Fitness questions and answers for October 10, 2005

Got a question about fitness, training, recovery from injury or a related subject? Drop us a line at...

Form & Fitness Q & A

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

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

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.

HR and VO2 stop responding
Cycling and impotence
Riding with Epilepsy
Getting back into it
Numbness on rollers
Strength, power and speed
Avascular Necrosis
Leg length discrepancy
Indoor trainer setup
In-turned foot
Strange looking knees
Cleat position
Toe numbness and pain
Mountain bike fit
Aspirin

HR and VO2 stop responding

Hi,

Three months ago I went to a lab to have myself tested for things like HRmax, VO2max and AT, etc. I maxed out at 200bpm and gave up, resulting in VO2max of 45.5ml/min/kg at 284watts on a bicycle ergometer.

After three months of structured and consistent training, I returned to the same lab to have me tested for the second time. What happened this time around is that, after I reached about 300watts, my HR and VO2 sort of stopped responding to the steadily increasing load, although my cadence didn't drop or anything and I felt I could still go on.

The doctor terminated the test before I gave them a sign that I could no longer go on, since there was no increase in VO2 at the point. My HR at the point was 191 and the load at 336watts. My VO2max increased to 53.7ml/min/kg (at HR of 191 bpm) which I hadn't really expected to at my age (38).

While the results, especially the increased VO2max and maximal power, gave me confidence in my training and I guess more power at lower HR means my cardiovascular system has become more efficient, I'm still puzzled by the fact that my VO2 and HR stopped responding to increasing load above about 300watts. Would you give me a plausible explanation why? Thanks.

Ken Sugawara

Scott Saifer replies

Ken,

This is a pretty easy one to answer, and you already know the answer even though you don't yet know that you know it. This one stumps a lot of physiology students too, at first. Then they say, "aha!" and move on.

Your heart rate and VO2 had stopped rising despite increasing workload because you had reached your VO2max. You could not produce any more power by increasing aerobic metabolism. In general the VO2-max power is no where near the much higher power that can be sustained for a short time. I can promise you that had the doctors allowed you to continue the test, you would not have gone much farther, perhaps just a few seconds, perhaps as much as a minute or two. The loss of power would have been sudden, dramatic and beyond your ability to push through.

Congratulations on the large increase in your VO2-max and power. If you keep up a good training plan you will probably continue to see at least small gains in power. It's unusual to have increases that large when you are close to your potential. As you approach your potential, you generally make smaller and smaller gains in power until you finally plateau. The VO2-max on the other hand may be maxed out, or might not be.

Ken Sugawara then responded:

Hi Scott,

Thank you for the explanation.

Now I understand what you mean by the "you already know the answer" part but I still have a question; what are the limiting factors of VO2 - max? My heart could go a little bit faster than 191 for sure as it had in the past. Maybe it's the gas exchange rate in my lungs? Heart could pump blood faster but then each individual red blood cell would pass the lung faster, having less and less time to exchange gas, maybe? (yeah, you can call me a science weenie).

I can promise you that had the doctors allowed you to continue the test, you would not have gone much farther, perhaps just a few seconds, perhaps as much as a minute or two. The loss of power would have been sudden, dramatic and beyond your ability to push through.

I believe you, but this paragraph makes me curious. If there's a next time, I might ask them beforehand to allow me to continue even after I reach my VO2-max, just to see the sudden loss of power you describe.

Ken

Scott Saifer replies

Ken,

When one goes from minimally trained to decently trained, maximum heart rate typically decreases. Most often the decrease is in the range of 6-10 beats, so the 191 you saw in your recent test might really be your current maximum heart rate, even if you hit 200 a few months ago.

The textbooks say the limiters on VO2max are heart stroke volume, maximum heart rate and blood hemoglobin concentration. That is, maximal cardiac output and the ability of any unit of blood to carry oxygen determine how much oxygen you can deliver to your muscles. The other two potential limiting factors are the ability of the lungs to deliver oxygen to the blood and the ability of the muscles to extract it again. The lungs are generally not limiting except at high altitude or in various kinds of lung disease. The muscles are rarely limiting except in entirely untrained individuals and possibly in some disease states.

