Fitness questions and answers for August 30, 2004

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.

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.

Fear
What kind of carbs?
IT band and fixed vs floating cleats
Power based training
Seatpost with setback
Tapering
Thyroid issues
Nutrition and base miles
Rotated hip
Correcting BMI
Q factor for women
Knee circles
New cleats and bike fit
Upper knee pain

Fear

I'm a 22 year old female cyclist and I've been competing in road races for the past three years. Rather than a physical problem, I would call this a mental problem: FEAR. There are three things which hold me back in cycling: cornering, downhills (especially twisty ones with potholes) and being in a group larger than two cyclists. In each of these situations I slow down tremendously feeling sure I'm going to fall. So in a race with a neutralised start (especially with a few sharp corners), I'm usually right at the back so that I've lost the race before we've even started racing!

My question is, is there anything I can do to feel more confident on the bike. I know I'm quite strong as I tend to do quite well in time trials and hilly races. But I'm far too in love with my brakes!

Michelle Wood
Malta

Dave Palese replies:

The feeling and weakness with skills that you cite are common issues for many riders.

Skills, like cornering, descending, and riding in a group are improved in the same way you improve the physical aspects of your riding/racing, you follow a sensible plan consisting of overload and progression.

The issue that I find most often limits good productive skills training, is that many athletes are reluctant to practice skills at slow speed, to learn good technique, before increasing speeds to race like levels.

I look at it this way. If you were going to teach someone to hit a baseball, would you put them up against a national league pitcher their first time at the plate? Probably not.

Most athletes struggle for seasons trying to learn paceline and group riding skills on the Saturday and Sunday hammerfests. This is very often unproductive, discouraging, and dangerous.

With this in mind, back to your question.

Cornering can be worked alone or in a group. At first you may want to work alone until you get comfortable. Find a parking lot that is empty on the weekend or after hours. Use the traffic islands, or some cones to create corners that you will maneuver around. If you can find a place that you can run into off a slight downhill, this works well, so you don't have to use a lot of energy getting up to a moderate speed.

Start by riding in the drops, where you have the most control, and just get used to leaning the bike over and relaxing as you ride smooth through the turns. Slowly increase your speed over time. Look at the line you want to follow through the turn and not the patch of road directly in front of you. When you are working with other riders, practice following others getting more and more comfortable riding tighter to the wheel in front of you. In criteriums, corners and your ability to ride through them efficiently is a big factor in how well you will perform in those races. The less distance and momentum you lose in the corners, the less energy you will need to use to hold you position.

As you cornering improves and you become more comfortable on your twisty descents. Some people are better descenders than others. To descend fast off of big mountains or even big hills, take a certain mind set. The best you can do is limit your loses and make up the difference with your strengths, whatever they may be.

The key is to take the time to work these skills in a productive way. If you do, even at the expense of a hard interval session, for just a few weeks, you'll see improved performance I am sure.

Kim Morrow replies:

Dave offered some great advice. Let me add briefly to his comments.

Each one of us, as cyclist, have a tendency to prefer certain types of races over others. For example, you may prefer time trials and road races because these are enjoyable to you and fit your strengths. Others may prefer technical, aggressive criteriums with tricky corners. It is normal to have a natural bent toward a particular type/style of racing.

But, what is important for us to do as cyclist is to spend time improving our weak areas. For some of us, this may mean working on technical skills such as cornering, bike handling, descending, etc. For others, this may mean focused attention on improving our time trialing abilities with specific TT workouts. The key is to set aside time in our training schedules so that we are able to specifically address these weak areas. We ALL have weak areas. But, we can improve on them.

A great way to improve your cornering is to practice following an experienced rider thru the turns, both during the week in training, and in a race situation. First of all (when practicing), take the corners at a slower speed so that you understand the fundamentals of cornering. Continue to progress until you feel confident taking them at race pace. Confidence comes through practice and preparation. The more you practice these skills, the more confident you will become. The next step is to test them out in a race situation. The more races you enter, the more experience you will have. The more experience you have, the more confident you will become.

Being afraid is not uncommon. Sometimes, however, we just need to jump in there and go for it, even if we are afraid.

I'll bet if you practice these skills faithfully and consistently, that you will look back in one year's time and see great improvement!

What kind of carbs?

I am 42 year old female recreational rider. Always working to improve my speed. You have so many articles talking about consuming carbs for fuel, well okay, but what kind of carbs? What kind foods should they come from, fruit, pasta, vegetables? Or how much of each if the answer is all of the sources.

I mean really, given the choice I'd like all of mine from ice cream but I know better and would like to make smart choices.

