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Form & Fitness Q & A

Got a question about fitness, training, recovery from injury or a related subject? Drop us a line at fitness@cyclingnews.com. Please include as much information about yourself as possible, including your age, sex, and type of racing or riding.

The Cyclingnews form & fitness panel

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.

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.

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.

Fitness questions and answers for June 28, 2004

Back problems
Balancing work & training
Coke
Time to respond to training stress
Water on board?
Carbs and protein
Thalassemia
Blood test

Back problems

I am 35 years old male. 70kg, strengths are sprinting and climbing, been racing for only a couple of years. Made A grade earlier this year, train about 400km per week.

I have a history of lower back problems including 3 operations to remove lumbar disc prolapses. The last operation was only a couple of months ago and has forced me to take some time off the bike. I'm just starting 15 mins per day on the stationary trainer now, on the advice of my surgeon.

I've asked quite a few surgeons, physios and GPs if serious cycling (e.g. racing at A grade level) is good or bad for the lower back, in particular, my condition. As this is a very common condition I thought it would be easy to get an answer, but, unfortunately, this has not been the case.

The general view seems to be that light to moderate exercise / cycling is good for the back, but being in the drops, riding hard, and doing lots of kms, may be bad for it, due to the bending at the lumbar vertebrae. Can anyone tell me, is this the case? Is it likely that returning to serious cycling will be bad for my back in the long term, and maybe even the short term?

I want to get back into serious racing, but if it's going to be bad for my back then I guess I'll have to consider 'retiring'.

Stuart Cathcart
Australia

Dave Fleckenstein replies:

This is indeed an interesting and common question. The reason that you have not received a specific answer from your medical providers is that it is not a simple question at all. I would start by having you read a response that I wroteon the low back to get oriented to the perspective from which I treat spines.

To simplify things from a clinical perspective, we find that some spine conditions are aggravated by flexion of the spine, others are relieved by it. We even find that while most disc herniations are aggravated with flexion, some are actually relieved by it. The underlying point is that each spine is very different and very specific. Making generalities about a lumbar disc herniation and then having people base their activities on those generalizations would be analogous to having a room full of patients with different heart conditions with only one drug to take for medicine. Some would get better, some would have no change, and some would probably die. Simply put, what is healing medicine for one type of back injury can be the exact thing that is an debilitating poison to another one.

However, keeping in mind that these are only generalizations, I feel comfortable making some comments about your condition based on what you have reported and what we tend to see most frequently. Generally, end range flexion places the disc under increased pressure and stress and can lead to breakdown of the fibers in the posterior portion of the disc, close to where the nerve roots are. Prolonged flexion accelerates the breakdown even more. Thus I would say that, in general, for lumbar disc herniations, cycling is not the ideal sport. However, there is a way around this. If you can generate your flexion from your pelvis rotating forward rather than from lumbar flexion, you will minimize the pressure on the disc (again I would refer you to the above response for more detail).

The most concerning thing to me about your condition is that you have had three disc herniation episodes. While the surgery certainly may have been a necessity to relieve pressure on the nerve, I have great concern that the forces causing the disc to break down are not being addressed properly. More simply, the surgery is relieving the symptoms ( the victim), but is not correcting the root cause of the problems (the culprit). For you I would have concerns about overall flexibility (specifically hamstring, piriformis, and psoas musculature), overall muscular stability (normal transverse ab and multifidus activation patterns), and bike alignment. I absolutely would not return to cycling until the above concerns are addressed - if the underlying mechanical forces on the spine are not corrected, what is to prevent surgery number four ?! If you a re able to correct what is driving the breakdown, I see nothing wrong with returning to riding - the body has an amazing ability to heal and I have certainly seen individuals return from greater problems.

