Fitness questions and answers for April 11, 2005

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Form & Fitness Q & A

Got a question about fitness, training, recovery from injury or a related subject? Drop us a line at fitness@cyclingnews.com. Please include as much information about yourself as possible, including your age, sex, and type of racing or riding. Due to the volume of questions we receive, we regret that we are unable to answer them all.

Carrie Cheadle, MA (www.carriecheadle.com) is a Sports Psychology consultant who has dedicated her career to helping athletes of all ages and abilities perform to their potential. Carrie specialises in working with cyclists, in disciplines ranging from track racing to mountain biking. She holds a bachelors degree in Psychology from Sonoma State University as well as a masters degree in Sport Psychology from John F. Kennedy University.

Dave Palese (www.davepalese.com) is a USA Cycling licensed coach and masters' class road racer with 16 years' race experience. He coaches racers and riders of all abilities from his home in southern Maine, USA, where he lives with his wife Sheryl, daughter Molly, and two cats, Miranda and Mu-Mu.

Kelby Bethards, MD received a Bachelor of Science in Electrical Engineering from Iowa State University (1994) before obtaining an M.D. from the University of Iowa College of Medicine in 2000. Has been a racing cyclist 'on and off' for 20 years, and when time allows, he races Cat 3 and 35+. He is a team physician for two local Ft Collins, CO, teams, and currently works Family Practice in multiple settings: rural, urgent care, inpatient and the like.

Fiona Lockhart (www.trainright.com) is a USA Cycling Expert Coach, and holds certifications from USA Weightlifting (Sports Performance Coach), the National Strength and Conditioning Association (Certified Strength and Conditioning Coach), and the National Academy for Sports Nutrition (Primary Sports Nutritionist). She is the Sports Science Editor for Carmichael Training Systems, and has been working in the strength and conditioning and endurance sports fields for over 10 years; she's also a competitive mountain biker.

Eddie Monnier (www.velo-fit.com) is a USA Cycling certified Elite Coach and a Category II racer. He holds undergraduate degrees in anthropology (with departmental honors) and philosophy from Emory University and an MBA from The Wharton School of Business.

Eddie is a proponent of training with power. He coaches cyclists (track, road and mountain bike) of all abilities and with wide ranging goals (with and without power meters). He uses internet tools to coach riders from any geography.

David Fleckenstein, MPT (www.physiopt.com) is a physical therapist practicing in Boise, ID. His clients have included World and U.S. champions, Olympic athletes and numerous professional athletes. He received his B.S. in Biology/Genetics from Penn State and his Master's degree in Physical Therapy from Emory University. He specializes in manual medicine treatment and specific retraining of spine and joint stabilization musculature. He is a former Cat I road racer and Expert mountain biker.

Since 1986 Steve Hogg (www.cyclefitcentre.com) has owned and operated Pedal Pushers, a cycle shop specialising in rider positioning and custom bicycles. In that time he has positioned riders from all cycling disciplines and of all levels of ability with every concievable cycling problem.They include World and National champions at one end of the performance spectrum to amputees and people with disabilities at the other end.

Current riders that Steve has positioned include Davitamon-Lotto's Nick Gates, Discovery's Hayden Roulston, National Road Series champion, Jessica Ridder and National and State Time Trial champion, Peter Milostic.

Pamela Hinton has a bachelor's degree in Molecular Biology and a doctoral degree in Nutritional Sciences, both from the University of Wisconsin-Madison. She did postdoctoral training at Cornell University and is now an assistant professor of Nutritional Sciences at the University of Missouri-Columbia where she studies the effects of iron deficiency on adaptations to endurance training and the consequences of exercise-associated changes in menstrual function on bone health.

Pam was an All-American in track while at the UW. She started cycling competitively in 2003 and is the defending Missouri State Road Champion. Pam writes a nutrition column for Giana Roberge's Team Speed Queen Newsletter.

Dario Fredrick (www.wholeathlete.com) is an exercise physiologist and head coach for Whole Athlete™. He is a former category 1 & semi-pro MTB racer. Dario holds a masters degree in exercise science and a bachelors in sport psychology.

Scott Saifer (www.wenzelcoaching.com) has a Masters Degree in exercise physiology and sports psychology and has personally coached over 300 athletes of all levels in his 10 years of coaching with Wenzel Coaching.

