Fitness questions and answers for September 5, 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.

Vastus lateralus burning
Tendonitis problems
Positioning for ladies
Energy gel question
Cleat wear and power
ITB problem
Foot injury
Adductor seizing
Pain in the neck
Pedal swapping
Breathing problems
Sweat smells like ammonia

Vastus lateralus burning

Hi Steve,

I'm hoping that you can give me some answers or suggestions for the following: I am 42 years old been riding a very long time; I've competed at the provincial level, won a few races, lost a few etc. Anyway, I'm experiencing a burning in my left quad under moderately high to high loads on the bike .The left quad fails before there is any fatigue in the right. What are some possible reasons and or solutions? My saddle height feels good (inseam of 87.5 cm) set at 77cm center to top, with Keo pedals set back of about 8cm, reach is good and I appear to be well positioned on the bike. I'm 6'2" and I know that I have a leg length discrepancy of about 1cm (right side short); I do stretching most days but not enough as you have written about. I wear size 46 Sidi shoes with cleats pretty much all of the way back. Thanks.

Mark Dwyre

Steve Hogg replies

Mark,

Have you addressed the leg length discrepancy [assuming that it's a measurable bone length difference and not a functional discrepancy] with a shim or packer underneath the right cleat? Do you sit square on the seat? To ascertain this, mount your bike on an indoor trainer and while pedalling with shirt off, have an observer behind and above you look at whether you are dropping either hip and / or rotating either hip forward on the pedal downstroke. If so which hip do you drop/ rotate forward? Let me know the answers to these and I will attempt to advise.

Mark then responded:

Well I seem to be really solid in the saddle. If anything, there may be slight movement on the left downward. It is tiny. The leg length thing was addressed a while back with orthotics which may have been lifting the wrong leg! A recent visit to my chiropractor showed a slight right leg shortness - maybe 5mm or less. My cleats are set up using your method which helped a lot. My second toe on each foot is longer than the big toe, more so on the left. I currently use Superfeet insoles in both shoes. Thanks.

Mark

Steve Hogg replies

Mark,

This sounds like a tricky one. I assume that you have done the obvious things like checking the suitability of the angle of your left cleat on the shoe.

The VMO as a quadricep plays a part in extending the knee but unlike the other quads, the muscle fibre orientation at the head is lateral rather than longitudinal. This means that it plays a part in the lateral stability of the knee. Given that you sit reasonably square on the seat, something other than the possibility of sitting twisted on the seat is challenging the lateral stability of the left knee. The VMO will usually load up when pedalling if the knee is rolling inwards or if other positional factors make the knee track through plane further from the centreline of the frame than it would like to.

I don't know what Superfeet are but assume they are some sort of generic arch support insole. If that assumption is correct, one of three things is likely to be happening and a process of elimination may be the only way to find out what the problem is. The order of the the three things that occur to me is from most likely to least likely.

1. May be the left insole is too much or a good thing in the sense that the arch support and consequent lifting of the inner edge of the foot is causing the knee to track further out than it would like. Try a couple of Lemond wedges with the thick side positioned so that it is closest to the OUTSIDE of the shoe. This will have the effect of lessening the degree to which the inside edge of the foot is lifted by the arch support insole and should allow the knee to track through a different plane. Once you have done this, make sure that you recheck the rotational angle of the cleat, as the angle of the foot on the pedal is likely to change. This will either feel better or worse. Either way you have something to go on and can fine tune to improve. If better, play with another wedge or two positioned the same way or consider removing the arch support insole from that shoe. If worse, then;

2. The amount that the arch support insole lifts the inner edge of the left foot may not be enough. If you found trying 1 made things worse, try a couple of Lemond wedges positioned so that the thick side is closest to the inside edge of the foot. If 1 didn't make a positive difference, then this should. Again, recheck cleat angle so that there is free movement either side of where your foot naturally wants to sit under load. If this works then experiment with the number of wedges by adding/subtracting one at a time until you arrive at what feels best.

