Fitness questions and answers for November 15, 2004

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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.

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.

Winter weight training
Long term use of prednisone
Knee Tendonitis
Menopause weight gain/training fatigue
New shoes and old cleats
Twisted pelvis
Tendinopathy
Supplements

Winter weight training

Weight training for cyclists seems to be a debated subject. I was wondering what the theories for and against were. I am two months into my squat program, and would say it does provide some help in my mountain biking (mainly when riding uphill on rough rocks and rooty trails) but was mainly hoping for more power on my road bike racing sprints.

Joe

Scott Saifer replies:

The latest evidence so far as I can tell says that a well conceived weight training will not improve your VO2-max or your power at lactate threshold but will probably enhance your ability to produce power near your VO2-max for a longer time. It might also increase peak power. A routine of high repetition, low-weight weight lifting will not cause appreciable hypertrophy but will make it harder to lose muscle mass, which might be good or bad depending on your current weight.

Strength training on the bike by pushing high gears at low rpm will also provide similar benefits, though it also requires that you get on the bike, which some riders prefer to avoid in the snowy season.

Long term use of prednisone

I am a 63 year old male, 6 feet, currently overweight at 225 pounds. in 1998 I was diagnosed with Sarcoidosis. I have been taking prednisone for the past four years and it seems to control the symptoms. Before the illness, I was competing in duathlons (run-bike-run), numerous running events, and I completed two marathons, each in less than four hours.

I am now finally interested in "getting back into shape" and have started a walking and casual biking program. Do you have any recommendations in regard to the long term effects of prednisone medication and how to train while taking this drug? Apparently, it will be necessary for me to continue on this steroid the rest of my life. I have tried to stop taking prednisone three times but each time the sarcoid flares up again as chronic fatigue, atria fibrillation (I am taking a drug called rythmol for this), and other systemic aggravations. A stress test shows my heart is in good shape to train but that when I am unmediated the sarcoid can somehow affect the heart's electric controls.

One of my doctors tested me for DHEA and found that I have extremely low levels. I have tried to supplement DHEA but I find it upsets my stomach and I can only tolerate small amounts. Do you have any suggestions on how to boost this?

Thanks for any help you can offer.

Eugene Johnson

Pam Hinton replies:

First, although you can’t hear it, I’m now backing away from the keyboard to applaud your determination and courage. I know plenty of people whose biggest obstacle to training is, well, training. So it’s good to be talkin’ to a real athlete. I have some recommendations that may help, but first let’s do the heavy lifting so that we know we’re on the same page.

Prednisone, a synthetic glucocorticoid hormone, is used to treat autoimmune diseases and to prevent tissue rejection after organ donation. Prednisone acts directly on the immune system to reduce the immune response: proliferation of immune cells, tissue destruction, secretion of antibodies and cell-killing compounds. These are fine objectives, and in your case they are necessary, but drugs this strong also have strong side-effects.

Glucocorticoids that are made in the body regulate the immune system and control fuel metabolism. Cortisol, the primary naturally-occurring glucocorticoid is made in the adrenal gland in response to signals from the brain. The hypothalamus senses the levels of cortisol in the blood. If cortisol levels are low, the hypothalamus stimulates the anterior pituitary to secrete ACTH, which travels through the blood to the adrenal gland where it stimulates production of cortisol and other hormones.

Starting with cholesterol, the adrenal gland synthesizes cortisol, aldosterone, androstenedione, and dehydroepiandrosterone (DHEA). Aldosterone acts on the kidney to regulate blood pressure, by stimulating sodium and water retention. Androstenedione and DHEA are weak androgens that are converted into testosterone in other tissues.

Glucocorticoids have a catabolic effect on skeletal muscle. These hormones prevent cell growth by inhibiting synthesis of DNA, RNA, and protein. Binding of prednisone or cortisol to the glucocorticoid receptor on muscle cells results in degradation of muscle protein. The amino acids that are released are used by the liver to make glucose.

