Fitness questions and answers for July 11, 2005

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Form & Fitness Q & A

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Carbs and Caffeine
Nutrition for fat loss and muscle gain
Electrolytes and hydration
Salt, fatigue and getting too skinny
Blood tests results and anaemia
Collapsed lung and pneumonia

Carbs and Caffeine

I'm a 39 year-old endurance hill climber. I've been doing this for 20 years. The last two years I've had trouble with getting into an "up-and-down" bonk cycle when riding more than 70-80 miles. The only cure I've found (and the only way I'm able to finish my long rides without severe suffering) is by consuming a water bottle full of brewed tea (non-decaf).

Once I do this, the glycemic peaks and valleys largely go away. So my question is what is the tea doing for me that my body seems to be unable to do on its own? Is the tea promoting better use of fatty acids? I know this is the trick in endurance athletics.

For the record, my main riding foods are Cliff Bars, Power Bar Harvest bars and more recently Odwalla Protein Plus bars with Cliff Shot as a gel. I've favoured these over maltodextrin-based foods because of the lower GI of brown rice syrup. I have hypoglycemia and avoid sugars and refined flours when not riding. Thanks for your input.

Jim Strange

Carson City, NV

Pam Hinton Replies

Hi Jim,

You didn't provide your height and weight, but since you have been an endurance hill climber for 20 years, I am going to assume that you are relatively lean. As I understand your problem, you repeatedly bonk on long rides even though you are eating bars and gels. Apparently you discovered that drinking tea during the ride (presumably you are still eating?) prevents you from bonking. Your question is why and how does the tea help.

I wish I had some more information to work with. Specifically, how much and how often you are eating during these long rides. I also am curious as to how much carbohydrate you get from your regular diet. A healthy individual should not experience hypoglycemia (low blood sugar) after eating. A person who does not have an underlying metabolic disease, like diabetes or liver disease, should be able to maintain their blood glucose concentrations within the normal range. Fasting is the only time that a healthy individual may experience hypoglycemia. The fact that you say you have hypoglycemia makes me wonder if you are not eating enough carbohydrates to replenish your glycogen stores and to maintain your blood glucose concentration within the normal range.

I suspect that you may be experiencing "up-and-down" bonk cycles because you are not eating enough or often enough during these long rides - especially if you start with depleted glycogen stores. In other words, the "downs" of the cycle might not be because of hypersecretion of insulin after you eat, but simply because you quickly use the glucose that you consume in the bars and gels. On average, 60g of glucose can be absorbed from the small intestine per hour. You might try consuming that amount (without drinking the tea) and see if that keeps you from bonking repeatedly. Your hypothesis is probably correct and fits with my suspicions, as well. The caffeine in the tea may promote use of fatty acids, so that glucose is used at a slower rate - a rate that does not exceed your glucose intake.

Try eating more on the bike and see if that does the trick. If not, you can go back to your tea remedy. Take care.

Nutrition for fat loss and muscle gain

Pam,

Your discussions about energy in versus energy out make a lot of sense for losing fat. What about gaining or losing muscle? Can you build muscle - evidenced by weight gain - while eating at a caloric deficit? Racers lose both muscle and fat over the season, but what about weekend warriors and recreational cyclists?

Here's a little about my background, which probably isn't necessary to print. I am a 40 year old female with about 15 years of road riding experience. After a couple of years in a sedentary, high-stress lifestyle, I'm now riding about 12 - 15 hours a week and carefully watching my food intake.

I've also been doing other summer activities such as hiking and heavy yard work. I'm losing body fat, and my leg muscles are regaining density. I have genetically bulky leg muscles that build up easily, but I don't want to gain weight in any form. My weight is generally dropping, but with curious fluctuations. Could I be adding muscle, or is it more likely that I need to keep adjusting my diet?