Balancing work & training

I am 17, male, and started racing mountain bikes in the Sport class this year. I laid down a good base, about 1000 miles and then started my build phase and racing. I just finished up my A race and am returning to base to rebuild some strength and prepare for my next race at the end of July which is a 60 miler with 11k of climbing. In school, I had no problem feeling good at the end going out for a ride. I trained consistently, overreached correctly sometimes, and didn't go off the deep end. I used Friel's training bible to help me train really smart.

However, now that school is out I need to some serious help. I work for my dad who owns a family stone yard business. I am on my feet, lifting heavy stuff sometimes, from 7:30 to 4. I drink lots and eat a high amount of quality foods. Unfortunately, work has its tolls. I just started working this week and have noticed that on my first ride I could barely get my heart rate up to 150 in the flats (my LT is 180).

Today, I got on my trainer to do force reps and after my warm up I almost fell off I was so exhausted. I am very unhappy. I really think I can do well in racing. I know this is only my first year but I am training consistently and getting good results from it. Work is getting in the way.

I have a feeling this pattern of exhaustion/poor ride results is going to continue unless i do one of a few things. One is to just do recovery rides on the week and do intervals/long intense rides on the weekends. The other is to ride before work and rest afterwards. The other is to work less hours. The last is to get a different job. The business is a very important family thing that is hard to explain. I can't really imagine working anywhere else, somewhere where I'd be sitting on my butt all day (which would be a good thing for training though).

I would really appreciate help in the decision process and making adjustments to my training.

Harry Precourt
Sudbury, MA

Scott Saifer replies:

This is a question of priorities. You will not reach your potential as a cyclist while doing a job that involves a lot of standing and heavy lifting. No specially arranged training program will get you around that. You could race well part of the year and work part of the year. You could race and train year round below your potential indefinitely while you do the job in the family store. A lot of people enjoy racing for years without reaching their potential, so this is not such a horrible thing.

If this though makes you gag, you need to talk to your parents about either working somewhere else or having tasks that don't require much standing or lifting. You can always return to selling stone later. If you are okay with not reaching your potential as a cyclist, admit it and enjoy riding.

Coke

A question about the article on soda pop as a drink while riding. Although I do believe all the data presented about absorption I still have a question. If it is such a bad choice why do all or almost all the pro riders in Europe (I have been over to watch races and seen the amount of use with my own eyes) drink Coca Cola as their choice for drinks while riding and afterwards. I tried to count how many a day these guys are drinking and it is a lot. These guys ride/race everyday and consume at least a few cokes a stage. If the absorption is so bad that you recommend something else - why do the best riders in the world, with the best nutritionist and doctors allow them to use such a poor choice for glucose and rehydration? Based on what I have seen it seems to be the best choice of beverage to consume while riding and right afterwards. I know they do drink other drinks while riding but they sure do drink a lot of cokes. I get so tired of hearing everyone say not to drink soda and how horrible it is for you but when cycling elites use them everyday it can't be too bad.

Brannon Amtower

Pam Hinton replies:

Really, I had two points in my response about soda pop and carbonation. The first point was not that soda pop is "a bad choice," but that there are better alternatives for athletic refueling. The second point was that even in the harsh glare of empirical evidence, sometimes when the going gets tough, even the tough just need a little "Pop!"

The popularity of Coca Cola among professional cyclists is observable and documented. A survey done at the US Pro Championship Road Race in 1997 corroborates your observation. Team soigneurs answered a 12-question survey designed to determine which sports drinks professional male cyclists consumed during a race. Of the 19 teams that participated in the championships, 11 of them completed the questionnaire. Ten of the eleven teams drank Coca Cola during the race. Coke, however, was not the only beverage that these racers consumed. Every team that consumed Coke during the race, did so in conjunction with other sports beverages containing carbohydrates and/or electrolytes. Seven of the ten teams handed out partially-degassed Cokes, so some of the carbonation had been lost. It would be my guess that the pros with the best nutritionists and doctors are "allowed" to drink Coke, because they are getting the electrolytes they need from these other sources. Also, drinking a Coke after a race is not as likely to cause gastrointestinal problems as it would during competition. Post-race blood flow to the gut and normal digestive processes, which slow during intense physical exertion, are up and running again.

