Fitness questions and answers for August 19, 2008

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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.

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.

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.

Earl Zimmermann (www.wenzelcoaching.com) has over 12 years of racing experience and is a USA Cycling Level II Coach. He brings a wealth of personal competitive experience to his clients. He coaches athletes from beginner to elite in various disciplines including road and track cycling, running and triathlon.

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.

Recovery from spinal stenosis
Scaring myself with a high heart rate
Cleat position and knee pain
Slow recovery
Knee / hip pain

Recovery from spinal stenosis

I am a 56 year old third category road racer living in Sussex in England. Over the past year I have noticed a weakness in my legs especially my left leg, so much so that there is a visible difference in muscle definition. I have recently had an MRI scan and I have been diagnosed with spinal stenosis.

I have been told that I will need an operation to relieve the pressure on my spinal chord which is causing nerves to be trapped and causing the weakness in my legs. What are the prospects of making a full recovery? I have recently semi-retired and have more time to train so I am finding this rather frustrating.

Cheers,

Richard

Scott Saifer replies:

I have not worked with anyone with exactly your problem, but did last year have a client who had lost strength in one arm due to a similar problem. Six months after his surgery he has entirely normal use of his arm again. You should ask your surgeon about the success rate of the proposed surgery and possible side effects. Only the surgeon knows exactly what he plans to cut and how much.

Dave Fleckenstein replies:

Spinal stenosis occurs when the opening for the nerve root is reduced in size due to a number of factors including spurs, loss of disc height, and alterations in posture. The typical surgery for stenosis is a laminectomy, during which the bony opening is enlarged to relieve compression of the nerve root. Your ultimate outcome is, unfortunately, somewhat unknown right now, as the nerve has been compromised over a significant time. I have found clinically that the longer that the nerve root is compressed, the less likely a full return is, although there is nearly always a significant improvement in function. So, the ultimate result of your surgery is not determined as much by the surgeon (although you certainly want the best surgeon you can find!) as by the time the nerve was compressed.

Once the surgery is performed you will have a much better idea for your ultimate prognosis. Keep in mind that, often, symptoms are slightly worse post surgery due to swelling and irritation at the surgical site, but the typically resolves after 7-10 days. Following the surgery, you should begin a course of therapy to restore the integrity of the spine (as the stabilization musculature is inhibited by surgery and injury) and regain the loss of the global weakness that you now have.

Scaring myself with a high heart rate

First, I'd like you to know that I really enjoy the great information you share in the F&F forum.

I'd appreciate your guidance on knowing whether I should be racing to a cardiologist or if I'm maybe just a bit "different" than my peers. Many of my friends seem to believe the former (well, both I guess) and seem to expect me to keel over at any minute. My concern is that I have a measured maximum heart rate of 199bpm (I'm 40 and 165lb and in reasonable condition) which seems to be much higher than the norm for people my age. My most recent measured resting heart rate (reading in bed) was 55. Recently I rode a 15KM ITT and my heart rated stayed between 192 and 198 for the entire race -- only a few beats off my max. Other than a side stitch for the last few minutes I felt fine. The position of my GP is that so long as there are no associated pains or discomfort they're not concerned - if I didn't have a heart rate monitor I probably would have never known better.

I guess my question is, in your opinion, am I far enough outside the norm that I see an expert?

Michael Madison

Scott Saifer replies:

Your maximum heart rate is a bit above the average for your age ( 190) but well within the normal range, which extends about 15 beats either side of the average. I concur with your GP that a maximum heart rate of 199 is nothing to worry about. I am surprised by your ability to stay within 7 beats of your maximum for a 15 K race. This suggests, though not definitively, that you would benefit from more lower-intensity riding (140-160 bpm for you, 70-80% of max for everyone else reading this) and less very high intensity, unless you won, in which case I'll just shut up.

