Fitness questions and answers for June 6, 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.

Blood Lactate testing
Fit for Powercrank revisited
Peroneal tendonitis and cleat position
Hip Flexor stretches
HR, eating, and lactic acid
Off-colour urine
Breathing

Blood Lactate testing

We recently purchased the Lactate Pro blood lactate test kit and have scheduled a test session with our race team. I would appreciate your sharing with me the best test protocol(s) for determining Lactate Threshold HR and Power using blood lactate testing. There are many tests based on perceived exertion, ventilatory threshold, HR/power breakpoint etc, however these are estimated testing methods that involve too many variables rather than true science - that is why we purchased the blood lactate kit. The company from whom we purchased the kit promotes the FACT method which can be found at http://www.fact-canada.com/LactatePro/FactTestInfo.html We have a Cycleops Electronic trainer that has a LT test mode which allows us to dial in specific power loads and increase them at prescribed intervals, so hopefully we have the equipment we need. Now we need the correct testing protocol. Thanks for your help.

Ben

Scott Saifer Replies

Hi Ben,

There are many useful protocols for determining lactate threshold. Since you have the ability to set power outputs on your trainer, try starting with a good long warm up (as you would for a race, say a minimum 45 minutes of gradually harder riding including a few jumps near the end). The do the following protocol:
100W, 1 minute
add 10W every 30 seconds (local or masters racers)
add 15W every 30 seconds (elite racers)
continue to exhaustion, which should take about 10 minutes.

Most riders will peak out between 300 and 500W. Measure lactate every 30 seconds at the end of a stage at a particular power. If your machine is not that fast, extend the interval time as necessary, but don't increase the power step size. Far too many times clients have brought me lactate graphs with such large steps between power levels and such large gaps in heart rate and lactate levels that all I can say is, "yup, your LT was between 140 and 160 bpm and between 200 and 280W", but nothing more precise. If you can't make small steps and test lactate on every step, a conconi test or perceived exertion test is more accurate than your high-tech tester test.

While you are recording power and lactate, record heart rate and perceived exertion as well so you can identify the heart rate and effort that correspond to the LT. That way you won't need to repeat the lactate test frequently during time trials or long breakaway attempts.

Andy Bloomer Replies

Hi Ben

Don't want to step on Scott's toes too much here but the way I'd do it is first of all avoid too much warm up. Yes, you heard correct! The reason being is that for a lactate test graph to be of any use you need the first one or two points on the graph to be at baseline or resting levels. If you do a vigorous warm up your lactate concentration could be well over baseline levels and (if your subject is particularly well motivated) even over the lactate threshold (or Onset of Blood Lactate Accumulation if you prefer) before you even start the test meaning you may have to wait for a long time for the concentration to reduce before you can begin.

The way I would do it is to turn the legs a little to limber up for 10-15 mins or so but no more and at no higher power output than your first stage of the test, otherwise the lactate sample you take after stage 1 will not be representative of that stage but of the warm up that you did at the higher power output. I hope that's clear, what I'm trying to say is that if you warm up at 150W and then ease back to 100W for the first stage, the lactate sample you collect will contain a lactate concentration representative of 150W as it take some time for the lactate concentration to fall.

Start the test at 100W depending on rider ability (possibly 150W for an elite/pro rider). The test should contain around 7 or 8, four minute stages where you maintain the same power for the full 4-mins. At the end of each stage take a lactate sample and record heart rate and power output that it corresponds to before increasing to the next power for the next 4-mins. I would say you should increase by 30W per stage or 40W for elite riders. The reason for 4-minute stages is that research shows it takes this amount of time for the body to reach steady state exercise, which is crucial to pinpoint the lactate threshold. I hope I don't upset any of the other experts on the forum here but I would use30-second stages possibly for a maximal aerobic power test as opposed to a lactate test, the two are very different. The body will take a little longer than 30 seconds to establish itself in steady state for the sample taken to be of any use. After 4-mins, lactate concentration and crucially heart rate will settle (remember, heart rate takes a little while to catch up with what the body is asking of it). Incidentally, steady state will only stay steady BELOW the lactate threshold, once crossed, lactate production begins to exceed its removal processes and will continue to rise, despite the maintenance of a steady power output leading to the peripheral fatigue that will eventually end the test.

