Friday, December 2, 2016

Functional and Integrative Medicine

I recently attended a course that spoke of "functional and integrative medicine". What exactly does that mean?  And how does that apply to physical therapy?  Functional in the sense of improving health and wellness through purposeful movements.  Integrative by way of caring not only for one's body, but mind and well being. 

In a word, it's a "holistic" way of approaching care.  In many ways, my colleagues and I already practice in this manner.  A patient/client is not a diagnosis on a prescription.  They are an individual person with individual lifestyles/personalities.  Treating a patient/client as a whole, not just a body part. 

As crude as it sounds, many clinics simply don't have the time to focus on you as a whole person, but you as a body part and only a body part.  This is why we promote patient focused one on one care.  We want you better and we'll take the time to do it.  It's not that health care practitioners don't want to spend more time with their patients, the current environment is not conducive to it for reasons I will not address in this post.  It's unfortunate, but that is the reality of health care in the US.  Sadly, many have accepted it.  Honestly, this is your health.  YOU should care.  Ok, I'm stepping down from my soapbox.

There is more to the puzzle than just a body part to fix.  Lifestyle, mindset/personality, nutrition, physical function, support all play a role in how we get injured and how we recover.  In my years of practice, I can determine the prognosis of a patient with all of these factors in mind.  In terms of modifying some of these factors to work in favor of the patient will be determined by the patient themselves.  Change is hard, I get it.  However, if change does not occur, are you willing to go on as is?  My role as a health care provider is to not only help you, but empower you to be proactive in your own physical and mental well being.  I can guide you in the right direction, but you must eventually take the reins.

Many times I have clients that ask for my advice or act as a sounding board.  I'm happy to listen.  If it helps my clients improve, then, by all means, please, I'm happy to listen and provide feedback, if wanted, on strategies that may continue to help you.  As part of my education background, I've taken many a psychology course.  While I do understand that does not make me a psychologist or a psychiatrist, I understand how the mind works.  Through sport and self education, there are many lessons I have learned on how to approach many of the annoyances and hardships that life throws your way.  The thing between your ears is very powerful.  Use with care.

On the functional side of things, purposeful movement and training of the body hone in your body and self awareness.  Athletes are known to have great awareness of their bodies. 

As a physical therapist, I look for efficiency of movement and posture.  This is not a generalized statement.  I want to know what you do in your life (work and play) and how you interact physically within these environments.  WHY?  Because these two things, if lacking, will cause a cascade breakdown of the body resulting in increased risk of injury.  These functional movements promote neuromuscular re-education of how muscles are activated and recruited to produce efficient movement patterns in line with how the body is designed.  I've always said, "It's not WHAT we do that hurts us, it's HOW we do it". 

The downside is that our bodies are primal in instinct meaning it will figure out a way to work around pain at the sacrifice of other structures, unbeknownst to itself.  Compensations can lead to other issues if not halted.  This not only pertains to movements themselves, but to changes in the physiology of muscle functioning.  If we let the problem persist, then the compensations become hardwired, rewriting the original efficient program.

Functional movements and training work to reprogram these faulty patterns to reestablish the original efficient program filed away in the inactive drawer of our brain.  In order rewire these patterns, it takes time.  Just like it took time to develop bad patterns, it will take time to dust off the old program.  Persistence and commitment to the process WILL lead to a healthier version of you in the long term.  Again change is hard.  Developing new habits is hard.  I do my best to instill this holistic approach because I want to see the best version of my clients. 

Functional and integrative medicine is a balance of all facets of well being.  The focus is on YOU not just treating your injury but also help prevent future injuries from occurring (hopefully).

Wednesday, July 13, 2016

Part 7: The Season Begins...Race Mode: a whole other animal.

This is part of the bike fitting and saddle series from the perspective of your physical therapist and competitive triathlete.

Part 6 lead us through more saddle testing, bumps in the road, and finally settling on saddle.  So, what would race day bring?  Were the last 7 months of saddle torment and dialing in my new bike fit pay off?  Would my feet be happy?  How would my body react to race pace efforts in my new position?

The race day test.

Race effort was really going to tell us a lot.  It is not something you can simulate well.  The mind set, the intensity, the effort, the competitiveness... the heat of the moment (in some sense this was literal) it only happens on race day.  Trusting months of training to unleash the race beast.  My short pre-race ride went well.  The saddle with my thin chamois shorts and the set up felt pretty good.  I was feeling excited and ready to roll. 

During the race itself, I was riding well, feeling aero and fast.  The one thing race day threw at me were the conditions: hot and WINDY.  The heat for this race was nothing new.  The winds on the other hand were blowing a bit more than other years.  Of the 56 miles, I swear 40 of it was directly into 15-25 mph head wind.  It was brutal.  I felt fast on my bike, but the winds made you work that much harder.  Race intensity had me moving all over the saddle.  Ride on the rivet, scoot back, ride on the rivet, scoot back.  I wasn't sure why but I know I tend to ride the nose during races.  About 90 minutes or so into the bike, my back started to get sore, my upper back and shoulders were tense and sore, and my nether regions were none too happy.  Now, objectively, it is hard to determine whether this was all a bad thing or not.  I rarely ride at this intensity in this folded over position on my bike in training for 99% of 56 miles.  Training and racing mode are clearly TWO different beasts.

The variables contributing to the tension I felt:

-race mode (your whole body tenses up in the heat of the battle)
-soaking up the asphalt (bumps, cracks, chip seal, pot holes, etc.)
-drastically new position at race intensity
-3rd real ride outside
-the winds (trying not to get blown off your bike)
-scooting back and forth on the saddle constantly

It is different than riding your stationary trainer because's stationary.  On the trainer, you can relax the postural muscles somewhat used to balance yourself on your bike while interacting with your environment outside.  From how I was feeling and moving around so much, my body had not adapted nor adjusted to my outdoor demands.  Stupid weather.  I maintained my objectivity of my race experience.  I was my own guinea pig in this experiment around my bike fit.

Curious to hear how things went at the race, I sent Chris my race report.  He was ecstatic over most of my results, while I was only luke warm over my performance.  I say he was "mostly" tickled with my results as he was equally unhappy as I was with my run.  He wondered why?  I'm faster than what I put out on race day.  My quads cramped throughout the first mile of the run and the heat made the shadeless run course feel like an oven.  I know I can't control conditions.  I can only control my attitude, my training, my nutrition, my recovery, my sleep, my effort, etc.  As a consequence, it directly influences what my body was willing to give back.  During the run, my body was in a minor state of revolt.  

Post race analysis had me questioning everything except my equipment.  I was not fully heat acclimated (nobody else was either), I didn't have enough bike to run transitions under my belt (weather limited), and my sleep was not good during race week for whatever reason.  Despite the discomfort on the bike during the race, I sucked it up and battled through.  Take what the day gives you.  It was a solid effort, but not what I know I can put out.  You could say, I wasn't satisfied.