Kendra Wenzel (www.wenzelcoaching.com) is a head coach with Wenzel Coaching with 17 years of racing and coaching experience and is coauthor of the book Bike Racing 101.

Steve Owens (www.coloradopremiertraining.com) is a USA Cycling certified coach, exercise physiologist and owner of Colorado Premier Training. Steve has worked with both the United States Olympic Committee and Guatemalan Olympic Committee as an Exercise Physiologist. He holds a B.S. in Exercise & Sports Science and currently works with multiple national champions, professionals and World Cup level cyclists.

Through his highly customized online training format, Steve and his handpicked team of coaches at Colorado Premier Training work with cyclists and multisport athletes around the world.

Brett Aitken (www.cycle2max.com) is a Sydney Olympic gold medalist. Born in Adelaide, Australia in 1971, Brett got into cycling through the cult sport of cycle speedway before crossing over into road and track racing. Since winning Olympic gold in the Madison with Scott McGrory, Brett has been working on his coaching business and his www.cycle2max.com website.

Richard Stern (www.cyclecoach.com) is Head Coach of Richard Stern Training, a Level 3 Coach with the Association of British Cycling Coaches, a Sports Scientist, and a writer. He has been professionally coaching cyclists and triathletes since 1998 at all levels from professional to recreational. He is a leading expert in coaching with power output and all power meters. Richard has been a competitive cyclist for 20 years

Andy Bloomer (www.cyclecoach.com) is an Associate Coach and sport scientist with Richard Stern Training. He is a member of the Association of British Cycling Coaches (ABCC) and a member of the British Association of Sport and Exercise Sciences (BASES). In his role as Exercise Physiologist at Staffordshire University Sports Performance Centre, he has conducted physiological testing and offered training and coaching advice to athletes from all sports for the past 4 years. Andy has been a competitive cyclist for many years.

Michael Smartt (www.cyclecoach.com) is an Associate Coach with Richard Stern Training. He holds a Masters degree in exercise physiology and is USA Cycling Expert Coach. Michael has been a competitive cyclist for over 10 years and has experience coaching road and off-road cyclists, triathletes and Paralympians.

Kim Morrow (www.elitefitcoach.com) has competed as a Professional Cyclist and Triathlete, is a certified USA Cycling Elite Coach, a 4-time U.S. Masters National Road Race Champion, and a Fitness Professional.

Her coaching group, eliteFITcoach, is based out of the Southeastern United States, although they coach athletes across North America. Kim also owns MyEnduranceCoach.com, a resource for cyclists, multisport athletes & endurance coaches around the globe, specializing in helping cycling and multisport athletes find a coach.

Advice presented in Cyclingnews' fitness pages is provided for educational purposes only and is not intended to be specific advice for individual athletes. If you follow the educational information found on Cyclingnews, you do so at your own risk. You should consult with your physician before beginning any exercise program.

Sore rear end question
More Upper Calf Pain...
Converting road bike fit to MTB fit
Position for Long TTs
Pedalling efficiency
Bone Density
Immune System
Cramp
Exercise Induced Asthma

Sore rear end question

I have been having a problem with the edge of the chamois in my shorts (Pearl Izumi) cutting into my buttock where it contacts the saddle (Selle Italia Prolink Genuine Gel). I enquired at the (reputable) bike store where I bought the shorts and they said they had not heard of this before. Is it a problem you have encountered previously, and if so do you have any suggestions how I could fix it? Many thanks for any advice you can provide.

Rob Bishop

Scott Saifer Replies

Hi Rob,

I have not had that issue with Pearl Izumi shorts. From your description of the problem, I judge that you need to get a different brand of shorts that has a pad that extends farther over the edge of the saddle. The edge of the chamois should be beyond the edge of the saddle so that your butt contacts only smooth pad, not edge. I can't recommend a particular brand since I haven't studied pad shapes. This is your chance to make yourself an expert on an esoteric aspect of bike tech.
Are you certain that you are contacting the edge and not a seam or a fold in the pad under the cover layer? Those could feel like being cut by and edge as well.

More Upper Calf Pain...

My pelvis is tilted, functionally making my right leg shorter. If you stand infront of me looking at me the right side of my pelvis is higher than my left. I hope that clears things up. Thanks.

