Proper fit and focused rehabilitation keep cyclists riding strong.

2. PTs PARLAY
THEIR PASSION
FOR BIKING
INTO THRIVING
BUSINESSES
BY BRIAN W. FERRIE

3. COVER STORY
Two therapists who embrace biking with
a passion are Greg Robidoux, PT, owner of
The Cycling PT in Malden, Mass., and Erik
Moen, PT, owner of Corpore Sano Physical
Therapy in Kenmore, Wash.
Hybrid Model
A PT for 16 years, Robidoux founded his
practice six years ago.
“My clinic is kind of distinctive,” he told
ADVANCE. “I operate inside a larger entity
called Fitzgerald Physical Therapy. My busi-
ness consists of working specifically with
cyclists and triathletes. The cycling popu-
lation encompasses mountain biking, road
cycling, cyclo-cross, track and any other
related disciplines. So the therapy I pro-
vide is billed through Fitzgerald, while the
other aspect of my business is bike-fitting
and that’s billed directly through me.”
The bike-fitting component is straight
fee-for-service, with clients ranging from
professional cyclists to those riding a bike
for the first time.
“I sponsor a few cycling teams, so I get
direct referrals from them,” explained
Robidoux. “I also have good relationships
with a lot of local doctors who send me
clients, as well as bike shops. An over-
whelming sentiment I hear from the local
cycling community is that they’re not well-
serviced as far as PT is concerned, other
than myself. I’m not completely unique but
I’d say there are very few therapists in the
New England region specifically treating
cyclists and triathletes.”
Robidoux’s credentials also include
being director of education for the Serotta
International Cycling Institute.
“So I teach one of the longest-running
certification courses in bike fit, as well as
write curriculum. I started with Serotta
around five years ago, first on an as-needed
basis, then progressing to permanent
instructor, before becoming director of
education about two or three years ago.”
Shifting Gears
Continuing education represents an
important aspect of Moen’s business as
well. A physical therapist for 22 years,
he established Corpore Sano seven years
ago. However, Moen is also the founder of
BikePT, a CE program regarding the bike-
fitting process, injuries and biomechanics,
as well as effective treatment and manage-
ment of bicycling clientele.
“I bought the BikePT URL in 2005, but
have actually taught bicycle-related con-
tinuing education courses since 1993,”
he told ADVANCE. “BikePT classes are
geared specifically to physical therapists,
although they can be for healthcare
providers in general. I just believe that
physical therapists are some of the most
respected professionals who can work
with injured bicyclists.”
Corpore Sano, meanwhile, is a gen-
eral outpatient and sports physical
therapy practice.
“However, we have a niche knowledge
base and skills pertaining to cycling,”
related Moen. “I’ve treated cyclists from
day one of my PT career but honestly I
rarely advertise bike-related services spe-
cifically. It’s been primarily word-of-mouth
and growing, to the point where we prob-
ably see about 1,000 cyclists a year for
bicycle-related irregularities.”
Road Racers
Both Robidoux and Moen can also claim
significant personal cycling experience.
“I came a little late to the sport,
T
here’s something beautifully simplistic about riding a bike.
After all, it marks a symbolic rite of passage for kids all over
the world. And the popular analogy, “It’s just like riding a
bike,” has come to define any skill that once learned, is rarely
forgotten. This simplicity represents an important part of cycling’s
appeal. Although technically operating a machine, you’re also provid-
ing its sole propulsion. No electricity, gas, steam or even wind is required
for movement. Yet compared to running, the practitioner can exert less
energy, achieve much higher speeds and cover far greater distance.
I just believe
that physical
therapists are
some of the
most respected
professionals
who can work
with injured
bicyclists.
—Erik Moen, PT
www.advanceweb.com/pt ❘ November 17, 2014 ❘ ADVANCE for Physical Therapy & Rehab Medicine 13
‹ The high speeds and
challenging terrain of
mountain biking both
exhilarate riders and
create injury risk.
—Photography by
Kyle Kielinski

