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Asthma medication and riding
Dear fitness panel,
What is the effect of Asthma on the (cycling)performance? And does the effect of cortisone and Ventolin (really) boosts the performance?
A few months ago I was diagnosed with Asthma. While there weren't any troubles with the normal long function test 6,5 litre before and after Ventolin intake (I am a 1.96m, 84kg male - 30 years old). The "provocation" test was really bad. They gave me Histamine and after three times inhaling that stuff I thought I was dying.
So now I am looking at the medication in front of me and I am really in doubt whether to use it or not. Honestly, although feeling some pressure on my chest and not able to breathe as easy as I use to do it doesn't affect my normal activities at all.
But I do have troubles on the bike, especially in stressful situations, with interval training or after two hours of my training rides. It's is just like my body doesn't want to breathe.
I was reading about (long-time) side effects of cortisone intake, and asking myself what to do. So in my consideration it would be real good to know If it really can boost my performance or not.
Thanks very much.
Amsterdam, the Netherlands
Kelby Bethards says:
You have, in a way, answered your own question... "But I do have troubles on the bike, especially in stressful situations, with interval training or after two hours in my trainings ride. It's is just like my body doesn't want to breathe."
You cannot perform well without oxygen, and if you cut your capacity to carry and supply oxygen to the tissues (brain, muscle) you will NOT perform as well. Asthma "clamps" down the airways, thus allowing less total volume to flow to your lungs when you breathe. Thus, requires more energy, just to breathe and limits your performance by limiting the most important fuel you have, oxygen.
You have, so it seems, EIA, Exercise Induced Asthma. While it may not have effects on day to day living, it DOES adversely effect cycling performance. Depending on the testing, I typically have used a Leukotriene inhibitor and Ventolin as a treatment for this, but the steroid is good too.
One thing to note, you will not necessarily be "boosting" your performance, so much as you will be allowing your body to perform to its full ability. By treating the asthma appropriately, you will be able to perform as you should. AND in a sport where a slight performance inhibition can be very very detrimental, you will perform better.
I suggest you try a ride without (as you have) your medicines (BUT HAVE YOUR VENTOLIN WITH YOU), and see how you feel. Then treat yourself as you were directed and see if you feel and perform better...
One last thing, with the EIA patients I have, I don't necessarily have them treat themselves every day, just when they know the effort they are doing will elicit the asthma attacks.
Dropping left hip
I have noticed that my left hip drops more during the downstroke than my right. A fellow cyclist pointed out that my left side looks lower. So i put my bike on the trainer and had a look in the mirror. I can see that it does indeed seem to drop more than the right.
I do get some discomfort on my left side and it just doesnt feel as comfortable as my right.
A few things I have noticed:
- My right foot is more to down than my left (I think may be wrong, but this could cause a slight leg length issue as the pointed foot makes my right leg effectivley longer)
- After a while I get a slight pain in the bit slightly above where the tounge of the shoe meets the foot only on my left side
- I feel like there is more weight on my left side (feel this in my tricep/shoulder blade)
- My left calf/foot sometimes feel like it is twisting
I am pretty sure no leg length issues exist, but am going to a chiropractor to get some x-rays taken to confirm this.
Really hoping you can help me out here!
Steve Hogg says:
The key to understanding your predicament is that we need to be as functionally symmetrical as possible to interact with a bike with lowest chance of injury and best potential for performance. Any challenge to the stability of a rider's position from any source will evoke a compensatory response. All patterns of compensation on a bike work by further increasing the natural human tendency to asymmetry.
So you are dropping your left hip and no doubt one of your methods of compensating for that is to pedal in a more toe down fashion with the right leg so you can reach the right pedal as you have noted. But what we need to know is why are you dropping your left hip?
You are dropping your left hip because that is your (only partly effective) way of dealing with a challenge to your position. The challenge could be any one or any combination of the following -
1. An arch that drops under load on one or both feet.
2. Too high a seat height. For years I've noted that most people sit too high (unless they are very tall in which case most really tall people sit too low), maybe you are too.
3. Much tighter in left side hip flexors and lower back
4. Shorter leg on either side
5. Jammed sacro iliac joint on the left
6. Bar height that is too low or too far away
7.Poor foot cant on the pedal on one or both sides.
8. Not enough foot over the pedal
9. Marked right cerebella hemispheric motor control dominance
I would suggest trying the easy possibilities first. Try dropping your seat 5mm and see if that makes a noticeable difference. Let me know one way or the other and we'll proceed from there.