Timothy Applegate

Steve Hogg Replies

G'day Timothy,

From what you say, it is very likely that your rightleg is overextending. In your original email you suggested that you are prepared to sort out the structural problems you currently have which is far and away the best long term solution. From what you have said previously, your right sacro iliac joint is either restricted or jammed totally. This is likely to need more than the Kit Laughlin book, some manipulation is almost certainly necessary as well. The enlarged left spinal erector suggests that you drop the right hip forward and down on every pedal stroke. In so doing, and because the restricted right SIJ causes the right ilium to drop with the right downstroke, the left spinal erector is loaded simply because it is trying to stay where it is.

Here is a suggested plan of action. Firstly, mount your bike on a trainer and have someone observe you from behind to confirm that you drop the right hip under load. Everything you have said earlier suggests that is the case but it is wise to confirm or otherwise. Proceeding on the assumption that you are, twist the nose of the seat to the right a little. This will bring the right hip back so that it is more or less square with the left one. If you point the seat nose too far, your body will not untwist with it, but rather the right hip drop will become even more exaggerated. Once you have a satisfactory level of seat twist, you may still need to build up the right rear of the seat where you bear your weight. This is to limit how far the right hip can drop. Properly done this will provide some level of benefit. However, no amount of stuff like this is a substitute for a pelvis that functions symmetrically, so the best of luck with your future improvement.

There is a small chance that once you have resolved the asymmetry off the bike, it will still occur on the bike. If this ends up being the case, get back to me and I will point you at the right people.

Converting road bike fit to MTB fit

Thanks for leading an extremely useful discussion of bike fit in recent months. After much tweaking, the moment when I made the final adjustment and felt my midsection relax was inspirational!

A final question (apologies if you have addressed this already and I missed it): if you have your road bike dialed, what modifications do you make to set up a mountain bike? Thanks for your thoughts.

Nathan

Denver, Colorado (where MTB season is upon us!)

Steve Hogg Replies

G'day Nathan,

I'm happy that you feel you are getting somewhere with your road position. I think that I covered this once before but I can't find it in the archives so here goes. How an Mtb position compares is an interesting problem. Let's assume that you are happy with your road position as you seem to be. With an Mtb, you want the same pedalling dynamics but the seat position will be measurably different to varying degrees because of

A. Suspension effect
B. Different pedal system and wider Q factor
C. Totally different bar set up

A. Suspension effect: The ideal is that when pedalling an Mtb, it should feel the same as that road bike that you are already happy with. If the Mtb has a rigid frame and fork and you are using the same seat and pedals as your road bike then it is simple to set up the seat position the same as your roadie. All you need is an indoor trainer to lock the bike up in, a 4 foot level to help with seat set back [don't ever use plumb lines, it is too easy to make a 10mm error!] and a measuring tape. Unfortunately it is unlikely that you are using a rigid frame and fork. If you are using a hard tail, the act of sitting on the bike will compress the front fork to varying degrees depending on the fork and how hard you have the preload set. As the fork compresses the seat will move forward and the nose of the seat will move down. Now the problem is that you want the same seat position as the road bike but you can only measure the Mtb when you are off the bike which of course negates the suspension effect. Typically, to counter the forward seat movement when the bike is weighted with rider caused by the sag of the front fork, the seat should be somewhere between 0.5 and 1.0 degree of seat tube angle further back.

This means from 5-10 mm further back for a small frame and 7-14mm further back for a large frame assuming an average seat height relative to frame size. On a dual suspension bike the rear end will sag much more than the front end, moving the seat further back than it measurably is when the rider dismounts and hence unloads the suspension. There is wide range of suspension systems and linkages out there for duallies and so the effect varies as it also does depending on the rider's weight and how much preload is dialled in. As a rule of thumb [not a phrase that I'm ever totally happy with] the difference can vary from 1.0 degree, to sometimes up to 2.0 degrees of seat tube angle. In mm this would mean a seat setback between 10 mm commonly, but up to 20mm further forward as measured with rider off the bike for a small Mtb, and for a large frame, 14mm commonly, and less commonly up to 28mm further forward with rider off the bike to mimic the same position as that same person has on a road bike.