Pam Hinton replies:

If you want to improve your speed, you don’t necessarily need to dine with faster people, you want to ride with them. But making those smart choices you mentioned will help. So here’s the deal on carbs. The word carbohydrate is a broad term that refers to substances in food that can be broken down into single sugar molecules (monosaccharides). The most common forms of dietary carbohydrates are starch, sucrose, lactose, fructose, glucose, and indigestible fiber. Starch, sometimes referred to as “complex carbohydrate,” is a polysaccharide, which is many sugar (glucose) molecules linked together. Grains, bread, legumes, fruits and vegetables are sources of complex carbohydrates. The terms “simple carbohydrates” and “sugars” refer to carbohydrates that are made up of one or two sugar molecules (i.e., the mono- and disaccharides). Glucose, fructose, and galactose are all monosaccharides. Fructose occurs naturally in honey and fruit. Galactose results from the breakdown of the sugar found only in dairy products—lactose. Sucrose (glucose + fructose), more commonly referred to as table sugar, and lactose (glucose + galactose), which is milk sugar, are disaccharides.

Carbohydrates differ not only in their complexity, but in their effect on blood sugar. How carbs affect blood sugar is important for overall health, fueling muscle during exercise, and replenishing glycogen stores post-exercise. The effect of a food on blood glucose levels depends on the type and amount of carbohydrate in the food and on how quickly that carbohydrate can be digested and absorbed. Some foods will cause a rapid increase in blood glucose levels, while others produce a slower and more prolonged rise. Scientists use the glycemic index (GI) to quantify the effect of a food on blood glucose and to make comparisons among foods. The GI is defined as the increase in blood glucose concentration above baseline during the 2 hours after eating a test food relative to the response to glucose for an equivalent amount of carbohydrate. The glycemic response to glucose is set at 100 and the glycemic index for all other foods is less than 100. Foods that have rapidly-digested carbohydrate and contain glucose will have the highest glycemic indices. For example, Gatorade has a GI of 80. Foods containing polysaccharides take longer to digest and have lower GI values. For example, the GI of bananas is 50 and the GI for lentils is 30. Refined grains have higher GIs than unrefined varieties. White bread has a GI of 75 and whole wheat bread has a GI of 50. (A list of the GI for 750 foods is found in the American Journal of Clinical Nutrition 76:5-56, 2002.)

For overall health, most dietary carbohydrate should come from unrefined whole grains, legumes, and fresh fruits and vegetables. Unrefined grains are superior to refined varieties because they provide more fiber and vitamins. Unrefined grains also have lower GIs, which may reduce the risk of non-insulin dependent (type II) diabetes. High GI foods may contribute to insulin resistance because the rapid increase in blood glucose levels after eating these foods stimulates a greater insulin response than lower GI foods. Although somewhat controversial, there is evidence that high GI foods contribute to elevated blood triglycerides (fats), which is a risk factor for heart disease. Fresh fruits and vegetables are superior to canned produce because the amounts of vitamins, fiber, and potassium in the fresh varieties are greater. Plant foods also contain compounds other than vitamins and minerals, sometimes referred to as phytochemicals, that have health benefits. For example, red grapes contain resveratol, a compound concentrated in the grape skin and seeds, which acts as an anti-oxidant, anti-inflammatory, and anti-coagulant. In general, the phytochemical content is reduced by food processing such as heating or irradiation.

During exercise and post-exercise, the carbohydrate story is different. In these circumstances, where elevating blood glucose levels quickly is an advantage, high GI foods are recommended. During prolonged exercise, depletion of glycogen stores is associated with the onset of fatigue. By consuming high GI foods during exercise, fatigue may be delayed by providing the body with a glucose supply that is readily available. Immediately following prolonged exercise (2-3 hours), the goal is to replenish glycogen stores so that you will be ready to train again the next day. Insulin secretion is needed for glycogen synthesis to take place because it increases glucose uptake into the muscle and activates the process of glycogen synthesis by stimulating the enzyme glycogen synthase. So post-exercise, the greater insulin secretion associated with high GI foods is a good thing.

So, Kim, it looks as if you’re in luck with the ice cream dream as long, that is, as you have it after having done a hard ride with those faster people we spoke of earlier.

IT band and fixed vs floating cleats

I've had an IT band problem for years. I was recently fitted with orthotics and in the process was changed to a fixed cleat (new Dura Ace pedals) from floating (Speedplays). When sitting on a table with my feet hanging loose they point straight ahead, therefore the cleats were set at 0 degrees. My saddle was also raised about 3/4 inch.

After 6 weeks with this setup and a lot of riding and racing, my problem has gone from bad to unbearable. I was told that it would take some time getting used to the fixed position because of muscle memory so I ignored some minor pain. However, I can't ride at all now and the pain is almost constant.

I noticed when I sit on a table and bend forward my left foot (problem side) turns outward. Am I better off going back to a floating system so my foot can go where it wants instead of torquing my hip and knee? Was the saddle height increase a contributor?

Dave King
Boston, MA

Steve Hogg replies:

In my view the advice you have been given about using fixed cleats without freeplay, given your injury history is just plain bad. Freeplay in pedal systems is cheap insurance against the potential for injury or the exacerbation of existing injuries. If you don't need rotational movement, you won't use it. If you are using it, then you need it. Everyone wins with a freeplay cleat. Judging your foot on pedal angle on a bike by looking at you with legs hanging from a table is a bad joke. There is only one way to judge an appropriate foot on pedal angle and that is under reasonable load on your bike!