Because glucocorticoids reduce glucose uptake and use by muscle and fat, some individuals treated with glucocorticoids may develop hyperglycemia. When the hypothalamus is exposed to high levels of prednisone, it shuts down production of cortisol and the adrenal androgens. This explains why your DHEA levels are low. As far as maintaining skeletal muscle mass is concerned, prednisone treatment is a double-whammy. Prednisone not only has direct catabolic effects on muscle, but it reduces the anabolic stimulus of DHEA and androstenedione. Long-term treatment with prednisone may cause loss of bone mass, leading to osteoporosis and increased fracture risk.

Thankfully, the prednisone treatment has you feeling good enough to consider training again. Unfortunately, the glucocorticoid treatment means that you will have to modify your expectations. You’ll need to concede that you won’t be able to significantly increase your muscle mass no matter how much you train. DHEA replacement therapy may help offset some of the catabolic effects of the prednisone. I know that you had trouble tolerating the oral DHEA prescribed by your physician, but don’t be tempted to experiment with over-the-counter DHEA in gel and patch form. It’s just too risky. In the United States, DHEA is sold as a dietary supplement, so it can be purchased without a prescription.

Because dietary supplements are not tested for quality by the Food and Drug Administration, they often contain less of the active ingredient than promised and have undeclared substances added. Since the anabolic effects of DHEA likely result from its conversion to testosterone in the body, you might ask your physician to measure your testosterone levels. Testosterone is available in patch form, so you could circumvent the nausea associated with oral supplementation, if testosterone replacement is appropriate. I also suggest that you have your bone density monitored to protect against osteoporosis. To minimize bone loss, be sure to consume adequate vitamin D and calcium (1200-1500 mg per day). Be careful with vitamin D supplements, though, it is easy to over do it.

Don’t consume more than 15 micrograms per day. Should you begin to lose bone at an accelerated rate, there are medications available that are effective in treating osteoporosis. These drugs, generically called bisphosphonates (Actonel, Fosamax), slow bone loss.

Also keep in mind that now you will be more susceptible to bonking. So, be sure to drink a glucose-containing sports beverage on your longer rides and fuel up with carbs after training. Bonking happens to everyone and It will be hard for you to not look down your nose at your training partners who have much less of an excuse than you do. And, Eugene, when others start whining and complaining on those really tough rides, try very hard not to be an elitist snob. Instead, smile to yourself, because you know what real suffering is all about.

Knee Tendonitis

I have been trying to work into a good winter training program after having a full season of road racing. My last race was in August, and following extremely consistent riding all season I hit a period of really sporadic riding. As a result, I now seem to have tendonitis in my right knee (hurts on the inside of the right kneecap). I have had this before, a few years ago, but didn’t know what it was at the time, and was very cautious. Over time, the problem just disappeared. This time, I really don’t want to spend as much time off the bike as I did last time. I think I can manage the pain, but don’t want to do any real damage. What is the best way to deal with tendonitis and still get good base mileage? I appreciate your time! FYI, I am a 26 year old male and participated in 12 races this year. Right now my style of riding is base mileage, but I tend to go harder than I am supposed to. I get around 150 to 200 miles per week during the racing season and maybe 100 to 125 per week in the off season, weather depending.

Thanks for your time, and have a great day!

Patrick Nicholls

Steve Hogg replies:

The incidence in the right knee only, always begs the question why only on one side? As well as following Scott's good advice, get a good structural health professional to have a look at you. By look at you, I mean with your shirt off and stripped to your underwear. This way an all of body picture can be gained of why you are having this issue.

You mention managing the pain. Take it from someone who has a serious knee problem, knees are hard to injure because the joint is largely comprised of fibrous tissue with limited blood flow. Because of this though, they can take a long time to recover once injured, so be careful.