The results you should see from, for example, and elite or professional rider would be roughly as follows:

Stage 1: 150W 110b/min 1.0mmol/l
Stage 2: 190W 120b/min 1.5mmol/l
Stage 3: 230W 130b/min 2.0mmol/l
Stage 4: 270W 140b/min 2.6mmol/l
Stage 5: 310W 150b/min 3.2mmol/l
Stage 6: 350W 160b/min 4.0mmol/l
Stage 7: 390W 170b/min 6.3mmol/l
Stage 8: 430W 180b/min 8.9mmol/l

So, for the rider in the example, the lactate threshold would be 350W at 160b/min. This becomes more apparent when you plot the results graphically when you see a clear jump in l;lactate concentration on the curve. Incidentally, not everyones lactate threshold occurs around the traditional 4mmol/l (just the majority of the ones I've tested). What you should be looking for is a clear jump where lactate concentration begins to rise exponentially. If you run the tests and send the results through I'd be happy to interpret them for you. Hope this helps.

Eddie Monnier Replies

I'll jump in here and hopefully also avoid stepping on toes. I agree with Andy's comments except I use much smaller increments than 40 watts when doing a ramp test. If I'm interested in the athlete's power when lactate is at 4 mmol/L and this point falls between two test increments - as it usually does - then if I use 40W increments I can only say, for example, that their 4 mmol/L point is between 260W and 300W. That range is too broad both for diagnostic purposes and for setting training zones, in my opinion.

I tend to use 25W increments if it's the first time I've tested somebody and I don't have any reliable reference as to where I think their 4 mmol/L point is. Where I do have a reference point (i.e., we tested before, or I have power files from their road training), then I will use smaller increments (e.g., 15W).

Dario Fredrick Replies

Hi Ben,

As you mentioned, many tests out there involve multiple extraneous variables and are not based on "true science." Before addressing lactate testing, let's consider why we are testing in the first place. We want to be able to accurately and reliably predict performance on the bike, including training intensities relative to that performance. The most valid predictor of cycling performance is power.

Defining cycling performance or a "performance threshold," the most repeatable criterion appears to be 30-minute time trial power, although some will argue that 1-hour is preferable. Regardless of whether it's 30 min or 1 hr, we have a tangible level of performance we're interested in measuring or predicting. Keep in mind that regardless of blood lactate appearance, the true defining limit to performance is your maximum sustainable power. (I'll get back to lactate shortly.)

While power is a direct, immediate measure of cycling workload, heart rate is also a useful variable. Heart rate is the body's response to cycling workloads, and despite its limitations, it is an excellent guide for training if used properly. Ideally, those who use powermeters should use heart rate as well. Given that powermeters are not always an option for cyclists, heart rate is suitable and the most commonly used alternative (other than perceived effort).

So we have two meaningful and directly-applicable variables to determine cycling performance and training intensities: Power and heart rate. Now if our goal is to determine training zones using a lab-based protocol, we are looking to accurately and reliably predict 30 min maximum sustainable power and corresponding heart rate. Otherwise, the best alternative would be to do a 30 min field test, ideally on a gradual climb, measuring average heart rate (and power if available).

How does lactate fit in here? Lactate threshold (LT) was born of the false notion that lactate caused fatigue, or was a direct measure of fatigue. For more info/references, take a look at this fitness article. Since lactate does not cause nor directly reflect fatigue, its usefulness in determining performance is questionable. OBLA (or 4.0 mmol/L) is not a reliable measure of performance. Furthermore, LT (using the most common protocols) tends to underestimate TT performance. If you have a valid power-based protocol that predicts your 30 min performance threshold, you do not need to measure blood lactate.

However, lactate is not a useless variable to measure. Lactate is an aerobically metabolized fuel, and our ability to transport lactate into muscle mitochondria (allowing its aerobic conversion to energy) improves with training. So at moderate to high intensity, we have an alternative fuel (to glycogen) to take advantage of. As Andy mentioned, if you see reduced lactate appearance at a given power output after a period of training, it likely reflects improvement, particularly, but not limited to, using this aerobic fuel more effectively at that workload.