With some of the dual suspension systems around, not only does the seat move backwards when the rider mounts but it also drops down somewhat as well. Assuming that you ride with your seat dead level [and you may not], on a hardtail you would need the seat nose slightly nose up off the bike to have it level on the bike. With a duallie the converse is true. All of this assumes that you are using the same seat as on your road bike. If not, things get a bit tricky as seats can vary up to 40mm in length and the design of different seats and where they have their width means that many seats of similar length force the rider to sit in different relative places fore or aft.

B. Pedal systems. The total height of your shoe sole and pedal and cleat system may vary between your road bike and Mtb. Many of the more recent road systems are very close or the same overall height as SPDs, but if using a non-Keo Look pedal for example, you would have to drop your seat 6-10 mm depending on what shoes you use, to get the same amount of leg extension when using SPDs on your Mtb. Mtb cranks have much wider Q factor measurements than road cranks. This forces the rider to a more heel in/toe out foot angle on the pedals. The feet are further apart but the hips stay in the same place. This in turn means that the ball of the foot moves forward as the heel is rotated in. If duplicating a particular cleat placement on your Mtb as on your road bike, always measure the cleat fore and aft position with the shoe in the pedal at the angle you would actually pedal at. As I said this is likely to differ somewhat on both types of bike. If using a Crank Bros Mtb pedal, the Q factor will be even wider again. They position the foot further apart than SPDs and their clones do.

C. Bar set up: Assuming the same seat is used as on your road bike and that you are using an Mtb 'flat bar', the overall distance from seat nose to handlebar is similar to what it would be on the road bike. On an Mtb the distance that the bar is below the seat is often 50-75 mm less than on a road bike for best control in a variety of terrain and conditions. In my view Mtb handlebars are poorly designed. With the 'flat bars' in their normal position the elbows are cocked and the shoulders carry unnecessary tension. Try rolling the bar back in the stem clamp so that the sweep of the bar is back and slightly down rather back and up. This is not a total solution but it makes a difference. With riser bars this can be accomplished better because many of them droop towards the outer edge. This means that as the bars are rolled back in the stem a much more comfortable position can be gained providing of course that you want the extra width of a riser bar. You are likely to have a few queries after reading this so let me know and we'll go from there.

Position for Long TTs

I've been crazy enough to be roped into the 80km bike leg of a Run-Cycle-Paddle event, and wondered whether setting up the bike for a TT (when you don't have a dedicated TT bike) is as simple as bolting on the aero bars. In club TTs of 25-40km this is all I've ever done. I've also completed a 63km and 57km TT with the same setup. I've done this more through ignorance of a better alternative than anything else, but would like an expert opinion on whether any other elements of the bike setup (eg, seat forward/backward, seat higher/lower) should be changed when going onto aero bars and if this could benefit me.

Unfortunately I'm a bit short (165cm) so my ability to gain an aerodynamic advantage through a more bum-up position is limited by the seat-to-handlebar height relationship. Is it worth investing in a stem offering a lower position? I have excellent flexibility in my hamstrings (take up yoga all you riders with back pain!), so getting lower isn't a problem from that respect, but I also understand that over 80km comfort might be more important than the benefits of a better aero position.

Quentin

Melbourne, Australia

Steve Hogg Replies

G'day Quentin,

Firstly have a look at the post: http://www.cyclingnews.com/fitness/?id=2004/letters11-08#Bike. Most of your question is answered there.
Next, don't worry too much about aerodynamics until you are convinced that your position allows good leverage on the pedals, good control of movement and the ability to breathe to the greatest capacity [a relaxed upper body is the same thing].
Once this is achieved then you can prioritise aerodynamics. Your greatest priority is to do a good time. An aerodynamic position is one of the means rather than an end in itself.
If you have further queries after reading that post, let me know.