3. The third and least likely possibility is that the amount that the inner edge of the RIGHT foot is raised by the arch support insole is either too much or not enough. Most bike riders favour their right side when pedalling, even those who are left handed. Sometimes problems on the left side such as you are experiencing are a consequence of a right side problem where the rider is autonomically doing whatever is necessary to protect the right side, and paying a physical price on the left side because of the compensatory mechanisms necessary to protect the right side.

I have seen this many times but in terms of possibilities, the odds are 1. or 2. is the solution. If you get as far as 3, again play with Lemond wedges. If you fit them the wrong way around, you will soon know about it, which gives you the info to head in the right direction. I hope this helps. Let me know how you get on.

Tendonitis problems

Mr. Hogg,

Recently I began to experience a discomfort while cycling that resembles tendonitis (about 2-years ago, I had fairly severe tendonitis - Vastus Medialis at the insertion point at the knee). This time, the discomfort is on the lateral side of my knee - perhaps the lateral side of the tendon that connects the rectus femoris to the knee or the insertion point at the knee of the vastus lateralis?

My question to you is: Can you make any suggestions as to what might be causing my new pain - i.e. toes pointing out/in, wide stance on pedal, saddle to low/far foward, etc?

I really haven't made any changes (on purpose) to my position...although I replaced my left cleat somewhat recently and it is my left leg experiencing the problem. I do not think it is strictly over-use because my volume of training right now is relatively low. My battle with tendonitis in the past was cured by some positional changes and very aggressive stretching...but ironically I am now having problems on the opposite side!

Any help/suggestions would be GREATLY appreciated with the off-season almost here.

Ben

Steve Hogg replies

Ben,

Firstly check the simple things like cleat position. Does this problem date from the changing of the left cleat? Even if not, it is worth checking the angle of your cleat on that side...and while you are at it, check the other side as well. Go for a ride with a screw driver in your pocket, accelerate hard and then while coasting, twist the left heel outwards. Is there free movement? If not, stop and turn the rear of the cleat inwards and retest. If there is movement, coast again after a period of effort on the pedals and twist the left heel inwards. Is there free movement?

If not, stop and turn the rear of the cleat outwards and then repeat the pedal and coast routine until you have a more or less even amount of free movement either side of where your foot naturally wants to sit under load. Let's assume that you have done this and that all is fine and that cleat angle on the shoe sole is not the problem. Have someone check out how square you sit on the seat from behind while you are on an indoor trainer. The most likely possibility is that you favour the right side in the sense of dropping or rotating that hip forward and /or down while pedalling. This is VERY common and often goes hand in hand with a greater right forefoot varus than left. If this is happening, the left knee will have to move laterally to accommodate the right side hip drop as well as reaching further to the pedals. If you are as described, this asymmetric pedalling style will be the source of your tendon problems on the left side.

The basic solution on bike is to see a podiatrist or physio with some podiatric knowledge and confirm that your right forefoot is significantly more varus than the left [by significantly, I mean more than 4 degrees difference between feet]. Once this is confirmed, fit 2-3 Lemond wedges to the right shoe; you'll have to experiment with exactly how many, and twist your seat nose a few degrees to the right. These measures will have the effect of straightening you up on the seat and reducing lateral movement of the left knee as well as making the distance that both legs reach to the pedals more even.

If this scenario fits you, let me know how you get on. The other possibility is that there is a level of dysfunction of the left foot/ankle or the left hip or a combination of both. Knee problems on a bike are rarely the knee itself, but are much more commonly planes of movement forced upon it by hip or foot/ankle. You would need to be assessed by a good structural health professional to determine this. If the problem is foot/ankle, the solutions are straight forward. If it is hip/lower back, then the only 100% solution is to address those issues. Let me know what you find.

Ben then responded:

Just to complicate things - here are a couple of things I should have stated earlier:

-I use a speed play zero on the left side. The inward float is 'locked out', but I have them set up to allow my heel to rotate outward (toe in). I had a past injury - tendonitis at the VMO insertion to the knee on this leg and these changes were recomended to me. They 'seem' to have helped eliminate my old injury so I am hesitant to reverse or change them.