If your goal is simply to experience the feeling of going to your limit and losing power (blowing up), you don't need to do another VO2-max test. Just do your own ramped protocol on a trainer or rollers. Warm up thoroughly and then start out easy and add 10W or 1/2 mph every 30 seconds for as long as you can. (For anyone else who is reading this, I'm recommending this test to Ken because I know that he recently survived two VO2-max tests. Don't do this test unless you have either been doing maximal efforts recently or have your doctor's okay. If you have hidden or known heart disease, this test could kill you.)

Cycling and impotence

I was reading the Globe and Mail (Canada) yesterday, and came across an article (see attachment) claiming there is new research supporting the notion that cycling causes impotence. Is this fact, or is it more of the same old sensational news that has cropped up in previous years?

The article states that 5% of cyclists will experience impotence problems. What's the statistic for non-cyclists?

I'm in my mid forties and have been cycling regularly for the past 15 years. I have never had any problems having fun on or off the bike, nor do I know of any problems any of my cycling buddies have experienced. The only comment I hear from my wife and other spouses is that endurance increases after years of cycling. Maybe all that interval training is worth it? Thanks.

Ira Birt

PEI, Canada

Kelby Bethards replies

Ira,

That is an interesting statistic on impotence. I am not sure how they arrived at that number. There are many places to find info, but I just looked it up. The article I read states that about 33% of males over 25 will experience sexual dysfunction at some point. This percentage increases with age. HOWEVER, that is not strictly impotence. That number includes psychological reasons also.

There is merit to the claims. It's not cycling though, it's the seat you set you and your stuff on. If a seat is not fitted correctly it can cause pressure points in the pudendal area and cause nerve damage that would result in true impotence. Someone that suffers from this would not be able to do "as well" with an erection, and possibly not be able to obtain an erection, even without psychological problems.

The other part of what you are speaking about in terms of "prowess" does also have some merit. Fit people tend to have a bit more "lively" sex lives. So, ride hard and protect your stuff.

Riding with Epilepsy

I'm 24 years old, male, and I have been training for triathlons for five years, and cycling for three years. I ride from 80 to 100km a day, flat and hilly courses, road cycling. I have been recently diagnosed with epilepsy and my question is whether I can still cycle - I like it very much and my girlfriend does too; it's an important part of my life. Thank you very much.

Vladimir Milicevic

Belgrade, Serbia

Steve Hogg replies

Vlada,

I am not a health professional and don't presume to offer you specific advice about epilepsy but I will relate a story. Now retired five-time world champion Marion Clignet is an epileptic and managed to win all of those titles anyway. As I understand it, she competed for her entire career without medication so you know that at least cycling and competition is possible.

I will leave it to Kelby to give you more specific advice.

Kelby Bethards replies

Vlada,

First and foremost you need to be seeing a doctor to manage your seizure disorder. He or she will be responsible for the proper medications and treating you appropriately.

That being said, I don't see any reason you can't still cycle. The obvious hazard is having a seizure while riding. You need to make sure you have your seizures controlled well before you ride again. THEN, I would suggest riding in a controlled environment, on a trainer or stationary bike, with somebody nearby, to make sure than you aren't somewhere on the road if a seizure happens.

Various things can lower seizure threshold or cause a seizure to start. Electrolyte imbalance, which all cyclists have while riding to some degree, is an example. So, start back to riding with caution and progress from there. Obviously, there are many types of seizures, and it'll be up to you and your doctor to work out the best plan for getting you back on your bike.

Getting back into it

Hi,

I've been off the bike for about two years now and want to get back in a big way. Could you help me out with some of the basics I need to know to set up some decent base mileage, approx. 35h a week. I have all the necessary tools like HRM and Power output. I use the Polar S725 so I have all the information at my fingertips. What I'd basically like to know is how to set up Power training Zones, how to gauge recovery so I know when to take it easy. I would really appreciate your input on this.