Lauren Dundon

Denver, Colorado

Pam Hinton Replies

Hi Lauren,

The short answer to your question is, "Yes, it is possible to gain muscle mass even if your energy intake is lower than your energy output." This can only happen if you use stored energy, that is, body fat to make up the difference, otherwise you'd be losing weight. The other caveat is that you are only able to add muscle mass if you are eating enough protein to supply the amino acids needed to synthesize new muscle protein.

Now, you didn't come right out and say it, but I suspect that you want to lose fat without adding muscle mass. Maybe I can persuade you to change your mind or, at least, to reconsider. First of all, unless you are going to the gym and doing power squats (or something else specifically designed to cause muscle hypertrophy), your muscle mass is going to be determined primarily by your genetics. I hate to say it, but you will have to resort to some pretty drastic and unhealthy measures to fight against your genetic make-up. The added muscle mass actually provides some health benefits. Your absolute resting metabolic rate will increase, so your body will require more energy just to maintain normal bodily functions. Additional skeletal muscle helps to maintain normal blood glucose concentrations and to reduce the risk of developing type II diabetes. Your bones also will benefit from an increase in muscle mass. The increased force of the muscular contractions against the bone provides an additional stimulus that helps to maintain bone mass.

I realise that the fashion magazines and models - even the "fitness models" in Shape, Runners' World and Bicycling send the message that very thin is what we should aspire to. But that's the beauty of cycling, all body types can kick butt, so to speak. There really isn't an "ideal". Look at the differences among Tom Boonen, Lance Armstrong, Jan Ulrich and Roberto Heras - or Christine Thorburn, Ina Teutenburg, and Laura Van Gilder. Take care.

Electrolytes and hydration

Hi,

I have several related questions:

How much can one "pre-hydrate"? Is there a limit to how much water you can take in, pre-effort, without flushing out your electrolytes? Will this cause a corresponding danger of going into a race or other hard effort on the verge of hyponatremia?

Can you electrolyte load? Take in excess salt, potassium, etc. in anticipation of a large loss during a race or hard effort? Are electrolyte supplements such as Endurolytes a good way to get them either in advance or to replace those lost?

In order to maximize both hydration and electrolyte stores. Would it be strategic to be excessively hydrated a day before a race then load up on electrolytes while leveling off on fluid intake?

Dean Hargett

Columbia, MO

Pam Hinton Replies

Hi Dean,

Essentially, you are asking if it possible to "water load" or to "electrolyte load." It is a logical question given all of the hype surrounding "carbo loading" to replenish and top-off glycogen stores. You are not the first racer to have made the leap from cramming glucose to slamming sodium. The supplement industry has run with this idea and, despite the fact that for most racers this just doesn't apply, there are products out there whose purported benefit is that they allow you to electrolyte load. Carbohydrate loading works because we are able to store excess glucose from the carbohydrate in our diets as glycogen for future use. The problem with the concept of "electrolyte loading" is that we do not have stores of sodium and potassium in our bodies. The concentration of sodium in the blood is highly regulated, so that it remains relatively constant.

For example, if you eat a meal that is high in sodium, your kidneys retain extra water to keep the concentration of sodium in the blood stable. Or, if you attempted to water load by drinking copious amounts of fluid, your kidneys would simply excrete the excess to prevent the concentrations of sodium, chloride, and calcium (among other things) in your blood from becoming too dilute. Potassium is the primary electrolyte located in the fluid inside of cells. If you consume extra potassium, your cells cannot retain it because it would cause the cells to take on extra water and burst. Instead, the excess potassium is excreted in the urine.

There are a few exceptions when additional sodium or potassium might be a benefit, but even then trying to make up for a deficiency the night before a race is too little, too late. If an athlete consumes a low-sodium diet, they may benefit from additional sodium, depending on the reason for the sodium restriction. A person, who is on a low sodium diet because of a chronic health condition (hypertension or heart problems) or because of physician's orders, obviously should not be exercising strenuously, especially in the heat. Some people (and I know at least one) purposefully limit their sodium intake. This is fine for most of the population which is sedentary and not at risk for losing large amounts of sodium via sweat. These sodium-free advocates, at least the one that I know, tend to be "health food nuts" and are prone to extreme dietary behaviors (sorry, Cobb). It is very difficult to consume a very low sodium diet.

