Fitness questions and answers for February 20, 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.

Morton's Neuroma - Result of spinning?
Achilles Tendonitis
Bike fit after total knee replacement
Over used quads

Morton's Neuroma - Result of spinning?

I'm a pretty active girl but not very extreme. My main exercise choices are spinning (indoor cycling), yoga, walking, and dance. A couple of weeks ago, I started experiencing pain in my foot and it got to the point where every time I take a step it hurts. I don't have a car and rely heavily on walking to get around so it's especially troubling that I have this injury. I went to the podiatrist and was diagnosed with a neuroma. I'm still not exactly sure what caused it - my doctor thinks its one pair of heels I wore once for about 4 hours. But I'm wondering if this injury can be caused by spinning. I typically spin twice per week for an hour session each. Occasionally, it's three times per week.

I wear Pearl Izumi shoes that fit me nicely and I wear socks faithfully - only occasionally do I forget the socks and spin without. In yoga, I jump to and from downward dog, so that's a possible cause for injury. And I do my swing dancing outdoors on concrete - but with comfortable rubber soled shoes. Can you help me solve this mystery and do you have any recommendations for treatment/recovery? Oh, and if it's important, I'm 30 years old and in good health except a few lingering back issues.

Heidi

Kelby Bethards replies:

It always hard to say what exactly caused the neuroma. Usually, but not always, it is chronic compression of the forefoot that causes this condition. So, in my opinion it would be unlikely to get the neuroma from just 4 hrs of high heels, unless they were very painful. Likewise if you have a foot in which a few of the metatarsals are very mobile, this can be a source of the problem also.

Morton's neuromas usually show up between the 3rd and 4th toes, but that's not a steadfast rule.

It's very good that you are quite active. But, it does make the task of figuring out which shoes/exercise is causing the problem. Concrete, in general is not good for the human foot without correct shoes. It could also be shoes that are either too constrictive (i.e. high heels) or ill fitting. Generally Pearl Izumi shoes are a little wider, and as long as the cleat placement is correct and you aren't trying to wedge your feet into the front of your shoes to get your fit in the right position over the pedal, I wouldn't guess spinning is the problem as its not very high impact.

Achilles Tendonitis

Help! I came up with tendonitis or a strain in my Achilles tendon in early January. Four weeks of icing, anti-inflammation drugs, Aspercreme, ankle wraps, cold, heat; stretching and weeks off the bike have done nothing. Any attempt to ride makes it worse after about five miles. This came up on a ride after about two months of a pretty concerted strengthening routine in the gym. Road miles consisted of low-intensity, low force riding. Occasionally, I'll stand up and churn a very big gear for a few minutes at low intensity to stretch the muscles and to rehab a weak hip I busted almost four year back.

This thing is not getting better. Am I an ex-cyclist? Do I need to purchase larger clothing?

Steve Hogg replies:

I need more info?

1. Which side is affected?
2. Is there Achilles tendon discomfort on the other side at any level?
3. What brand, model and size of shoe do you ride?
4. What type of pedals do you use?

Give me those answers and I'll do my best.

Morgan responds:

Thanks for getting back.
To answer your questions:

1. Left leg, left side of tendon, inside forward (towards toes). About 1.5 inch (4 cm) above heel in that soft area between the tendon and the bony protuberance of the ankle.
2. No pain anywhere else.
3. Lake CX 200(?) road shoe. The kind with the big lugs for walking. Not the touring shoe. Size 43
4. Crank Brothers Eggbeaters.

Other data:

I'm kind of bow legged with a wide stance; I've done big-mile years (8k miles) with nary a squeak. Fewer since wrecking and breaking bones four years ago.

Steve Hogg replies:

1. As a first step I would see a good physio or similar. it is possible that this problem could stem from the gym work you did; particularly if you were doing squats or leg presses or something similar and rolled the left ankle inwards under load. It may be that the subsequent riding aggravated this, but that's a guess.

If that's not the cause and it was caused by riding your bike, then you are probably rolling or have rolled the ankle in with serious pressure on the pedals. The question is why would you roll the ankle in?

Possible causes are a) a tendency to favour the right side which would pull the left leg towards the centreline.

b) A shorter left leg in either a function or measurable sense.
c) An uncompensated for varus.
d) Seat too high.
e) Cleat position too far forward on the shoe, though this is the least likely unless combined with one of the other factors.

Do any of those possibilities strike a chord?

3. I don't know whether this plays a part but often lakes don't have the cleat mounting holes in the same place on the sole proportionally speaking. they seem to place the first hole the same distance from the toe of the shoe for two or three sizes and then change it for the next two or three sizes. This means that each of the sizes with the same distance from the front hole to the toe has the cleat mounts in a different proportional place for each of those sizes.

I can't say that is the cause but it could play a part.

4. They have a widish q factor but below you say that you prefer that.

Other data: may play a part and cause you to roll the left ankle in (bow-legged-nes tends to cause this) but if so, why not the right ankle as well?

Could be any of the reasons above.

Bike fit after total knee replacement

I am 57.5 years old 3 years post L Knee Total Knee Replacement (LCS System by Johnson and Johnson). Even after extensive Physical Therapy Range of Motion of replacement Knee is only a maximum between 100 and 105 degrees. I have developed a small decrease in ROM of the same side ankle. My R side has no problems. Curious on type of bike fit system that will help fit me to ride a bike more efficiently. I have been trying many different changes including shorter cranks and moving cleat to my mid foot on the effected side. With the increased baby boomers developing knee problems from over use and changes in ROM of knees information on how to adapt a bike fit to accommodate there problems.

Thanks for any suggestion or help with this problem

Steve Herrman

Steve Hogg replies:

In my experience there are 2 types of replacement knee joints; one a 'sports' model with a greater ROM than the other but still not approaching that of a good knee. The simplest solution is to shorten crank length. If you shorten your crank length 5mm for example, then you can lift your seat 5mm higher as measured from the centre of the bottom bracket. This in turn means that at the top of the pedal stroke, your knee will be 10mm lower and hopefully, within the comfortable ROM afforded by the artificial joint. If not, shorten crank length further.

By using a midfoot cleat position on the affected leg only, you will have to drop the seat 30 - 40 mm which will cause the good leg to under-extend and eventually cause problems on that side. If you are going to go for midfoot cleat placement, I would suggest you do it on both sides as otherwise, you will have a noticeably different muscle enlistment pattern on each side that will eventually bite you.

Over used quads

I have been struggling with sore quads for quite some time when riding the trainer, I have my saddle pushed quite far back (my knee is a good cm behind the bb and my cleats are as far back as they will go) yet still get this feeling of fatigue in my quads even during a zone two ride, and feel my hamstrings are not nearly under the same strain. Is it possible my saddle could be too far back or too low/high?

Mike

Scott Saifer replies:

A saddle too low will certainly cause increased work by and fatigue in the quads. How have you established your saddle height?

Mike responds:

I have an Argon 18 Platinum that was bought through the store that sponsored our team last year, they had a fitting kit that Argon manufactures, it calculated from my measurements what my saddle height and setback should be. Everything felt really good until I changed my saddle in the fall and have been fighting with my position ever since. I have been putting in 10-12 hours a week on the trainer and my quads feel they are taking the brunt of the work which was not the case previously.

Scott Saifer replies:

Any chance the new saddle as a lower profile (less space between the rails and the top of the saddle) than the old one? That could have put you lower without "changing" the saddle height.

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