Scott Saifer replies:

Most knee problems are caused by shoe or bike fit or pedaling style issues. They can also be caused or exacerbated by increasing distances too quickly, pushing hard gears before adequate conditioning, or not covering the knees on cold days. So, assuming you have begun to gradually build up base miles, that you are spinning for your first month or so of rides and that you are smart enough to wear tights if it is chilly and double tights or tights plus leg warmers if it is cold, it sounds like you probably have a biomechanical problem.

The best solution is to have yourself watched by an experienced and competent bike fitting expert. In case you don't have access to one, I'll suggest that two things which often cause pain in the place you are describing are inadequate extension (see too low or two far forward) or, if you have flat feet or collapsing arches, a lack of arch support in the shoe. If you dig through the archives a bit you will find many excellent posts from Steve Hogg describing setting the saddle height and set-back. Arch supports can be purchased at a shoe-repair shop or many drug-stores and are inexpensive enough to be worth trying. The ones you get need to be firm enough to stay "up" even when you stand on them.

Menopause weight gain/training fatigue

I'm going through the "pause" at age 50, can't lose weight with high miles and a very healthy diet. I eat: veggies, fruit, whole grains as a general diet and fuel up for my long rides, 80 miles, with gels so I don't bonk. No mater what I do or eat, I stay 140-145 lbs. I want to be at least 130. I'm a medium frame and 5' 6". I recently started running again - 2 miles walk/run and am on the bike 4 to 9 hrs a week. I am Gaining fat not losing it! Also I am having more fatigue on the climbs. Can you suggest a good diet for me?

Lee Kerger

Pam Hinton replies:

The “pause,” as you refer to it, is defined as the absence of regular menstrual cycles for 12 consecutive months. Typically, women experience menstrual cycle irregularity before cycles stop completely. Changes in cycle length and frequency are common. During this perimenopausal period, estrogen level may also be highly variable and after 3 months of missed periods, estrogen declines significantly. Menopause, like puberty, is a time of hormonally-driven changes in body shape and composition. During middle age, women gain an average of 0.5kg ( 1 lb.) per year and menopause does not seem to increase this rate of weight gain. Some studies have found that women lose muscle mass and increase fat during menopause, but these changes seem to be due to a decrease in physical activity as women get older, rather than an inevitable consequence of menopause. Even if total body fat does not increase after menopause, there is a shift in body fat distribution from the hips and thighs to the abdomen. In other words, the “pears” start to look more and more like “apples.” It is the accumulation of fat around the internal organs located in the abdomen that probably causes changes in fat and glucose metabolism. Postmenopausal women have higher total cholesterol, LDL (bad) cholesterol, triglycerides (fat) and lower HDL (good) concentrations in blood than premenopausal women. These changes explain why the risk of cardiovascular disease increases in women after menopause. Women, especially those who gain abdominal fat, after menopause may become insulin-resistant. In other words, the body becomes less responsive to insulin, the pancreatic hormone that is needed for glucose uptake into fat and muscle. As a result, glucose levels become elevated and the pancreas secretes more and more insulin to compensate.

These changes in body composition and metabolism are not only because of the direct effects of lower estrogen, but due to estrogen-mediated changes in other hormones, too. Growth hormone and insulin-like growth factor-I exert anabolic effects on bone and muscle and GH increases fat use as an energy source, by stimulating release of fatty acids from body fat stores.

The good news is that exercise can counteract many of the unfavorable metabolic changes that occur after menopause by: reducing weight gain, increasing fat utilization, maintaining skeletal muscle mass, improving cholesterol and triglycerides, and increasing the body’s response to insulin. Recognize that menopause is a normal part of the female life cycle and try to accept that a little more effort may be required to maintain your body weight than before the “pause”. You might consider incorporating some strength training to maintain or even increase your muscle mass. Because metabolic rate (the amount of energy you burn at rest) is proportional to your lean body mass, losing muscle mass decreases your energy requirement, making it easier to gain weight. Strength training with weights will also benefit your bones by stimulating bone growth due to the mechanical stress placed on the skeleton.