Stay away from the people whose advice you have followed. The best advice I can give in the short term is to go back to your Speedplays and old seat height. The SPD - SLs are a good system, but even the freeplay cleat option has far less margin for error than your previous Speedplays. Once you are back to your base state in so far as your left ITB is concerned, have a good, and I stress above average health professional with a cycling interest or background, do a full structural assessment of you and get back to me with the results and we'll proceed from there.

Power based training

I read a great article by Ric Stern on power based training, which I think was written back in 2002. I am hoping that with the passage of time that more experience has been gained with power based training to perhaps provide an update on the web. Thanks for your excellent column.

Bruce Williams
Australia

Ric Stern replies:

Thanks Bruce. Glad you liked the article. The zones that i prescribed in that article are the zones i still use! What sort of article are you now interested in? If you're looking for specific advice on how to build a training programme or for actual coaching advice, it'd be best to contact a coach, such as the RST group or one of the other coaches here, who would be able to tailor advice accordingly.

Eddie Monnier replies:

If you're looking for more general reading on power-based training, then you might want to check out the articles in the library section of my Web site.

Seatpost with setback

I just wanted to drop you a line regarding seatposts with setback. In a recent Fitness Q&A response, you mentioned a Time seatpost that's no longer available. Although I'm not familiar with the Time post, from your answer I gather that it had significant setback.

I've been using a Titec 'Hell Bent' MTB post on my road bike. Sure it's heavy (it probably weighs twice as much as some light road posts), but it has more setback than any other post I've found. It won't help someone who doesn't have much exposed seatpost, but it's worked for me. And given it's heft, I can't imagine it ever breaking. I just thought I'd pass it along.

Mitch Kelly
Philadelphia, PA, USA

Steve Hogg replies:

thanks for the positive comments and your interest in seat posts with more than average set back. For others interested, here is a list of some of the seat posts that have more than standard set setback. Standard setback I would define as when the front edge of the seat rail clamp is in line with the centre of the seat post shaft as viewed from the side. Common examples of standard posts are Campagnolo and Shimano seat posts. By that standard the below posts will give you more rearward adjustment.

Kalloy [one piece 'Ritchey' style]: + 10mm
Easton EA 70, EC 70 and EC90: +12mm
American Classic (if the seat is pushed all the way back till the rail bend meets the abbreviated upper clamp) + 13mm
FSA SL 220 and FSA K Force Carbon: +22mm
TruVativ XR single clamp and TruVativ Team single clamp: +20mm

There are others including a wierdo looking Race Face that has separate tilt and clamping adjustment and looks at a glance that it has significant extra setback but it is actually +12mm. Additionally there is the post that Mitch mentions, though I am not familiar with it.

Tapering

Maybe my last question was expecting too detailed an answer so Ill be more simple. When tapering many people talk of reducing volume while retaining intensity. The question is how intense? The answer is often "race pace". For long road races there is no race pace - there are race paces. Should a variety of intensities be riden or just the most intense that will not lead to race day fatigue?

Andrew Gannon
Australia

Scott Saifer replies:

I've read with interest the suggestion to maintain intensity while cutting volume. I have spoken with two Olympic medalist track cyclists who say that is exactly what they did before their moments of glory: Continue all out sprints but very few of them.

For my road and MTB cyclists in the ten days before a key race, I actually have seven days of only short rides with no heart rates above 70% of maximum, followed by two short days of up to 80% maximum heart rate and a final short day with a short interval near the lactate threshold. This scheme has yielded a hand-full of masters national medals, so while it may not be perfect it apparently doesn't hurt an athlete's chances too much.

Thyroid issues

I have been dealing with a roller coaster thyroid problem for 1.5 years. First I was hyperthyroid and then fell into hypothyroidism. Since I was not climbing out of hypothyroidism, I have been on thyroid medicine. I have been taking the same dose for six months and now, after a recent blood test, I am in a hyperthyroid state. As an expert mtn. bike racer, I train 12-15 hours a week and am wondering if my cycling is not allowing my body stabilize. Does anyone have any suggestions?

Meggan Flaherty

Scott Saifer replies:

I also have a history of odd thyroid measurements and lots of bike racing. Was your hypothyroidism diagnosed by your T4 (Thyroxine) level or your TSH (thyroid stimulating hormone)? If it was diagnosed by a slightly elevated TSH level, you may never have actually been hypothyroid. It's common for highly trained endurance athletes to be euthyoid by T4, but still have elevated TSH. If you actually had low T4 measured when you were diagnosed as hypothyroid, then it sounds like you need to adjust your dose downward. That you would only do with your doctor's supervision of course.

Either way, you need to find a doctor who knows about the effects of exercise and thyroid hormone levels. Good luck!

Nutrition and base miles

I am a 35 year old, current Cat4 crit racer ready to upgrade to Cat3 in 2005. I continue to read up on base training at aerobic levels as both preparation for more specific training periods and the value of burning body fat. My question may seem a bit unorthodox, but a concern to some low body-fat cyclists. Can burning too much fat be detrimental? Taking a look at cycling athletes and other active individuals like myself with already low body fat, about 6-8%, what happens when you run too low on fat to burn? especially during base miles when the body is burning on average 80% fat and 20% sugars. If we "carb up" for more intense training and racing, how should we nutritionally prepare ourselves for the "base" period.