Pedalling efficiency

I'm a masters-age cyclist, reasonably fit, been at it fairly seriously for seven years. I've been told I tend to hammer unevenly on the pedals - or make them go round in squares as some would say. I've had some advice from the bunch and tried a few things but my technique is still off the pace. I know this costs me in terms of power and overall efficiency. Can your team suggest appropriate exercises to make the right technique second nature? Many thanks

Mike V

Melbourne, Australia

Michael Smartt Replies

Hi Mike,

Before you decide if your pedal stroke needs to be significantly changed, let's look at some of the issues you have brought up. First of all, efficiency refers to the ratio of external work going out of the body (in cycling, we measure this as power output) to how much oxygen is being metabolized to perform the work. Since a cyclist is attached to the bike at the feet, saddle and hands, and movement (i.e.: pedaling) takes place in only one plane of motion, simply pedaling a bike does not require any significant level of technical skill (a good contrast would be swimming, where technique and physical capacity are almost equally important in achieving top performance). As such, there is little difference in efficiency between cyclists of varying levels, largely because of these "confines" the bike puts on the cyclist. Several research studies have demonstrated that over a large range of abilities, cyclists typically have an efficiency rate of 22-24%.

Furthermore, the idea of losing power due to a presumably inefficient pedal stroke is not supported either. Research comparing the abilities of state-class and national-class cyclists (Coyle, 1991) showed that the national-class cyclists had what is often incorrectly referred to as and "inefficient" pedal stroke. In a 40k TT test, the national-class cyclists put more of their power into their downstroke, while the slower, less powerful cyclists distributed more of their power in all directions of the pedal stroke. Yep, the more powerful cyclists mashed (at least more than the other cyclists) their way to 40k times that were 10% faster. One way to potentially change the efficiency of your stroke is by manipulating cadence. This is where it gets interesting, because if you pedaled with the intent on being as efficient as possible, you would ride around at a cadence that is much slower than the typically freely chosen cadence of most cyclists ( 90rpm). As cadence increases, so does the oxygen demand for a given power output. I personally don't know any top cyclists who pedal all day at 60rpm, so one has to wonder why having an efficient pedal stroke is a desirable goal at all.

While many cyclists, and coaches, will talk about having an "efficient stroke", that concept is really not supported when the variables of cycling efficiency are directly studied. There still might be some good reasons for you to work on your pedal stroke (e.g.: limiting the work done by the rest of your body), and I've yet to find a better way than by using a good old set of rollers.

Bone Density

I am a 44 year old Cat 3 racer. I'm 6 feet tall and weigh about 155 lbs, bodyfat 5%. I've been cycling for about 15 years now, but only racing for the last four years (lots of miles, commuting, touring in the previous 10 years, but no high intensity training/racing).

Presently I train about 12-15 hours/week, and lift weights three days per week off-season, and two light days per week during the season (I am 'in-season' now). I recently had a bone density test during an annual exam. The test consisted of putting my foot in a device that put two probes up against my heel, and took some readings. The results said I had low bone density (BMD = .359, Tscore = -2.0, if those numbers mean anything to you). I have also had blood work done, and found to have low testosterone levels (I don't know if these are related).

Can you tell me anything about low bone density, why it occurs, and what I can do about increasing bone density? Thanks.

Craig Long

Mesa, Arizona

Pam Hinton Replies

Hi Craig,

First of all, here's a bit of information about measuring bone mineral density (BMD) and the results of your test. Interpreting the results requires a brief explanation of statistics, so bear with me. There are two general methods available for measuring BMD: central bone density machines measure BMD of the hip, spine, or whole body; peripheral machines measure BMD of the heel, wrist, shin, finger or kneecap. The central BMD assessment provides more accurate and complete information than the peripheral measure. For the peripheral method, BMD of one site (e.g., heel) is used to estimate BMD of the whole body. Either method gives you bone mineral content per bone area. This absolute BMD is then compared to two standards: "young normal" (T-score) and "age-matched" (Z-score). The T-score compares your BMD to the mean (average) BMD for 30-year old males and is used to determine your fracture risk. The Z-score compares your BMD to the mean BMD of males of your age and body size. Because BMD decreases with age, the Z-score is not very useful in assessing fracture risk.

Everyone loses bone mass and increases their risk of bone fractures as they age. Your fracture risk is determined by comparing your bone density to the mean BMD of the young adult population. Your T-score is the variation between your BMD and the mean of the young adult population, expressed in standard deviations (each standard deviation [SD] is about a 10-12% reduction in BMD). The World Health Organisation defines normal BMD as a T-score of ± 1 SD. Osteopenia, or low BMD, is a T-score of -1 to -2.5 SD. Osteoporosis is a T-score of less than -2.5 SD. For each SD below the mean, the risk of fracture increases 1.5 to 2.5 times. To put the significance of low BMD into perspective, the relationship between low BMD and fracture risk is stronger than that between cholesterol and heart attack.