Chris and I discussed my discomforts and wondered if there was another small little tweak we needed to make to lessen the stress on those areas.  After a bit of back and forth discussion, we decided to swap to a shorter stem (by 10 mm) to see if that would improve my overall body comfort, distributing my body weight better from front to back.  We didn't even mention much of the saddle.  Apparently, I have now become a long term study.  He wanted this saddle to work. 

First ride with the shortened stem resulted in what felt like a better more natural body position.  Not too cramped, not too stretched even at effort.  No abnormal discomforts in my shoulders or my back.  It seems we've found my sweet spot for my cockpit length.  The shorter stem has shifted some of my weight back onto my saddle.  Speaking of saddles, the saddle continued to be problematic.  Chris remained hopeful that this tweak would settle me into saddle nirvana.  I was having my doubts as I tried to just roll with it and not get caught up in the annoyance and frustration of it all. 

After a couple more outdoor rides, I modded the saddle itself in an effort to shave a few millimeters off the width.  It was nothing drastic, since the saddle was technically still on loan from Chris.  I noticed the padding of the saddle softened in my time riding on it.  As a result, the padding on the "prongs" started to flare outward just a wee bit.  Those few millimeters of flaring were giving me points of irritation into the crease of my thigh.  So, out came the electrical tape.  One of the few cheap items for quick fixes (zip ties are among the other items).  Much like taping an ankle, I taped a small section of the each "prong" to provide more structure and support to the padding to minimize the flaring.  It seemed to do the trick despite looking a little funny.  Honestly, I don't care if it improves my comfort.

A few rides on the trainer and outside,  I started experimenting with my pelvic angle as I sat on the saddle.  I may have found the sweet spot.  If I rolled past the pubic bone (anteriorly rotated my pelvis a hair more), then I can rest on the lower abdomen region without issue.  It's like laying out on your bike.  No pains, no discomforts, actually comfy.  The taped region of the saddle creates a small indentation in the padding which my pubic bone seems to sit in and lock into place while in this position.  Because of the added "structure" from the tape I felt more supported rather than sinking into the padding and bottoming out.  I also lowered my front end 5 mm to see if that would help facilitate more forward roll of my pelvis.  It seemed to help.  I eventually lowered it another 5 mm to really see if I could comfortably roll forward and maintain that position.  I wasn't out for getting more aero by lowering myself, I was searching for saddle comfort.  The aero part would be a bonus.

During this time, my communication with Chris was limited.  There wasn't anything really to discuss.  I told him my theory and what I was doing.  He didn't have anything to contribute as it seemed he was following my lead in my quest for saddle comfort.  He was interested in the next race result and wanting to re-evaluate the fit after the next race.  So, we wait.

The next race day test would provide more information as to how my body interacts with my bike.  Millimeters here, millimeters there, a half to a full degree up or down... the difference between agony and comfort.  Think about that for a moment, a MILLIMETER!?!?  Placebo or not, my body has a small tolerance zone.  It's become annoying.  I just want to ride my bike!

Breathe.... patience.  Perfection takes time...I said this to a patient recently.  It struck me.  I, like my patients, wanted instant results and gratification.  Unfortunately, that is not how processes work.  The bike fit process, the rehab process, they all take time to achieve the desired end result.  Back to the roots of trusting the process.  Stop over thinking.  It's not going to be all roses to get there.  Breathe....

Next race...

Results from the 2nd race of the season were promising.  The ride itself from a time perspective was good.  My body was dialed in well except for my undercarriage.  It's apparent now that my race kit shorts DO NOT agree with the Cobb.  The seamless seam of the chamois contact the saddle and me in all the wrong ways.  It's all I felt the whole ride.  The hot spots were different than in my training shorts.  I still moved all over the saddle during the race.  Scooch forward, push myself back, scooch forward, push back... it's obvious now that my race habits vary a great deal than my training habits.  No matter what was done to improve my relative comfort, it was short lived in small doses.

My low back felt fine, the cockpit length was right where it should be.  My upper trapezius muscles were the only parts of me that were unhappy by the end because of race effort, sighting the road, and hanging out in aero position.  They were otherwise ok during training sessions even on the trainer.  The saddle was the only thing torturing me during the bike portion of the race.  I was eager to get off the bike for relief. 

I sent Chris my official race report and follow up of more specifics of my race day bike experience.  He was happy with the outcome but not so happy with my lack of saddle comfort.  If he only knew.  We were both at a loss as to what to do next.  He re-emphasized that he's "here to help."  The Cobb over the last 2 months just hasn't met the comfort needs of my undercarriage.  If I'm this uncomfortable for a 56 mile ride, I don't even want to venture to find out the misery of a 112 mile ride. 

I mulled over the saddle options (or lack thereof) and debated on whether to gamble on the one saddle I eyeballed for months without a return policy.  I looked at the pictures and compared notes from other saddle designs I saw and sat on.  What worked, what didn't work and what theoretically would work.  I measured the Terry's sweet spot.  I measured the seated area of the Cobb.  I was trying to ascertain the potential of this one saddle and decide to cough up a small chunk of change.  What the hell, it's only money right?  It was either going to be a functional purchase or a really nice paperweight. 

I think both, Chris and I, wanted to put this bike fit to bed and live happily ever after. 

What will this next fancy pants saddle bring?  The majority of the reviews are glowing, but remember, saddles are very personal.  Personal indeed. 


Friday, June 17, 2016

Part 6: The saddle saga continues

Welcome to Part 6 of the bike fitting and saddle series by your resident physical therapist and OCD triathlete.
Part 5 took us on a spontaneous road trip to Connecticut to work with industry legend and pioneer of triathlon bike fitting, Dan Empfield.  Yup, true story.  Armed with more information and ideas from the venture, I hoped it would help Chris and I piece together the last bits of my fit and saddle comfort.  Will we reach a happy ending?
The next visit to see Chris was scheduled (I've lost count)…in the meantime…

Step one: set up bike per Dan’s recommendations.  Check.
Step two: custom inserts.  Check.  Await final product.
I received the mail order custom orthotics molding kit.  It was not the typical foam impression kits.  It had a heat moldable “form” and a specially designed pillow you stepped on, to mold your foot.  The guy that makes these orthotics does these for a living and his technique to get molds is a proprietary thing.  He creates orthotics for ski boots, cycling and whatever else you might need an insert for.  The nice thing is that he deals with tight fitting footwear and he understands how an orthotic is to be made to fit in such footwear.  These aren’t super expensive either.  So we’ll see if these will help my little tootsies while I’m biking.