John Mattio

Pam Hinton replies:

The answer to your question is very simple in a complicated sort of way. The short answer is don’t worry about running out of fat, carb-up before, during and after you ride, then eat a balanced diet thereafter. For the long answer, get out your calculator.

We usually focus on eating enough carbohydrate to replenish glycogen stores, but your question draws attention to a new, and somewhat controversial, development in sports nutrition research.

The assumptions of your question are that fuel selection (fatty acids or glucose) is determined by exercise intensity and that fuel availability may be limiting. There are four fuel sources available to muscle during exercise: plasma glucose, muscle glycogen, plasma free fatty acids, and muscle triglycerides. Plasma glucose is primarily maintained by breakdown of glycogen in the liver. Free fatty acids in blood come from breakdown and release of triglycerides (fatty acids plus glycerol) from stored body fat. When we are exercising at low intensity (25-30% of VO2max, equivalent to walking), most energy (about 90%) is derived from plasma free fatty acids. During exercise of moderate intensity (65% VO2max, base-mile pace), a greater proportion of energy is derived from carbohydrate, so the body is getting about half of its energy from carbs and half from fat. In addition, as exercise intensity increases from low to moderate, the muscles begin to rely more on the fatty acids stored within the muscle and less on plasma free fatty acids. At 65% of VO2max, the rate of total energy expended is about 0.220 kcal per kg of body weight per minute (equivalent to about 900 kcal per hour for a 70 kg cyclist). Of the total energy, intramuscular fatty acids provide about 0.050 kcal/kg/min, plasma free fatty acids 0.060 kcal/kg/min, muscle glycogen 0.080 kcal/kg/min, and plasma glucose 0.030 kcal/kg/min.

There are two reasons that fat will not become limiting. First, even though you are very lean, you still have a huge surplus of fatty acids stored for future use. As an example, let’s assume that you weigh 70 kg and have 6% body fat. This means that you have 4.2 kg or 4200 g of stored fat. At 9 kcal per gram of fat, you have 37,800 kcal of stored fat. That’s a lot of hours in the saddle doing base miles. The second reason that you won’t run of fat for fuel is that even extremely lean athletes have intramuscular fat stores. In fact, one adaptation to aerobic training is an increase in intramuscular triglycerides. Fatty acids stored in the muscle are an important energy source and training increases these fat stores. Even exhaustive exercise sessions (3 hr at 65% of VO2max) produce only a 20-25% reduction in intramuscular fat stores.

The controversy arises in how to best replace the fat stored in muscle without compromising glycogen repletion. High carbohydrate diets, regardless of fat intake, seem to interfere with the restoration of intramuscular fat stores to pre-exercise levels. For example, one study of highly-trained cyclists found that intramuscular fat stores were replenished after 48 hours of a diet providing 39% of energy as fat and 49% as carbohydrate, but an isoenergetic, low-fat diet providing 24% of energy as fat and 62% as carbohydrate was ineffective. Clearly there is a tremendous downside to consuming inadequate carbohydrate post-exercise. You will not replete your glycogen stores and it is well-established that pre-exercise glycogen levels are strongly associated with time to fatigue during endurance exercise. The best practical recommendation is to consume carbohydrates immediately post-exercise and then a normal diet containing carbohydrate, protein, and fat thereafter.

Rotated hip

Several of your recent questions remind me of a personal injury I've been dealing with for a couple years. I've been experiencing recurring weakness in my left leg. MRI and angiograms have not discovered any obstruction or injury, however I have demonstrated a tilt and forward rotation of my hip on the left side. The result of this is loss of power in my left leg, and to date a rather obvious difference, increase, in hypertrophy on the right side.

Recently you addressed a complaint of Persistent finger numbness which also reminded me of my own situation; I also have had hand and finger numbness on the left side too. Would you be able to offer an explanation as to why this might be recurring, the pelvic tilt,? And could you recommend some form of strength training and or stretching routine that might help keep my hips from falling over?

I do not have a leg or foot length discrepancy and I have had a professional fitting.

I'm pretty sure this situation isn't unique, I think I've heard of a couple pros who have had a similar problem. To date I've seen a PT who swore I had a torn hamstring, a vascular surgeon who thought I needed a stent, and I finally resorted to seeing a rolfer who offered some relief.

Steve Hogg replies:

I am not a health professional but have an interest in developments in various health specialties. This is because of what I do for a living, but also because a combination of youthful stupidity and misadventure has caused me to be a fairly heavy consumer of the services of various health professionals at different times in my life. I too, have been on what I term the 'medical merry-go-round'. In my case it took nearly 20 years to find long term solutions to my problems. Essentially, the orthopaedic/biomechanical model of the way humans function can only go so far. For the majority of people that is far enough, for some it is not.

You could do worse than Contact the Carrick Institute www.carrickinstitute.org and see if you can track down someone relatively near you that has been trained by them. They have a functional neurological model that satisfactorily explains, and can resolve long term, postural issues that there is seemingly no explanation for, or no consistent explanation for.