Three Tours challenge
In just over one year I will have finished sixth form college and it will be time for me to go to university. I currently ride approx. 8 hours a week, and am of medium fitness, and comfortably ride 50-80 miles at weekends (50-60 miles solo with no stops, or 80 miles club run with cafe stop). I have a resting heart rate of 58bpm, and I am 6' 3" weighing in at around 70kg.
I have seen a website about Mick Ives' 3 Tours Challenge, where he completed the routes of the Giro D'Italia, Tour De France and Vuelta a Espana in one day less than the pros, all in a single year.
Over the past few weeks I have been toying with the idea of having a gap year before I go to uni to complete a personal challenge to either raise funds for tuition or for charity. Mick Ives is obviously incredibly fit, but my question is: would it be physically possible for a teenager like myself to complete a challenge similar to that of Mick Ives, and complete the routes of the 3 grand tours in the same number of days as the professionals with the time frame that I have to prepare? The challenge would take place in 2012.
Thank you in advance for your advice.
Scott Saifer says:
No question if you are already riding 60-80 miles per day, you have two years to train, you'll be taking one of those years off to focus on training, and you are basically healthy and plenty lean, you can, with some luck, complete the challenge you are considering setting yourself - completing the routes of the three grand tours in a day less than the pros.
You'd be putting in some very long days so if you asked about completing the routes in fewer hours, forget it of course. You might have some trouble covering the exact route if any of the exact route segments are not open to bikes other than on Tour days.
Lower back pain
I just read the question from Dave Walker on "Lower Back Pain". I had almost the exact same symptoms as Dave with my lower back. Then, I found out about a muscle called the Psoas. I believe there is a Psoas Major and Minor.
Stretching this muscle (or muscle group) changed everything for me. I am now able to do my six hour plus MTB races, or 100 plus road miles, without lower back pain. It's a huge deal for me! I even feel better sitting at my desk during work. I stretch after every workout.
I'm no expert. But, I think it may be important to have all the muscles in your body loose and stretched before making any other changes.I just want to tell Dave, stretch you Psoas, stretch you Psoas, stretch you Psoas !!!
I'm interested to hear your opinion on the Psoas. Or better, the properly stretched Psoas.
BTW, I really enjoy reading the Cycling News fitness Q&A section. Thanks for lots of sound advice!
Steve Hogg says:
This is probably more a question for Dave Fleckenstein and he may weigh in with an authoritative answer. As you've asked me, in the meantime, here goes.
The psoas major (some people don't have a psoas minor) originates at the front and sides of the 5 lumbar vertebrae and the lowest thoracic vertebra on each side and crosses the hip joint, lumbosacral joint and sacro iliac joint on each side and attaches to a bony protuberance high on the inside of the femur named the Lesser Trochanter.
The psoas plays a complicated role in movement and posture and is working in just about any posture we can maintain except lying in bed or similar. The psoas helps maintain an upright posture when standing or sitting; it helps flex the spine forward; tilt the pelvis forward, lift the upper leg, turn the leg inward and outward and plays a part in stabilising the spine. In short it has a complex role and is working almost the entire time that we are conscious.
However it is poorly adapted to an upright bipedal posture. In quadruped mammals the angle between torso and upper rear leg rarely exceeds 100 degrees and the psoas only has to stretch to allow that. In contrast, to stand upright, humans need an angle between torso and upper leg of more or less 180 degrees.
Knowing this and the complex role the psoas plays in movement and posture, it is hot hard to see that a tighter than ideal psoas can play havoc with our movement patterns, (and potentially) be the source or part of the picture of back pain, bulging or ruptured discs, lumbar degeneration, compression of the femoral and sciatic nerves, groin pain, excessive flatulence, front of thigh pain, constipation, femoral nerve pain, sciatic pain and a long list of other ailments.
So why would a psoas tighten up more than other muscles?
Most of us don't stretch enough and we spend too much time sitting; 12 or more years at school, at home watching TV, eating dinner or working on the computer; at work, in a car, bus or train travelling to work etc, etc all while seated. Excessive sitting equals short, tight psoas which has a negative effect on posture as soon as we stand up.
In addition, and more specifically cycling related, a tighter than ideal psoas through a process called 'Reciprocal Inhibition' causes tightened, weakened glutes and tightened hamstrings. Our glutes are the largest, most powerful muscle group in the body and anyone who is serious about their cycling performance needs to have their glutes working properly. This won't happen with a psoas that is too tight. How common is a psoas that is too tight?