For a right pedal, I use a dura ace pedal (look style - spd sl?). I have Le Wedges stacked up evenly about 1/8 of an inch - to account for the leg length discrepancy. My right leg is shorter than the left off the bike, but a couple local 'bike fit experts' tell me that on the bike the left leg is functionally shorter...my guess is that my body has 'twisted' as you suggest to 'make up' for my natural descrepancy...in the process my body has over-compensated and now the left leg appears shorter - functionally - when I'm on the bike.

Does all this make sense?

I'm not sure I understand your description of how to test the cleat position. Can I do this test with my current pedal set up? Thanks again and sorry to be a pain in the butt.

Ben

Steve Hogg replies

Ben,

What you say does not complicate matters; if anything it makes the picture clearer. If you are twisting to the short legged right side to such a degree that the longer left leg is 'functionally' shorter on the bike, then it is likely that one of three things is happening or possibly a combination of all or any.

1. It may be that your shim under the right foot is not enough.

2.It may be that a lifetime of walking/running with a right leg falling further to the ground and hitting harder with every step has tightened you up much more on the right side hip etc and now causes you to favour that side to the point where that causes discomfort on the left.

3. Your left side could be significantly tighter and possibly with a restricted sacro iliac joint as a compensatory measure for what is happening on the right side. This assumes that you have been able to eliminate the left cleat position as the source of problems. Make sure that you do test your cleat angle as described previously.

Go for a ride, do a dozen of so hard pedal strokes then stop so that the left foot is forward and you are coasting down the road. Try and move your left heel inwards. Is there movement?

If not, take out your screwdriver and adjust the Speedplay cleat. If yes, pedal hard again and coast again with left foot forwards, then try and move your left heel outwards. Is there available freeplay? If not, stop and get that screwdriver out again. You want to end up in the situation where you can pedal hard and coast and have an even amount of freeplay either side of the point where the foot naturally sits under load, whether that be heel in, heel out or whatever.

You may find with your Speedplay Zero left pedal that you need more freeplay in one direction than the cleat rotational adjustment will allow. If this is the case, get hold of a Stanley knife or any similar sharp bladed knife. On the base of the Zero cleat are two grub screws marked 'Heel Outwards' and ' Heel Inwards' that thread through the hard yellow plastic of the cleat. If you find that you have used up all the available play and still need more after your pedal and coast test, you can screw the appropriate screw out further still, and excise material from the yellow plastic at the end where the grub screw would make contact with the flat circlip shaped spring that engages in the slot in the pedal. By cutting plastic away there, essentially increasing the distance the circlip shaped spring can rotate before it contacts the grub screw, a greater range of rotational movement can be gained.

Once you have tried all of the above and it worked or otherwise, it would be a really good idea to have a knowledgeable structural health professional assess you and show you the way to address the underlying issues of asymmetry that are the root cause of your problems on bike. You won't make any change to a measurable leg length difference, but you should be able to get to the point where it is managed well enough, and you are flexible and symmetrical enough so that it is not an issue. Luc Leblanc won a World Road Championship and was I think, KOM in the Tour, with a 30mm leg length discrepancy. The bottom line is that the better you function off a bike, the better you will function on a bike.

Positioning for ladies

Hi,

My name is Helen, and I am learning to cycle - I am really enjoying it and looking to race in the near future. I have just purchased a Pinarello, and would appreciate some advice on positioning for ladies. I find my saddle very uncomfortable with tremendous pressure on my special bits - is there some general advice you can give for ladies positioning on a road bike, ie; saddle tilt, saddle set-back etc as I assume it will be different from men's positioning. I can't find any reference on your site. I am 5'6, weigh 7 st 10 llbs, inside leg 79cm. Many thanks in anticipation.

Helen

Steve Hogg replies

Helen,

Click on this site and this site. Once you have read those and have any specific queries, please let me know.