To do this, one would have to avoid all processed foods, baked goods, cheese, and many seasonings. Sodium is consumed in things that don't taste salty, like toothpaste (sodium fluoride) and softened water. However, there are people who are vigilant enough to limit their sodium intake. Hopefully, these people are not endurance athletes, as they are at risk for becoming sodium depleted while exercising in the heat. When the concentration of sodium in the blood is too low, hyponatremia (low sodium) develops and you suffer some serious consequences: muscle cramps, dizziness, chills, delirium, seizures.

Because it is not possible to load up on water and sodium before you head out on a ride or start a race, you are obligated to replenish fluids and electrolytes as you go. Ideally, you'd like to keep up with the losses, but this is near impossible to do. The general guideline is to drink eight ounces of a sodium-containing sports beverage every 15 minutes. You also could use the electrolyte supplements as long as you drink enough fluid with them. Since you can't keep up with the losses while you are sweating, it is critical that you make up the difference as soon as you can by continuing to drink a sports beverage or to eat salty foods and drink water as soon as you are done with your ride or race. Of course, it only makes sense to start out normally hydrated (as opposed to dehydrated). You'll know that you're there when you are peeing clear.

A straightforward, albeit very simple, analogy is a sponge. It (like our bodies) has a limit to how much water it can hold. Beyond that point, it does not good to continue to try to soak up additional fluid.

Salt, fatigue and getting too skinny

Hi,

I am a 30 year old rider (MTB/Road mostly), 1.62m tall, 58.5kg in weight, 22.2 BMI, averaging 150-200km per week. I've been training more structured and riding decent distances for the past four years, before that I spent all my time riding the same MTB rides over and over. Now I ride 90% on the road, but I only compete in MTB endurance events like La Ruta de los Conquistadores (3 days/400km) here in Costa Rica.

Anyway, my questions are these:

1. Salt. After every ride I end up covered in salt, especially my face and arms, the straps of my helmet end up totally white and if the intensity was high, my shorts end up white too. Last year this eventually lead to cramps, but not this year, I have covered 4,000km year to date without cramping once or even coming close to. Is there anyway I can prevent this? I only drink Gatorade during my rides. As I said it doesn't seem to impact my performance, but I end up every ride looking spent.

2. Fatigue. The past three months, after 10 minutes into the ride I start to feel my legs heavy and slow, but my times remain the same and actually I'm riding a little bit faster every time. I do have massages every 2-3 months, but my legs don't feel fresh; again, this doesn't seem to be affecting my performance (maybe it is), but I don't like how I feel. One change I did this year is that I do 3 "long" rides (50-120km) a week, instead of 3 short (45min on rollers) and 1 long (80km) like last year. What's better: high quantity of short distance rides per week or low quantity of long distance rides per week? Remembering I like to compete in endurance events.

3. Too skinny. I've noticed this year that my body volume has decrease, my arms & torso especially, I feel and look too skinny, but I'm getting quicker, my weight has remain unchanged for the past 10 years, is there a way to increase your speed, but look better? (for day to day life purposes) One thing - I hate gyms.

Hopefully I'll see the answer to these questions, if you have to answer only one, #2 is the one that intrigues me the most. Thank you.

Luis Rubi

Pam Hinton Replies

Hi Luis,

I must confess that I am a bit confused by your questions. Is your goal to race well or to look good while riding your bike? Okay, that's a stupid question - you want to do both, as we all do.

You seem to have solved your cramping problem by drinking Gatorade, but are still distressed by the salt that ends up all over your helmet straps, shorts, and body. As long as you are not cramping, I wouldn't complain about "looking spent." Plus, there's not much you can do about it. You are just one of those guys whose sweat is particularly salty.

As far as the fatigue goes, it is perfectly normal to experience some additional heaviness in your legs as they adapt to the longer miles. Your performance is not suffering. Because you are getting faster, and not slower, there is no reason to suspect that you are currently overtrained.

