Fitness questions and answers for October 16, 2007

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

Form & Fitness Q & A

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

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

Jon Heidemann (www.peaktopeaktraining.com) is a USAC Elite Certified cycling coach with a BA in Health Sciences from the University of Wyoming. The 2001 Masters National Road Champion has competed at the Elite level nationally and internationally for over 14 years. As co-owner of Peak to Peak Training Systems, Jon has helped athletes of all ages earn over 84 podium medals at National & World Championship events during the past 8 years.

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

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

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

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

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

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

Since 1986 Steve Hogg (www.cyclefitcentre.com) has owned and operated Pedal Pushers, a cycle shop specialising in rider positioning and custom bicycles. In that time he has positioned riders from all cycling disciplines and of all levels of ability with every concievable cycling problem. Clients range from recreational riders and riders with disabilities to World and National champions.

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

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

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

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

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

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

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

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

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

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

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

Michael Smartt (www.wholeathlete.com) is an Associate Coach with Whole Athlete™. He holds a Masters degree in exercise physiology, is a USA Cycling Level I (Elite) Coach and is certified by the NSCA (Certified Strength and Conditioning Specialist). Michael has more than 10 years competitive experience, primarily on the road, but also in cross and mountain biking. He is currently focused on coaching road cyclists from Jr. to elite levels, but also advises triathletes and Paralympians. Michael is a strong advocate of training with power and has over 5 years experience with the use and analysis of power meters. Michael also spent the 2007 season as the Team Coach for the Value Act Capital Women's Cycling Team.

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

Toe overlap
Optimum climbing cadence
Genital numbness
Deep vain thrombosis
Fore/aft cleat position
Concussions and the older cyclist
No Speed
Hip joint pain
Hamstring tendon injury

Toe overlap

I'm a 42 year old male who used to race/ride for 25 years but still go out for training rides with my ex team-mates. I always had custom bikes because of my un-proportional body. I'm 6' tall with 31 inseam, 42 shoulder, 175 lbs and wear size 44 shoes. I also have fairly long arms. I had a 55 frame but the top tub was too short. Then I had a 58 to 60 frame and the seat tube was too long. Currently, I have 2 custom made Serotta Legend Ti (tradition geometry not compact) and they are very comfortable. Their measurements are, 53 seat tube (c to c), 58 top-tube (c to c), 73 degree angle for both HT/ST, 100cm Wheelbase, 100mm Stem.

I just bought a Time VXR in Medium (compact geometry) that has 51 seat tube (c to c), 56 top tube (c to c), 73 degree ST angle, 73.5 HT angle, 99cm Wheelbase, 120mm Stem wheelbase and I find this bike even more comfortable than my custom Ti.

My question is when I have my foot clicked into my pedal with my crank arms at 180 degree (perpendicular to the ground) and turn my front wheel, the tip of my foot slightly touches very back of my front wheel. Should I be concern with this or is this normal?

Scott Safier replies:

The touching of toe and front wheel is known as "toe-overlap". It is common and not a cause for concern unless you are in the habit of pedalling tight corners at a walking pace. If you are, be careful to point your toes down.

Optimum climbing cadence

Are there any rules and/or techniques for determining optimum pedal cadence while climbing for an individual? The reason I'm asking is that I was climbing the other day on a moderate incline (5 percent or so) which is constant for 7 kilometres. I was in the small chain ring (39 tooth) and was 'blowing up' trying to maintain the speed of my companions. (22-23kph)

Other times on the same climb I am in the big chain wheel (53) and find that my legs are burning like crazy but I can maintain the same speed as I did with my little chain wheel without blowing up.

I know Lance said 100rpm is good but like Ullrich I prefer lower dieseling style gears although I'm a 'spinner' on the flats.

To add to this a fellow cyclist has been advocating low cadence/high gears as intervals (2k long) which I have been doing for some time to build power. I'm powerful but I'm in limbo as to what my cadence should be. The intervals are 65 RPM & 85% Max HR.

I have access to a HRM & cadence functions.

