The need for better diagnostics.

In the past few weeks I’ve run into a number of fitting issues which have pointed out the need for better diagnostics. The first was a rider I had fit in the past who had developed a hip issue that either pointed at the TFL or bursa sack. The initial adjustment I made should have reduced the tension of the TFL, so it was a process of elimination. Nothing seemed to change. I then decided to see what was really going on by using the Fit Kit R.A.D. pedals. I had to remove the Speedplan cleats, install Shimano SPD-SL cleats and watched them pedal the bike. The R.A.D. pedals showed almost 15 degrees of rotation which I hadn’t been able to see with SpeedPlay cleats because of the stops. I adjusted the Shimano cleat based on the angle, then drew a parallel line on the shoe. With the Speedplay cleat remounted I set the adjustment screws to accommodate the angle, and the problem went away.

The second case was dealing with FAI (femoral acetabula infringement) on SPD cleats that have no lateral float. FAI is accommodated in walking because when the foot leaves the ground it’s free to go where it wants. On the bike the foot has to follow the travel of the crank, which is always parallel with the frame. On road pedals the solution is to get the alignment in the ball park and us a pedal that has lateral float like SPD-SL yellow cleat or older Time pedals. There are no such options in recessed cleats. The base alignment of this client was well outside the normal bell curve – they had a wider stance than normal pedals could handle. There are no Shimano SPD pedals with longer spindles, so the answer in this case were “knee savers”. Knee Savers are steel spacers that move the pedals outboard. The problem is the shortest spacers need to be longer than the threaded section of a pedal, or 2cm. That put the client in the ball park, the lateral adjustment on the cleats would do the rest. The problem was in fine tuning, the first adjustment was too far outboard. The complaint was the heels were moving inward and some hip pain (very common with FAI). I once again used the R.A.D. pedals, this time with the knee spacers. I saw the heel kick inward at the back of every pedal stroke. I then reduced the outward adjustment with the lateral cleat adjustment until the pedals were stable as he pedaled. We also tested this at higher effort levels to make sure.