Your diet, which includes fruits, vegetables and whole grains, is a sensible and healthful one. Dairy products were missing from your list of regular foods, which means you may not be getting enough calcium. Adequate calcium intake is especially important for postmenopausal women. In addition to dairy products, some vegetables, fish with bones, and fortified foods (e.g., orange juice, cereal) are good sources of calcium. During the first 5-7 years of menopause women lose up to 20% of their skeletal mass. Consuming 1200-1500 mg of calcium per day can minimize that loss. Plus, there is new evidence that adequate dietary calcium (especially from dairy products) can help prevent accumulation of excess body fat, by promoting fat oxidation.

New shoes and old cleats

hello, im a 20 yr old cat3, 142 lbs (off season weight...137 lbs race weight), 5ft8in. i have a question regarding my cleat positioning. i want to buy a new pair of shoes (those silver shimano ones) but want to have the same cleat positioning that i have now on my current shoes (carnac quartz). is there a correct way of making the transfer so as to not cause an injuires further down the road? thanks in advance.

Giancarlo Bianchi

Steve Hogg replies:

Have a look at the post entitled 'Ball of Foot' for October 11, 2004 on this forum. Follow that method and ascertain where the centre of the first metatarsal joint is in relation to the pedal axle now in your Carnac Quartz's. Once you have done this you can repeat the process on the new shoes to make sure that you maintain the same relationship between foot in shoe and pedal axle. There is one potential trap. The Carnacs you are coming from have a moderately high heel lift last. The Shimanos you are considering have a lower heel lift last which in my view is preferable. This means that under load you will not need to drop your heel as much coming off top dead centre of the pedal stroke so as to get behind the pedal axle to push forward and down as early as possible in the pedal stroke.

What this means to you is that even with the same measured cleat position, the pedalling feel in new shoes is unlikely to feel the same as in the old ones. Assuming they fit well, they should feel better. If you have any problems, yell.

Twisted pelvis

I'm a 37 year old male who broke his pelvis several years ago. I had an open book fracture (broke at the pubic bone and the right sacroiliac joint) that healed a little crooked. You are right if you say I'm twisted. I have found through trial and error that if the nose of my saddle is turned to the left a little, I feel straighter. When I ride, I feel like both legs are performing about equally, although at times I felt like my right leg might be doing more work.

My back mucles are not symmetrical. The muscle that runs down the right side of my back to my sacrum is very large, but the left side is not nearly as developed. If I exert heavily in a ride, I almost always get back pain, presumably from uneven forces in the lumbar area. Is the difference in my back muscles due to depending on one leg more than the other, or to riding twisted? Should I try to even the back muscles out through weight lifting or by making a change on the bike? What are appropriate exercises to strengthen the back evenly?

Matthew Brinkley

Steve Hogg replies:

The enlarged muscle you speak of is the right spinal erector. This over development on one side is typical where the pedalling forces cause uneven stresses between right and left sides. It would be a good idea to find someone knowledgeable to position you who takes a structural approach. It is probably worth you while experimenting with a packer under the right foot if this is not possible. Try 3mm for starters and if that feels better, try 5mm and possibly more if necessary. For every 5mm you pack up under the cleat move the cleat back another mm on the shoe relative to foot to negate the rocking torque effect.

Two books that you should buy are 'Pilates For Dummies' by Ellie Herman and 'Stretching and Flexibility' by Kit Laughlin.

Tendinopathy

This is a question for Steve Hogg please.

I have had extensive treatment for tendinopathy of a hamstring insertion in the lateral aspect of my right knee - inc physio, massage, chiro and injections. It has eased over the last 6 months but recurs at extreme efforts and at the end of long rides - effectively stopping me from racing. The other end of the same muscle (ischial insertion) had tendonitis 18 months ago (resolved with injection) so is clearly under duress.

It appears I have a flexibility and positional imbalance that causes stress to my right hamstring and elicits comments from fellow riders regarding the fact I am leaning off to one side in and particularly out of the saddle (to the left)etc and the nose of my saddle wears out quickly on the right due to the rubbing of my leg.

