James Daley: The Cycling Column

A balanced argument for physiotherapy

After paying a visit to Europe's only cycling ergonomics centre, Cyclefit, at the end of November, I found myself referred on to a specialist sports physiotherapy clinic, Balance in south London, due to some niggles I was suffering from in my left knee.

While Cyclefit had tweaked the positioning of my saddle, handlebars and shoes to ensure I was cycling as efficiently as possible, as well as to minimise any impact on my joints they decided that the ongoing problems in my knee required a more specialist opinion.

My hour at Balance last week was in many ways similar to my morning at Cyclefit, as I found myself being filmed on my bike and on the treadmill. But this time, the focus was more on the movement of my knees and pelvis, and whether I was keeping these in straight lines, as I should be.

A quick check of the video gave an insight into why I was suffering from problems in my left knee. On each peddle rotation, my left leg was swinging way over to the right, while a similar imperfection could be seen while I was running.

Graham Anderson one of the owners of Balance, who is a physio at the All-England tennis club and has worked with numerous national sports teams pointed out that Lance Armstrong always talked about his legs as being like pistons, and this helped me to visualise what I should be aiming for. In the video, my legs looked nothing like pistons they were all over the place.

A few tests of my flexibility gave a few more clues to why I might be suffering. For a start, my hamstrings were clearly very inflexible compared to other muscles in my legs, and, interestingly, I tended to be much stiffer on my left side. This was certainly true when it came to testing the flexibility of my "gluteus" muscles (that's your bum muscles), which were tighter on my left side.

Before I left, I was given some stretches to help improve flexibility in my hamstrings and glutes and over the past few days, I've been doing my best to find time to do them.

The problem for commuters like myself, is that it's almost impossible to find time (or space) for proper stretching once you get to work. Yet, Cyclefit were quick to remind me that getting off your bike and slumping into an office chair for several hours is about the worst thing you can do.

I'm lucky enough to have showers at work, but I don't think I will persuade the paper to provide a nice soft stretching area.

For the time being, I've decided to settle for a quick touch-my-toes hamstring stretch when I get to work, and a proper stretching routine when I get home.

I'm sure it'll take several more weeks to get on top of these problems, and to improve my flexibility, but the process has helped me to realise how ignorant I was to ignore the pain in my knees over the past few months. I think part of the problem in Britain is that it's very difficult to get physiotherapy on the NHS unless you've got a very serious condition and private rates remain relatively steep. Friends of mine in the US know that their insurance will pick up most of the bill, so are more inclined to go. But several weeks of private treatment in London can easily set you back 400 or 500, not exactly small change.

The sad truth is, that had I not been offered all this treatment for free, as a result of my job, I may never have bothered to get these problems checked out. I'm glad I did.

Visit The Independent's cycling blog, Cyclotherapy, at www.independent.co.uk/blogs