Pretty confused about what my body and coach are trying to tell me. What do I do - spin or push??

Please help!

Steve

Scott Safier replies:

Here's the perspective from a racing coach: Keeping up is all important and most people can ride a little faster at a lower cadence at least for a little while. The trade off is that if you climb a big hill at a low cadence, recovery takes longer and you'll be using up your sprint before the finale. So, in a competitive situation, use the lowest gear that allows you to keep up. In training do a mix of efforts over the whole range of cadences you might ever need in competition so that you'll be ready for whatever you need to do.

Genital numbness

Whenever I ride for over 50km I start to feel numbness in my genitals, as like, you know that nasty feeling when your leg falls asleep while you are sitting on it or when you held it on the table for a while! Well, this numbness is then with me for 2-3 days and I really don't feel much down there, so you can imagine my girlfriend going crazy about not having you know what! What should I do, I mean this is really starting to annoy me! Oh, my seat is Selle Italia Filante! Please HELP!

Mito
Slovenia

Kelby Bethards replies:

Mito!!!!

If you are getting numbness for 2-3 days after a ride you NEED to change something! You are risking permanent damage. Not infertility but impotence.

Your seat is either too high, adjusted wrong, or you need a new seat. This, in my opinion, is important for you to understand. STOP riding your bike until you recover completely and get a new seat setup. Whether that means a new seat or adjusting yours correctly. You should NOT HAVE ANY numbness at all.

Deep vain thrombosis

I'm a 45 yr. old male and have recently torn my right MCL and bruised the tibial plateau of the same leg... 4 weeks from the date of the injury I developed a DVT that ranged from my lower calf to my upper leg...

4-5 days prior to going to the hospital I had severe pain and assumed I had a case of sciatica not even thinking of deep vein thrombosis. Subsequently I've been diagnosed with Factor V leiden thrombophilia and am 2 months into recovering...I'm looking at 6 months of being on Coumadin and wearing compression hoisery on the affected leg.

I've gotten some conflicting information as to how long (if ever) I can expect the pain and swelling to subside from the site of the clot... I'm very keen to get back to my regular regimen of training and am just curious if anyone could give me some thoughts from personal experience or somewhere to look for info regarding my situation?

Tod

Kelby Bethards replies:

That is a tough question.... I would expect the pain and swelling to resolve in your leg over time. How much time is difficult to say. It all depends on your vasculature and the extent of the clot. The clot usually doesn't dissolve, so much as becomes cannulised (little tunnels through the exiting clot). The clot then becomes "integrated" into the vessel wall. Anyway, if you have a large clot it may take longer to resolve.

The risk from exercising comes from 2 things: clot fragments mobilizing and travelling to your lungs and so forth. The second risk, obviously, is taking Coumadin. The medicine causes your blood to not clot very well and if you were to crash, bleeding can be a problem. Not from scrapes necessarily but in the brain and tissues.

So, here comes the legal caveat. Go ask you health care practitioner about your specifics. Then, when he/she says go ahead and exercise, be careful.

Fore/aft cleat position

Steve Hogg mentioned in an answer on cyclingnews.com that if the person's cleats couldn't be moved far enough back, to contact him.

I've got some issues with numb spots mostly related to cleat position. I have the Look cleats now moved back as far as possible, and this helped my condition, but I'd like to get just a bit more. At least to find out if that helps. A shoe width increase helped already.

I was wondering what solution you had for getting the cleats back a bit more? I'd thought that some extender might exist to screw into existing holes and provide adjustment to 3 new holes, but either I'm not finding the right term to search on, or it doesn't exist.

Using Shimano shoes properly sized, so the existing holes are in the correct place, for an average rider anyway.

Mike Bales

Steve Hogg replies:

The only solution I have for you is this:

1. On a Look cleat there is a vertical line on each side which equates with where the pedal axle is if the cleat is pointing straight ahead. Use a marker pen and place a dot beside where each vertical line meets the shoe sole.