I understand this is very difficult for you to help remotely but can you recommend someone in Perth WA who could assist?

I expect they would need to see me ride in and out of the saddle under load in controlled conditions and assess my flexibility and position?

Many thanks

Ian Calverley

Steve Hogg replies:

From the information you have given me it is a safe bet that your hamstring problems on the right side is a consequence of your tendency to hang to the left while riding. By so doing you are increasing the distance the right leg has to travel to the pedals and probably putting your knee under a lateral load as well. This pattern of motion is unfortunately more common than is generally realised. The best you can hope for with a positioning solution to this problem is to lessen the impact of it. Over the last 5 months I have posted a lot of stuff about the general solutions to problems like yours on this site. However, how effective an on bike fix can be depends on the extent of the problem. A good bike position cannot change you, only how you relate to your bike. The only person I know of in Perth who may be able to help to some degree is Rick Churchill of Rick Churchill Cycles. I have met him once about 7 years ago and don't claim to know him but in the limited time we spent together, his views about position were sensible. Give him a call.

In my experience there are two basic causes for pelvic asymmetries in a general sense. I'm not a health professional but am a layman interested in anything that impacts on the relationship between bike and rider. I say this because I am happy to be corrected about the detail of what I am about to say, but the guts of it will hold up. I see a lot of people with pelvic asymmetries that cause them to drop one hip on the bike while riding. Sometimes any pain they feel is on the side of the dropping hip. More often any pain they feel is on the opposite side. This is because generally speaking, we will look after one side of our body unconsciously and compensate like mad while paying a physical price for this on the other side. Often, but by no means always, the protected side is the handedness side.. Nearly every one of what I will call the hip droppers displays clear physical reasons for this. It may be hip flexors that are much tighter on one side than the other; it may be a restricted sacro iliac joint on one side; it may be a measurably longer leg on one side; it may be the legacy of a heavy crash or fall; there are a host of possibilities. I position these people to the best of my ability and STRONGLY suggest they seek a solution to their pelvic asymmetries and often point them towards health professionals who get results. Most of these hip droppers return to me at a later date having by their own efforts and the guidance of others, eliminated the underlying cause[s] for their hip dropping tendencies. I adjust their position accordingly.

But, and this is a big but, probably 20% of those people STILL DROP THEIR HIP ON ONE SIDE ALTHOUGH THERE IS NO LONGER A PHYSICAL REASON FOR IT! This has really caused me to pick a lot of brains and read everything I could get my hands on over a period of years to try and understand why this could be happening.

Of those what I call problem children, 10% or thereabouts will stop or minimise their hip dropping by wearing the correct nanometer [colour] of lense in their sunglasses while riding. 20% of the fibres in the eye play no part in vision but play a part in balance and proprioceptive awareness. By blocking out the correct, in an individual sense, wavelength of the light spectrum, some of these hip droppers can be prevented from dropping their hip. What about the other 90%?

Well that is where things get a bit interesting. I will explain later. Has any health professional you have seen to date, asked you to strip to your undies so than can get a global perspective of how you function? If not and they have only concentrated on the site of the injury, then you need to stop seeing the people you are currently going to and find more thorough and knowledgeable health professionals. Go down that path and see how you go. Most people will find their asymmetries of function can be addressed like this. If however, at some future time you are convinced that your core strength and flexibility is good and relatively even between left and right sides and that there is no longer a physical reason for your hip drop on the bike, BUT you are still doing it, here is a diagnostic test for you.

You will need to stand about 400 mm away from a wall while facing away from it. Fold you arms across your chest, close your eyes and start walking on the spot and continue for about 60 seconds. Open your eyes and look where your feet are in relation to the wall behind. Have you started to turn in one direction?

If so, repeat the process again. Have you started to turn in the same direction again?