Step three: more saddles... check?
I sourced the Koobi 232T saddle and my initial reaction…good gravy this this is hard as a rock!  The design and concept I really liked:  The large cutout, the not too narrow, not to wide downward swooping nose…all things I really liked, but I had a feeling the relationship ended before it started once I felt how darn firm the saddle was.  It was reminiscent of the Cobb Gen2 saddle, just shorter and firmer.  The “prongs” of this saddle were narrow which reminded me of some of the other saddles I tried with cut outs. I wasn’t too sure about how my anatomy was going to receive this saddle.  It made the Cobb Fifty Five feel like a tempur pedic pillow.  I said as much to Chris.  I was hesitant to put this on the bike until I saw him.  The Cobb Fifty Five, at least, was tolerable for a couple of hours.  I wasn’t sure if the Fifty Five was going to be a long term love affair.  Anything beyond 2+ hours was just torture on the trainer.  My next meeting with Chris couldn’t come soon enough. 

Meeting with Chris again, we captured film of the “Dan changes” and the numbers were all within a degree or two of where Chris had me.  We had a little bit of range to work with and it was a matter of rider preference at this point, so Chris wasn’t all that concerned.  He wanted me to be comfortable on my bike!
More saddles.  Starting with the Koobi, we both really liked the design but not the firmness compared to the other saddles.  As I suspected, the firmness stood out the most.  The width was good but not too sure about the actual contact patch downstairs.  It was reminiscent of how the other Cobb saddles (the V-flow series), and how the Selle SMP contacted me. There was something about the shape and feel of those saddles that just didn’t disperse the pressure enough.  Below is my artistic attempt to illustrate these saddle shapes as viewed from the front looking down the nose.  

Frontal profile of the nose of the Cobb Fifty Five (Left) and some of the others (the right: SMP, Cobb VFlow series, Koobi): Notice the Fifty Five's broader, flatter surface (plateaus) which helps to disperse weight more evenly.  The mountainous peaks of the other saddles have more localized points that push into you as you compress the peaks to gradually disperse the pressure.  You still have that "point" of highest pressure with the mountain profile.

-ISM Adamo PR 2.0: like all Adamo saddles, two pronged, noseless/short nosed saddle, unlike the PL and PN series the “nose” stayed the same width until the rear of the saddle.  Your rear end was really the only thing that was supposed to contact this thing, NOT anything to the front of your anatomy.  This was the softest saddle I tested and the heaviest.  I can see the appeal of it as it was very plush, almost pillowy.  According to ISM the padding is foam with gel.  The PR 1.0 is soft but not quite as plush (it only had the soft foam according to ISM).  It was still a bit wide for my liking and locked you into one seating position.  I tend to move.  In general, Chris didn’t like how I sat on the ISM saddles relative to how I interacted with the rest of the bike.  Off it went.
-Fizik Tritone 5.5: 55mm short nose, 140mm rear, large relief channel open from the tip of the nose which tapered back to the “seat”.  The demo of this saddle sputtered out of the gate.  The rep gave Chris the carbon braided version of the saddle to try out.  Unfortunately, the shape of those braids were not compatible with my seat clamp interface on my bike (note to readers: the carbon braided version of this saddle is NOT compatible with Cervelo seat clamps).  For 45 minutes, Chris tried to make a modification to the hardware but to no avail, all efforts were fruitless.  Well…that sucks.  I gotta give him credit for his persistence.  (sigh)  Chris seemed equally frustrated; he just wanted to make me a happy rider.  He promptly ordered the Tritone with the Cromoly rails that would actually fit my seat clamp.  Why did I think that this would all go smoothly?  Add another layer of “UGH!!!!”  My inner triathlete told me to roll with it, nothing you can do about it.  Adapt and move on.   Things will work out.   
At that current moment, there really wasn’t a saddle that was less offensive than what I originally rolled in with.  I reluctantly elected to put the Terry back on the bike until I came back.  I felt defeated and a bit dejected.  I didn’t want to even ride my bike.  It was almost depressing as I seemed to be stuck in a vicious circle of saddle discomfort.  I was trying not to be pessimistic, but mentally this saddle thing was beginning to wear VERY thin with me.    I’ve managed to either ruin or write off a number of my training rides because of this saddle dilemma.  My first race of the season loomed around the corner. 

Recognizing the urgency, Chris offered to squeeze me in during the week if I could manage to get there a few days later.  I knew it would be a monumental task driving to the shop in the middle of the week.  Shit, at this point, I’ll find a way to make it work.  So close to possible resolution…
A few days later, as expected, the traffic to get to the shop from my office took longer than driving from my house and I was 15 miles CLOSER!  Welcome to DC/MD/VA traffic! 

Before we started, I showed Chris the newly fabricated custom foot beds I just received.  He liked them a lot.  Light, minimal, and well made.  I had yet to ride with them, so the evening session was the maiden voyage. 

Foot Dynamics Custom Footbeds: Minimalist, light weight.  The metatarsal buttons were added to further help minimalize possible "hot foot" or neuropathy to the feet.

Our evening session focused on the correct Fizik saddle and try the Cobb Max saddle.  I tried the Max saddle before (a long time ago) and it didn’t work then, but what the hell?  Try it.  Rule it in or out. 

We finally mounted the Fizik saddle, I hopped on and gave it a trial ride on the trainer.  Initial impression: I liked it.  It’s not instant lust or love but it seemed less offensive than everything else we’ve tried, at the moment.  I was willing to have a test run with it to see if it was truly going to be “The One”.  With my legs feeling a bit tanked from my workout earlier in the day and the old brain heading to late day zombie mode, I didn’t want to keep Chris later than need be.  The shopped closed 30 minutes after I finally arrived (traffic was painful, maybe not as painful as my saddle issues, but nonetheless painful).  We threw the Cobb Max on the bike just to rule it out.  As I suspected, my time was short lived on it.  The Max felt like the "mountain" split nose profile I mentioned above.  We ended the brief evening session with the Fizik back on the bike. 
First ride at home on the trainer…odd, it’s not as comfy as when I was in CT or at the shop (bang head here…).  ARGH!  Time to tinker.  Hmmm, why do I keep spinning my wheels with these saddles?  Two trainer rides with small tweaks and no improvement in comfort, in fact, it seemed to worsen with each passing ride.

It’s a totally different type of discomfort than the Cobb Fifty Five.  To be slightly graphic, the Cobb was like sitting on a 2x4 after 2 hours with what felt like bone bruising to my pubic bone while the Fizik had a lot more soft tissue discomfort (abrading), glass shards sensation causing inflammation.  What would you rather deal with given the options?  Personally, neither sounds appealing.

