Saturday, June 30, 2018

Review of the Schwinn 170 (MY17) Exercise Bike

I’m doing something different today. I’m reviewing an exercise bike I bought recently, with a section at the end especially for people with knee problems.

First, cycling can be a great activity for bad knees. However, a few things are important before you make cycling your knee rehab activity: (1) Your knee must have good range of motion, so that you can go through the full pedal stroke without discomfort during or after (2) Your knee must “like” cycling – different knees like and don’t like different activities (3) You need to be able to control the effort expended so you don’t overdo it.

Number three is why you should consider using an exercise bike as opposed to cycling around the neighborhood, especially if the neighborhood happens to be hilly, or has a lot of traffic lights that cause you to stop and go a lot. Generally, cycling steadily at a low resistance (or backwards for no resistance at all) is much easier to do on an exercise bike.

Now a short lead-in, explaining how this Schwinn wound up in my basement’s exercise room:

The death of my old stationary bike, a Bodyfit 90x (that came with the house that we bought in April 2014) made buying a replacement necessary. The drive belt frayed apart. (As I had a little free time, I disassembled the bike, scavenging interesting-looking bolts and other pieces. There was a beautiful cast-iron flywheel inside, but even thinking creatively, I could see no future use for it, so reluctantly placed it curbside with the trash.)

On to the review:

The Schwinn 170 (MY17) plugs into the wall and has a detailed console. A user can choose from a selection of rides, from mountains to light cruising through the park (or you can just start spinning away on a flat course, if you wish). The Schwinn is Bluetooth enabled (for geeky super-connectivity). It also supposedly syncs with some virtual reality devices (which I think is cooler).

The seat adjusts for varying heights (warning: it’s a bit limited on the top end – a proper cyclist sets up a seat for a near-full leg extension, and following that rule of the thumb on the Schwinn will only get you to a 6’ 2” or 6’ 3” person, it appears. I’m 6’ 0”, and my seatpost setting is only one hole above the safety warning.)

Set up: It comes in a heavyish box. I set up mine in one hour forty minutes and easily could have done it faster, had I needed to. Unpacking the pieces and laying them out on the floor (always your best strategy) took a good fifteen to twenty minutes of that assembly time. The nice thing is there aren’t too many parts to deal with. Some negatives on the assembly: the included Phillips-head screwdriver on the multi-purpose tool isn’t a good fit for the screws, so be careful not to strip them (I used a smaller screwdriver from my toolbox). Also, like most exercise bikes in this price range, it has its share of cheapish molded plastic. The main shroud, for example, isn’t designed particularly well and doesn’t fit as well as it should.

Pros:
* Very quiet and smooth.
* Value: It was $324 on Amazon with free shipping (when I bought it). I would call that a good value for an exercise bike that has all these features. 
* The resistance spans an impressive range: 1 is very easy (my wife, a non-cyclist who gets little exercise and who kind of has a bum knee, thought 4 was fairly easy). At the high end, level 25 will grind even a Tour de France rider into dust in short order.

Cons:
* The pedaling speed measurements are terrible. On a regular bike, I can sprint at 30 miles per hour or higher; if I crank up the resistance and put forth the same effort, this bike registers about 24 mph (my old Bodyfit was much more accurate). On the low end, I can barely pedal and still get credit for 10, 11 mph. Because the speed is close to useless, I wouldn’t put much credence in the reported distance (as distance is a function of time multiplied by speed, and we already know the speed is off).
* The seat is spongy and looks ample for the largest of derrieres, but not that comfortable. I did gradually get used to it.
* The “media tray” is friendly to the iPad user or DVD watcher; it is not very good for physical books.
* I think the console could be better laid out. For example, the right side is devoted to showing what percentage of your maximum heartrate you’re at, in 10% increments. To save space, just put that number in a box. Also, a better system would allow the user to input their own maximum heartrate, as there can be high variability here (I know a 56-year-old who has a max heartrate of 185, when “normal” for a man that age is about 165!)

For the knee pain sufferer: Yes, you can pedal backwards with no resistance, if you want to. If you can handle the lowest level of resistance, or 1, you should be able to get in a nice, easy ride. Also, the bike’s smooth ride is favorable for knee rehabbing.

So that’s my take on the Schwinn 170 (M17) – and if you’re wondering why the “MY17”, it apparently signifies the later edition of the bike.

Hopefully I’ll be able to do a few more cycling-related reviews in the months to come. I’d love to review Zwift, which is kind of like an immersive cycling world, but the monthly fee of $15 has put me off. If I’m going to spend money for indoor cycling equipment, I really don’t want to be shelling out for montly subscriptions on top of that, unless they’re really cheap.

Saturday, June 16, 2018

When You Lose the Thread Between Cause and Effect

Knee pain is often a strange, baffling thing.