I doubt that I am the right person to explain this, but essentially, if you are particularly right or left brain dominant, that can set up neurological inhibitions or excitations that cause functional and postural changes in the body that are difficult to address by conventional means.

This may not be you. But if you think it could be, give it a try.

Correcting BMI

I am an avid cyclist, at 53, I still get in between 100 and 150 kilometers a week... I recently was in a discussion with a few friends, and we started comparing BMI's and I ended up on the overweight scale compared to my more sedate friends... since I have been researching this I find out that BMI is not an accurate indicator, and did find a site that used waist circumference in the formula, but my BMI is still 25.5... I am 5 foot 9, weigh 172 most days, some weeks I get as low as 168, I have a 32 inch waist... when I look at my body, I can see muscle definition in all parts of my body, especially legs, shoulders, arms and back, I have a little extra "skin" on the abs, and "very small love handles"... Why am I scoring higher, and what formula can I use to correct the BMI?

'Dusty One'

Scott Saifer replies:

Try getting a body-fat percentage test instead of looking at your BMI. BMI is a "fast and dirty" way to identify overweight people, and of course many very fit athletes score "obese" on BMI scales because BMI does not distinguish fat from muscle from buckshot left over from a hunting accident. If you have visible and defined muscle and over most of your body, you are very lean.

Q factor for women

One for Steve Hogg. Considering women’s wider pelvic and angled femur, how does this effect movement concerning q-factor, cleat placement (rotational, also) . I can picture this statically but have a problem figuring out what is happening when movement occurs, i.e. force on hip joint and torque on knee depending on the q-factor. I think (and this could be way off) that a wider q-factor with a slight eversion on the pedal would be optimal.

With your experience, what are the indications of the proper q-factor for a women’s structure?

Erica Leister

Steve Hogg replies:

There is such a variety of female humanity and morphology out there, that it is hard to give you a general answer that is generally applicable. The wide range of proportion, function/dysfunction, symmetry/asymmetry and technique that exists in the female population means that individuals have to be treated on their merits and that I don't have a 'general' approach to positioning women that in any way differs from my 'general' approach to positioning men. Women are different to men but the range is so great that I approach the task of positioning women using the same basic principles that I've talked about on this site.

The goal is always to improve leverage, improve ability to breathe under load and promote good control of movement. The means is by stabilising the pelvis by passive means as much as structure and function allows, unloading the torso musculature as much as is practicable, and by positioning cleats [and in many cases modifying foot plant on the pedal] so as to allow a given rider, male or female, to ride hard without discomfort and avoidable injury.

I understand where you are coming from, but it this is generally only a typical concern on wide hipped, proportionally short-femured women who have as a result, a large 'Q' angle, ie, the angle that the upper leg meets the lower leg at the knee.

Knee circles

I'm 48 years old, 195 cm, 96 kg recreational roadie. My problem is recurring bouts of ITB soreness which may build up gradually during a ride or appear suddenly. The bouts may last weeks or a single ride. I do several ITB stretches in a 20 minute stretching routine after most rides and ice the knee after rides as well. I ride 4 - 5 times a week and the pain seems to occur just as often on light recovery rides as it does on fast group rides. A dozen years ago I snapped my right ACL and in the process injured the ilio-tibial band although this last injury was only picked up months later when I had problems during rehab after the reconstruction.

Apart from the ITB pain which only appears when riding the knee has generally been fine since the op. What I have now is a right knee that moves in circles laterally when riding. The knee moves towards the frame on the up stroke and away from the frame on the down stroke. I have noticed that I also ride on the outside of my right foot. When I force the foot flat on the pedal the knee circles are greatly diminished but the ITB soreness increases immediately.

The advice of my sports physio is to persevere with the stretches/icing/pain or consider a release op. I haven't heard much good said about the op and anyway I don't favour surgical solutions unless absolutely necessary. Some months ago I bought a new, lighter bike and had the shop set it up. I immediately found the ride to be much more comfortable than my old bike but the ITB problem remains the same (I was hoping for a change of one sort or another). My searches for a "cure" have led me down many different paths including one to my local podiatrist and I now ride with orthotics. I still wear the orthotics but I haven't noticed much difference.

When the pain hits it can be severe and I have found that riding with my heel hard down relieves the pain and allows me to get home again. As far as I can tell my left knee tracks "normally", basically up and down with very little lateral motion noticeable and no ITB soreness.

Any suggestions?

Steve Gunn
Australia

Steve Hogg replies:

Steve, you are posing a tough question. Obviously finding the root cause of the issue is the key, and you have been trying to find that out with limited success. On this site David Fleckenstein or Benoit Nave are the appropriate people to ask. The only thing that I can contribute is this:

1. The first thing to do is to establish that this is indeed a right side problem, and not caused by something you are doing on the left side where you feel no pain. Mount your bike on an indoor trainer, level the bike between axle centres, and have an observer watch you pedal in a biggish gear at 80 - 85 rpm so that you are working reasonably hard but not sacrificing technique. You will need your shirt off. What your observer needs to look for is whether you are dropping your left hip on each pedal downstroke. If you are, and it is possible rather than likely, then the problems you are having with the right leg are largely a consequence of what you are doing on the left side. If this is indeed what is happening, get back to me and I'll give you advice on how to work around the problem.