At this point, emotionally, I went numb.  I remained objective, shelving my emotions as I informed Chris of my experience.  We were both baffled.  Why have the last few saddles felt ok at the shop but as soon as I ride at home, it’s a completely different saddle?  He joked that I needed to do all my workouts at the shop.  Funny, that’s what Dan said. 

My underlying theory for the Fizik as a possible match was debunked.  I quickly realized the Fizik’s trough/ relief channel was not agreeing with me nor was the subtle firmness of the saddle while the seams at the end of the truncated nose dug into me.  Chris encouraged me to keep trying the saddle.  My long weekend ride was BARELY tolerable.  A change of shorts eventually lead to swapping the saddle with my Terry just to get through as much as the ride as I could tolerate.  The soft tissue irritation became too much to deal with, I had to get off the bike.
In the meantime, I sent the Koobi 232T back as it was too firm.  The owner of Koobi, Phil, recommended one of the two “softer” versions of the same saddle.  I asked to try the middle one, he ended up sending both to me to see if one of them might work.  Can you say awesome customer service?   I mentioned to Chris I was getting these saddles and sourced yet another saddle, the Profile Design Vertex 80 Tri saddle. 

Knowing the Fizik was not what I thought it was going to be, Chris was willing to meet with me in the middle of the week (once again, staying after hours) just to help me out.  I didn’t want to impede on his weekend schedule when he could be making money on other fits.  Our schedules were not matching up well, but we were both trying to work something out.  I have this feeling Chris would be the type to work on his day off to accommodate clients and in no way was I willing to infringe on his personal time.  I respect the value of personal time away from work.  It’s a necessity, not an option. 
Another evening meeting well after hours.  I showed up about 10 minutes before the shop closed which was not what I had intended.  It took twice as long to get there than it should as the midweek traffic in Southern MD, makes getting out of Tyson’s look like a cakewalk until you get on the Beltway.  Add rain and people drive like idiots.  However, Chris said he was fine with whenever I arrived (I'm not sure this was what he bargained for but I got there, eventually).  All this time, Chris continued to impress me.  He never wavered in his overall demeanor working with me and maintained his patience through everything.  I’ve been amazed by his persistence and dedication through this process in an effort to get me comfortable on my bike, not to mention all the time spent.  I cannot thank him enough.   
Earlier in the day, I emailed Chris giving him a rundown of my initial thoughts on the new Koobi saddles and my time with the Fizik just to save a bit of time that evening.  I didn’t want to forget any details due to any late evening brain farts on my end.

We were down to these, some new, some to revisit, in summary:
-Cobb 55 JOF-worked in short doses, BUT bone bruising after 2 hours.  Was this discomfort something my pelvis would “toughen” up to?  I really didn’t want to settle and it would be a long term experiment.
-ISM PR 2.0-soft pillowy, slightly wide.  Chris didn’t like how I sat on any of the ISM saddles.  Not just where I physically sat but, as Chris put it, how I “addressed” my bike.

-Terry FLX- same issues prior to the whole saddle soap opera.  I would prefer to find something less offensive.

-Koobi 232K- soft top on a firm foam on a firm base (per Koobi), great width, shape.  The lycra/neoprene top covering was something I was not 100% sold on.  It added a different type of “softness” to the saddle.  It was almost “squishy” or “spongy”.  Our concerns were long term wear especially with a wet backside after a swim during a race.  The saddle rails were also really short.

-Koobi 232 Sprint- soft foam on a soft base (per Koobi), great width, shape.  Same observations to its sister, the 232K except this saddle was really soft.  Almost too soft.  Chis and I played with this one for a short time to see how I sat on it and how it felt.  It felt ok but we both had long term ride concerns of not offering enough support for a 5 to 7 hour training ride.  Chris didn’t like how I postured or interacted with my bike on the Koobi's. 
We started the evening with the 232 Sprint saddle.  It was mounted to the bike all ready since I was "playing" with it at home.  We spent maybe 10 minutes or so trying this one.  As noted above, we both had our reservations.  Chris jotted the numbers down in case I ended up switching to it later.

Revisiting an old friend?

Chris really wanted to get me back on the Cobb Fifty Five to see how it would go.  Back on the Cobb Fifty Five.  Oh…I remember you now.  It’s like the on again, off again relationship.  Compared to the Koobi Sprint saddle, the Cobb had a firm but slightly forgiving nature.  My undercarriage, now getting reacquainted, it’s everything I remembered it to be.  Chris let me ride for a little bit before we decided to do one last tweak that Dan recommended but had not tried.  After 10 min, we moved the saddle forward 1 cm and again, started riding.  We figured why not?  Those 10 little millimeters forward might just be the magic ticket to this saddle.  By moving the saddle a touch more forward, a little bit more weight shifts forward to my bars with a touch more saddle under me.
A quarter after eight or so in the evening, with the shop closed and the staff gone for the day, it was eerie.  I was used to the foot traffic and the people watching coming and going.  It was just us and the shop music playing.  Chris has me spinning away and dripping in sweat as I have done in previous sessions.   We chatted, he watched and he filmed.  He commented on how much he loved my position and postured on my bike on this saddle.   Chris’ subtle way of admiring his work, as he should, especially if this rockets me to a few podium finishes this season and beyond. 

After 20 minutes, I was ready to call it a night because I didn’t want to keep him late, but Chris just said “I want you to keep riding.”   Um, okie dokie.  At his request, I kept riding and we chatted some more.  At one point, I said “you know, I can keep going as long as you need me to if you just feed and water me.”  He kinda laughed.  After a good while, I peeked at my watch and noticed the time.  Damn, I’ve been on here for over an hour.  I looked over at him as he briefly wandered about the shop doing random end of day stuff and asked, “So, are you bored yet?”  Chris responds, “No, I’m good.”  Again, he wanted this right and taking the time to get it right.  As I was riding all this time, he asked how it felt.  I told him “if the saddle felt like this in 5 hours, then I’d be fine.”  However, past history pointed to the two hour limit before the bruised 2x4 feeling, leaving me sore. 

By the end of the session, Chris and I discussed the different aspects of what we liked and didn’t like with the saddles.  I pointed out that despite all the initial frustrations with the Cobb Fifty Five, it was the one saddle I tried on a trial basis that I didn’t have the compulsion to tear it off the bike after a week.  I was running out of time screwing around with different saddles with a race in 6 weeks.  We both agreed to try out the Cobb Fifty Five again and race on it.  Once we get through race day, we'll re-evaluate everything.  We both wanted to know if my body would adapt to the bone bruised feeling I was getting to my pelvis.  I felt like I was a long term case study for Chris.  He recorded the fit numbers from the session and we called it a night. 
By the end of the week I received the next saddle:

-Profile Design Vertex 80 Tri – initial reviews per Triathlete Magazine indicated very soft, but may bottom out.  55mm nose, a rubbery type outer, super soft.  There was a shallow relief channel at the nose that transitions to a deep cut out towards the rear of the saddle.  Rails are on the short side.  The edges of the channel are rounded so no hard edges to dig into you.  My body has not gotten along well with relief channels.  I compress the padding and then contact the bottom of the relief channel which subsequently defeats the purpose of said relief channel.  Later, I showed Chris the saddle and he was surprised to see how “fat” the nose of the saddle looked.  It was my initial impression as well.  The Vertex saddle reminds me a lot of the Cobb Randee saddle except the Cobb has a longer cut out and a deeper relief channel towards the leaner nose.  Suffice it to say, the Vertex saddle never made it to my bike.