Energy gel question

I had a question regarding the content of a certain energy gel on the market that I have been using. I noticed its main ingredient is brown rice syrup. Upon researching this I found out that brown rice syrup is composed roughly of 50% soluble complex carbohydrates, 45% maltose, and 3% glucose. The website in which I found this information says that the maltose may take up to 1 and 1/2 hours to digest and anywhere from 2 to 3 hours for the complex carbs.

If this information is correct, I was wondering if this combination of carbohydrates is ideal for use during medium to intense riding in the 2 to 4 hour range, or should I be using an energy gel that contains a higher percentage of simple sugars and save the one I'm using currently for pre/post riding?

Matt Monton

Pam Hinton replies

Matt,

The short answer to your question is as you suspect. Yes, you want to consume sugars that are rapidly digested and absorbed. The idea is to eat or drink carbohydrate at regular intervals to maintain blood glucose concentrations while you are racing. After the ride, you want to quickly supply your muscles with glucose for glycogen synthesis.

But the question, really, is whether gels or bars that are sweetened with brown rice syrup rapidly elevate blood glucose concentrations. Brown rice syrup is made by fermenting brown rice and barley and breaking down the starch in the grains into simpler carbohydrates using acid or enzymes. When the starch in fermented brown rice is hydrolyzed, some of it is broken down into maltose, a disaccharide made of two glucose molecules. The carbohydrate in brown rice syrup is, as you say, about 50% soluble complex carbohydrates, 50% maltose and a little bit of glucose. This mixture of carbohydrates is rapidly digested and absorbed, elevating blood glucose quickly.

The glycemic index (GI) reflects how quickly and how much your blood glucose increases after eating a food. Straight glucose is the reference with a GI of 100, causing the largest and most rapid elevation in blood glucose level. The terms "simple" and "complex" refer to the number of sugar (glucose) molecules in a carbohydrate. There are some complex carbohydrates that also have high GIs-synthetic sweeteners, like maltodextrin, are an example. The complex carbohydrates that result from hydrolysis of brown rice fall into this category. Cooked brown rice has a GI between 50 and 80; enzymatic or acid hydrolysis will increase the GI even more. Maltose tops out the glycemic index scale, hitting 100 along with glucose.

Food manufacturers use ingredients like organic brown rice syrup or malted barley syrup because they sound wholesome and natural compared to common sweeteners like corn syrup. The irony is that brown rice syrup and corn syrup result from the same chemical processes. The starch in the grain is broken down into sugars using acid or enzymes. So, if you prefer to get your sugar from a gel that uses a "natural" sweetener, one made from brown rice syrup probably gets the job done just fine. Take care.

Cleat wear and power

I have a question about cleats that wear unevenly and what that might indicate about power output. My Look Delta cleats (the floating style) always wear much faster on the outside rear corner, the left cleat faster than the right, to the point that the inner corner is barely worn when I have to replace the cleats. I have tried to use the LeWedges to correct this problem, but that seemed only to increase the wear. I'm on my 3rd pair of cleats this season, which seems a bit excessive since I only train and race 6-8 hours a week. I have very flat feet and wear orthotics in both my cycling shoes and my street shoes.

My question: would it be better to reverse the LeWedges so that my foot tilts towards the crank, rather than away as their literature suggests? It seems that putting all of the force onto the outer part of the pedal would make for a less powerful stroke, but I'm not sure I grasp the physics involved. Thanks for all the great advice!

Christian Sheridan

Chicago, USA

Steve Hogg replies

Christian,

It takes a Look Delta cleat a long, long time to wear away from riding. The great majority of the wear is incurred by walking in the cleats or putting one foot down at traffic lights and other stops while riding. I would not be surprised at all if your left cleat wears more if that is the foot that you take out at the lights. You need to eliminate this possibility or confirm it before mucking around too much. If the wear occurs because of contact between shoe and road, consider a pair of SPD - SL's as they have little 'stilts' so that the part of the cleat that contacts the pedal is protected when walking or putting a foot down.