If you are not dropping the left hip, you are either not dropping either hip, or are dropping the right hip.

2. If you are not dropping either hip, it is safe to assume that this is indeed a right side problem. The potential causes are many and varied but if, and I stress if this is a consequence of your ACL and ITB injuries then it is likely that you do not have the ability to extend the right leg as far with power and control as pre accident. It is probably worth fitting a 3mm - 5mm spacer underneath the right cleat to ascertain whether this relieves the problems you have. Sometimes what you describe can be a consequence of trying to reach too far with one leg. From what you have said about the pressure on the outside of your foot when you pedal, a medial lift in your right shoe probably wouldn't go astray either. This would enable you to spread the load over the whole forefoot, rather than the outside edge and, as you have noted, bring the knee back to a single plane of movement.

3. If you are dropping the right hip, then the question we have to ask is why? The answer is commonly overtight hip flexors on that side, and less commonly asymmetries of pelvic function or measurement. If you are dropping the right hip, get back to me and I will advise you from there.

New cleats and bike fit

1) I recently changed to new cleats about two weeks ago. I use Look cleats and have for years, but this time I have noticed some slight pain to the left and front of the knee cap. Its a dull ache and it seems to go away pretty quick after I'm done riding. During my rides, I find myself wanting to push my heel out away from the bike and toe in almost pigeon toe. I tried adjusting the cleat to allow me to do so, but the cleat is already over as far as it will go on the shoe. For lack of a better description, with my old worn cleats, my foot could float over the pedal and I could move around, but with the new one, my feet are locked in and I can't seem to get comfortable with the left foot. My right foot does just fine. Any clue as to what is going on and what I can try to make it better? Will the new cleat eventually "break in" and give me the float that I had with the old ones?

2) I'm in the market for a new frame this winter and I've been a victim in the past of a poor fit and obviously would like to avoid that happening again. We used the Serotta size cycle, dialed in the numbers until I felt comfortable and voila, instant measurements for a frame. Today, I am the not-so-proud owner of a rather odd shaped frame. Short of traveling to someone who has the reputation as a good bike fitter and is equipped to do the job, what should I look for from my local bike shop in terms of assessing if they can do a good job? How do you qualify who's got the goods and who doesn't?

Dan Reed
Apex, North Carolina

Steve Hogg replies:

In answer to your question 1. There are a multitude of possible reasons for what you are feeling, but given that you had no problems with your old cleats, here is what I would suggest. On the base of a Look cleat there is a black rubber pad. When new this can tend to protrude quite a bit, particularly if the cleat mounting screws are torqued really tight. This means that though there is freeplay, it is has a 'stiffish' quality. Get a razor blade or Stanley type knife and trim most of the height from the rubber pad. Trim it back till it is almost flush with the cleat. This will allow the quality of freeplay to become just that ' free', and solve the problem. The other thing that occurs to me is are you using Look branded cleats or some of the clones?

I have noticed that some of the Look clones, particularly Exus brand, are a much tighter fit in the pedal when new than the Look branded original. If this is the case, switch back to the Look originals and if necessary, trim the rubber pad.

Your question 2, and proceeding on the assumption that the retail bike scene in the US doesn't differ much from what happens here in Australia, I, in your shoes would travel if necessary to someone who comes well recommended as being able to do the job. For most bike shops, rider positioning is an 'add on', rather than a job in, and of itself. Many either can't, or don't wish to spend the time and effort necessary to solve the positioning puzzle at a high level of proficiency. Frankly, there is not much incentive for them to go down that road either. If they do, they will find that most of the commonly bruited about info is suspect at best, and that production frames have less relevance to a large portion of humanity than they should. In short, what I'm saying is that in my view, mass production bicycle frames owe more to keeping unit costs low than they do to addressing a mid point in the range of human needs out there. This approach explains why if you pick on any single manufacturers particular model, you will find almost invariably, that chainstay length, and fork offset doesn't change from the smallest to largest sizes but seat tube angle does. This approach is illogical.

If you are spending a reasonable amount of money, you want the best result for that money. Find the right person. Ideally they should take a structure and capability based approach to positioning and have enough confidence in their abilities to design and supply a frame on a money back if not happy basis.

Dan responded;

I am using clone cleats and I trimmed the rubber pad back last night. I went out on a short ride and the knee felt great; plenty of play like my old cleats!

I would love to travel to be fitted by a specialist, but I would have a hard time justifying the expense since I'm buying a production frame in the $1100 to $1400 range. Hopefully armed with more experience and knowledge now than my first attempt, I can have a reasonable dialogue with some of the shops in the area and determine who will be the best to work with. One last question though, you mentioned that chainstay length and fork offset do not change from one frame size to the next. How much should each one change from one size to the next and why?

Steve Hogg replies:

I am glad that you got a result with the cleat. It is a problem that I have seen often.