I just reacquainted myself with the Cobb Fifty Five and dialed it in (I hope).  At the moment, due to limited time and options, I was more or less content except for the parting gift the Fizik saddle left for me to deal with (the gift that keeps on giving) so I had to work through that discomfort.  If only the saddle would feel the way it does at hour 1 to hour 5 or 6.  I was going to stick with this one for the time being until race day as Chris and I discussed.  I’ll have these three, the Profile Design and the two Koobis, on stand by for a couple of weeks if things really hit the fan before I send them back. 
After the first couple of weeks, my long rides turned into a shear test of how long can I tolerate the soreness down there after the two hour mark.  The wet cool spring has not allowed me to emerge from the depths of the pain cave to play outside.  I decided to tilt the saddle a touch more, a whole whopping degree, to ascertain if that just might relieve the post 2 hour soreness I continued to experience on the Cobb.  Knowing the other three saddles I had in my possession were not good matches, I shipped them back.  I was putting all my eggs in one basket with the Cobb, so I’ll either end up with scrambled eggs or cute little fuzzy chicks by race day.  Chris and I were in a holding pattern.

During this time, the new foot beds took some getting used to. The foot beds I liked, but the left pinky toe numbness persisted.  I have now relegated my foot issue to some biomechanical anomaly with how I press through the shoe and pedal with that foot.  I needed to train myself to pedal through my big toe versus my lateral foot.  With these foot beds, I can feel my big toe contact the bottom of the shoe, but I still want to pedal off the outer toes.  This is how my foot moves when I run, slightly toe in.  However, the foot was the least of my concerns considering the saddle comfort issues.  Maybe I need more time to break them in.
A month with the Cobb Fifty Five (2 weeks out from race day), the weather finally broke from the 20 some odd days of rain streak and below normal temperatures.  I spent a week off the bike to let some saddle sores go away (I said, I hated these little buggers.  Soaking wet shorts from the last 4 hour basement ride, despite a change in shorts, left me with gifts you care not to receive without a return receipt). 

Finally, the first outdoor ride of the year, 90 degrees and sunny.  It was glorious!  The new position on the road felt a bit weird as I regained my road feel.  The jury was still out on the saddle, however.  I realized I move around a great deal when I’m riding outdoors.  Part of that was from the rolling/hilly terrain, safety, and slowing a little as my training partner reeled himself back up to me.  The saddle discomfort onset a bit later, but I’m not sure how exactly I’m sitting on the saddle on the road.  Peeking down at myself to see where I am on the saddle with all the potential road hazards is a recipe for disaster.  No distracted riding!  The width seemed to be the one thing that stood out to me.  Again, I wasn’t sure if I’m more hyperaware since I still had some signs of resolving hotspots.  Position-wise, I felt fast.  There were short sections where I know I was faster than I was last year.  Just imagine if I had my race gear on.  Another positive from the first outdoor ride: no foot numbness!  With all the climbing on the bike, my feet were fine.   The new set up outside felt great other than the saddle.

I emailed Chris with my outdoor observations.  There were a few things I wanted his feedback on (position).  He wanted me to stick with what we had set up through race day unless there was something blatantly awful when riding outside.  He was pretty psyched to find out how it would go on race day.  I was eager to find out as well, but I know not to go into races with huge expectations.  I have a historical relationship with my first race of the season, a soon to be 12 year history on 3 different race bikes.    It’s all relative.  How will the day unfold?  How will my body feel? What will mother nature decide to throw at me?  We shall see. 
A week later, I couldn’t leave well enough alone and made one last tweak prior to race day.  The thought, “What if this is the one thing that makes the whole fit feel that much better?”  The second outdoor ride provided a nice test and it made a big difference in my all around comfort despite nursing a resolving hotspot.  My feet remained happy since the inserts were finally broken in.  Perhaps, things were finally falling into place.  Now, I’m ready to see what race day brings.

Monday, May 16, 2016

Part 4: The saddle struggle continues...the extended version

This is the continuation of a series of posts on bike fitting and saddles from the perspective of your resident triathlete and physical therapist.

We left off frustrated with my agonizing Terry saddle tormenting me in my new found position on my bike which I was loving.  So, the search continued.
Scouring the triathlon world for possible candidates meeting my saddle criteria, I brought two saddles to Chris’ attention he wasn't too familiar with.  He was interested by the prospects as we set up a plan and date to meet again.  Both were newer saddles to the market with no real world reviews.  Then again, results may vary as saddles are VERY individual as to what will agree with one’s anatomy as we are finding out with my hunt.
As the date of my next meeting with Chris neared, we, unfortunately, rescheduled.  A blizzard along with 2 feet of “historic” snowfall slammed our area basically shutting the whole region down for days.  ARGH!!  Everything was perfectly planned out…stupid snow.  My nether regions were getting a bit…irritated and looking for relief.  I was on my own to try the next saddle.

-Specialized Power (Sourced from another shop since Chris is not a dealer for this brand): really firm, narrow in the nose (38mm), a bit more T shaped/pear, hmmm….the ridges of the cut out were blunt and the lady bits were none too happy.  Nose riding was not too comfy.  This saddle seems to be designed more for sitting on the middle/rear and doesn't allow me to rotate my pelvis the way I want.  The semi rubber like outer was interesting.  Good for minimal sliding on the saddle and a seemingly durable material for wet butts.  In the end, my time with the Power saddle lasted 45 minutes with some tinkering, it just wasn’t going to work.  I told Chris, “No Bueno.”  He encouraged me to try again, but I just knew that I’d just be miserable and wasting my time.  Back to the Terry until I saw him again in another two weeks…stupid snow.  It would be a long two weeks.

Back to the fitter…(meeting 4, about 2 ½ months after my first visit)

Chris seemed more optimistic about the next one and eager to find out my impression of it.  I, too, was hopeful, but tentative. 