Cleat position and knee pain

I have recently started getting slight knee twinges; I have been riding a year and have previously been absolutely pain free. When I started riding I noticed my boyfriend (who is an experienced rider) positioned my cleats slightly inwards (literally a millimetre off centre, inwards). I ride black Look Keo cleats. I am happy with no float, I tried red ones and didn't get on with them at all, and I prefer the stability of black. So, when my cleats needed replacing I did it myself, drew the outline and placed exactly on the top, I may have been a bit complacent as I didn't realise you needed to be so exact. But my question is - as I am now having to try "trial and error" adjustment now that I have totally cocked up the original placement, should I re-think this inwards pointing cleat position?

The other possibility is (and it could be coincidence, I'm not sure) I am pushing my cycling to get a higher average (16mph on all my rides). I am also riding longer distances and climbing more, which I am good at as I am slim and tall. Please try and advise me. I have Googled this problem of cleat position and it tends to concentrate on fore and aft positioning not angle of the cleat.

Lucy Woodward

Scott Saifer replies:

Some riders are very sensitive to cleat position, to the point where the cleats must be replaced exactly where they were to avoid pain. As you have pointed out, the current appearance of knee pain may well be coincidence. Increasing volume and increasing force on the pedals as you do more hills and higher speeds may well be showing up a weakness in you original cleat position.

With regard to the cleats being pointed in a bit, the vast majority of riders do best if they set the cleats so that their neutral foot position aligns with position in which the cleat holds the shoe. That is, if you can in any way feel the cleat turning the shoe when you ride, or you push the shoe to rotate one way or the other when you ride, you'll end up with sore knees. The cleats in position may or may not be right for you. If you feel the shoes turning your feet, turn the cleats until you don't have that any longer.

Slow recovery

I am a male, 149 lbs, 5'9 54 years old/ young I am a ex cat 1 racer from the 70's and 80's. I have recently started riding again in the last four years only on a tandem as I have lost a lot of my eye right due to Retinitus Pigmotosa.

I notice that I tend to stay sore for a few days longer than I remember in the early days. When I go out we usually ride for 35 to 60 miles. I take one to two rest days after riding hard. On rest days I ride my trainer very easy at 100/114 BPM of 45 minutes in 39x21. I eat between 100 to 125 grams of protein a day. I also take Glutamine BCAA and Inosine. This seems to help a lot as I used to stay sore for a week.

Is there any other thing I should be doing or taking? It has been a lot of fun to go fast again.

Thanks,
Stan Moore

Pamela Hinton replies:

Unfortunately, a decline in recovery time is an inevitable consequence of aging. That said you've taking a reasonable approach to minimizing the age-related decline. You might also be sure to consume a diet that is high in fresh fruits and vegetables. Although not proven to improve performance, there is some evidence that the antioxidants found in fruits and vegetables can reduce exercise-induced muscle damage and, therefore, accelerate recovery. I caution against using dietary antioxidant supplements, however, as they often provide nutrients far in excess of the recommended intakes. Somewhat surprisingly, nutrients that have anti-oxidant properties at physiological levels can become pro-oxidants when present in excessive amounts.

Omega 3 fatty acids are another nutrient that may be of some benefit. The omega 3 fatty acids have anti-inflammatory properties, in addition to their lipid-lowering effects. However, because they are found only in select foods, e.g., fatty fish (salmon and trout) and some nuts (walnuts), many individuals do not consume optimal amounts of these fatty acids.

Knee / hip pain

I have knee pain on the outside of both knees as well as in my hips. The knee pain is usually present and the hip pain comes and goes. Doctors always say it is due to tight it bands. I have recently been told by a chiropractor that my left hip is higher than my right hip and that it is farther forward than my right hip causing me to have a shorter left leg. He did not tell me how much shorter, but the difference is small. I would guess 3 or 4 mm shorter, but you can definitely see my left hip is forward of my right. My shoulders are also slightly different heights and I get pain in my left shoulder blade as well.