Kevin Kalis

Scott Saifer replies

Kevin,

35 hours a week is enough time to train at a professional level and also enough to really hurt yourself. If you try to go from zero training to 35 hours per week in a few months, you'll almost certainly burn out quite quickly. You can learn how to set up training zones from any of several books, but what you really need to do is establish some goals and a long term plan for achieving them. Equally important with the zones is how much time you will spend in them, and at what time of the year.

As to when to take easy days, very briefly any time a power or heart rate effort feels much harder than the same power or heart rate effort on a good day, you are probably tired. Most often if you are tired you should take an easy day. Occasionally you might train while tired just for a few days if you are setting up a peak or preparing for a psychologically grueling event.

I hope you'll consider working with a knowledgeable coach who can help you develop a big-picture training plan as well as helping you with the smaller details like training zones and when to back off.

Numbness on rollers

Hi,

Let me start off by saying how great it is to have a fantastic discussion board like this one! My question relates to using rollers as an indoor trainer when the weather is not cooperating, or when trying to do focused and controlled interval sessions. The issue that I run into is that after around 10-15 minutes of non-stop riding on the rollers, I start to get a bit of numbness in the crotch area. I never have this problem on road, but I think the issue lies in the fact that on rollers you're not nearly as stable as on the road, and are limited to a very steady pedal rhythm, whereas on the road you're allowed to 'squirm' around, not to mention traffic lights, etc that vary the pace. I also find it quite difficult to stand and pedal when riding on rollers. Is this normal, or am I doing something wrong? I have had limited success standing and pedalling, but I have rolled forwards off and over the rollers - not catastrophically, but very unnerving. Any suggestions?

Chris Hui

Melbourne, Australia

Scott Saifer replies

Chris,

Your experience that riding rollers or a trainer brings on symptoms that you never have when riding on the road is not uncommon, but that doesn't mean that it is unavoidable. As you have noted, when on the rollers you change positions much less and unweighting the saddle less frequently than on the road. So any minor problem in your bike fit or pedaling style is magnified into a major pain the.Most likely your problem can be corrected by a combination of perfecting your bike fit and learning to unweight the saddle a bit without actually standing up. Just lifting your weight without actually clearing the saddle. You can find lots of instructions from Steve Hogg in the archives for perfecting bike fit. Good luck.

Strength, power and speed

So, if as cyclists we all want to be more powerful (or at least maintain that power), then is there any use in training pushing a big slow gear up a hill if I could train that same hill at a higher cadence and speed in a lower gear? I've decided there is not and am keen to tell my mate that I am right. Can you adjudicate?

Vecic

Scott Saifer replies

Vecic,

Sorry to disappoint, but I have to disagree with you. Low cadence, high-force pedaling will recruit more motor units (muscle fibers and the nerves that control them) than higher-cadence, lower-force pedaling. Only motor units that are recruited in training become aerobically trained. They also become easier to recruit. That means that low-cadence, high force pedaling can help you develop aerobic power and make it seem easier to deliver that power when it is needed. The most important variable for determining recruitment is the force requirement of the task, so you could do something similar by doing higher cadence with similar force, but that would be exhausting.

While I agree with your buddy that low cadence hill work is valuable, I would still suggest making it a small part of the total training plan, and doing lots of climbing at racing cadences as well as flat riding. My answer is also entirely based on theory. If you can find me a couple of dozen riders willing to split randomly into two groups, one which does and one which doesn't include the low-cadence work, I'd be very grateful to know their race outcomes next season.

Avascular Necrosis

Hi,

Just thought I would drop you a line to see if any of your fitness panel can give me any advice.

I am a 42 year old male cyclist, I live in France.

In May last year I was involved in a race accident. The guy that brought me down got away with road rash, I unfortunatly had no road rash but broke the neck of my left femur. I was operated on within 20 hours. I went through the 6 months of rehab and started riding my bike again in November 2004. Everything seemed to be going reasonably well, but in February 2005 when my cycling club started the seasonal training I began to notice a problem. When I was on the drops I could not stay in this position for more than 20 km without getting pain at the top of my left thigh and in my groin area.