Here goes…

-Selle SMP T3: great concept, deep cutout the length of the saddle, more triangle than pear shaped, narrow through the nose with gradual widening, looks cool, but will it work?  My initial feel, “not bad.”  We dialed in the tilt and I pedaled away at the shop.  I’m not joking when I say I pedaled away.  For nearly two hours, I pedaled at a moderate effort dripping in sweat (it’s a good thing I’m an Ironman athlete, other folks may not have gotten too far).  Chris circled me like a shark, observing and listening as I rode.  He pressure mapped it.  By far, the best mapping of all the saddles we tried, but no matter what the maps show, my nether regions had the final say.  

For the 2 hour session, with a few breaks to tweak and saddle map, all was fairly comfortable, like couch comfortable.  I quietly and cautiously thought to myself, maybe this is “The One.”  Chris was kind enough to let me borrow the saddle for however long I felt I needed to try it or just out right buy it if it worked out.  He may have sensed that I wasn’t sold on this saddle and wanted me to really try it out before I plopped any money down.  He already knew I was hell bent on finding the right saddle and I’d be back at some point.  

For 3 weeks and close to 300 miles or so, I gave it a go, tweaking (saddle forward/back, up and down, millimeter by millimeter) and riding, but I could never find that “couch” feeling I had at the shop.  Each ride left me more and more discouraged as my frustration mounted.  There were few options left out on the market that might work for me. 

I emailed Chris throughout the trial period giving him feedback on the saddle.  He always openly appreciated my feedback as he wanted to help in any way possible, or I was driving him nuts with this saddle issue of mine. 

Chris and I spoke several times on the phone to discuss the saddle issue and come up with a different game plan.  He was out of ideas and I was tired to having to deal with this issue.  There had to be an answer.  I needed some time away from the bike for a few days to decompress and then start up again.  The weather was half way decent, so I spent it running instead of cycling.  Nothing better than getting outdoors to clear the mind.  Now only if it was consistently 75 and sunny...

My "before" in action photo.  The red line denotes the "spinal take off angle" referenced.

Not one to really give up easily (persistence can be a dangerous thing), my physical therapist brain started to kick in on the anatomy side of things.  What was going on and why don’t any of these saddles work for me?  At the office, I stared at my life size spine/pelvis model picturing in my head how it would sit on the saddle.  I remember watching a bunch of bike fit analysis videos critiquing the bike fits of the top PROs at Kona.  They spoke of “spinal take off angles” as it relates to pelvic tilt, see photo above.  It got me thinking…"what is my spinal take off angle?  I know I anteriorly rotate my pelvis a good deal on the saddle, but how much and how does that translate to where my pelvis is actually sitting on the saddle??"  

In aero position your ischial tuberosities (aka your sit bones) really don’t contact your saddle.  Mine certainly do not.  You actually “sit” on the pubic rami (see illustration above for anatomy lesson).  This misnomer of “sit bones” gets generically used in saddle discussions in triathlon circles (ischial tuberosities do NOT = pubic rami), so be careful what you read.   Now that we cleared up…what is the sacral angle at which you are on your ischial tuberosities and transition to your pubic rami??  How anteriorly rotated do you have to be before you are on your pubic bone itself?  I know for sure I’m perched on my pubic bone (symphysis and arch) and all the soft tissue around it.  At least that’s what I feel like I’m sitting on!  So what’s the deal as it relates to contacting my saddle?
I left my office that day with my plastic life sized model and goniometer in hand to do a few tests at home.  I asked Chris to send me pics of my fits so I could further analyze my positions.  I measured my sacral angles from all of my fit pics (pre fit, post fit day one, and post fit lower cockpit) it was around 40 degrees relative to horizontal.  I checked a few old race pics on my old race bike and the new one, both were around 40*.  Hmm…no matter the saddle to pad drop, or saddle tilt, I was still at 40*.  So what does this mean as far as what was actually contacting my saddle?? 

I set up "Bones" on the SMP T3 saddle that was still on my bike. In aero, my pelvis teetered on the pubic bone (symphysis) therefore focusing all the pressure on that small area, top photo, above.  When I found the sweet “couch” spot, the contact point closer to the nose of the saddle, my weight distributed more on the rami while the pubic bone had some relief as the nose swooped downward, bottom photo, above.  Hmmm...interesting.

The sweet spot on the Terry above the cut out.

Curiously, I moved "Bones" to the trainer bike (old race bike) which has a Terry saddle on it and found a similar result.  Interestingly, I later found the sweet spot of the Terry was towards the rear of the cutout where my rami were actually a little more supported.  I could tolerate that saddle if I rode on the saddle in this manner but I was still irritating the soft tissue to the front because the nose was in the way.  When out of aero position, my sacral angle was around 45* and I’m happily sitting on my rami with the saddle cradling my pelvis.

I shared my “findings” with Chris as he found my theory pretty interesting.  I pointed out that guys don't really have this problem since the "boys" are in this anatomical region of their bodies blocking them from really rotating as far forward as my pelvis.  Guys tend to sit more in favor of their pubic rami or their ischial tuberosities (for those with flexibility issues) in aero position.  I sent photos to Chris so he knew what I was talking about.  So with all this in mind…the one saddle that came to mind that might match my criteria to support the rami, but keep me off my “junk” so to speak was the Cobb Gen2.  Not wide, not too narrow, swooped down nose….maybe??  There was one other saddle out there that may work, but it would be an expensive experiment if it didn’t work.  A $300 saddle with no return policy.  Um…yeah…let me think about that.  I contacted the company (a US based one) and the owner basically said, no returns.  It becomes a really nice and very expensive paperweight if it doesn’t work.  I don’t have that kind of money to throw around (I am taking donations…).

For kicks, I threw my stock ISM Adamo Prologue saddle on my bike.  I did a 60 minute session on it, tweaking it as I went along.  While I get how this saddle would work for those that love this saddle, I found it a touch too soft, and it flared out way to too much from the nose back, much like the ISM Adamo Attack saddle (except the Attack was firmer).  Even hanging off the front like you’re supposed to, the width of the saddle going back hit in all the wrong places (namely the crease of my leg and groin, which was not too happy with me by the end).  Also the pressure, more like pain, on my right side down there…yeah, um… oh HELL no.  SO….back on the Terry I went.  If I was going to be uncomfortable, then please let me be on a saddle where I at least know what to expect and just tolerate it.  I informed Chris of my findings with all of this and we scheduled yet another time to meet. 