2. Buy a pair of Speedplay Zeros with Speedplay part no. 13330 which are alternate base plates with much more than the usual base plates fore and aft adjustment.

3. Speedplay's with standard base plate have approximately 5mm LESS rearward adjustment than your current Looks but when used with part no. 13330 have up to 10mm MORE rearward adjustment potential.

4. If using Keo's, drop your seat slightly; 2 - 3mm should be sufficient to allow for the greater extension of the leg that a more rearward cleat position usually causes. If using the higher profile older Look Deltas, then you will need to drop your seat more like 9 -10mm in total

Concussions and the older cyclist

I can sometimes be a little slow on the uptake, and hence my dilemma. I just turned 54; I have been riding bikes for over 50 years. I'm a cat 1, and have been racing since 1983 or so.

I make it a point to avoid crashes, but sometimes things happen. On my 50th birthday, I was rear-ended in a hit and run in my car with a big pickup truck, and later realized I'd suffered a concussion in the process.

Just a year ago, I went down in a cyclo-cross race and hit my head hard with my helmet on. The result was: broken ribs, collarbone and collapsed lung as well as a sore head despite wearing a helmet. Then three months ago, I was taken down by a vicious wild animal on a concrete road I wasn't wearing a helmet and as a result I broke more ribs, fractured my scapula, and ended up with a big bloody crack on the noggin.

For several weeks thereafter, I was dizzy, light-headed, and suffered annoying headaches. it later occurred to me that most likely I'd endured yet another concussion.

My question is this: how long is the recovery for folks my age from this kind of thing? Everything I find has to do with high school student, or professional athletes, all of whom are 25-35 years younger than me. What's in store for me?

Grandpa Kim

Kelby Bethards replies:

So, what you are alluding to is something called Post Concussive Syndrome (or Post Concussion Syndrome). What is that you ask? Well, just what the name implies. It is not uncommon (we like saying that in medicine), for people with head bonks to have a concussion. As you may have learned, there are varying degrees of concussions. Minor to very severe. And, as you would imagine, given the severity of the concussion, the recovery from that concussion can be varied. The symptoms that you describe; headaches, dizziness, lethargy, nausea, confusion and so on (I know you didn't mention all of these) are the major features of PCS. These symptoms can take weeks and even months to recover from completely.

So, the meat of your question. You have an older brain. What is the time frame for you? Hard to say. In the studies we know a few things, older brains heal slower, But athletic brains heal faster. I'm sure I'll get lambasted for simplifying that one as such. Let 'er rip readers. Generally speaking, older bodies heal slower. The brain is not an exception to this rule. That being said, athletes in general heal better than the more sedentary counterparts of society.

The important thing we have learned is that we do NOT want people having recurrent concussions in general, but more importantly, before the prior concussion has healed.

I will forward you a synopsis of PCS and let you peruse it at your leisure.

No speed

I'm a 50 year old, 5'8" tall and 168 lbs. cat 4/ masters/on the road, and a sport mtb on dirt. I also race (love) cyclo-cross . I have been riding and racing for fifteen years and have averaged anywhere from 5000 to 6000 miles per year. The problem that I am (always) having is that when riding at threshold, my speed is not that fast (21-22mph).Also, it seems as if I'm at threshold on group rides before others. I believe my max heart rate is around 185bpm and threshold is 165bpm, I see heart rates up to 177-179 several times during races. I have the ability to go over threshold and recover, up to a point then just fall apart. My training includes long easy miles, sprints, threshold repeats (2 * 30') and short intervals although I don't do all listed workout throughout the year. Any suggestions or thoughts would be appreciated.

Jeff D.

Jon Heidemann replies:

It appears from your training description that your present training targets the general spectrum of road cycling requirements (lower level aerobic training from your long easy miles, threshold training & "super" anaerobic training from your sprint workouts, etc). However, since you wish to be able to ride faster at what you believe to be your threshold, I would suggest focusing on that portion of your training regimen for the following suggestions:

First things first, try to verify your true threshold. There are many topics on the forum that address determining your threshold, but if you have difficulty finding those topics, most of the writers on the forum can help you or get you pointed in the right direction. If what you believe to be your threshold is too low or too high, targeting a specific intensity for specific training will not proficiently achieve what you hope to by doing those workouts. If you are confident your threshold is accurate or you have had it tested recently, great.