So, at this point, you are probably realizing that your T-score of -2.0 puts you in the "osteopenia" category with an increased fracture risk of 3 to 5 fold. Your low BMD may be a surprise to you because osteoporosis is typically thought of as a disease that afflicts elderly women. You have probably been asymptomatic as well, which is why osteoporosis is called a "silent disease". This apparently bad news really is good news--now you can take actions to increase your BMD. If untreated, your osteopenia would have progressed to osteoporosis.

There are three main factors (other than genetics) that affect BMD: nutrients, hormones, and mechanical stress. Any one of these or all three may have caused your low BMD. Many nutrients are needed for bone health, but calcium and vitamin D are the key players. With inadequate dietary calcium, the body has to use the calcium that is stored in the mineral matrix of the bones to keep blood calcium levels stable. Over time, insufficient calcium in the diet can lead to a significant loss of bone mineral, making the bones less dense and, thus, more fragile. The recommended daily intake of calcium is 1000 mg. Dairy products ( 250-300 mg calcium per serving) are excellent sources of calcium.

Other foods, like breakfast cereals, orange juice, and soy milk are sometimes supplemented with calcium, so check the food labels. Vitamin D is critical for calcium absorption from the intestine. The body can make vitamin D from cholesterol; the process requires skin exposure to ultraviolet (sun) light. So individuals who live in northern latitudes are at greater risk for vitamin D deficiency. Good food sources of vitamin D are milk and other dairy products, fatty fish and liver. Your low testosterone levels probably contributed to your low BMD, as growth and maintenance of BMD depend on normal hormone levels. The sex steroids (estrogen and testosterone) and growth hormone stimulate bone formation. For men, part of the normal aging process is a gradual reduction in testosterone and growth hormone production, which may contribute to lower bone mineral density. For both men and women, a chronic energy deficit causes a reduction in the sex steroids. Athletes who severely restrict their energy intake in order to lose weight or body fat may be in negative energy balance. For women, the lower estrogen production may result in irregular or absent menstrual cycles. Unfortunately, for guys, there are no overt signs of low testosterone levels.

Mechanical stress on bone is critical to maintaining BMD. Body weight is one source of mechanical stress on the skeleton. The significance of weight on bones is illustrated by the dramatic loss of bone mass that occurs with weightlessness (e.g., during space travel or bed rest). Low body weight is a risk factor for osteoporosis; your relatively low weight for height may have contributed to your low BMD. In general, physical activity increases bone density because of the increased stress on the skeleton. Dynamic exercise has a greater positive effect on bone mass than static exercise because it provides a larger stimulus for bone growth. Fluid shifts within the bone cells are the signals for bone deposition. High-impact activities like running and jumping cause greater fluid shifts than low-impact activities (e.g., walking or weight-training). Non-weight bearing activities (e.g., swimming, cycling) do not increase bone density.

A recent study of master cyclists, who had been riding for at least 10 years, found that the older cyclists had lower bone density of the spine and hip than young adult cyclist and age-matched controls who were moderately active. The cumulative effect of hours spent with the skeleton unloaded is the likely cause of the lower bone mineral density in the masters, but not young adult, cyclists. I have several suggestions for you. First of all, consider getting a whole body BMD test, as it will provide a more accurate assessment of your total BMD than the heel BMD test. Be sure that you consume adequate calcium and vitamin D. Follow up with your physician regarding your low testosterone levels, remembering that your testosterone will be low if you are not consuming enough energy to meet your needs. Consider adding some dynamic, weight-bearing activity to your training program. Running, jumping rope, and plyometric exercises, would all be good options. Good luck.

Kelby Bethards Replies

Again, I agree with Pam. I would add that taking calcium with vitamin D at 1500 mg a day is actually considered a treatment of sorts for osteopenia/osteoporosis. Also, in my experience, taking hip and lumbar BMD tests tend to be more accurate, if (and only if) they are interpreted correctly.

Immune System

I am a 38-year-old recreational cyclist (5'9" - 76kg). I have been cycling on and off for over 26 years but apart from a criterium and a couple of TTs in my teens I have not raced competitively. I am hoping that this year will see me compete in my first road race. My question centres around the issue of the effect of hard riding on the body's immune system.