This continued to get worse and gradually my training broke down altogether. I tried to continue riding my bike once a week during summer but this became impossible. 60km of riding would leave me unable to walk properly and take about four days to recover from the pain.

I have been to see a specialist this month who operated on me this week and removed the metal plate and screw that was in my femur. He also sent me for a MRI scan to try and find the cause of the pain. The conclusion of the MRI scan is stage 1 of Avascular Necrosis. The surgeon and myself are hoping that the removal of the big screw that went into my femur head will have released internal pressure and allow a better blood supply to the femur head. I have an appointment with my surgeon in three weeks where I may be scheduled to have another type of scan, the name of I cannot remember.

I am really scared, I do not want to have a false hip at 42. I assume it would be the end of competition cycling?. Although I am just an amateur I love my cycling. I am looking into ALL possible means to enable me to recover from this. These include diet, chinese medicine, homeopathic medicine, electrical stimulation of the femur head to encourage revascularization, etc.

Can your panel offer me any advice from what must be a vast array of experience in cycling and injuries?

Andrew McDonald

Kelby Bethards replies

Andrew,

You will probably be getting a bone scan and a nuclear medicine scan in the next appointment to look at the perfusion of the femoral neck and head. This can tell the docs if there is metabolism in that area and thus bone formation. Your orthopedic surgeon should be able to tell you the chances of a bone graft, if necessary, taking hold and also the possibility of riding.

I personally think you will be able to ride again. Make it known to you orthopedic surgeon that you would like to have competition cycling as your goal and see what he/she thinks. Make sure you are getting enough calcium and vitamin D daily.

Leg length discrepancy

Hi, I read with great interest your advice provided on the Cyclingnews website for the fellow who had one arm shorter than the other by seven inches. It was a very good solution and thought that you may have some advice for someone who has one leg shorter than the other.

Problem: My left leg is shorter by 1/2 an inch.

Current solution: I use in my Nike cycling shoe a heel lift inserted within the shoe. Problem is that there's not much room in those shoes for the lift of my foot, and as a result, my heel easily comes out of the shoe.

Bike stores have recommend that I use a lift underneath the cleat of the shoe. I've tried that before and could never get used to the odd angle of the foot required to pedal evenly. Other stores have recommended that the best solution is an orthopedic cycling shoe. Yet, who manufacturers such cycling shoes at reasonable prices. What do you recommend?

Christian P. Brun

Ottawa, Canada

Steve Hogg replies

Christian,

A heel lift can work well for leg length discrepancies when walking because the heel is first point of contact. A heel lift is useless when cycling because the contact area with the cleat is the forefoot, not the heel. Remove the heel lift from your cycling shoe and fit a spacer under the left cleat. Make sure that when you fit the spacer under the cleat you follow the advice on this post for both cleats - have a look at this post and this post for more information. For every 5mm you have to pack up the left cleat, move the cleat on that side back an additional mm relative to foot in shoe. I have had numerous people in the past mention that they couldn't cope with a packer under their cleat and in every case the problem was not enough foot over the pedal. Those posts if followed, should point you in the right direction.

The other consideration you need to think about is how the discrepancy that you have has caused you to compensate pelvically for. Many people like you with a long right leg, will end up with an anterior iliac crest on the same side. This typically means that you may be sitting further forward on the seat with the right side of your pelvis and reaching a lesser distance to the pedals with the longer leg. To find out whether this is happening, fit your bike to an indoor trainer and while pedalling in a hardish gear, have someone positioned above and behind you look down at how square you are on the seat. You may not twist to the right because not everyone who has a long right leg does, but enough that I should mention the possibility. If you find this is the case, get back to me for further advice. Let me know how you get on with the cleat packer.

Indoor trainer setup

I ride a Giant OCR3 on the road and I have a Raleigh Technium that I have up on a fluid trainer. When I am on the road I have little to no discomfort except for some minor foot numbness after about 30-45 minutes in the saddle, I attribute it to being up on my toes for most of my power stroke.