Meanwhile, just to add to my n=1 theory, I looked up a few known PROs who have had a number of fits over the years on different bikes (from more upright positioning to much more “aggressive” low positions).  I measured their sacral angles and they were practically all the same, no matter how upright or aggressive their fits.  Could this sacral angle (basically how we sit on the bike) be a self-selected position?  
I emailed back and forth with Chris for a week about this and he was taking my lead on this theory.  He kept telling me that he’s here to help in any way possible.  We both had invested an enormous amount of time and energy into figuring out my saddle issue.  Mind you, I’ve only paid him for my initial fit and all the work that has been done to the bike (cranks and cockpit install).  Chris wanted this fit right and really cared about my comfort on my bike (remember the passion and pride thing?).  In this day and age, customer service died a slow death years ago, perhaps decades.  Chris had definitely gone above and beyond for me; it was WAY more than I ever expected.  He could have easily just said “I can’t help anymore,” blew me off, and let me go on my way with a bike fit that was only partially complete.  This was HIS body of work and he wanted to reach a happy outcome.  It seemed as long as I was willing NOT to give up, he would be there to do what he could to help me.  I was grateful (more than he realizes) knowing I wasn't alone in my saddle struggles.  

In the meantime, I contacted the nice folks over at Cobb Cycling, namely the women’s specialist, Rachel.  I wanted more intel on the Gen2 and maybe the Fifty Five saddle.  I also sought validation of my findings (my “theory”).  She replied pretty quickly and gave me a ton of feedback.  She understood everything I had told her about my situation and made her recommendations to me.  I’m not sure they actually put a sacral angle number to that “point of no return” tipping on your pubic bone or happily sitting on you rami, but she knew what I was talking about. 

A shot in the dark...
FOUR months into this process (and has it been a process) I’m back again meeting with Chris for the FIFTH time.  Honestly, I didn’t think the process would be this long, I’m sure he didn’t either.  Feeling like we were beating our heads into a wall, we both had committed; Too far to turn back and we both wanted to have the best outcome.  We discussed my renewed time with the Terry.  It was more data to add to the mix of what was working and what wasn’t.  Based on my position and my observed feedback on the Terry, we decided to start with the noseless saddle first, the Cobb Fifty Five (the first saddle Rachel recommended to me).  Now, we were both trying to reserve our optimism since we haven’t had a lot of luck finding “The One.”  Time to see how the next two saddles work out…

-Cobb Fifty Five JOF: initial first contact impression…hmmm…not bad.  No abnormal pressure points, really not a lot of anything.  I didn’t think about the width of the nose or where I contacted the saddle; I was just sitting and pedaling.  The saddle seemed to disappear.  Chris, again, circled me like a hawk, studying my position and body interactions from all angles.  For a good two hours, I pedaled and gave feedback about the saddle and the position.  We really didn’t tweak much from where it was mounted from the start.  My nether regions were quite happy.  

My pelvic rotation position on the Cobb Fifty Five JOF.  Seems like it would work.

At the first sign of soft tissue discomfort (it took a while, and it wasn't in the obvious spot.  The point of discomfort was closer to the crease of my groin.), Chris wanted to pressure map it.  It mapped better than most of the other saddles we had tried.  I didn’t want to jinx it, but part of me was thinking this could be the “where have you been all my life” moment with a saddle?  Honestly, its probably the best saddle I tested.  Sitting up out of my aero bars, I was reasonably comfortable with the 135mm seat width in the back and provided enough support (even though I don’t really rotate my pelvis back far enough to contact my ischial tuberosities).  My pubic rami were supported in an upright position as I found a couple of areas on the saddle I could sit on with little issue when climbing.  Despite its width in the nose (at 55 mm, the one thing that crossed it off the list early on so it never resurfaced on the radar), I didn’t really feel it.  It was VERY different than the Adamo saddles, even though the nose widths were similar, the shapes of the saddles made them distinctive. 

Meanwhile, I brought up another bothersome bit of my fit: my left foot numbness (an ongoing issue well before this whole process began).  While I tested the saddle, Chris and I discussed what he could do to help eliminate the numbness.  I provided feedback constantly about it.  He tweaked one thing, we tried another.  I already had Superfeet inserts in my shoes, a metatarsal gel pad, and cleat wedges (Chris had put these on prior to this foot only).  While I’m not sure we eliminated the numbness (more ride time on my home trainer will be more telling) we decided on a more rearward placement of my cleats (in between the traditional and true midfoot/arch positioning).  There were a few things we discussed that I could try on my own.  I’m not quite ready to commit to custom cycling shoes at this point.  It would mean a minimum of $1k to get custom shoes….um, no (again, donations are being accepted). 

Now despite testing well and the beginnings of perhaps a lasting relationship with the Cobb Fifty Five, we tested the next saddle to completely rule it out.

-Cobb Gen 2: A more traditional saddle shape, firm, split nose with a 47 mm nose width.  Its definitely long in the nose with a longer downward sloping nose at the tip. We set it up per Cobb’s recommendation on the tilt.  First impression: hmmmm…not sure I like this.  Immediate pressure and discomfort in places I was trying to avoid.  It did not map well.  After maybe 10 minutes, I was done with this one.  No warm fuzzies.

We put the Cobb Fifty Five saddle back on the bike.  AHH…much better.  I rode a bit more, Chris adjusted the seat clamp, and did a couple more pressure maps: one at moderate/tempo pacing, and another at a higher intensity.  The pressure was next to nonexistent, the best pressure maps yet.  After riding off and on for over 2 hours, I dripped in sweat at the shop while other customers came and went, gawking at me as they walked past.  I wondered what they thought as I was riding while Chris studied and checked my mechanics and movements.  

We decided to give the Fifty Five a go and keep trying to figure out how to relieve the numbness in my left foot.  Again, Chris let me “borrow” this saddle until I ultimately decided it was a “take my money!” moment or I whimpered back to the shop completely discouraged in the search for saddle relief and give it back.  On my way out of the shop, I stated to Chris, “I like to think of this whole experience as one of those memorable lifelong learning experiences (from the professional/career thing).  I have learned more about bike fitting than I really ever wanted to know.”   However, we weren’t done.  We were both going to see this to the end or go crazy trying. 
I left with a renewed hope that just maybe, we had found “The One.”
A new hope?

Time for more testing on the Fifty Five and seeing how the foot responds to the updated cleat position. 
In my optimism and eagerness to try the saddle, I hopped on the bike the day after my session with Chris.  Bad idea.  Why?  Let’s just say the saddle time was not a pleasant experience.  The glorious couch feeling at the shop was nowhere to be found.  UGH!!!  Immediately, I flashed back to my time with the SMP saddle.  Not again.  A comfy couch at the shop, and the next time I rode (which was days later) it was torture.  I never really found the comfy couch feeling again riding the SMP and it was happening all over again with the Cobb Fifty Five.  Dammit!!!  I sucked it up for the ride, but realized the soft tissue (despite feeling totally fine after my initial test ride) had not recovered.  It was definitely sensitive and not in a good way.  I declared that I was an idiot for doing what I did, all because the weather was “too cold” for me to get my run workout done (and for me, temps in the low 40’s…is too damn COLD).  I flared up one little hot spot into a larger area of irritation and mentally, I began to question this saddle and its possibilities.  I didn’t want to confess to Chris what I had done as I wanted to give it a few more rides before reporting in. 