Your question 2; no production frame by its very nature can hope to fit everyone. One would like to think though, that each size is designed to address a mid point in the range of needs for people of an approximate size. This is not the case. For large manufacturers, the question that a bicycle frame is an answer to is ' how do we produce large numbers of these at the lowest possible unit cost without affecting quality of materials or integrity of construction'.

Leaving aside the question of whether the information about appropriate positioning for humans on a bike that modern production frames are supposedly based on, is accurate [ and if you've been reading this forum you will know my views about that], the larger the frame, the further over the rear wheel the rider is going to sit because of the increased seat height. For instance, check out a catalogue with detailed frame geometry specs from any large manufacturer. You will find that the smallest size and largest size have the same chainstay length. This means that the larger, heavier rider on the 62cm frame is going to have his [greater] weight further out over the rear axle than the smaller and likely significantly lighter rider on a 50cm frame. This means that larger riders have noticeably worse weight distribution over the wheels than smaller riders. The modern approach to relaxing seat tube angles in larger sizes only adds to this.

Briefly, the smaller the frame size the shorter the chainstays can be. The larger the frame the longer the chainstays need to be. Seat tube angles play a part. The steeper the seat tube angle required, the shorter the chainstays can be [consistent with the perfect operation of 9/10 speed derailleur gear systems. 410mm is about as short as you want to go ideally]. The more relaxed the seat tube angle the longer the chainstays need to be. The higher the handlebars of a given rider, the longer the chainstays need to be to counter the effects of unloading the front wheel that this can cause.

Conversely, the lower the bars the shorter the chainstays can be and so on.

Fork offset or rake. It is a rare manufacturer [ there are some] that offers much range of fork offset across their range. It is cheaper to buy in forks in one size than in a range of sizes. The only reason that small frames have steeper seat tube angles than larger frames is that by moving the top of the seat tube forward [ and hence transferring the riders weight more on to their genitals and hands, and overloading quads and under utilising glutes and hammies] is so that they can move the front wheel further forward from the bottom bracket centre for a given top tube length and avoid toe over lap

Large manufacturers could do this but it would increase their cost base and put them at a disadvantage against other manufacturers that did not go down that path.

A large marketing effort would be needed [ more cost ] to make this higher cost approach successful in the market place. And if a large manufacturer succeeded in this, they have an 18 month window of opportunity to recover their higher costs before every competitor is on the same band wagon. I think I will leave it at that; this is in danger of becoming a treatise. I don't have a website, but will soon. I have written lengthy articles [15000 -20000 words] about this subject some years ago that I will track down and put on the site. Once you see the link on my bio on the Forum, have a look for more detail.

Dan replied:

I like the treatise and you make some valid points, but from my experience over the last 10 years, 90% of the people I have ridden with are on production frames. (By production, I mean any frame not made to your exact specifications.) It is the rare individual that is willing to pop for a $2000 to $3000 custom made frame and then add another $1500 or so for components. Its hard to justify the cost when you are a club rider and maybe an aspiring amateur racer and to top it off, the thought that you could trash it on the first ride is almost unbearable. So taking into account that the majority of riders have to ride on what's available, how do you shop for the best frame and how do you evaluate a frame's geometry to determine if it going to be suitable? For instance, given a range of sizes, what range of measurements should you be looking for in say fork rake, seat angle, head tube angle, chainstay length, etc?

Don't get me wrong, I agree with you about the manufacturer's illogical approach to making frames; however, I've got ride one of them (and so do many others), and since its unlikely the manufacturers are going to change, I need to do the best I can with what's available. One last bit, we've never made mention of specific manufacturers which begs the question - "Are there any manufacturers making production frames with suitable geometries i.e. those that can address a midpoint in the range of needs for people of an approximate size." I guess I'm looking for the lesser of all evils.

I have enjoyed the dialogue and will be looking for that link with great anticipation.

Steve Hogg replies:

Your problem is a common one but given that I know nothing about your size, structure or capabilities, it is impossible to be definitive. That said, I want to answer your question. I have data on thousands and thousands of people who have been happy with my approach to positioning them. I have sold custom frames with every seat tube angle between 69.5 degrees and 74.5 degrees, and including those who have not purchased frames from me, recommended a slightly wider range again, as an ideal . About 85% of those fell into the range between 71 and 72.5 degrees. The further in either direction from that range, the number of people requiring a really relaxed or really steep drops dramatically. This is seat tube angles only. In my view, that is the most important frame dimension because it largely determines how you will bear your weight and what musculature you will enlist and to what relative degree you will enlist it.

Proceeding on the assumption that you fit into the Joe Average category, the best bet out there in the sense that the seat tube angle stays the same in all sizes, and that the fork offset changes in the smaller frames [ which is the intellectually honest approach to stock frames] are some models of Look. The KG 481 SL, KX Light, KG 451 and KG 386 all have 72.5 seat tube angles in every size. I don't have their current full specs available, but in some of those I think that the fork offset increases and head tube angle decreases in the smaller sizes, though I may be wrong in that.

