 Well, kind of looking back to my story, 00:29:35.288 --> 00:29:37.009 I would... 00:29:38.314 --> 00:29:40.736 I would go to PubMed and 00:29:40.836 --> 00:29:43.678 type in bicycle and just 00:29:43.698 --> 00:29:44.557 start doing research. 00:29:45.098 --> 00:29:45.298 Yeah. 00:29:45.618 --> 00:29:46.398 You know, there's a lot of, 00:29:47.160 --> 00:29:47.940 I'll say a lot of 00:29:48.240 --> 00:29:52.383 well-intending authority 00:29:52.462 --> 00:29:54.064 figures on YouTube who will 00:29:54.265 --> 00:29:58.207 tell you all sorts of stuff 00:29:58.366 --> 00:29:59.567 that I oftentimes spend 00:29:59.607 --> 00:30:00.709 myth busting with people. 00:30:00.808 --> 00:30:00.969 But 00:30:02.512 --> 00:30:03.314 But I would start with the 00:30:03.354 --> 00:30:05.397 research and understand 00:30:05.657 --> 00:30:08.082 some of the clinical and 00:30:08.343 --> 00:30:10.767 basic science and math and 00:30:10.926 --> 00:30:12.390 physics of bicycling. 00:30:14.588 --> 00:30:15.249 I find, 00:30:15.548 --> 00:30:18.549 I have found in my past that leaning in, 00:30:19.109 --> 00:30:20.070 almost thinking like a 00:30:20.111 --> 00:30:23.832 mechanical engineer in how 00:30:23.892 --> 00:30:26.152 we deal with pedaling, pedaling function, 00:30:27.012 --> 00:30:28.093 positioning on the bike, 00:30:29.153 --> 00:30:30.653 makes you so much more of a... 00:30:33.248 --> 00:30:35.929 efficient bicycle clinician. 00:30:36.069 --> 00:30:38.451 So I think really starting there. 00:30:38.990 --> 00:30:40.712 And then I would say in 00:30:41.553 --> 00:30:42.693 looking at the research, 00:30:42.874 --> 00:30:44.934 don't just look at the last 00:30:45.015 --> 00:30:46.336 five years and assume that 00:30:46.355 --> 00:30:49.137 that's the only valid body of research. 00:30:49.898 --> 00:30:50.759 There's some really 00:30:50.818 --> 00:30:52.800 important stuff that's throughout the, 00:30:53.260 --> 00:30:53.480 you know, 00:30:54.421 --> 00:30:57.303 the 80s 90s 2000s 2010s 00:30:57.722 --> 00:31:00.423 2020s so don't just look at 00:31:00.525 --> 00:31:02.105 like current research and 00:31:02.144 --> 00:31:03.665 assume that's the sure 00:31:03.826 --> 00:31:05.047 that's the most informed 00:31:05.086 --> 00:31:07.828 research sure so so I don't 00:31:07.848 --> 00:31:08.989 know I i would start there 00:31:09.028 --> 00:31:09.809 and then there's always 00:31:09.890 --> 00:31:11.891 classes I mean I i teach 00:31:12.330 --> 00:31:14.092 some classes uh and there's 00:31:14.372 --> 00:31:15.873 I'll say there's been some 00:31:15.932 --> 00:31:18.173 spin-off tributes uh uh to 00:31:18.214 --> 00:31:19.055 some of the stuff I've 00:31:19.075 --> 00:31:22.156 taught and then also some uh 00:31:22.817 --> 00:31:24.498 just people who've been interested. 00:31:26.019 --> 00:31:27.461 AOPT, I have to mention, 00:31:27.480 --> 00:31:29.182 they do have an independent study course. 00:31:29.622 --> 00:31:30.542 That one sort of rolled 00:31:30.603 --> 00:31:32.144 cycling in with a couple 00:31:32.183 --> 00:31:33.164 other disciplines too. 00:31:33.484 --> 00:31:35.046 And it's ISC, 00:31:35.106 --> 00:31:36.146 Physical Therapist Management 00:31:36.186 --> 00:31:38.068 of Individuals Who Cycle, Surf, 00:31:38.628 --> 00:31:39.349 and Rock Climb. 00:31:39.630 --> 00:31:40.871 So they sort of bundled 00:31:40.891 --> 00:31:42.031 those together in one 00:31:42.352 --> 00:31:43.272 independent study course. 00:31:43.673 --> 00:31:45.013 Let me ask you this last question. 00:31:45.875 --> 00:31:48.636 Do I need to be a cyclist to 00:31:48.676 --> 00:31:49.436 be a great physical 00:31:49.457 --> 00:31:51.358 therapist who treats cyclists? 00:31:54.855 --> 00:31:57.497 I like that. 00:31:57.616 --> 00:31:58.117 Made you thick. 00:31:58.137 --> 00:31:58.498 I like it. 00:31:59.699 --> 00:32:02.602 I think it really helps. 00:32:03.021 --> 00:32:05.263 Yeah. 00:32:06.265 --> 00:32:07.266 That's probably one of the 00:32:07.425 --> 00:32:09.807 biggest pieces of advice I 00:32:09.847 --> 00:32:12.849 give people is go ride a 00:32:12.871 --> 00:32:15.292 bike and understand it. 00:32:15.653 --> 00:32:18.555 I think for me to be the 00:32:18.675 --> 00:32:20.537 clinician that I am and for 00:32:20.557 --> 00:32:22.598 the opportunities that I've had, 00:32:23.894 --> 00:32:26.674 it's been because I've been 00:32:26.694 --> 00:32:28.194 a bicyclist and I 00:32:28.474 --> 00:32:30.336 understand the rigors and mechanics of, 00:32:30.776 --> 00:32:31.675 of this and the other. 00:32:32.675 --> 00:32:39.577 And so, um, so I would say that, um, 00:32:41.298 --> 00:32:42.759 it's very helpful to ride a bike, 00:32:44.058 --> 00:32:46.400 just like if I were to, um, 00:32:48.971 --> 00:32:51.173 mentor a person a clinician 00:32:51.272 --> 00:32:52.914 who is wanting to treat any 00:32:52.954 --> 00:32:54.615 other practice group sure 00:32:55.176 --> 00:32:57.939 running triathlon whatever 00:32:58.219 --> 00:33:00.641 any other sport you have to 00:33:02.722 --> 00:33:03.824 it just makes it so much 00:33:03.884 --> 00:33:07.507 better sure so I i would 00:33:07.567 --> 00:33:08.868 encourage I would encourage 00:33:09.048 --> 00:33:10.029 everyone to ride a bike of 00:33:10.089 --> 00:33:14.814 course but yeah ride a bike 00:33:15.528 --> 00:33:16.328 All right. 00:33:16.368 --> 00:33:17.329 The input study course I 00:33:17.369 --> 00:33:19.490 mentioned can be found at AOPT's website, 00:33:19.510 --> 00:33:22.612 and that is orthopt.org. 00:33:22.791 --> 00:33:23.011 Eric, 00:33:23.031 --> 00:33:24.173 appreciate the time giving us some 00:33:24.252 --> 00:33:26.534 insight on the athletes on two wheels. 00:33:27.354 --> 00:33:28.515 Thank you so much for having me.