Regarding your question about the correct LT protocol, If you do decide after all to measure blood lactate in your testing, I would agree most closely with Eddie's protocol approach. Nonetheless, power is your most useful, predictive variable in testing. Best of luck.

Fit for Powercrank revisited

Your observations about the powercrank are very interesting and I may be making some of the same conclusions. I originally purchased the powercranks because I thought they would be a novel way to improve core strength by recruiting my hip flexors...and I'm a glutton for training gadgets...haven't bought a new bike in 10 years but serious glutton for training gadgets. Anyway, the first time you swap the powercranks out for normal cranks the almost unconscious tick of your legs through the top part of the pedal stroke seems like undeniable proof that the PC is a magical training tool. However, over the course of using my powercranks ( 1year) I have noticed as my hip flexors became more active my glutes and quads slowly became less active.

With my normal cranks the unconscious tick over the top stroke continued but was also accompanied by a set of burning quads-glutes. Whenever I describe what it's like to ride the powercranks I always tell people this..."It's like starting to roll a ball downhill and trying to stop it at the same time," ie; one pulls the crank over the top (rolling the ball downhill) and then on the down stroke you have to pull-back to prevent yourself from accelerating out of control (stop the ball rolling down hill). These events become more and more apparent the faster you spin. For example, in my experience, riding downhill is probably the most difficult time to pedal because spinning so fast you're basically can only use your hip flexors to pull up and back.

However, Frank Day makes the case that as you become stronger one begins to pedal on the down stroke more and dependence entirely for the hip flexor will fade. This is an interesting idea in that it hypothesises that hip flexor musculature must catch up before the glutes and quads can be used aggressively again. Even if this is hooie I believe over-recruitment of the hip flexors is at least situational. As I said before, when I'm spinning I'm forced to predominantly use my hip flexors. In contrast, when I'm hill climbing or hammering on the flats I'm not forced to pull back on the down stroke quite as much.

Instead I find myself having to push and hence I'm able to recruit more of my glutes and quads. Alas, since I'm wimpy (140lbs) and I spend most of my time trying to spin at fairly high cadences I feel that my hip flexors will continue to be over-recruited, resulting in the switching off of my quads/glutes. Hence, I feel that the ultimate value of the powercrank and me will be in those situational events: hill climbing and hard on the flats.

In any event, I would also like to question some of your reasoning on how you feel about the powercrank for exercising one's hip flexors and share my experience with it and stretching. In your response you make the case that because of our largely sedentary lifestyles we have tight, underutilised, and underdeveloped hip flexors and so most people shouldn't overtax them with the use of powercranks. Wouldn't it make sense that if modern society has taken its toll on our hip flexors we should seek exercises to off-set these deleterious effects? Provided it wasn't overdone(as discussed earlier), shouldn't improvements in hip flexor strength be considered beneficial and an improvement in overall core muscle strength? Isn't that why you suggest Kit Laughlin books to so many, to help improve structure. Couldn't Powercranks be considered a novel 'on the bike' exercise to treat..."Overly tight hip flexors [which are] are directly implicated or a pre condition or associated factor for much back pain and many of the structural ills that plague Western society".

I agree the powercrank is a brutal exercise and one could easily injure themselves if they did not begin slowly. For example, when I first got my powercranks I took them out of the box, strapped them on my bike and went on a two hour ride, which resulted in me practically destroying my hip flexor. But, in my own defense, I'm not really this stupid (stop laughing) I was trying to impress a girl (I said stop laughing) and since her body now keeps me warm at night, it worked (told you I was smart). My original plan was to 'take it easy'. Thinking my hip flexors were too tight I immediately began stretching. two months later, I began riding the powercrank, and 'taking it easy' and now I'm quite proficient with them. However, in a little less than a year of stretching I have achieved what I believe to be no gain in flexibility.

My lack of improvement in flexibility may be due to the fact I'm very flexible in my hips already from a previous running career were I had developed a 'very large stride'. As my flexibility hasn't changed since last year my own conclusions are stretching and flexibility don't seem to play much a role in the use of powercranks. Also, since, my glutes and quads under-recruit regardless of my flexibility it seems likely that my squished 'unit' problems are due to the powercrank. This is even more apparent when you review part of an email Frank Day sent me Monday morning in response to your and my postings...