So, in some moment of desperation, I reached out to the folks at Cobb Cycling to help me and Chris (indirectly).  By doing so, I felt like I was cheating on him.  I wasn’t looking for validation of Chris’ work on my overall fit (I know it was mostly dialed in), I wanted COMFORT on my SADDLE!!!!!  We needed another set of eyes.  Since I was trying one of their saddles, I thought maybe they SHOULD know best in terms of how to dial the saddle in most effectively, and just maybe they could help with my foot numbness as well.  I emailed back and forth with Rachel about what was going on.  I sent them photos of my bike, my fit and eventually videos of my pedal stroke from all angles to ascertain what in the world was going on.   I waited eagerly for their feedback that perhaps we might come to some resolution. 

Meanwhile, with all back and forth with Rachel at Cobb, I emailed Chris to confess, I was cheating on him.  As I expected, as I’ve gotten to know him, in his humble ways, Chris wasn’t offended at all.  In fact, he was happy I reached out to them for help.  He wanted the best result and more than willing to have another set of eyes (especially those of an industry legend, John Cobb himself) that could help us find resolution. 
All the more reason why I really like working with Chris.  He always referred to the whole process in terms of “we” and “us” and considered it a team effort.   He knows I’m a physical therapist and, hopefully, together we could reach the desired result: COMFORT, POWER and AERO.   If we had to tap into other resources to assist us, then we'd do it.  Over the years, asking for help has been one of those things I’ve had to learn to do.  I’m of the generation that you figure it out yourself.  And if I couldn’t figure it out, then find someone who knows the answer.  And if you’re motivated (trust me, I’m motivated), then by golly I’m going to try and find the solution!  Somebody has to have the answer.  Maybe Cobb and his staff have it.  Time was now starting to work against us.  My first race was in less than 12 weeks, so we needed to find an answer sooner rather than later.
During this time, I had gotten a 2nd shorter ride in two days after my “mistake.”  It was a little bit better, but my hot spot was not happy with me and my foot was still going numb.  However, I still needed time away from the bike to let things settle down and recover more.  It definitely didn't have the couch feel from the shop.  Fortunately, the weather cooperated and I was able to get my runs in without stressing over whether I was getting my bike training in. 

Rachel asked John Cobb to look over everything and make his recommendations to dial in the saddle position but also help my foot numbness.  Per Cobb's recommendations, move saddle forward (2cm), and drop the saddle a little (5mm).  Who am I to argue with a guru in the industry who’s been pioneering stuff longer than I’ve probably been riding a bike as a kid?  He also had me flip the cleat wedges from their original orientation (varus to valgus) to help ease the left lateral foot numbness. 

I kept Chris in the loop as he was interested in what they had to suggest.  The cleat wedging recommendation left Chris a little puzzled as to why you would do this.  It was contrary to what he learned/trained to do.  Initially, I was a bit perplexed, but as my PT brain kicked in, I had a feeling it had to do with other biomechanical components up the kinetic chain (away from my forefoot and more my rearfoot).  After digging through my archives, Cobb’s method made sense, in theory, for a walking/running foot contacting the ground (there are studies that support this).  It most definitely had to do with altering other aspects of my foot mechanics to help “align” other parts of the kinetic chain.  There is more technical, anatomy jargon to explaining all of this which is more than most people want to know.  Basically the best way to describe it, by improving the mechanics of a critical part of the chain of the foot/ankle complex, it causes a shift in how one weight bears through their forefoot.  In my case, it shifts from lateral (pinky toe) to more medial (towards big toe) dispersing the pressure across my foot rather than just one spot (lateral foot).  BUT how does that translate to a foot that is locked in a shoe fixed to a pedal??  
My next ride with all of the recommendations from Cobb, sadly, did not really improve things.  In fact, it stirred up some nigglies that were dormant for years.  It got ugly.  As I later wrote to Chris, “what an f-ing disaster!”  The intolerable saddle discomfort, the random nigglies cropping back up (both anterior (TFL) hip regions and my knee from the saddle being too low, my back from the shortened cockpit and posturing to find the sweet spot squirming all over the saddle), my left foot was still going numb, and a buildup of mental frustration over the course of 90 min ended what was supposed to be a 3.5 hour ride.  I’ve never felt so uncomfortable on a bike than I did during this “ride.” 

Systematically, over the 90 minutes, I put everything back to where it was before, but the damage was done.  I begrudgingly got off the bike feeling utterly deflated, frustrated, annoyed, pissed, and disappointed all at the same time.  So much so, I was on the verge of throwing in the towel.  Overwhelmingly upset and beyond frustrated, I was literally left in tears with my emotions boiling over (and I’m not one to cry).   All this time spent trying to find a saddle only to be back at square one.  I initially emailed one word to Chris to voice what happened (it will not be repeated here, but it was a colorful 4 letter adult word, phonetically spelled without the last letter).  He replied, “That does not seem to be good...”   I gave him a brief reply to summarize how I was feeling and that I was instead washing and mini detailing my cars for therapy.  So, I wasn’t sure if he’d try and call me to find out what happened or if he’d leave me be to bond with my four wheeled babies.  Once I decompressed after the ride, I emailed Chris debriefing him of what happened.  

At this point, I’m pretty sure Chris was feeling bad for me and really didn’t know what to say or do.  Like most guys…they listen and look for solutions rather than express any emotions.  There was nothing wrong with that as somebody had to keep calm and collected through all of this.  Rather than getting sucked into my emotional saddle hunting roller coaster, he always looked at things objectively, maintaining his professional demeanor focusing on solutions despite my moments of hysteria (thanks for hanging in there with me!).

Time to regroup, wait for feedback from Cobb et al and Chris, and come up with another approach.  In the meantime, I decided the hell with it.  Time to wander out of the box a little.  I put my saddle position back up to where Chris and I set it and tilted the saddle down a little more.  Nothing about this process has fallen into the realm of the “normal”.  I know nothing about me falls into the middle of the bell curve, so why would my bike fit be any different??  I also decided to try a different pair of shorts, hoping that maybe the chamois would make a difference.  I hoped by accident I would fall into the sweet spot and balance would return to my cycling world.  Stranger things have happened in my world of unexpectedness.

Holy hell, can we get this girl some comfort on her saddle!?!? 

I can't really imagine what Chris could possibly be thinking or feeling during this process.  Well, maybe.   I have tough cases I work with clinically, so I have an idea.  I'm not sure where I'd be without his support and help with all this.  

Part 5 continues with an interesting twist... is there an end in sight?