A foot and ankle examination to identify foot flexibility, ligamentous laxity, and position in weight bearing (i.e., degree of navicular drop) may illuminate a potential culprit for more proximal problems.If available, the third part of the cycling-specific evaluation should include an assessment of the cyclist’s position and biomechanics on the bicycle. This requires relatively little in equipment, a stationary bike trainer, and a keen eye for mechanics. The physician should not double as a bike fitter without the appropriate training and certification; however, the physician should be familiar with the basic principles. A collaborative evaluation with a certified bike fitter, as is done in our Cycling Medicine Clinic, is extremely helpful in making specific recommendations regarding modifications to fit or components.