However, asymmetric wear, whether incurred in or out of the pedal, translates to less than ideal footplant on the pedal. There may be something to what you say about reversing the usual thick side towards the crank placement of the wedges but be careful. I say this because while there are people out there who need what you are suggesting, they are a tiny percentage of the riding population. Does this unusual cleat wear cause you a problem on the bike? If all else fails, find a podiatrist with cycling experience and have him/her assess your feet and the way that you come at the pedals.

ITB problem

I am a 58 year old avid, recreational road cyclist. Last year my mileage almost tripled (1200 to 3400 miles) I began having ITB pain, but not at the knee. My pain came from the hip area. My ortho doctor said that the band was snapping around some area near my hip. His x-ray showed no arthritis or other problem. A cortisone shot cleared up the problem. That was at the end of last season. Now that I've exceeded 2000 miles this year, the problem has returned.

Obviously there's a fit problem with my bike. I have a leg length difference. The longer right leg has the pain issue. My leg difference is almost 1/2 inch. What about the fact that my position on the bike could be causing such a problem? Should the seat be raised, lowered? I have also noticed that, as I pedal, my right knee (the problem side) tends to travel left and right instead of straight up and down, especially during strenuous, seated climbing.

Rik Gagnon

Massachusetts

Steve Hogg replies

Rik,

My experience is that most [not all] cyclists with a longer right leg favour that side in the sense of twisting further forward to that side while pedalling. This is a result of the greater torque exerted at the hip of the longer leg over a lifetime, causing the iliac crest on that side to move forward which in turn means that the hip has to move up and back, though a lesser distance. This leaves you with a situation where you stand with the right hip behind the left.

Anatomically, you will do whatever you have to to align your hips. Usually this means that the right side will twist forward, bringing the hips into square but leaving the pelvis with an anterior right iliac crest and a posterior right sit bone. Additionally, they often have a notable varus forefoot to a degree not present on the left.

The shorter explanation is that both of these things are usually the fallout of spending a life with different length limbs. What all of this adds up to, and what maybe occurring in your case, is a longer right leg with compromised function around the hip reaching a lesser distance to the pedals than the shorter left leg. If no steps have been taken to accommodate the leg length difference in terms of shims under the short leg or whatever, and you make no mention of that, often the rider sets the seat height so as to be comfortable for the shorter left leg that is reaching further anyway, because of the propensity to twist towards the right side.

Where this leaves you is with right side hip flexors that are being cramped up and restricted in their movement, which may be the basic problem that you have. Do you have anyone available to you with experience in positioning people with noticeable asymmetries? It would be worth asking around and seeing who has a good reputation.

If this option isn't open to you, I would confirm what I have said above or otherwise by having someone look at you from above and behind while you pedal on an indoor trainer with your shirt off. If as I suspect, you are twisting forwards on the right side, then the seat will probably need to go up, the seat nose will need to point to the right a few degrees and a shim of whatever size is appropriate will need to go under the left foot and I would play around with some Lemond wedges under the right foot too with the thick side towards the crank.

Foot injury

I'm fairly new to the sport of triathlon, and about a month ago began suffering from what I believe is Metatarsalgia - pain on the ball of my left foot just beneath the toes. Now I'm beginning to suffer from the same thing in my right foot. I've done some research on running sites to see how to treat this condition. The first time I felt this pain (and it was very painful the first time) was immediately after getting off a ride when I began to run (doing a "brick" training session). I couldn't run more than 100 feet the first time.

I've done one Olympic distance race since I started having these pains (about a week ago) and was hoping to stay off my feet for a while to see if it would go away. Pain isn't as bad now, but still there. And it seems to be made worse by cycling - not running. Can this condition be caused by cycling and if so, what can I do so I can heal but still continue riding?

I'm 38 years old, approximately 180 lbs, 6 feet tall. High arches. I'm a mild overpronator when I run. Good health. Never had a sports-related or caused injury that I can remember even though played many sports growing up as a kid.