Frank Day: "Regarding your saddle sores. This is a common problem with almost every user. It is impossible to ride the PC's without putting more pressure on the saddle. Users have commented on two different saddles as really making a difference here. The fizik Arione being one and the Flow saddle from Saddleco. The Flow seems like it is the most likely to solve the problem IF you can ride it without your legs significantly rubbing it, which is the case for 90% of us. If your legs hit the saddle when you ride then this will probably not be the best one of the two."

Thanks Frank...so basically, it seems that flattened monster is a result of powercranking, not seat height - and saddles might help... One last question before I leave. Have you ever considered conducting a study to compare improvements in power production with a Steve Hogg fit and powercranks use? I'm sure you have pretty healthy pre/post- power reading data bank and maybe some long-term data too. So all you would have to do is recruit a few people who just bought powercranks. Could be very interesting. Anyway, thanks for your time.

Kemp

Steve Hogg Replies

Before I go any further, you have taken an inference from my reply that was unintentional on my part. You say that I infer that the hip flexors are "underutilised and under developed". This is not so; the problem with many people is that they are just too tight. As humans have evolved upright bipedal posture, hip flexors had to lengthen to allow that - ie - to allow our legs, pelvis and torso to be more or less in a single plane. Look at how much the average person sits in their life. More than six hours a day for 11 - 13 years at school; in a car, bus, train or similarly on the way to work; at work for lengthy periods; eating meals; riding a bike; etc, etc. I am sure that you get the picture. All of that sitting shortens hip flexors.

One of our general problems as cyclists is a cultural one. We devote a lot of time developing our engine [power producing musculature and cardiovascular system] but generally speaking, tend to house this engine in a less than ideally functioning chassis. Who out there trains their posture with as much enthusiasm as they train their engine? Not many is the answer. Given all the sitting that most of us have done from our early years, without ever working on our posture both static and dynamic, a lot of people have tight hip flexors because of sitting [slumping], induced shortening of them without ever stretching them out. Our rib cages provide a framework for muscles to attach to and can act as a stabilising structure for the upper body for good or ill. The pelvis does the same lower down for good or ill. What is in between?

The five lumbar vertebrae unsupported by other than the muscles that attach to them [as well as potentially some of the abdominal muscles that can support them indirectly by intra abdominal pressure, ie. pressurising the viscera. This is what happens along with other mechanisms when we have ' core strength']. This in turn means that the musculature of the abdomen, lower back and sides below the 12th rib need to be the best functioning in the body to prevent potential backpain emanating directly or indirectly from the lumbar spine.

For many, these are the most dysfunctional muscles in the body and so the lumbar spine is prone to stress from any musculature that is overtight that attaches to it. The psoas attaches to the lumbar spine directly. For many people the last thing they need is increased pressure on an already tight muscle group while they pedal a bike in their own dysfunctional way. This is my beef with Powercrank usage. Most of the people who seek me out have a problem of some sort. Of the Powercrank users I have seen, some were fine once some positional tweaking helped matters because they were fairly functional riders without particular pre disposition to the type of problems I'm talking about if they used Powercranks sensibly. Others, I felt, had their priorities wrong. They lack performance and are in a state of discomfort or pain because of poor posture and all of the problems that can arise from that. Yet felt that by spending money on Powercranks [and not just Powercranks; a lot of money is spent misguidedly on 'go fast' gear] they would improve performance. Instead they were pushed over the edge by this further hip flexor and particularly iliopsoas enlistment. These people receive a strong message from me that their priorities need re thinking. The motto here is Function First. This means sort out body problems and achieve a reasonably functional structure and then buy 'go fast' bits if that turns them on.

Since your earlier email, Frank Day has taken issue with various parts of my response to you. Not without some cause but there is a basic disagreement between us. I am a put up or shut up kind of person and Frank seems to be of like mind. The upshot of our conversations is that I am likely to be riding a pair of Powercranks sometime in the future for a lengthy period and a report on my experiences will follow in this forum. Given the additional info that you have given in this email regarding your Powercrank problems, you are not probably someone at risk from their use unless you are still trying to impress your girl. Your high cadence style is likely the culprit in your not feeling like there is the glute/quad enlistment that you seek. You are generating a lot of momentum and the only requirement is to lift the leg moving upward as with the PC's otherwise of course they fall to the bottom. You might want to temporarily abandon your high cadences and push harder gears at lower cadences. That should ease your pressure on the seat because the harder you push down the less weight you will bear on the seat, as well as promoting more use of glutes/quads as well as hammies and calves eccentrically.

