Fitness questions and answers for April 8, 2008

Got a question about fitness, training, recovery from injury or a related subject? Drop us a line at...

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.

Jon Heidemann (www.peaktopeaktraining.com) is a USAC Elite Certified cycling coach with a BA in Health Sciences from the University of Wyoming. The 2001 Masters National Road Champion has competed at the Elite level nationally and internationally for over 14 years. As co-owner of Peak to Peak Training Systems, Jon has helped athletes of all ages earn over 84 podium medals at National & World Championship events during the past 8 years.

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. Clients range from recreational riders and riders with disabilities to World and National champions.

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.wholeathlete.com) is an Associate Coach with Whole Athlete™. He holds a Masters degree in exercise physiology, is a USA Cycling Level I (Elite) Coach and is certified by the NSCA (Certified Strength and Conditioning Specialist). Michael has more than 10 years competitive experience, primarily on the road, but also in cross and mountain biking. He is currently focused on coaching road cyclists from Jr. to elite levels, but also advises triathletes and Paralympians. Michael is a strong advocate of training with power and has over 5 years experience with the use and analysis of power meters. Michael also spent the 2007 season as the Team Coach for the Value Act Capital Women's Cycling Team.

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.

Subcutaneous nodules in cyclist
Which frame to choose?
Hyperglycemia insulin and riding
Junior gears
Calf cramps
Scaphoid fracture

Subcutaneous nodules in cyclist

I am a male, 25, I race expert MTB and have developed what seems to be a subcutaneous nodule at the base of my sit bone and saddle contact point. I was riding a lot of 3 hour days in the saddle ignoring any discomfort. It is a small nodule, the size of an almond, and I can still ride but I think it will make it worse. Seeing that the season is about to start I have decided to cut back on the long miles and do short interval sessions, until I can get a doctor to cut it out.

I have heard that this "accessory testicle" is common in professional cyclist and more in Europe than the states. What do the pros do when this happens? Should I ride on, and just have it cut out or stop riding? The doctors always tell you to stop riding, but they're not competitive cyclists. It is not threatening but needs to be removed. I was just wondering if there was a common treatment among the pros that you might know of?

Sean Daley

Scott Saifer replies:

It sounds like you have a cyst, a hard, contained infection. They rarely clear up on their own, especially if you keep riding on it. I've heard of pro getting through races by cutting out chunks of padding on their saddles, but that doesn't mean they don't go for medical treatment shortly after. Home treatment with "drawing salve" has saved more than a few butts from pea-sized bumps, so that's worth trying, but I've not heard of it working for bumps the size of an almond.

I'd suggest a visit to the doctor if drawing salve doesn't fix the problem in a couple of days. The treatment will be lancing (popping the cyst) and draining, not actually cutting anything out if you have what I think you have.

Which frame to choose?

Hello and thank you for everything I've read.

I am a 60 yr old coming back to cycling after 45 yrs. After about a year of riding a folder and working out at the gym, I'm looking at buying a real bike. The Cervelo R3 or RS would be my poison of choice. I'm an ex-racer (45 yrs ago) and have an affinity for the R3 but I'm getting mixed signals. How do I determine which frame? If, in fact, I'm flexible enough for the R3, how do I determine that? And then the question becomes can I expect to be flexible enough for it for the next 5 years or better?

I'm not looking to race on this bike; more to train and take centuries and so on. If I were to race, it would be time trials and I'd assume another bike would be in order for that.

One other really dumb question....why do I need rim tape for clinchers? I know nothing of clinchers, as in my day we only rode sew-ups or what you guys call tubulars (which I have to tell you, I find hysterical).

Grumpy Phil

Dave Fleckenstein replies:

I have been waiting for this question as it brings up a concern that bicycle manufacturers are trying to address - the aggressive positions applied to many in the pro peloton cannot be generically applied to all riders.

The simple act of reaching forward to the handlebars involves two actions occurring through the spine and pelvis. First, the pelvis must rotate forward and secondly, the lumbar vertebrae flex forward. For those who have restricted hip girdle musculature (hamstrings, hip external rotators, etc), the pelvis won't rotate forward and the lumbar vertebrae are forced into early and excessive flexion. Excessive lumbar flexion (both in duration and magnitude) results in breakdown of the posterior support elements of the spine - the disc and posterior ligaments.