Anytime you hope to increase your threshold speed or power output, it is important that you train your aerobic system for efficiency and be as aerobically powerful as possible. This is akin to building a solid foundation for a quality house. If the foundation is poor, the house you put on that foundation will be poor. The long easy rides you mention are not detrimental to your overall training routine, but, often long easy miles eventually start to become junk miles, especially as your fitness level increases.

Aerobically, I would suggest spending some time working on your ability to produce as much power or speed as you can and still stay just under what you believe to be your threshold (5 to 7 beats below threshold, for example). It appears you are using heart rate to gauge this and that is fine. Targeting this area of intensity once or even a couple of times per week for at least a full cycle of training before you begin to work on threshold or higher intensity seems to prepare most riders well. Whether you choose intervals or not, the key is to start with a certain amount of overall time spent just below threshold, gradually increasing that amount of time as the training cycle progresses. For example, if you can do 30 minutes at this level during the first sub-threshold targeted ride, maybe by the fifth sub-threshold targeted ride you might be up to 50 minutes….you will have to gauge this on your own for what is most appropriate. As easy as this may sound, this is actually very taxing work and proper recovery from these workouts is imperative. And, it is not unusual for your speed to drop as you continue through the workout.

After you have completed at least one training cycle of the above (and you can obviously do more if you want), beginning to focus on "threshold and greater" work may now be appropriate. Your 2x30min threshold workouts are in mind, but you might want to start with 2x15's first and gradually increase that workload to 4x15's & 3x20's. Then move on to 2x30's or even greater as you become more trained. The key here is to spend some amount of time at or just over threshold and give your body time to adapt via training and recovery. Using shorter intervals initially might allow you to ride faster before fatigue sets in. It's important to note your average speed between intervals 1 to 3 or 4. Any significant differences between the first and last will indicate you may be targeting too hard a pace. A slight difference is OK as that is presumably normal fatigue.

Lastly, shorter duration VO2 intervals (ie 2, 3, & 4 minutes, for example) can also help to train systems involved in lower level threshold work. You can even put them in the same training cycles as above, but, I would caution you to be very careful about adding them into the threshold cycle. The training stimulus can be high during this early phase and to add them can very hard to recover from. In fact, I tend to either prescribe them during the aerobic phase (even though some consider them to be anything but aerobic), or after the threshold phase. In the circumstance you describe for yourself, I suggest doing them after the aerobic and threshold phase.

Please understand these are general recommendations. Variations on timing and combining the above workouts are acceptable, but doing so increases the importance of recovery. During the initial months of the season, combining them may even slow overall adaptation. However, later in the season after you have made some progress toward your goals, the combination of these workouts might be a good way to help to simulate the various physiological demands required during group rides and races. A reputable cycling coach may be able to help you formulate a good plan so that you can build your weekly training schedule into solid training cycles that include proper recovery for efficient adaptation.

Hip joint pain

I am currently in physical therapy for hip joint pain after I felt a pop in my hip during a very hard effort (860 Watts while seated). I was wondering if my saddle could be causing some of my hip problems. I have only been riding it this season. I have the most control over my bike with this saddle hence why I ride it. It is the Selle SMP Pro. It is a fairly wide saddle and I am thinking that its unique shape may be interfering with my hip function. Is this possible?

Mark

Steve Hogg replies:

Interesting question. The best answer I can give you sight unseen is possibly. If the Pro is too wide, you will find that it either forces you forward on the seat when you are going hard or that the back of your leg just under the glute will contact the rear of the seat. If that's the case and I suppose it is possible, the SMP Stratos may be a better choice as it is narrower.

It is more likely though, that something about the way you function pelvically is not symmetrical or that there was a pre existing propensity or issue that the hard effort pushed you exacerbated.