Peroneal tendonitis and cleat position

Hello. I have read several of your articles regarding cleat position in attempt to make sense of my recent foot injury. I have diagnosed myself with peroneal tendonitis (I'm an MD) which I've had for approximately 4 weeks. Although it could certainly stem from hill running, I am an efficient runner and have bought stability shoes - thus I believe the injury stems from my cycling and cleat position. I have spent more time training on my tri bike (a QR Typhoon) and in my Sidi T1 carbon soled shoes with Look cleats with float (than on my road cycle Seven with Sidi road shoes and Look cleats with float). I feel that my foot goes from the 3o'clock position downwards (point of greatest torque) in a relatively horizontal manner, ie, not plantar - nor dorsi-flexed. While this certainly feels to generate more power (than on my road bike/road shoes with more flex), it also seems to place more strain on my outer peroneal tendons.

Does this seem like an adequate assessment? If so, how should I best move my cleat position in order to relieve some of the torque/pressure off of my peroneal tendon to enable healing and prevent further injury? Thank you in advance.

Kiki

Steve Hogg Replies

Firstly I apologise for the delay in replying. Not enough hours in the day unfortunately. There are a number of questions where it occurs to me to ask - you imply that this problem only occurs on your tri bike. Is this correct? If this is so, is a QR Typhoon like the QR's that I am familiar with in the past; ie steep seat tube angles of 76 degrees and more? Is the problem present on both sides with similar severity? Have you tried your road shoes on your tri bike? If so was the problem still present? If so was there any reduction or increase in severity? Do you have a noticeably varus or valgus forefoot on either side? Are your feet unusual in any way; flat or perhaps unusually high arch and instep? Let me know the answers and I will do my best.

Kiki responds:

Here's the answer to your questions:

You imply that this problem only occurs on your tri bike. Is this correct?

YES. I have spent the past three rides riding only my road bike/road shoes and my ankle pain has improved a fair amount, leading me to believe it truly is something with the tri bike/tri cleat. If this is so, is a QR Typhoon like the QR's that I am familiar with in the past; i.e. steep seat tube angles of 76 degrees and more?

YES (76.5)

Is the problem present on both sides with similar severity?

-No - only on my left ankle peroneal tendon.

Have you tried your road shoes on your tri bike?

-NO - I thought that given the different set-up on the tri vs. road bike that I couldn't interchange them. Is this not true?

If so was the problem still present?

-Have not yet tried.

If so was there any reduction or increase in severity? Do you have a noticeably varus or valgus forefoot on either side?

-No, but I would consider myself an over-supinator. The outers of my shoes get worn; could also account for the greater strain on my outer ankle/tendon.

Are your feet unusual in any way; flat or perhaps unusually high arch and instep?

-Definitely not flat. Higher arch but not "abnormally" high. The ankle definitely feels better when I wear my Danska clogs (with higher arch) or my Superfeet inserts (with arch) - vs. hurts more with flat shoes/especially the T1 cleats that are flat and rigid.

From my reading, it also appears that for a size 8.5 (39.5) womens cycle shoe, that my 1st MT head should be approxmately 8mm in front of the spindle. Correct? I will check out my road and tri shoes to see if they are aligned properly.

Steve Hogg Replies

Here is what I would do in your situation:

1. Ensure to the best degree that you can, that the cleat position fore and aft, and the rotational angle of the cleats is duplicated with both sets of shoes. Bear in mind too, that having the cleats in the same relationship to foot in shoe may mean differences between left and right shoes in relation to cleat placement on the sole.

2. Once this is done, ride your tri shoes on your road bike and your road shoes on your tri bike.

3. This will tell you whether it is a shoe problem or a bike position problem. Given the type of bikes that you have, it is unlikely that you have the same seating position on both. Am I correct to assume that? The soles on your Sidi T1 carbon are notably less flexible than on your ' normal' Sidi shoes and while it is not likely that that is the cause of the problem, it is possible. If the shoes are NOT the problem, there should be little difference in severity when you ride the road shoes on the tri bike providing of course, that the cleat position and angle is the same on both pairs of shoes.