I am still in the early stages of turning my body into a lean mean cycling machine and I'm only averaging about 120km (75miles) a week. This is achieved over five days of riding to and from work (20 km a day) with perhaps a club ride on the weekend. I am pleased with the progress in my fitness level but concerned that I regularly feel 'run-down'. I find it difficult to not ride medium/hard and I regularly feel like my immune system is under pressure and dealing with some mild cold or flu like symptoms. It doesn't stop me riding to work but I just wish my body could remain clear and 'powerful' for a prolonged period of time.

When my body is good I go hard. This often seems to result in me succumbing to another bout of feeling 'run-down'. It's like a cycle which keeps recurring. Can you recommend anything to boost my immune system; is my situation common and does the immune system become proportionally stronger as one becomes fitter? I am aware of the impact of sleep, diet, alcohol and daily stress on the immune system. I look forward to your response

Jason

Perth, Western Australia

Pam Hinton Replies

Hi Jason,

Let me reassure you that what you are experiencing is not uncommon, but unfortunately that won't make your flu-like symptoms go away. In fact, your sluggish immune system is part of the body's normal, adaptive response to exercise training. Exercise, particularly high intensity or exhaustive exercise, causes the brain to signal the adrenal gland to make glucocorticoid hormones. Cortisol release during exercise is beneficial because it stimulates glycogen breakdown and synthesis of glucose in the liver, making more carbohydrate available to the muscle. Cortisol is also a potent modulator of the immune response, which is both good and bad. Cortisol-induced immuno-suppression is beneficial in preventing excessive degradation and inflammation of skeletal muscle after exercise.

The downside of the immunosuppressive effects of cortisol is that it increases susceptibility to viral upper respiratory infections (URTIs) by shutting down cell-mediated immunity (see February 21, 2005 Fitness Forum for further discussion of the immune system). The increased susceptibility to infection in the 3-72 hours post exercise is the price that must be paid to reduce post-exercise muscle damage and soreness.

As you become a lean, mean cycling machine, you may find that your struggles with chronic infections diminish somewhat. Exercise training not only improves cardiovascular fitness and muscular strength and endurance, but it strengthens the immune system as well. Immune cells in the blood of exercised-trained individuals are less sensitive to the immunosuppressive effects of cortisol than the immune cells of sedentary individuals. As a result, the immune cells of fit people are less likely to be shut down by cortisol, increasing their resistance to infection. However, even the pros battle with URTIs after a sudden increase in training volume or following a stage race.

As you noted, adequate rest and a healthful diet are also key to staying healthy. If you were to make one change to your diet, consuming adequate carbohydrate during and after exercise, would be the one to make. Carbohydrate is the single dietary intervention that has been shown to reduce cortisol and catecholamine secretion in response to exercise and to maintain immune function after exercise. Vitamins A and C are needed to optimize immune function, so be sure to eat 4 servings of fruit (2 cups) and 5 servings of vegetables (2.5 cups) every day. Vitamin D is also needed for a healthy immune system and recent survey data suggests that many Americans have vitamin D insufficiency. We have two available sources of vitamin D; food and synthesis in the skin with exposure to UV light.

So, if you live above 40° N or S or if you religiously use sunscreen, you will have to rely more on food sources. Fatty fish, liver, and fortified dairy products are good sources of vitamin D. Of the minerals, zinc is needed for normal immune function. If you eat a normal mixed diet, including red meat, your zinc intake is probably adequate. However, if you follow a vegetarian or vegan diet, you may need to take a supplement. Remember, when it comes to vitamin and mineral supplements, more is not better. Stick with a multivitamin and mineral supplement that provides no more than 100% of the RDA. Staying well hydrated will keep your first line of defense against bacterial and viral invaders - the mucus membranes of your nasal passages, sinuses, and lungs intact.

Another strategy is to reduce your exposure to the disease-causing bugs. Use a saline nasal spray to keep your sinuses open and flushed clean of allergens. These sprays are available over-the-counter or may be mixed at home using pickling salt and water. Don't forget the tried and true way to reduce your exposure to germs--frequent hand washing. Take care.