The pros may drink Coke because they believe that caffeine will give them an advantage in the second half of a race or because the soda tastes good. They may also drink it because it is tradition to do so. Coca Cola was around decades before electrolyte-replacement drinks existed.

It is worth noting that the United States is the primary consumer of high-fructose corn syrup worldwide. High-fructose corn syrup is used in place of sugar by food manufacturers. It is popular in this country because we have an abundance of corn and the excess can be used to make corn syrup. The advantage for food manufacturers is that the price of the corn syrup is stable, unlike that of sugar. Most carbonated beverages and fruit drinks are sweetened with high-fructose corn syrup. In Europe and other countries, there are government regulations in place that limit the use of high fructose corn syrup. So, a soda pop purchased overseas may or may not be sweetened with corn syrup.

Athletes are people and people are creatures of habit. And on this last point, I have a confession to make. There is a type of soda that I really love - its name is evocative of runoff from the high country and also is back-country slang for home-made liquor. Well, during a recent long training ride my boyfriend pointed out that maybe in light of my replacement-fluid advice, I was being a bit hypocritical as I lovingly cradled my little bottle of nectar at the checkout counter of the convenience store we'd stopped at. I was tired and sore and the only defense I could muster was, "I need a pop!"

Time to respond to training stress

I'm a 25 yr old Cat 4 racer with only about fifteen races under my belt. I began riding the bike about a year ago, and I began training more seriously this past October. In the spring I competed in my first race (collegiate Men's D in the Eastern Conference) and have been racing since then with a break after the end of the collegiate season before getting into my first USCF races.

My question is this: how many days, generally speaking, does it take for the body to grow stronger from training stress? I realize there are many variables--amount of sleep, whether one is training through and adding more stress, nutrition, life stress, etc. Let me contextualize this better. (It's too late now to do anything differently, but I'll know for the future). I am doing a 4 day stage race that begins in ten days. Three days ago, I had planned to block together two or three high-intensity, high-volume training days and then do only recovery and aerobic rides from one week out until the day before the race when I would do an "opener." I am wondering whether the training I do seven to ten days before the race will actually make me stronger (assuming I rest well) before I begin the race. Is there an average amount of time the body needs to recuperate and strengthen? I know that when people do two week crash cycles, it takes almost two weeks of recovery for the body to fully respond and strengthen. What about "regular" training cycles?

Zachary Hoover

Scott Saifer replies:

There are two questions here: How long does it take to respond to training stress and how long does it take to recover from training stress. The answer to the first question is not nearly so relevant as the second. Very hard training will slow you down for ten days to three weeks or even longer. Milder training leads to a shorter period of fatigue. As you learn your body's way of responding you'll figure out how much to do how close to important events. As a rule of thumb until you know better from your own experience, I'd suggest not doing anything hard enough to make you tired in the final ten days before an important competition.

Water on board?

I really enjoy Pam Hinton's extended responses to nutrition questions. My question involves the ubiquitous advice to have a drink with 6-8% carbs, etc. I only drink water and rely on food for my carbs/protein mix and electrolytes. The various sports drinks just don't work for me. Water is always appetizing, no matter the near-death experience currently underway, and I can always choke down real food.

I eat fig newtons and bagel sandwiches (with a little lean pork or chicken) and the ever yummy Clif bars. I measure salt onto the sandwiches during prep for rides over 3 hours (~1 gm/hr), where experience shows I need electrolyte replacement. I like keeping the food and hydration separate so I can fine tune either as I ride, depending on how hot it is, how far I'm going and how I feel (feed me now!). I have rules of thumb about how much I need of everything per hour, and keep learning as I go so I'm not shooting in the dark on the target century or performance event du jour.

Is there any performance advantage/disadvantage to the water only approach? Almost everyone I ride with have something green or pink or whatever in their bottles and while I'm munching away on my real food, I do wonder if it's marketing or if I'm missing something.