For younger riders, the disc and posterior ligaments are more elastic and they are less prone to suffer these problems. However as we age and accumulate microtrauma and age-related disc changes, the ability of the disc to tolerate prolonged end range flexion is much less. This is where bikes like the RS become valuable - they reduce the amount of lumbar flexion needed to reach the bars.

Signs that riders may have a position forcing excessive lumbar flexion include lumbar or buttock pain onset 30-45 minutes into a ride, excessive rounding of the spine, the inability to rotate your pelvis forward on the saddle, and the inability to use your drops (I know of many high level riders who use their hoods as their drops - a sign that I will always be in business!).

So, if the R3 allows you to maintain your current position with no symptoms, go for it. If there are concerns as listed above, or if you need to have your steerer tube cut extra long, opt for the RS.

Finally, flexibility is certainly something that can be gained and maintained at any age. I have written past posts on hip girdle mobility, why the ability to touch your toes doesn't guarantee normal flexibility, and how a combination of lumbar stability and hip girdle mobility are optimal for correct position and performance - check them out.

Hyperglycemia insulin and riding

I'm a 28 year old on again off again road racer. I have long suspected that I have some trouble regulating blood glucose. I frequently urinate, constantly feel dehydrated, and have periods of low blood sugar induced stupor. My fasting blood sugar is normal, around 90mg/dl as measured along with a CBC panel. I bought a glucose test kit and measured myself and normally I'm around 130 but have seen spikes over 200 from drinking a fruit smoothie. About 45 minutes after taking that measurement I was back within a normal range.

On the bike I feel as if I frequently have to take in calories to have any endurance. I probably do 400 calories an hour from gels and sports drinks. What I'm wondering is, could I have trained my body to have a slower insulin response by feeding it these high glycemic index products on a regular basis where my muscles would burn it off rather than storing it? Does the body adapt in this way?

I feel as if it has gotten worse over time. I'm going to an endocrinologist soon but I'd like to hear specifically how sports and sports nutrition will affect insulin response over time.

Jeff

Kelby Bethards replies:

I'm not entirely certain what is going on with you blood glucose levels, but I know it doesn't seem right. I think going to the endocrinologist is a prudent choice and make sure you explain to her / him that you are an athlete. In this day and age, it'll be a treat for them to see somebody athletic and motivated.

The thing that concerns me is that when you randomly check yourself you are around 130, which is too high but explainable. But, spiking to 200 is a bit too high. Make sure, if you haven't already had one, to have a Hemoglobin A1C done. It is a 3 month blood glucose "average" marker.

The body is a very adaptable machine, but I don't think you could train it so much to be "used" to only high glycemic index foods that you couldn't re-adapt to normal foods.

Junior gears

I am writing with some confusion regarding junior gear restrictions. I have an 11 year old son who races and his gearing is allowed to be the same as a 17 year old rider. I noticed that many of the European cycling federations limits junior gearing based on age with the younger age's restricted to smaller gear ratios.

I am under the impression that these gear restrictions are in place to protect the health and development of younger riders, so why can young children be allowed to push the same gears that older kids use? There seems to be a disconnect here? I also notice that on the track there are different gear restrictions based on age. Could you shed some light on this situation for me?

Tim

Scott Saifer replies:

Here's my answer, "The rules are stupid and have no basis in science but you still have to follow them." Most juniors train in adult gears anyway and put their racing gears on for races only. Many elite juniors train with elite seniors. Yes, the concept is to protect the developing knees of young riders, but climbing a hill in a gear that brings the cadence to 50 or 60 rpm puts far more stress on the knees than spinning a 53x12. The rules are similar to the rules that until recently made women's tennis matches shorter than men's.

That rule arose because back around 1900 women were collapsing on the tennis court during long matches on hot days. Of course they were also required to play in "modest" attire that covered them from wrist to neck to ankle while men competed in shorts.