4. Once you have been able to eliminate shoes as the cause [ if indeed you can], the likely cause is the position forced upon you by your ' forward position' style Quintana Roo. I find that the style of position required to ride those kind of bikes is what I would describe as "high maintenance". For some people they are just not the way to go at all. When you sit as far forward as QR style bikes dictate, the crank arm must move further forward past top dead centre in the pedal stroke before the rider can get over and behind the pedal axle to propel it forward and down. This means for many that there is a larger ' dead spot' of limited leverage either side of top and bottom dead centre which promotes a ' step machine' style of pedalling with significant force applied, but for less degrees of crank arm arc than is the case on a conventional bike. This in turn means the ' on/off style' of pedalling places more strain on any part of the pedalling chain that is susceptible. Given that you describe your self as an "over supinator", and have minimal problems on your road bike, the probable cause of is that the radical forward position needed to ride your QR either pushes you a little too far in the sense that a pedalling style contrary to what your ankle can cope with is needed OR that the compromised pelvic stability typically needed to ride forward position style bikes, causes you to favour one side or the other while attempting to stabilise yourself autonomically. In short, I think it likely that you are forced to hang to the right somewhat on the QR and that this means that you need to supinate more to have the cleat on the left side flat on the pedal.

You could play around with Lemond wedges to reduce the supination stance on pedal if this is the case once you have eliminated the shoes and cleat position as a variable. If you have to do this though, I would try doing a tri or three on your road bike with aero bars fitted to allow you the same upper body position as you have when riding the drops on your road bike. Assuming of course that you have an effective and comfortable road position. Most people will perform at least as well on the bike and typically run better off the bike this way, than with a dedicated forward position style bike. Let me know how you get on.

Hip Flexor stretches

On May 23, Steve Hogg, wrote: "Hip flexors, particularly iliopsoas [iliacus and psoas], are poorly adapted to upright human posture, and very susceptible to overload for anyone with a job involving a lot of sitting, or bending forward, or repetitive activity. In our society this would be the case for a majority, probably a large majority, of people. Overly tight hip flexors are directly implicated, or a pre condition or associated factors for most back pains and many of the structural ills that plague Western society." I was hoping Steve or any of the panel could explain one or two effective stretching exercises for the hip flexor. Is there a resource you recommend for this?

Alex

VT, USA

Steve Hogg Replies

I don't claim any expertise advising on stretching and would not try to advise on specifics via email anyway. There are a lot of stretching books out there with step by step instructions and photos. Alternately, find a good yoga class or similar. The book I recommend to anyone interested is " Stretching and Flexibility" by Kit Laughlin. For anyone with current issues with back pain, I would suggest " Overcome Neck and Back Pain" by the same author. If you elect to buy either, the best advice I can give is to read the instructions and cautions thoroughly, and don't just follow the pictures. They are good books but other panellists may have additional recommendations.

Dave Fleckenstein Replies

Alex,

The following stretch is the most effective stretch that I have found for hip flexor mobilization. The error that most people make in stretching their hip flexors is that they arch their back (relative anterior rotation of the pelvis). This places the hip flexors on slack. By performing a posterior tilt (rotating your pelvis to bring the front rim of your pelvis up), a much more isolated stretch of the hip flexor occurs. I perform 3-5 repetitions of 30-60 seconds.

I am adamantly against "Thomas test" positions of hip flexor stretching (lying on the back, pulling one knee up while the other leg hangs off of the edge of a table or bed) as the spine is not as well controlled in this position.

There are certainly more effective stretches that I perform with patients, but they are relatively convoluted and require careful monitoring of the lumbar spine.

I would also state that I am very much in agreement with Steve's comments regarding the hip flexors, but I find the use of "iliopsoas" to be one of error, as there are actually two very distinct muscles, the iliacus and the psoas, each with very different function and anatomy. The psoas is a muscle that can best be described as the very exquisite integrator of upper and lower extremity function. The number of patients that I see with pelvic, lumbar, and thoracic dysfunction and correlating psoas dysfunction is astounding. I find that often the iliacus is tight, and the psoas is in spasm or poorly recruited.