And the varied fallout is the most common problem that I have to deal with or work around when fitting a client to their bike.
So you are right, STRETCH YOUR PSOAS (but not just your psoas). If you are interested in finding out more, there is a wonderful short book called "Front To Back - The Hidden Culprit" by Aileen S Jefferis. Aileen is as close as I have ever met to a world authority on psoas hypertonicity and treatment.The book is written for a non medical audience and is available on the net.
Etape du Tour training issues
I cannot figure out went wrong for my Etape du Tour experience this year and hoped you could shed some light so I do not repeat the experience next year.
I enjoyed the Etape du Tour cyclosportif last year up the Ventoux and after doing a slight change in training this year (see below) which though would make me faster I struggled all day.
I am a 90kg, 6'1" muscular build cyclist with low body fat while this hinders my climbing I can typically grind out all the local climbs at 6,000-14,000 ft here in Colorado.
- I went in to the ride with over 3k miles of cycling this year same as last
- This was accumulated by doing approx 200 miles per week commuting and EM rides.
- In addition to this I did min of one hour tempo twice per week
- One day each weekend I would do 65-80 miles with 8-13 mile climbs at 5-7 percent
- The following day I would do light EM rides for recovery
- The only things I changed this year from last was I did 2 days per week of high intensity max effort two minute intervals which I did to make me faster
In June I did a 500-mile week-long tour of Colorado but kept my efforts less than 80 percent of max HR
Two weeks prior to going to France I traveled for business and did not ride.
one week prior I arrived in France and did two endurance paced rides with one intensity session for less than one minute
- At the beginning of the Etape I noticed my HR was unusually high.
- I took it easy up the col du Marie Blanc
- Unfortunately this was the best I felt all day.
- I struggled to maintain 7mph up the col du Solour (typical climb speed is 8-10mph
- When I got to the Tourmalet I thought I was going to have to pack in.
- I was very uncomfortable on the bike I could not spin and had to stop approx every mile to stretch and try to gain some strength to continue and felt like I was over heating
I maintained my usual 65 gram of carb per hour and drank min 20 oz of water per hour.
Was it the food - did I need more?
Was it the lack of last few weeks of training?
Did I still have jet lag?
Did the 500 miles fatigue me more than I knew?
Any help advice appreciated already thinking of how I do better next year.
Scott Saifer says:
It sounds like the most likely explanation for your problems relates to the last couple of weeks before your trip, but fill in a few more details so we can be sure. How many two-minute all-out intervals did you do in each session, and were those in addition to the tempo and hill days or did you replace some other harder day?
How hard do you ride your 8-13 mile climbs on the weekend? Are you saying the only riding you did in the final two weeks before l'Etape was the two endurance paced rides?
If you did two-minute intervals to exhaustion in addition to two tempo rides and a long, very hard climbing day each week, you were most likely deeply fatigued, though the fatigue may have come on gradually enough that you didn't recognise it.
Did you have any signs of fatigue such as changes in appetite, difficultly raising or controlling your heart rate, trouble sleeping or sore muscles? As a general rule, you'll get more from your training if you limit harder-than-endurance riding to one or two days per week rather than more, other than occasional peaking periods where you might do a third day for a few weeks running.
If you really only did two riding days in the two weeks before the big day, that in itself would explain having a terrible day at l'Etape. I have many times had riders who were in great shape report lousy performance the first few days back from a week of lay off. In particular when a rider has had two or more days off in a row, the heart rate almost always rises unusually easily and stays high for the power generated.
You might or might not have needed more food, but since you started to suffer early in the ride, it's unlikely that lack of food was the problem, unless you didn't do a good job of fueling up the night before.
Leg length affecting riding
Hello again, I written before regarding fit issues and have been given some great advice, but still have some issues I can’t figure out as far as fit.
A little background about me. I'm 53yr old male, 168 lbs, 5'8" tall, and ride between 6000 and 7000 miles per year for the last 19 years, race road in masters and mountain as cat 2 masters.
I broke my right hip and right leg as a child and as a result my right leg is 1cm shorter (measured with a tape by my orthopedic and a physical therapist). I use speedplay pedals (the ones with free float). Seat height 73.3cm, crank length 172.5mm, front tip of saddle to centre of bars 53cm and ride a 55cm Bianchi.