It doesn't sound like you intended to lose weight. It probably just happened as a result of the added long rides this year. Reading between the lines, you are upset because you are losing muscle mass from your upper body. The only way to keep those muscles from shrinking is to exercise them. You don't have to go to a gym to do an upper body workout. With a couple of dumb bells you could easily do some bicep, tricep, lats, and shoulder exercises at home. Even push-ups and pull-ups would do the trick. Take care.

Blood tests results and anaemia

Hi Fitness team,

Please can you help me, since I moved back to the UK from Melbourne I've discovered that the information offered to sports people outside of Olympic athletes is non existent at best.

My problems have been plaguing me for some time now. I noticed that I after a few weeks of intense training I would become very fatigued (more than normal), this lead to a general feeling of fatigue and malaise with low concentration in general circumstances.

A blood test revealed that my RBC were low with a blood count of 12.9 and haemocrit of 29 (My blood cell volume is 90.) Despite this my doctor says it's not a real problem but has put me on ferrous sulphate for three months. In addition to this I'm taking B12 and I'm starting to feel better already, my concentration has improved (although not brilliant unless the conversation is about cycling and my general feeling has improved significantly.

The problem is, this has occurred before (once in Melbourne) which leads to my question - is this normal? The haemocrit level also seems low as I've read somewhere that a normal male should be around the 40 - 44 level. Can you tell me what you would consider good for a cyclist?

I tend to do about 7-9 hours a week on the bike or around 200 - 250km. I don't get the time for big hours or big rides due to having a young child but make sure what I do is quality stuff with good efforts every week. My HR max is around 188 and all my efforts are between 160 and 180 depending on what I'm training for. I also make sure I listen to my body and get good recovery days each week after learning the hard way about overtraining.

I eat red meet around once - twice a week but I also have chicken once - twice a week and have pasta quite often with vegetable dishes making up a fair chunk of my meals. I also have a couple of Lattes a day after becoming addicted to them in Melbourne but never more than 3-4 caffeine drinks a day. I appreciate your help as there's no chance of getting any here. Kind regards,

Andrew Hill

Pam Hinton Replies

Hi Andrew,

Well, it won't remedy your problem, but it might help you mentally to know that what you are experiencing is not normal. There is no doubt based on your hematological values that you are anaemic. Your haematocrit (proportion of your blood that is red blood cells) is far below normal for physically-active men and has dropped below the cut-off that is used to determine anemia in males (

Anemia can result from inadequate production of red blood cells or from loss of red blood cells at such a rapid rate that your bone marrow cannot replace them fast enough. Some drugs (chemotherapeutic agents, for example) prevent the bone marrow from making new red blood cells. People suffering from this type of anemia may be candidates for erythropoietin. Deficiencies of many nutrients can also slow production of red blood cells. The way to identify which nutrient may be the culprit is to look at the size and pigmentation of the red blood cells using a microscope. For example, inadequate B12 or folate prevents cells from dividing. To compensate, the existing cells grow very large with normal amounts of hemoglobin and, therefore, normal pigmentation. This type of anemia is called megaloblastic or macrocytic, both descriptors meaning, "large cells." Iron deficiency results in insufficient hemoglobin production.

The body attempts to make up for the decreased oxygen carrying capacity by cranking out new red blood cells at a rapid rate. Under the microscope, you would see large numbers of small (because they're immature) and very pale (due to lack of hemoglobin) red blood cells. This type of anemia is called hypochromic (pale), microcytic (small cells) anaemia. Another measure of RBC size is called mean corpuscular volume (MCV, corpuscle is another term for RBC). Your MCV is 90 fentoliters (a fentoliter is 10-15 liters), which is within the normal range, 80-100 fl.