Kelby Bethards Replies

I agree with Pam completely - the other thing I have seen, anecdotally, is success with echinacea and zinc when coming down with the URI's...and NEVER underestimate the importance of REST in a training program...not that you are overtraining, but when athletes overtrain, they become sick easier and even have mental health changes. So rest well, we don't want you to be a lean mean, whimpering mentally unstable racer.

Cramp

I'm a 30 year old male - 5'6 and 140 pounds, I train 2-3 times a week for 2-4 hours at a time.

I am a heavy sweater and I often experience sever cramp when racing. I have been using Horleys Carbo drink powder as it contains 221mg of sodium and 196mg of potassium and this has helped to some extent.

Is there something I should be doing before the race besides stretching and drinking (and how much should I be drinking before a big race)

Does diet have an effect on cramp and can my position on the bike also have an effect (I usually cramp while sitting). Nine times out of ten I only cramp in my thighs, usually after about 1 1/2 to 2 hours into a hard ride/race. Could this be a seat height problem, and if so what's the best way to determine the correct height? Thanks!

Adam

Kelby Bethards Replies

In my humble opinion, quadriceps cramps will arise from a couple of possible positional problems…all making the seat height virtually too low. But, the most common would be just plain ol' having the seat too low. There are various websites/etc that have seat height "calculators" etc. The one I have used and seems to be the one for me, is on Leonard Zinn's website. Zinncycles.com…they have a bike fit calculator on there.

The other two problems that I have seen give quad cramps is a seat too far forward, tilted down too much in the front and cleats positioned on the shoes so that the ball of the foot is behind the pedal axle.

Exercise Induced Asthma

I am a 61 year old male who has been riding and racing for many years. Some time ago I found it difficult to breathe during extreme exercise. This manifested itself in my inability to ride hard either on hills or (my version of) fast for prolonged periods. My nickname became "Puffing Billy".

On investigation, I was diagnosed with Exercise Induced Asthma. This was determined after an exercise ECG to exhaustion breathing through a mouthpiece. Oxis, Vicron and Tilade were prescribed. The Oxis and Vicron are taken (two puffs each) 30 minutes before exercise and two puffs of Tilade immediately before.

Whilst this has provided some relief, it has never been 100% and recently it has seemed to be less effective. My riding is mainly fun-rides in summer and short handicap and massed-starts in winter. I liken the effect to the end of a kilo or a pursuit.

I have varied my warm up techniques. Last week I did a short turbo session at home before going out to race. These have helped in TTs but not otherwise. Of course, it could simply be lack of fitness. With the fun rides and TTs that I have ridden recently, I don't think that is it. In the TTs and fun rides, one can back off before the heart rate gets too high but that is not an option racing.

I understand that this condition is quite prevalent in the pro peloton and hopefully your panel may have some helpful comments

Colin Evans

Auckland, New Zealand

Kelby Bethards Replies

Colin,

I have treated quite a few exercise induced asthmatics…and there is quite a bit of variation in the results. I had to look up the meds you are on, as they have different names in the USA. There is one other thing I think that could worth trying if it is available to you. Trade name: Singulair (generic: montelukast) Also, I couldn't find Vicron, so I am not certain what that is…

There are many "pathways" involved in reactive airways disease (asthma). Histamine receptors, beta receptors and leukotriene receptors. Singulair is a leukotriene inhibitor. The way I have used it is to have the athletes use it in the evenings (10 mg pill) for about three days prior to a big effort (hard ride, race, etc.) For easy rides they don't use it if they don't need to. It can be used with the beta-agonist and antihistamines. It just helps to block one more of the pathways responsible for bronchospasm.

I have one cyclist that I have treated that has been able to use just the Singulair - the beta agonist didn't give him as good a peak flow and made his legs feel heavy. We increased his peak flow by 30%, which helped him significantly (obviously).

There is another thing to consider - it sounds like your testing was extensive, so EIA is likely to be the diagnosis, but if the breathing problem seems to be in your throat, and give you a choking sensation,.acid reflux from all the increased abdominal/intrathoracic pressure is a possible complicating factor.

If the reflux is significant enough it can cause laryngospasm and the sensation of shortness of breath and choking…. The way to stop that is with a medication called a proton pump inhibitor.(Prilosec, Nexium, Prevacid, etc in the USA). Hope this helps - I apologise for not knowing the medication names in New Zealand, but your doctor may know the names there and if the Singulair is available.

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