HR, eating, and lactic acid

I was recently on a long ride and decided to refuel about three hours in. I watched with interest as, for the next hour of the ride, my HR was 10 beats higher per minute for the same power output. (Note to self: easy on the mid-ride burritos). While this didn't surprise me, it did get me thinking about what that meant about HR, blood flow, and lactic acid. My basic question is - should I drop the intensity so the HR goes down, or should I keep at my endurance power and ignore the higher HR? My underlying question is - how does the fact the body is re-routing some of the blood to the digestive system change the body's ability to clear lactic acid, etc. How does the relationship between HR and lactic clearance change? I would assume lactic acid clearance is really about amount of blood (and ability of blood cells to carry oxygen) your body can deliver to the muscles, so then your 'Threshold' would correspond to a higher HR during times like eating. In others words, your 'Threshold' would still be the same power, but not the same 'HR' - but is this right?

Dean

Scott Saifer Replies

Hi Dean,

You are on the right track, but not all the way there. The body does shunt blood away from muscles and toward the digestive tract after meals during easy and moderate exercise, but as intensity increases, the blood is shunted away from from the gut again. This is at least in part why meals that you could enjoy comfortably at home make you feel bloated and uncomfortable while on a harder ride with digestion shutting down.

The shunting of blood to different body systems changes with training, so the only way for you personally to know if your threshold heart rate is different after a meal would be for you to test it yourself after a meal.

Off-colour urine

At the beginning of the week I was startled to notice browny-red urine. It has continued throughout the week although a little better today. (I raced yesterday and put on 80 km commuting. My stomach is a little queasy when pushing it hard on my commutes and a little off during the day. Otherwise everything is normal. No pain etc. I am a 48 year old commuter putting on around 300-400 km a week. I have been pushing it on my bike as I am doing a little racing for the first time in my life and I took off 15-20 lbs since Feb. to hopefully improve performance. I have noticed that I am not as thirsty as normal. Is this just dehydration? Too much weight loss too fast?

Ralph Hildebrand

Kelby Bethards Replies

Ralph,

This could be dehydration, but I doubt it. Another possibility is myoglobin, muscle break down products in the urine. HOWEVER, I think it is more likely blood in your urine. You need to go see your physician, and they can run a simple test on a sample and tell you what it is...this is NOT a reason to panic, but I feel you should have it evaluated further. Infections and other transient things can cause this, but the list is very long of reasons for blood in your urine.

Breathing

I'm writing because something quite worrisome happened to me yesterday a few minutes into a local race. The weather was sunny, hot (31 C) and somewhat humid. The pack started off at a fairly brisk pace; no problem there. But after 10km, we hit the first climb of the race: a steep and sharp wall of about 1.5km. And that's when IT happened: I seriously ran out of breath. I mean I just simply could not get enough air in my lungs, like they were tightened by some vice, or not "expandable" enough. And it hurt! This lasted for several minutes, and when I saw that I couldn't get back to "normal", I quit the race.

I am asthmatic, and on occasions such as these, I use my Ventolin pump. After a few minutes, I'm able to get going again. But this time, it just didn't work. Going 25km/h on the flats was tough, so imagine what it was like climbing. Was it too much too soon? I'm a fairly good climber and "rouleur". I'm 39, have a good winter training base, and apart from asthma, I'm fit and healthy and an experienced amateur racer. Thanks for your comments.

Vic Marsh

Kelby Bethards Replies

Vic,

As you are well aware I'm sure, asthmatics can have varying degrees of attacks...depending on the temperature, the season and so on. Some people may well have attacks because it is humid, some because it is hot. It sounds to me like you had an Exercise Induced Asthma attack (also called Exercise Induced Bronchospasm). Is Ventolin the only med you take and did you pre-medicated before the race? And, although you may have never had an attack like this one, it could happen for no good reason and be aware that it can happen again. I guess what I am getting at, is that you will need to learn the thing that trigger your attacks, and do a preemptive strike. So, if you know hot/humid weather will make it worse, you may need to be on a second (or third, or fourth) med to "control" the bronchospasm when those conditions exist.

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