Darrel Stickler
San Mateo, California USA

Scott Saifer replies;

The riding diet you describe is very similar to what I did when I was racing and doing long distance tours. I won a few events and if I didn't, it wasn't because I was bloated or ran out of fuel, so I know water + food works just fine. On very hot days you may need more to drink than you can carry from home, and I never liked carrying and mixing powders at each water stop. I also never had trouble riding with a belly full of sandwich. Many riders find it difficult to ingest and digest solid foods while riding hard, and for them carbo-drinks or gel-foods are essential.

Carbs and protein

What are the advantages and disadvantages of eating both carbohydrates and protein together or should they be eaten separately?

Patrick

Pam Hinton replies:

Basically, the body uses carbohydrate when it's exercising and a combination of carbohydrate and protein when it's at rest repairing the effects of exercise. So, you can do the math and stop right there or read on and get the full meal deal.

Another "basic" truth is that most typical meals are made up of both carbohydrate and protein (and fat). Imagine what a pain it would be to eat something so basic as a peanut butter and jelly sandwich if carbs and protein had to be eaten separately. First you would have to decide if you were going to eat the carbs or the protein first. Say you went with the protein. So you scrape the peanut butter off the bread and are about to lick the knife when panic strikes. You remember that peanut butter (except for the au naturel version) has added sugar, i.e., carbs. And what about the jelly that came along with the peanut butter? To abide by the separation of carbs and protein principle, you'd have to give up PB&J. Then there's the dilemma of dairy products, which naturally have protein and carbohydrate. You would have to abstain from milk, yogurt, and ice cream (heaven forbid).

My answer to your question is only as ridiculous as are the diets that forbid eating carbohydrate and protein together or that put a ban on all carbohydrates or all fats. People follow particular diets for many different reasons: habit, health, convenience, moral or religious beliefs. Have you heard of these diets? The Eskimo Diet, the Paleo Diet, the DaVinci Diet, the Hallelujah Diet? Why do these diets appeal to people? Maybe it is that they claim to prescribe foods that humans were "designed" to eat or to be founded on some ancient principle that has been lost by modern man.

Experts in nutritional science add to the diet confusion by changing dietary guidelines to reflect the current nutrition knowledge. Take heart disease as an example. Nutritionists first blamed diets high in cholesterol, then the culprit was saturated fat, now trans-fatty acids and simple sugars are to blame. New scientific findings will continue to shape diet recommendations, however, there are two immutable principles concerning diet and health: variety and moderation. If we eat a variety of foods, we will ensure that we consume adequate amounts of all of the nutrients. If there was a "perfect" food, one that contained all of the nutrients, then we would not need to follow the principle of variety, but such a food does not exist. Most of us are familiar with the food groups and know that we need to consume foods from each group daily because the dairy group provides calcium and vitamin D and because the fruits and vegetables are high in vitamins C and A, and so on. It is important to apply the variety principle to the food groups as well because nutrient content varies between foods within each food group. For example, some fruits, like oranges, are high in vitamin C, but not in vitamin A. The opposite is true for melons. So, even if you ate the recommended number of servings of fruits and vegetables, but chose the same ones day after day, you might not be getting the nutrients you need.

The principle of moderation states that all foods may be eaten, as long as we eat them in limited quantities, because there are no "bad" foods. The principle of moderation allows us to eat a diet that is healthful, yet tasteful and satisfying, by including foods that are higher in fat, sugar, and calories. This keeps us from developing a "dieting" mentality instead of lifelong eating patterns and from feeling deprived. Conversely, moderation prevents excess consumption of foods, leading to weight gain and diseases associated with excess body fat.