Your anemia is most likely due to iron deficiency, so it makes sense that your physician has prescribed ferrous sulphate. Since you are not a vegan, you get plenty of vitamin B12 in from the animal foods in your diet. So any improvement in your symptoms is most likely because of the iron supplement and not the B12. There is another blood test that is used to confirm that your body has run out of iron. If the concentration of ferritin in your blood is low (

My guess is that you slowly became iron deficient because your intake of dietary iron is too low. Dietary iron comes in two forms-heme and non-heme. Heme iron is present in hemoglobin and myoglobin-proteins that are in blood and muscle, i.e., in red meat. Non-heme iron is iron that is part of iron salts, like the ferrous sulphate that you are taking as a supplement. Non-heme iron is the type of iron that is in plants. There is a reason that I am bothering to differentiate between the two types of dietary iron. Heme iron is readily absorbed from the small intestine (up to 50%). Non-heme iron doesn't even come close to 50%--only 2-10% of non-heme iron is absorbed. The main reason for the poor absorption of the non-heme iron is its poor solubility in the small intestine. The iron salts dissolve more readily in an acid environment (the pH of your small intestine is close to neutral) so one way to increase the absorption of non-heme iron is to consume it with an acidic food or beverage, e.g., citrus juice.

I have several suggestions for you. First of all, have your ferritin tested to get a read on your iron stores. Second, try eating red meat more than 1-2 times per week. When you take your ferrous sulphate have some orange juice with it. Rule out any possible blood loss. If you regularly donate blood, refrain from doing so until your iron stores are fully back to normally. The greatest source of blood loss is via the gastrointestinal tract. Imperceptible blood loss from the gut can result from strenuous exercise, but it also can be a sign of colon cancer. I would have a physician rule that possibility out by getting an occult blood test. In the meantime, get your ferritin, haematocrit, and hemoglobin check every month or so. Good luck.

Collapsed lung and pneumonia

Hello. I am a 50 year old male racer, 5' 10" and 147 lbs with BFP of about 5%, who is very fit. A little over three weeks ago, Saturday June 11, I was hit at the finish line in a crit and suffered two fractured ribs and a collapsed lung. I was in the hospital with a chest tube until the following Thursday. Immediately after returning home I came down with pneumonia, which was successfully treated with a ten-day course of antibiotics.

Approximately two weeks, Monday June 27, after the accident I saw my pulmonologist who said there was no sign of the pneumonia in my chest x-ray or in my breathing. She said that the rib fractures looked "old" already, and she cleared me for return to activity as the pain allows. I had started on my trainer on the prior Saturday, exactly two weeks after the crash, and by mid-week I was outside on my time trial bike. Three weeks after the accident I competed in a time trial and then a crit. In both events I finished a respectable 15th, but my wattage is way down from about 268w to 233w for a TT effort. The primary problem is breathlessness. While my legs appear to have hardly missed a beat, my respiration cannot support my usual wattage nor my usual cadence, which has fallen from the low to mid-90s down into the low to mid-80s (at least to be able to sustain wattage).

My coach and I agree that some of the difficulty is due to blood volume loss, which we can work to rebuild, but I have the strong sense that my lung simply is not hitting on all cylinders. What can I expect in this regard and can I affect this course by a particular type of training regime? I admit that my recovery has been miraculous so far, but my fear is that I will be stuck at this lower than normal capacity for a long time. Thanks.

David Frankford

Kelby Bethards Replies

David,

I think the fact that you were able to do as well as you did only three weeks after an illness like pneumonia is very commendable. I also believe that you are correct in that you are not yet back to full form.

While the X-ray and listening to your lungs may have "told" your doctor that you are better, in my experience it can take quite a while to completely recover from something as serious as pneumonia. As a general rule, I tend to tell people to expect recovery to take about three times as long as the illness...thus if you were ill for say 10 days, it may take another 30 days to feel as you had before the illness. And in reality, evidence of pneumonia may even be visible on chest x-ray many weeks after treatment. So having an illness isn't equivalent to just being off the bike for 10 days, its requiring a lot of energy to heal.

SO, the long and short of it...you are still healing - but apparently healing well. Take it easy and rest when you need it.

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