My current issue is with the indoor training setup. After about 30 minutes on the trainer I develop some pretty strong tightness in the outside of my right knee and it turns into a manageable pain after about 45 minutes. I am 1.79m and 87 kg...maybe built more for football but I do enjoy cycling.

Recently, with the help of a cycling book, I sized the trainer to the suggested setting for my height. The road bike was fitted in the bike shop and I have not made any adjustments to it.

I also had an interesting pain in the arch of my right foot that went away with a day off. It felt like I stepped on something and bruised my arch. Are these related? Thanks for your help

Terry Daley

Steve Hogg replies

Terry,

I can't account for the variance in experience when on the trainer other than by suggesting that locking the bike up may prevent you from compensating in some way which you are able to do on the road.
Re the lateral knee pain on the right knee; get hold of some Lemond wedges and have a play. They may well be the solution. Additionally, seeing as you mentioned arch pain, have a look at this post and this post, and position your cleats accordingly. What's suspect is that you have a varus right forefoot [very common] and cleats that are too far forward. I don't know this, but playing the odds a bit, think it likely. If there is a further problem, let me know.

In-turned foot

I'm a 25 year-old male whose left foot turns in. When I originally started riding three years ago, I thought I would compensate by rotating my cleat out on the bottom of my left shoe. For three years, this seemed to work fine but I wasn't riding a lot (about once a week). Now I'm riding three times a week for about 250km a week (155 miles) and I'm experiencing pain in the muscles around the left knee.

I've tried playing around with various cleat positions to no avail. I don't think my pedal has any float adjustment (it's an older model Shimano Dura-Ace SPD-R), just a vertical cleat play adjustment. Before I dump a bunch of money on a pedal upgrade that would give me float, I wanted an opinion on any other options to fix this problem. I want to increase my training during the off-season with the hopes of doing some Cat 3 races on the Ontario O Cup road series, but this knee problem is causing some concerns.

Charlie Philbrook

London, ON

Steve Hogg replies

Charlie,

Find a physiotherapist who is either a cyclist or who treats a lot of cyclists and have them assess you. There are a variety of reasons that could explain how you function. It could be a foot issue, it could be a hip or lower back issue, it could even be a compensatory measure for something awry on the other side. Once you have done this, get back to me with what you have found out.

Charlie Philbrrok then responded:

I got checked out by a physiotherapist and they found some interesting things. My left hip doesn't rotate like it should, which is likely causing increased stress on the nerve that runs down the back of my left leg. This is causing pain behind the left knee with that same nerve. They suggested some stretching exercises to increase the flexibility of the left hip joint, but didn't have much advice beyond that.

So here's where I stand right now. Prior to seeing the physio, I had taken four weeks off the bike to rest the injury. I did the suggested stretches for a couple days before cycling and again just before getting on the bike. My first ride was for one hour at 60-70% max HR with some hills en route. I could feel the nerve behind my left knee, but it didn't hurt. The next day, I did some light resistance speed spins on my indoor trainer for 30 minutes and the nerve began to hurt again.

I've checked my bike setup (saddle height and saddle set-back) and everything appears in order. What do you suggest I do next? Is it simply that the nerve hasn't healed enough yet? Perhaps I should setup regular appointments with the physio.

Charlie

Steve Hogg replies

Charlie,

There is a reasonable chance that you should be able to ride pain-free with this internally rotated left hip. Here is a plan of action:

1. Go back and see the physio and ask whether this is a left side problem or a compensatory mechanism for a right side problem. If the physio doesn't know, find one who does. Either way, don't leave and pay the bill until they have explained to you in language you understand the issues afflicting you.

2. While you are at it ask them to quantify whether you have varus/valgus forefeet relative to heel on each side and how many degrees. I have seen a number of people with the symptoms you describe, and a massively varus right forefoot played its part in a majority of cases.

3. Have an x ray in a standing position from the waist down and have leg lengths measured from joint centre to joint centre on both sides. Is there a discrepancy? If so, how much and where?

Get back to me with the above info and we will proceed from there.