Craig Menden

Steve Hogg replies

Craig,

The most common cause of what you describe is poor cleat position, usually too far forward. People with high arch feet, which generally means more rigid than average, are particularly prone to this in my experience. Have a look at this post: and this post. Setting up your cleats like that will probably provide relief. Once you have done that, if the severity doesn't change, or if things improve but not enough, play around with some Lemond wedges fitted underneath your cleats so that the thick side of the wedge[s] are towards the crankarm. That pronating foot plant of yours running may be transferring to on the bike. What shoes in what size and what pedal system do you use?

Adductor seizing

Hello,

Hopefully you can shed some light on this. I am a Masters 55, criterium-type racer, cat 2, racing on and off for 18 years. Last year in a crit I experienced a seizure in my right adductor muscle, stopping me completely from the race. It eased off somewhat and I had massage to alleviate it also. I went to see Dr. Testa in Sacramento. He moved my saddle back, suggested a shorter stem and I also got a Fizik Arione longer saddle. All to help me not come too far forward to the nose of the saddle which we think was pressing too hard and causing the trouble. During a recent hard riding century with friends I could feel it coming back into both legs, not just the right. After the century ride and a nap, both legs seized up for at least ten minutes...then finally loosened up enough to be able to massage. I was taking electrolytes and fluids during this ride - is there something else I am not seeing? Cleat placement? In/Out? Strength training?

Alan Atha

Steve Hogg replies

Alan,

Adductors usually only fire up on a bike to the degree you describe when there is a challenge to pelvic stability on the seat. Whether it is a function or positioning issue or a combination of both is impossible to tell without more information. If you are not stable on the seat and are going hard or long, you will enlist whatever you have to in an effort to maintain a stable pelvis, which on a bike is the platform and base from which the legs hang down and exert force and that the upper body cantilevers out from.

How tight are you in the hips and lower back? If you're not sure, have someone assess you and find out and let me know, and I will attempt to advise.

Pain in the neck

I ride a Giant TCR2 Composite (L size). I find it quite comfortable and 2 or 3 ours rides are not a problem. However in the last two weeks I have noticed I have pain in each elbow and a pain high on my back (close to where my neck stops and back starts). It seems to have started after I took a week off cycling to go snow skiing (no injuries or strains were encountered during skiing).

I'm not sure if the elbow pain and the neck pain are related, and my thought was that there is something not quite right about my position that causes me to put too much weight on my shoulders through my elbows, and that is causing the pain I suffer. The pain is not bad enough to warrant medication or to make me stop riding, but it is uncomfortable at times. Any comments/thoughts?

Brian Glendenning

Newcastle Australia

Steve Hogg replies

Brian,

The sore elbows sounds to me like you are bearing too much weight on your arms. This would cause you to enlist the muscles of the shoulder complex which in turn is likely to restrict the range of motion available to the neck.

Why is this happening? The likely possiblities in no particular order are:

1. Your seat's too far forward, transferring weight forward onto the arms that has to then be supported.
2. Handlebars are too low.
3. Handlebars that are too far away.
4. Any combination of the first three.

This should be fairly easy to sort out with a bit of experimentation. Go for a ride on flat road and warm up so that you can push a hardish gear at 85 - 90 rpm with pressure on the pedals. While doing this place your hands in the drops and then suddenly take your hands off the bars and hold your arms out to the side. Do you collapse uncontrollably forward or arch your back noticeably to prevent from falling forward?

If you do, it is likely that your seat is too far forward. If you teeter for a bit and feel like you are creeping forward slightly on the seat that is ok. If you can pass this test reasonably well, then the bar height or the reach to them is more than likely to be the problem.

If you can't pass this, then the seat position fore and aft is likely to be the problem. Once you have addressed seat set back, if indeed you need to, there will be probably be changes necessary to the bar position to compensate for a different seat position. Cleat position can have a big effect on the ability to pass the balance test, so to that effect it is probably worth reading this post. Let me know how you get on.