I used to have a Polar with power (crashed last year and broke it, and have not replace it) that showed how equal your pedal stroke is and I use to get 48 percent-52 percent per leg and even 50 percent-50 percent at times, but I always felt like I was limping while pedaling and did drop my right hip (wife watched from above and behind while on trainer) but never really had any problems (sometimes right IT band hurt) and could ride 100 miles with no discomfort.
Last winter I had a bad case of hip bursitis in my right hip, treated with two cortisone shots and physical therapy. Both my orthopedic and physical therapists are bike riders and said the bursitis could have been caused by improper bike fit causing me to do some adjusting with my fit. I placed a 3mm shim under my right cleat to address the leg length difference, moved my saddle height up and down, back and forth until I settled on the above numbers (have always been bad about moving my saddle up and down trying to find that perfect spot).
Now my left quad seems to be working harder and burns before my right quad (to the point that while doing intervals I have to stop because my left quad starts burning so bad) and I feel like more of my weight is on the left side of my butt while on the saddle. I readjusted my cleats moving them forward about 5mm but still under the ball of my foot but now the front of my left knee tends to get sore.
Some of the guys I ride with told me I looked to be seating more to the left of my bike than I use to. I have never had any problems with my left side before these adjustments and I'm wondering if I should take off the shim ignoring the leg length difference but I do not want bursitis again.
I don't have any of these problems on my mountain bike but I would guess it's because I’m moving around so much and not just sitting in one spot spinning.
Any help will be appreciated
Steve Hogg says:
You're sitting too high. Drop your seat, test for a week and drop more if necessary. You've got a shorter right leg and have probably developed a left cerebella (right side of body) dominant pattern of motor control because you have had to favour the shorter right leg all of your life.
You probably do need a shim under the right foot but only experimentation will let you know how much; but everything you describe - more pressure on the left sit bone, quad burn etc, suggests that your seat is too high and this challenge to your position means you will do what you have likely spent a lifetime doing, which is look after the shorter right leg. That means that you are dropping your right hip and causing your left leg to reach too far to the pedals.
Drop your seat and let me know if that doesn't favourably impact on the situation.
V02 Max and age
I am a 49-year-old male (50 in October) weighing about 165lbs with around 17 ercent body fat. I have gotten back into riding with a little more intention with the desire to perform well in a 10 mile team TT in the Texas heat.
In my 20's I raced bikes/did triathlons and when I was 24 I had my V02 max measured on a treadmill using, I believe, the Bruce protocol and it was 69.5. I know V02 max on average tends to decrease about one percent per year after about age 30.
And I have read that some people who remain highly trained and fit can keep most of their V02 max into their 50's. I also believe that the decrease is more a function of a decreased muscle mass and increased body fat, along with decreased training intensity.
My basic question: If I reduced my body fat, increased my muscle mass and trained appropriately (I have about 4-5 hours per week) could I recover or get close to my old V02 max? Thanks so much!
Scott Saifer says:
Unless you have accumulated injuries in the meantime, you can get your VO2-max at age 50 back about where it was when you were in your 20s. The research says that athletes who maintain a high level of training maintain their VO2-max at least out to about age 55, and probably more, though 10 years ago when I was doing my library research on this topic there weren't enough 60+ year olds training as much as they did when they were 20 to create a statistically significant data set, so it's possible that VO2-max can be maintained even beyond 55.
In order to get back to your old VO2-max, you'd need to get back to your old weight. VO2-max is more a function of maximal cardiac output (how much blood can your heart pump in a certain amount of time) than anything that happens in your muscles, so muscle mass is not relevant so long as have enough to use the blood that your heart can deliver.
Four to five hours per week is not a lot of training. It may or may not be enough to optimise VO2-max. Certainly if you could up that to eight hours per week or so and keep it there for a 2-3 months, you'd max out your VO2-max.
There are two elements to training to maximise aerobic power. First is to remember that we are talking about aerobic power: you want to do aerobic base sort of training to optimize VO2-max. Second is that when you test VO2-max you want to make a very hard effort and not blow up mentally. You want to keep going until your muscles give out even while you maintain effort and motivation. That takes some practice at very high intensities.
I'm not sure why you would train specifically to ace a VO2-max test, but if that were really your goal, I'd have you ride base pace, every other day for two months, then add one day per week where you go flat out until you blow for two five-ten minute intervals (after a good warm up and with some recovery in between of course). When you've been doing those for about four weeks, you'd be ready to test.