Thalassemia

I don't know if you could answer this regarding low red blood cell counts, hematocrit and hemoglobin low numbers. I have a physical once a year for work so have 7 years worth of data, each revealing low rbc counts. I have thalassemia so am blessed with permanent low blood cell counts. I am 36, 6'1", 195 lbs. somewhat healthy. I snow ski 35+ times a year, water ski and mountain bike with a little road riding. Looking at getting into road riding more seriously. Is there anything I can do to offset this? I don't give blood because of this. I will have to check to see about the ferritin levels in the liver and if they are reported. I was told to stay away from iron supplements because they could cause me stomach problems. I haven't run across a doc that has any experience in thalassemia. Any suggestions?

Steve Owens replies:

I used to coach an athlete that has beta thalassemia. It's important for you to know your limitations with this blood disorder and always to be very careful. To understand the significance of Thalassemia, you should understand the different forms, how it effects the body and why the different forms are named what they are. The following is a small section I found at the following web address that I feel describes the blood disorder very well and a provides a brief review of hemoglobin structure for you to better understand it: http://www.cariboo.bc.ca/schs/medtech/rice/thalassemia.html#review written by F.A. Rice, ART, CLS March 1, 1996. It is still current information. I've provided additional insight after this section on hemoglobin structure.

Review of hemoglobin structure

In the adult there are three hemoglobin types normally present:

* Hgb A 2 alpha & 2 beta chains - 95% of total
* Hgb A2 2 alpha & 2 delta chains - 3% of total
* Hgb F 2 alpha & 2 gamma chains - 2% of total

During fetal life the majority of the hemoglobin is of the
Hgb F type.

During embryonic life at least two different hemoglobins are produced:

* Gowers 2 2 alpha & 2 epsilon chains
* Gowers 1 4 epsilon chains

The manufacture of each of these chains is controlled by specific genes. During development from the embryo to the adult these genes are switched on and off accounting for the different hemoglobin types. In thalassemia there is a genetic failure in the production of globin chains. Although a failure of production can and does occur in the production of any of the five globin chain types a failure of production of beta and alpha chains is the most common. Hence the thalassemias are classified according to the type of chain which is not produced. The most common being: beta thalassemia - a failure of beta chain production alpha thalassemia - a failure of alpha chain production.

So, there are 4 different types of the disorder - alpha, beta; each with their own subsets, and also E beta and Sickle Beta. It will be important for you to try to determine which of these types you have and also its severity. I'm under the impression that you have a mild form of the blood disorder being as athletic as you have portrayed. For one, you should not give blood (as you state you do not) because it is not uncommon for someone with Thalassemia to have a hematocrit (red blood cell) level of 20-25% (normal values per ACSM guidelines are 40-52% males, 26-48% females). Secondly, common treatments of this disorder (depending on the degree of the disorder) are transfusions. With this, you need to be aware of iron toxicity. You should talk to a doctor about this.

You said you haven't run into a doctor that has experience with thalassemia, but I would encourage you to actively seek out a doctor that knows blood disorders. The more educated you are with this disorder, the better you can live with it. I'm not an expert in blood diseases and disorders but merely have worked with an athlete that has Thalassemia. It is possible for someone like yourself to compete and be moderately competitive, so don't loose hope. My suggestion would be to stay at low altitudes and possibly look into track cycling or events that have a more anaerobic component over aerobic. Reducing or eliminating the aerobic component of your sport will bring you (competitively) to just about the same levels as anyone else. It's something to consider.

Blood test

I have seen a few references here to the impact of donating a pint of blood on performance. I am wondering if two vials of blood drawn for lab tests two hours before a 10 mile time trial could account for a difference of about 15 seconds (for a time under 22 minutes.) I am 6' and 155 lbs.

I know there are myriad other factors which could account for it but I'm wondering if it is plausible that a loss of this relatively small amount of blood could have an impact.

Colman O'Connor
Boston, MA

Scott Saifer replies:

Loss of the blood contained in two blood test vials would not explain a fifteen second difference in a 22 minute race. If you have a great fear of needles and blood tests and experienced the test as extremely stresful, that could adversely affect your performance though.

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