I know I will get responses from people concerned about Osgood-Schlatter, but as I noted, climbing in low but not low enough gears causes more stress than pushing a big gear on a flat or in a sprint so I'm not convinced that the junior gear rules protect anything expect perhaps the egos of the less developed kids since they are at less of a disadvantage if the other riders can't use their superior strength to great effect.

Calf cramps

Hello - I'm a 38 year old, Cat 5 racer from CA. I have been riding consistently for the past few years (1-2k miles/year), and previously focused on triathlons. I have noticed throughout this time, and especially now that I'm doing short, focused criteriums, that I tend to get cramping in my upper calf during protracted hard efforts. It can be debilitating, both during and after a race!

My previous bike was professionally fit, but my current one was not, although I took the measurements from that fitting to set it up. I am concerned that my saddle is too high - is it possible that this could be affecting my pedal stroke and stressing this part of my calf? I have my Speedplay cleats moved pretty far back (as far as possible I think, but it doesn't seem very far) on my Sidi Genius 4's.

Jay

Scott Saifer replies:

A saddle to high could well be causing you to use your calf muscles in a way that causes them to cramp during and after a race, though there are many other causes of cramps as well, and the bike change may be a mere coincidence.

Setting a second bike to have its saddle at the same height as a first bike often doesn't really mean duplicating the range of motion you had on the first bike. If the cranks lengths are different, one saddle is set farther behind the bottom bracket or even if the saddles are shaped differently so that you sit farther forward or back, the "same" height saddle won't lead to the same leg extension. Even a large difference in the thickness of padding can have an effect.

The easy answer for you is to drop the saddle three millimetres or so and see if it makes a difference. If not, drop it three more. I'm operating here on the assumption that if the new saddle had you more than five millimetres higher than the old saddle, you'd know. If dropping the saddle those six millimetres doesn't fix your problem, the bike fit is not the problem.

Did you change cleats, shoes or pedals before you started to have the cramps? If so, cleat adjustment could well be your answer.

Scaphoid fracture

Two weeks ago I was involved in a crash which left me with slight swelling on my palm between the thumb and index finger, and a small amount of wrist pain. A back slab was immediately fitted and subsequent MRI revealed a non-displaced scaphoid fracture across the distal pole. The wrist was immobilised in a short thumb spica fibreglass cast within 3 days of the fracture occurrence. I am attempting to maintain aerobic fitness by using the trainer/spin bike and strength by core and leg training at the gym.

I understand scaphoid fractures are not uncommon in our sport and yet I hear of professional riders resuming training within 2 weeks of similar, or more severe, scaphoid fractures. Unfortunately it is difficult to find a specialist who can empathise with our desire to resume training (and in my case also work) as soon as possible. Given the present 6 week immobilisation prognosis, I would be grateful if you could suggest other treatment options that may be available which may accelerate the treatment of this type of fracture, or, at the very least allow training back on the road.

Pete Fleming

Jon Heidemann replies:

First off, I'm sorry to hear about your crash.

I can understand your urge to get back on the road and resume training. However, I urge caution to do so before getting a second opinion from another qualified specialist. I would like to be able to offer advice that would get you back on the road sooner, but unfortunately, I can not do that.

My experience with working with several athletes who have broken their scaphoid bone (in similar places and varying levels - small fractures to complete breaks) has not been good. All had issues with the bone mending and healing in a time line that their specialist would have normally expected. One specialist noted that, generally speaking, this area of the scaphoid bone usually has relatively little blood flow associated with it and this will affect the healing process. He went on to add that it is possible that the vibration coming from riding on the road (through the bars) might be fracturing any new bone growth, regardless of immobilization technique used. Yes, this is speculation on the part of one specialist, but educated speculation with a cyclist who was having issues with healing.

Of those athletes who tried to keep training, half healed fine, but it generally took longer than 6 weeks. The other half wound up having at least one bone graph, and one had 3 bone graphs over a 2.5 year period (and this started out as a minor fracture).

I'm not trying to scare you with this response, but I want to emphasize that getting a second opinion is very important. Base your decision to "get back on the road" with as much information as you can get.

Best wishes on the recovery process and try to be patient through it all.

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