Strange looking knees

Have you seen people with knees pointing outwards or inwards while riding? These same people will apparently have their seat heights adjusted properly but in the case of one rider I know his right knee can be seen to almost take a separate path to the right midway through the pedal stroke. Quite a sight, and somewhat painful to watch. This person rides often and says he experiences no problems. Is this a biomechanical problem or is it a result of unusually tight tendons or ligaments in the hips or upper legs that turns the knees out?

And is it simply an appearance problem or does it need to be corrected to prevent problems down the road?

Howard Gilbert

Napa, CA

Steve Hogg replies

Howard,

Yes I have. Some people like this experience pain, others not. The reasons for the lateral movement of the knees or feet pointing in or out are many and varied but all have to do with either accidents of birth, hip/ lower back dysfunction or common malformations of the feet. Often more than one of those things. I have learnt the hard way that you can't 'fix' everybody and that the art of bike positioning in as much as there is one, is to know when to intervene and when to leave well alone.

Cleat position

I have a question about cleat position

I am a junior cyclist and this year I have noticed a marked decrease in climbing performance. I'm wondering whether this can be because of cleat position. Currently I ride with my cleats as far back as they can go because this gives me a good drive with my quads - but I tend to have sore quads and not really sore calfs/hamstrings after a hard race/ride.

I ride:

- 172.5mm cranks
- 43 size shoes
- I am 1.77cm tall
- I have an inseam measurement of 845mm. From crotch to floor when standing straight with no shoes on.
- I also measured the outside of the centre of my knee to the hip bone that sticks out (edge of pelvis) to be 560mm in length, but I'm not sure if that will be of any help to indicate femur length.

Any advice that you could give me would be much appreciated.

Eliot Crowther

Steve Hogg replies

Elliot,

Set your cleats up after reading this post and this post. Once that is done, let me know what happens and if necessary we can go on from there.

Toe numbness and pain

I have bicycled 10 - 20 miles a day for at least 20 years on a conventional upright bike with no physical problems. About five years ago, my husband and I bought Bike E's (recumbant bikes). Not too long after we had them, I began having numbness with severe shooting pains in the three middle toes on both feet about 20 minutes into my ride. Last year I invested in biking shoes for the first time. I have Shimano shoes without cleats - I also started using toe clips, but this has not aleviated the problem at all.

I am wondering if this is a common problem for recumbent bike users and if you know what might be the cause of this problem. Thanks.

Corinne Lauridson

Steve Hogg replies

Corinne,

Here is a plan of action:

1. Consult a podiatrist and make sure that you don't have any issues with the feet that are causing nerve compression in the forefoot.

2. If that isn't the problem, it's likely that you don't have enough foot over the pedal. Get hold of some clipless pedals because then your foot is in the same place every pedal stroke and the amount of foot over the pedal can be adjusted. This is hard to do well with toe clips. Once you have the clipless pedals, look at this post and this post and let me know whether you have solved the problem.

Mountain bike fit

Hello, I recently bought a hardtail mountain bike and was wondering how a mountain bike fit [should?] differ from my road set up. Except for the obvious handle bar height difference, I'm a little confused. Should you keep the seat heights/fore-aft positions the same? Thanks in advance!

Giancarlo Bianchi

Steve Hogg replies

Giancarlo,

I have covered this before. Have a look at this post. Once you have read that, get back to me with further queries if need be.

Aspirin

This may be totally unfounded but I have a question regarding aspirin, and racing. Aspirin is a blood thinner, and when you train/race in the heat your blood get thicker, so would you get any performance benefits from taking aspirin before a race?

Giancarlo Bianchi

Kelby Bethards replies

Giancarlo,

Actually, aspirin does not "thin" blood, it makes it less likely to clot by preventing platelet aggregation. So, it makes the platelets not work as well and in doing so, they don't "log jam" or stick together to cause a clot. The blood itself does not actually become less dense. It's just how it's been described as "thinning" the blood.

The "thickening" of the blood from training/racing in the heat is usually due to dehydration, so the best way to combat this is from maintaining adequate hydration. Now, there may be a benefit from the aspirin in terms of its anti-inflammatory properties but I doubt there is much benefit.

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