Hamstring tendon injury

First, I've learned a ton from the Cyclingnews fitness Q&A - My thanks to all contributors!

When I start building miles & fitness I seem to get same ligament injury in my hamstrings/knees. Trying to figure out where root cause is: Position, muscle imbalance, stretching, gain muscle strength quicker than tendon, pedalling technique?

From online anatomy images, it is one of the tendons behind the knee from either the semitendonosis or semimembranosis (Can't figure out which.) Of the right knee's cross section, if the Patella is north, then this tendon pair is at the South-West corner. Of the two, the problem tendon is to the east (away from top tube).

With knee at 90 degree, no muscle tension, I can cram 2 fingers between the pair about 1.5-3 inches from knee axis, and it sings a 'therapeutic' kind of good pain. The injury comes on very quickly, slow to heal, and only seems to subside after months of lower intensity. This leads me to believe it is more a ligament problem than muscle strain.

I thought this was just a first year injury (December last year), but it resurfaced a few days ago and now I'm worried.

About me:
29yrs old
5'5" tall
Lean race weight 155lbs, currently 168.
Sprinter body type (5s 1100w just about any day of week), FTP 230ish.
Always loved cycling from age 7-21 commuting/mtb, 6yr hiatus and been back now riding 2yrs roadie. I will be starting my first racing season next spring on the road/criterium circuit.

Recent changes/possible causes in sequence of my best guess:
1) Moderate sprinting from standing start.
2) Moving cleats back 4mm & saddle forward 3mm (did not lower saddle.)
3) Trying to pedal circles out of saddle. (May have flexed hamstrings at too tight of a knee angle.)
4) Recently did some Stair Running
5) Recently did some Jumps from slow roll
6) Not Stretching (Though I regularly use a baker's rolling pin to work out tightness in legs.)
7) Saddle height is adjusted for forced heels down pedalling where it feels more powerful for steady state pedalling circles. But my natural style is heels way up.

Dave
SoCal, USA

Michael Smartt replies:

As you have alluded to, there are several possibilities for the pain you are experiencing, some of which I can't speak to without seeing you in person. However, you have brought up several issues related to technique and training that I can address and which I feel are the most likely cause for your pain.

First of all, there are now several studies demonstrating that "pedalling in circles" (while seated) is both less efficient and not the technique adopted by elite level cyclists. In order to pedal in circles, you must increase the activation of the lower hamstrings through bottom dead centre of your pedal stroke and during the upstroke (pulling the heel of the foot towards the saddle). I've often heard this related to scraping the mud off the bottom of your shoes, but the pertinent issue is that pedalling in circles suggests reducing peak torque (down stroke) and negative torque (upstroke). While this is not only inefficient, you are effectively asking your hamstrings to put out as much power as the much more powerful quadriceps and glutes. The result is either putting too much stress on the hamstrings or a reduction in power output from the quads and glutes so that the hamstrings can "keep up". For a more detailed write up check out this link.

While I've never seen it studied, trying to pedal circles out of the saddle as you have described is likely putting excessive stress on the hamstrings as well. Anecdotally, if you are looking to increase leg turnover while out of the saddle, I recommend utilizing the upper body and hip flexors (Illiopsoas) to pull the knees towards the chest and get that pumping, running motion you see from the best sprinters. If nothing else, this will provide you with a technique that will limit the activation of the injured area.

However, overall you should re-evaluate your choice of training techniques and focus if they are perpetuating the problem. For example, the standing start can be an effective on-the-bike force workout, but its application is limited, especially when you consider the amount of stress it imparts. Focusing on raising your FTP, VO2max and anaerobic capacity will provide you with far greater benefits for racing and can be done without applying any near the stress of standing starts.

If these adjustments in your training do not relieve the pain your are experiencing, I recommend two things: checking your bike fit from someone who can speak to the anatomical issues I have described and that are related to your hamstring injury; and if necessary, visiting a physical therapist who can treat the area, asses any possible muscle imbalances and check your flexibility.

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