4. COVER STORY
starting about 15 years ago in my mid-to-late 20s,” Robidoux said. “I
had been a soccer player in college, then got into marathon running.
After I developed some injuries, I decided to get on a bike for cross-
training. I took to it very quickly since I already had a good fitness
level, and kind of never looked back as far as running is concerned.
I thought, ‘Wow, this is way faster and more fun.’”
So Robidoux started competing in time trials and road racing, even-
tually branching out into cyclo-cross and mountain biking as well.
“I’ve had the opportunity to race in many places around the world,
and kind of progressed through the ranks as far as category racing.
At one point I even won a national championship on the moun-
tain bike for my age group and class. But I think one of the most
interesting events I competed in was the Tour of the Himalayas in
Pakistan in 2007. That was a three-day, mountain bike stage race.
Five Americans went, there were teams from eight different coun-
tries, and it was pretty epic.”
Moen related an impressive cycling background of his own.
“I’ll say I’m a has-been racer right now,” he laughed. “I started out in
road racing and have also done track, cyclo-cross and mountain bike.
Last year, I participated in a five-person, 24-hour mountain bike relay
team. And in 2012, I did the Leadville 100-mile, which is a well-known
mountain bike endurance race in Colorado. A lot of cyclists look at it as
a bucket list activity because the elevation is just so high and requires
a lot of preparation. I don’t get to race as much anymore because of
having so many irons in the fire for my business, but I was able to enter
one this year as well.”
Mountain Men
With both practitioners experienced in mountain biking and treat-
ing mountain bikers, they discussed injury considerations common
to this specialty.
“Mountain biking is pretty interesting as far as injury patterns are
concerned,” Robidoux commented. “The truth is you can see nearly
anything. Mostly that’s because of the terrain people are dealing with.
Riding on something as simple as a gravel road could be considered
mountain biking, all the way to really technical single-track riding or
even down hilling.”
Although wear-and-tear ailments typical in road cycling can arise
among mountain bikers too, the most striking difference is in the preva-
lence of impact injuries.
“So you’ll see broken collarbones, AC joint separations, lacerations,
head injury, blunt trauma, some pretty nasty stuff that people can do
to themselves on a mountain bike,” continued Robidoux. “I know from
my own personal experience, I put a tree branch through my leg while
warming up for a mountain bike race.”
“What we find with mountain biking is that a lot of common inju-
ries occur from people essentially going over the bars,” agreed Moen.
“And that’s an important distinction because with road cycling, it’s
really a static position while pedaling. You’re basically glued to the
saddle and maintaining a repetitive motion. So if you get hurt, it’s
usually because your saddle or cleats are in a bad position, creat-
ing irregular tension, rub or grind. With mountain biking, it’s more
dynamic as you move in and out of the saddle on a regular basis.
So you’re less likely to develop an overuse or pain syndrome due to
posture, but more likely to sustain a traumatic injury.”
Fitting Focus
For both types of biking, proper fitting plays an important role. In fact,
Robidoux said an initial bike-fitting session at his clinic is so multifac-
eted it will typically last from 2.5 to 3.5 hours.
“When people come to an orthopedic sports PT practice with
bike-related pain syndromes or injuries, the most effective treat-
ment is to consider the bicycle in addition to the cyclist,” emphasized
Moen. “Just like if you’re evaluating an injured runner, you have to
look at how he runs and the shoes he’s running in. Otherwise you
may totally miss the boat, end up treating inefficiently, and he’ll still
have the same problem.”
For cyclists with overuse injuries or musculoskeletal pain syn-
dromes, Moen said that issues can typically resolve within one or
two visits so long as treatment includes evaluation of the bike and
changes to positioning.
“If a patient comes in with iliotibial band or anterior knee pain, and
you work on strength, flexibility, coordination and anti-inflammatory
measures, but don’t look at the bike, I guarantee that person will not
get better,” he concluded. “So there are very simple things that PTs
can do to have successful, effective interactions with cyclists. But it all
has to be based on knowledge of the bicycle, how it works and how the
cyclist works on it.” n
Brian W. Ferrie is on staff at ADVANCE. Contact: bferrie@advanceweb.com
14 ADVANCE for Physical Therapy Rehab Medicine ❘ November 17, 2014 ❘ www.advanceweb.com/pt