I have tried everything from seat up, down, forward and back. I currently have the ball of my foot forward of the pedal spindle. If I drop a plum from the most forward part of my knee, it will fall about 3-4 mm behind the pedal spindle. I have my right cleat about 2mm farther forward than my left. My thinking is that my left leg was having to reach farther than my right because my right hip is farther back. I had a bike fitter watch me ride and he said I look fairly symmetrical on the bike. We did do some power tests though and I definitely pedal with more effort with my left leg than my right leg. Approximately 55% of my effort comes from my left leg and 45% of my effort comes from my right.

He chiropractor made me cycling orthotics and told me to work on my hip flexor strength which was very weak. I already stretch every day.

My questions are:

1. Should I put a lift in the shoe of my shorter leg?
2. Should I rotate my seat towards my shorter leg?
3. Should my cleat placement be as is or should they be the same on both sides?
4. Any other suggestions?

Mike Brooks

Steve Hogg replies:

1. Should I put a lift in the shoe of my shorter leg?

It depends. How you present off the bike and how you present on the bike aren't necessarily the same thing. The higher and anterior left iliac crest can often, but not necessarily, be accommodations for a long leg. What matters is that you sit as squarely on the seat as possible and have both legs reaching through the bottom of the pedal stroke with equal or similar fluency. What you have described of your issues makes it unlikely that you sit squarely on the seat and that is something that you need to address off the bike. Stretching is fine but many people's stretching techniques are ineffective, so get some good advice. Tight hip flexors are the likely reason for the pain on the outside of your knees and in your hips, though other factors may play a part. On the bike, do whatever you have to do to sit as squarely as possible on the seat. If this isn't possible, there is plenty of stuff in the archives about mechanical means to get closer to that ideal. Off the bike, tick all the boxes regarding freeing up the hip flexors. Tight hip flexors tend to set off a predictable chain reaction of neurological inhibitions and postural changes that are all negative in their effect on performance. Has your chiropractor checked you out for trigger points in the psoas?

Have you got good advice regarding hip flexor stretches and general postural improvement?

Once you have done whatever it takes to get yourself sitting as squarely as possible on the seat, then you may need to shim one or the other cleats depending on which side isn't as fluent through the bottom of the pedal stroke.

2. Should I rotate my seat towards my shorter leg?

Maybe; you have described what may be a functionally short leg off the bike. A standing pelvic obliquity and anterior iliac crest off the bike may or may not translate onto the bike. In the same way, if you sit with your left iliac crest forward just as you stand, it is worth trying pointing your seat to the left. This is only effective if it works. It isn't a silver bullet in that some people respond really well to an off centre seat and some don't

3. Should my cleat placement be as is or should they be the same on both sides?

Unless you have a substantial difference in foot sizes, your fore and aft cleat placement should be the same on each side. Rotational angle may vary depending on pelvic and functional symmetry. And when I say the same, I mean the same placement relative to foot in shoe which may or may not be the same placement on the sole of each shoe. I hear often of people trying to accommodate real or apparent leg length differences by using differential cleat position.

My lengthy experience with this subject is that it is exceedingly poor advice except in the most exceptional of circumstances. Some studies suggest that cleat position makes no difference to power output and while I have my own views on that, I think that belief has been extrapolated incorrectly by some to mean that cleat position doesn't matter. Cleat position matters a LOT and plays a significant part in determining the relative muscular enlistment pattern of the legs, particularly the lower limb. Most problems on a bike stem from rider asymmetries Differential cleat position tends to heighten existing asymmetries and increase the tendency to injury. .In a positional sense, a bike is a symmetrical apparatus. Your self description is of a functionally (and possibly measurably) asymmetrical rider. You need to be as functionally symmetrical as possible on a bike and differential cleat position is antithetical to that aim.

4. Any other suggestions?

I liken answering questions on this forum to groping in the dark. The quality of any answer is dependent on the information that you give me because that forms the basis of any advice I give you. Your query contains detail about your condition and asymmetry off the bike. What would really help is similar detail about how you function on the bike because that is what matters and why I have had to qualify these answers much more than I would like.

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