Upper knee pain

I am a 33 year old recreational road rider, 6’1”, 164 pounds. Two years ago, I had reconstructive knee surgery on my left knee for an ACL tear, in which a patellar tendon graft from my left knee was used to replace the ACL. After the surgery, I began riding for rehab. I ride four to five days a week on rolling terrain. Most rides are after work, about 1 to 1.5 hours (20 to 25 miles), with longer rides on the weekends (40 to 50 miles).

I have begun to experience moderate pain directly above my left patella, slightly to the left (or “outside”) of the knee. Of course, it is worse when going up hills (especially seated), and in pushing larger gears any time. I have no pain in other parts of the knee, and it does not swell during or after riding. It does not feel as though there is any rubbing or popping going on; it just feels moderately painful, and is a nuisance. I would love to eliminate it, and I am slightly concerned that it may worsen over time.

I made a frame change about three months ago, at which time I replaced a Thomson straight seat post with a USE Alien set back post, and replaced my 120 mm stem with a 130. I really like the more stretched out position, as it is more comfortable for my neck, and it allows me to stay in the saddle longer without discomfort and/or the beginnings of numbness. The frame change was from a 57 to a 58. I ride Shimano Dura Ace pedals with float, and use Sidi shoes.

My questions are; what is the most likely physical problem causing the pain, and what are some suggestions for easing (or hopefully eliminating) the pain? What parts of the bike or equipment do I need to address?

Thanks in advance for your help.

Steve Hall

Eddie Monnier replies:

It's unclear to me if your pain began only with the recent bike change or if it preceded that. Pain toward the outside of the knee is often caused by a cleat angle that sets the toes inward too much. To check to see if this alleviates the problem, mark the current position of your cleat (fore/after and angle) and then turn your cleat in a few degrees (yes, turning the cleat in moves your toes out). In most cases, if your problem is related to cleat angle, you will notice immediate relief with the cleat correctly repositioned. If it doesn't help, then return your cleat to its original position. Pain in the front of the knee is often caused by having the seat too low or too far forward, so I would check your fore/aft position (see Steve Hogg answers to previous questions for guidance on this) and your seat height.

Finally, I have noticed some riders experience problems with pedals that float, although in my experience this is usually under higher volume riding than you're currently doing. Still, if you've tried everything else without relief, I would try the limited float Dura-Ace cleat.

Steve Hogg replies:

Do as Eddie has suggested and if the problem is still present, here are some other things to think about.

1. Are your Dura Ace pedals the SPD - SLs? If so, the range of rotational movement is less than on other systems that allow freeplay and it is not hard to get the angle of the cleat wrong.

2. Are you tighter in the hip flexors on the left side? If so this could be playing a part.

3. Does one leg feel jerkier than the other at the bottom of the pedal stroke? If so, which one?

4. Does the left knee waver laterally while pedalling?

If need be, get back to me once you have worked your way through Eddie's suggestions.

Steve Hall responded:

Thanks for your further advice; I have already turned the cleat in a little to give that a go. In answer to your first question; yes I have the SPD – SL Dura Ace pedal. I switched to these pedals about a year ago from Time Impacts, and have been generally happy with them. The knee pain has certainly developed well after the switch. I definitely have a waver in the left leg through the pedal stroke (in both legs, actually;) I developed the habit of riding with my knees pulled inward toward the top tube from watching Chiappucci ride long ago, as well as because it feels like it brings stronger quad muscles into play. However, my sense is that this would, if anything, cause the inside of the knee to become agitated. What do you think? And for what it’s worth, I’m right side dominant, and obviously, my left leg took quite some time to get back its strength after the ACL surgery. I definitely have the sense that it is the weaker leg, and work on evenly distributing the load while I ride - particularly during the upstroke in the pedal stroke up hills.

Steve Hogg replies:

I have no problem with your knees-in pedaling style providing it comes naturally to you. Double check your angle of cleat placement. Ride along on a quiet road putting a bit of effort in, and then coast with the left leg forward. Twist the heel outwards, is there movement before you hit the stop?

If yes, no problem and repeat the pedaling and coast routine and twist the heel inwards. Is there movement before you hit the stop?

If yes, cleat angle is not the problem. If no to either, adjust the cleat so that when your foot is at its natural angle, you have an even range of movement either side of that point. This can be a bit fiddly on SPD - SLs simply because with the freeplay cleat, the range of rotation available is not as great as many other systems.

If you go through that exercise and have no joy, have someone to observe you from behind and see if you drop the hip of that ' dominant' right leg that you mention. If you are doing that, the left leg will have to reach further and will be forced to move laterally as a consequence. If this is the case, get back to me for a solution.

If you are sitting squarely and not dropping either hip, you may wish to consider whether you are reaching the bottom of the pedal stroke with the same power and control as the right. If not, try a 3mm spacer under the left cleat. Again, if this makes a positive difference, get back to me for more advice.

Lastly, read the posts of the last 8 weeks or so and make sure that your seat setback is ok. Too far forward and too far back can also give rise to knee issues. Check the Cleat Position questions on July 26 so as to eliminate that as a potential cause.

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