Pedal swapping

Hi,

I have used all kinds of different pedal systems; Look, Speedplay, Keywin, etc. and I can usually swap between different pedal systems with no problem. I just measure the height stack of the pedal and adjust the seat height as necessary. Then I make sure the cleat is in the same place as the old one as far as positioning using the axle as a reference point. There is an exception to my experience with pedal systems and that is with Time pedals. The first time I tried Time pedals in the late 90's I developed a real bad case of ITBS and had to stop riding for over a year. I have alway liked the simplicity of the Time system but I gave up on it. Now, I have bought the new Time RXS pedal and after adusting my seat height and cleat position, I get a tightness on the ouside of my leg, basically a tightness on my IT band.

Is there a reason that you know of that would cause this to happen? Why when I switch to the Time pedal system do I get that tightness on the outside of the knee? I can feel the tightness in the first 5 minutes of the pedal swap. It's almost intantaneous. I tried adding a shim between the pedal and the crank and moved the cleat as far forward as possible and it seemed to help some. But moving the cleat forward makes me feel like I'm pedalling with the tip of my foot.

Is there a mistake I'm making or is there something with this pedal system? The only thing I can think of that could make a difference is that with all other pedal systems, the pivot point is at the toe or under the axle (Speedplay) and with the Time pedal the pivot point is behind the axle.

I really like the Time pedal system and would like to use it but I also don't want another flare up in the IT band. If you can help me with this problem I would greatly appreciate it.

Manuel Rodriguez

Steve Hogg replies

Manuel,

During these pedal swaps, are you using the same shoes and just changing the pedals? What size and brand of shoe are you using at the moment and what brand and size were you using at the time of the itb problem with the earlier Time pedals in the 90's?

Manuel then responded:

Hi Steve,

I am using the same shoes. They are regular Sidis with the plastic sole. When I had the ITB problem in the late 90's, I was using the same Sidi shoes; they are quite durable! When it happened in the late 90's, I was going from the Time Mid 57 to the Time Equipe. Right now I am using Speedplays, and before the Speedplays I had LOOK pedals.

The shoe size is 45. I am 5'7 and weigh 155lbs. My inseam is 32 inches and right now I have my seat height at 72.5cm (with the Speedplays). I have always used 172.5 cranks. Something peculiar about my anatomy is that I have knock knees and I walk and pedal pigeon toed. Another thing is that I have scoliosis and when I look in the mirror, I can see that my right hip is higher than the left. And the ITB flare up was on the right leg. The only thing is that it happened only with the Time pedals. After the very first ride, I could feel tightness on the outside of the right knee. Thinking that it would go away, I kept riding until I was forced to stop.

Right now I have tried the Time RXS and even after five minutes of riding, I can feel tightness on my right leg. As soon as I go back to my regular pedals, the tightness vanishes. One sad constant with all pedals systems is front knee pain on my left knee, but that is a different story. Sometimes I wonder if the tilted hips cause my right knee to be prone to ITBS and the left knee to pain in the front of the knee.

Another part of the story is that in the mid 80's (I'm 37) I had to stop riding because of ITBS (right knee). At that time I was using regular caged pedals with Diadora cycling shoes. No float. I wonder if the spring loaded float could have something to do with it. Or maybe the side float that Time pedals allow. Or, like I had mentioned, having the pivot point behind the pedal axle. I simply do not understand the root of the problem. Thanks for your help. I read your articles in Cyclingnews and find them very informative.

Manuel

Steve Hogg replies

Manuel,

I think you may be right about the spring loaded self centering tendency of Time pedals, though you have used three quite different Time systems with not much in common other than that, though the degree varies between the three. Assuming that that is the problem, this suggests to me that your foot 'wanders' around a bit during the pedalling action. I have no doubt that the structural issues you highlight are the cause of this. Have you access to a good structural health professional who can assess you?
If you can, and in the interest of advising further, I would be interested to know:

1. What kind of feet you have; i.e; high arch and instep, low arch and instep, flat, pronator/supinator and varus/valgus on each side.
2. Whether you have a measurable leg length discrepancy.
3. Is the higher right side of the pelvis twisted forward?
4. Which shoulder is higher?
5. What are the differences in tightness between left and right hip flexors, glutes, hamstrings and how tight are they?