I tried to figure it out. I eventually healed my own hurting knees, and learned enough that I was motivated to write a book about my experience.

But at the same time I knew there was a whole lot I didn’t understand (and neither did the smart people out there who study the origins and treatment of knee pain).

One thing I always tried to do: draw lines between cause and effect, especially when I had a setback on the long road to getting better. For me, setbacks were like small teaching moments: my body teaching me something, very important, about how I should go about healing.

Sometimes it’s easy to draw that line. If you carry a heavy backpack up six flights of stairs, then have knee pain the next day, or a couple of days later, what caused it isn’t much of a mystery.

But what’s frustrating are those setbacks when you can’t point to a likely culprit. What then do you do? What if your knees hurt worse then ever, out of the blue, and you can’t figure out why?

These are the good, hard questions. I’ve thought about them more since I started the blog, as a stream of readers have confronted me with issues that weren’t always ones I had to deal with, but that usually made me think.

My gut feeling – and this may work for you, or may not – is to hit the reset button and scale back your activity significantly. Maybe try returning to your activity level from a couple of months before?

But I would be reluctant to go “full couch potato.” I’m not saying it doesn’t work for some people, because apparently it does. But I’d rather find a way to get in some motion, even if I’m seated and resting my feet on a wheeled dolly that I slide back and forth, back and forth.

It can be maddening to be racking up small wins over three or four months then have a weird, sudden, inexplicable setback. But they happen. I think there is a reason for all setbacks, because I’m that kind of logical “things happen for a reason” kind of guy.

But let’s face it: the human body is a very complex stew of chemicals and cellular processes, all interacting in complex ways. It shouldn’t surprise us that the results of some of these interactions are close to unknowable. And some of them probably lead to unpleasant knee pain symptoms.

So, even if you can’t figure out what caused your setback, carry on. Don’t get too discouraged. Try to figure out what you can, but I think there will always be mysteries.

Saturday, June 2, 2018

On Experts, and a Growing ‘Antipathy to Expertise’

A recent article in Harvard Magazine, “The Miracle of Knowledge,” gave me occasion to reflect on my ordeal with knee pain. A political scientist by the name of Tom Nichols has noticed in American public discourse “a new and accelerating – and dangerous – hostility toward established knowledge.” The article refers to it as an “antipathy to expertise.”

The article caught my eye, because in a sense I suppose my knee pain recovery can be construed as an “antipathy to expertise.” Ultimately I rejected what my doctors and physical therapists – the true experts – told me about my prognosis for healing, and about what my treatment should consist of. I became a Google’ing omnivore, devouring all I could find about knee pain similar to mine, and sifting for clues about how I could beat this condition.

In the end, I think I proved the experts – at least those in my immediate circle – wrong. I healed, when I was told I couldn’t, and did so by rejecting the core muscle-strengthening advice of my physical therapist. If there were a parade of “don’t trust the experts” activists you might expect me to be right up front.

Except I wouldn’t be. Not at all.

In fact, I pretty much agree with Nichols. I'm also worried about the erosion of belief in experts, which is all too often replaced by the conviction that an ignorant opinion, or a private consensus reached after consulting the Google hive mind, works just as well. “Who needs doctors, climate scientists, whatever?” This attitude frightens me because today, more than ever, a cavalier disregard of facts and truth is becoming acceptable.

So to be clear (and some of you have heard this before):

* If you have knee pain, I would always start by seeing a doctor. In comments on this blog, I’m careful to say that. At the least, a doctor can order imaging and other tests that can shed light on what’s going on in your joint. But more than that, a doctor will typically have the intelligence, breadth of knowledge, and experience (gained from examining scores of patients like you) to make a better diagnosis than Mr. Google.

* My rejection of the experts wasn’t knee-jerk and immediate. It arose from three main things:

(1) Doctors never gave me a plan for getting better. A plan – “do this, then this, then this” – I would have respected. A fatalistic shrug, or the tepid suggestion to avoid activities that bother my knees – that feels like a dereliction of duty.

(2) In other cases, the plan I was given failed. At some point, when confronted with repeated failure, you have to wonder, “Is it just me or could the advice I’m getting be faulty?”

(3) I tried to approach the puzzle of my knee pain in a scientific-minded way. If my doctors knew X and Y, I looked for Z, the thing that perhaps clinical trials had discovered, but that wasn’t commonly accepted when my doctors were being taught in medical school, five, 10, 20 years ago. An example: I located a clinical study where cartilage defects improved, at a significantly high rate. This is part of what informed my optimism about my knees getting better. And I also looked for smarter, out-of-the-mainstream experts. I was lucky to find a few.

So with experts, I would not reject their opinions out of hand. Experts are experts for a good reason. But there are times when they are wrong, and that possibility, no matter how small in a given instance, can’t be overlooked. They are not some monolithic, omniscient body. They are people. And people are fallible.