If the answer is yes, it is likely that there is a neurological basis to your problem. For conscious actions the right hemisphere of the brain controls the left side of the body and the left hemisphere of the brain controls the right side of the body. Conscious actions are apparently about 10% or thereabouts of our daily behaviour. The other 90% of our actions are unconscious. By this I mean that we are using the parts of our brain that we do not have conscious control over. Bike riding and walking are example of unconscious behaviour. It may be a conscious decision to get on the bike but once aboard no one thinks about every pedal stroke. We are to a large degree on auto pilot. Under these conditions the brain hemisphere control of the body is ipsilateral, i.e. right hemisphere controls right side of body and left hemisphere controls left side of body. Some people have a hemispheric dominance that is pronounced enough to cause asymmetries of function. Simply put, the signals from one side of the brain get through more loudly and clearly than the signals form the other side.

If after you have gone through all of the above and this is you, get in touch with the Carrick Institute, www.carrickinstitute.com for name and address of someone near you who has been trained by them. Their is some controversy within some areas of the health profession about their methods and beliefs but I have seen the before and after of enough cases to see that they get results.

My apologies for the length of this reply but asymmetric function of the pelvis that manifests itself as a pronounced hip drop on the bike is the toughest problem on the bike to solve in a positional sense. There have been enough people enquire knowingly or otherwise about this issue on the forum for it to be time for their to be a comprehensive answer for anyone interested now or in the future.

Supplements

I just read Pam Hinton's advice to Vincent Desmarais re: supplements and I have to ask, upon what empirical evidence to you base your conclusions? My personal experiences (i.e., anecdotal) with over 30 years (I'm 45 years of age) of combined high school/college wrestling, powerlifting (coaching and competing), bodybuilding coaching and biking (leisure and competitive) experience, has taught me supplements can be a terrific benefit to meeting fitness goals and overall health. And, the empirical evidence appears to support these assertions also.

Over the years, I've been skeptical of manufacturers' claims, and thus, I do my own reading/research, as well as have conducted many double-blind studies on myself, seeking benefits. My experience is that some supplements are helpful, for some people. But in the name of fairness, isn't a generalized " The rest of the time, you are just throwing your money away" statement a bit extreme?

James Thacker

Pam Hinton replies:

Let me amend my answer to the following, “The rest of the time, you are just throwing your money away--unless, you firmly believe that your supplement of choice works. Then by all means, continue to spend money on the placebo effect whether it be in pill, powder, or capsule form.” The power of the mind cannot be underestimated, if an athlete believes that a supplement is going to help their performance, it probably will. However, if the ergogenic effects of that supplement were studied in a double-blind, placebo-controlled trial (meaning subjects randomly receive the supplement or an identical looking placebo treatment and neither the subjects nor the investigators knows who gets what), you may or may not find a significant difference between the supplement and placebo. Dietary supplements range from the conventional (multivitamins) to the everyday (caffeine), exotic (chinese herbs), weird (caterpillar fungus), disgusting (pituitary extract), and dangerous (ephedra). As I stated in my reply to the question about supplement use in general, supplements that are taken to correct a nutrient deficiency will certainly be beneficial. With a few exceptions, there is little evidence from double-blind, placebo-controlled studies to support the use of dietary supplements to enhance athletic performance. A search of PubMed, a data base of peer-reviewed journal articles for the phrase, “supplements and sports” returned over 500 entries, so “empirical evidence” exists and most of it finds no effect of supplements on performance.

Even among the few supplements where a performance-enhancing effect has been repeatedly demonstrated, the magnitude of the effect is relatively small compared to the sum of the improvements that could be obtained from increased training, positioning on the bike, or better equipment. For example, take performance in a 40km time trial. According to an empirically derived, mathematical model to predict 40km TT performance in novice and elite cyclists: training can shorten time by 60-420 seconds; riding in an aerodynamic position, 120-150 seconds; riding an aero frame and wheels, 75-105 and 60-80 seconds; ingestion of a carbohydrate/electrolyte drink, 30-40 seconds; and caffeine may improve performance by 60-80 seconds. (See the paper published in Sports Med. 2001;31(7):559-69 for details.)

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