Let me know and it will be interesting to see whether we can get you into your Times pain free. Until then, it is a good idea to stay with your Speedplays.

Breathing problems

I'm a 30 year old road racer in Northern California. For the last few years I've been experiencing breathing problems when riding. This year has been especially bad. I seem to have asthma like symptoms- shortness of breath, coughing, some wheezing- if I'm riding in areas with car traffic. A single car passing on a mountain road can be enough to create these symptoms.

On long mountain bike rides away from cars my breathing seems to get better but is still not as free and easy as in the past. I rode for a few years before this with little or no symptoms. I've been to the doctor and have had various tests with the verdict - no asthma, but allergies and "sensitive lungs." Inhalers and allergy medication seem to diminish the symptoms, but I never feel symptom free. Obviously riding away from pollution would be ideal, but would limit my available riding. Is this common for cyclists since we are constantly outside in less than perfect air? Would a specialist tell me anything different than my doctor? Am I expecting too much of my medications?

Dave Allbut

Kelby Bethards replies

Dave,

What medications have you been taking for your "sensitive" lungs? I don't want to usurp your doctor's diagnosis, but you could be still having some asthma, or reactive airways that they weren't able to recreate at the office.

Allergies and asthma have a tendency to run in the same circles (along with their friend eczema) so there are some meds that seems to help. Not everybody is the same, but I have had good luck treating people with Singulair for Exercise Induced Asthma and allergies. Sometimes they need inhalers and antihistamines too. It does sound like you may need some further treatment or evaluation.

Sweat smells like ammonia

I seem especially troubled by the heat this year, and my sweat volume is far greater and it smells overwhelmingly of ammonia. On the way home from a ride the car reeks like I've spilled an entire bottle of ammonia. This is all new this summer. No changes in diet or training. Would you have any ideas on the cause of this? By the way, my power seems way down. Thanks.

James Bailey

Pam Hinton replies

James,

Well, your sweat smells like ammonia because it contains ammonia. Why the sudden change in odor? If your training and diet haven't changed, I don't have any idea. You may be wondering how ammonia gets into sweat. I can answer that question. Ammonia is produced in skeletal muscle during prolonged exercise, enters the blood stream, and is secreted by the sweat glands.

Ammonia is generated in skeletal muscle as a byproduct of adenosine triphosphate (ATP) breakdown into adenosine monophosphate (AMP) and inorganic phosphate. During high-intensity exercise, the rate of ATP consumption exceeds ATP production and AMP begins to accumulate in the cell. Ammonia is released from the excess AMP by the enzyme, AMP deaminase. During prolonged, exhaustive exercise, skeletal muscle generates ammonia from oxidation of branch chain amino acids (BCAAs) to make ATP. In the process, the amino group is removed from the BCAA, producing ammonia.

Elevated ammonia within the skeletal muscle and blood negatively affect performance. Neuromuscular function is impaired by ammonia, leading to local muscle fatigue. Ammonia can cross the blood-brain barrier. So it accumulates in the brain when blood levels are high. The brain's capacity to get rid of ammonia is adequate for short-term maximal exercise, but it is overwhelmed during prolonged, exhaustive exercise. Abnormally high levels of ammonia in the brain can disrupt normal neurotransmitter function.

Ammonia depletes the excitatory neurotransmitters, glutamate and its precursor, gamma-amino butyrate, leading to central fatigue. Training and diet affect the production of ammonia during exercise. Endurance training decreases the amount of ammonia produced in skeletal muscle, thereby lowering blood and sweat ammonia concentrations. Depletion of muscle glycogen following a low carbohydrate diet increases the blood ammonia response to exercise due to increased use of BCAAs for energy. Carbohydrate consumption during prolonged, submaximal exercise reduces muscle ammonia production from BCAA degradation.

Since your training and diet haven't changed, it's a bit of a mystery why your sweat has gone ammonia on you. Your best solution seems to be a change of clothes for the car ride home.

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