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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. Due to the volume of questions we receive, we regret that we are unable to answer them all.

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 December 6, 2004

Power training without a power meter
Fit for track cyclists
Weight training
Supplement rating
Hamstring?
Watts per kilogram redux
Energy replenishment for the Etape
Broken collar bone

Power training without a power meter

I'm a 41 year old Cat IV with one year of racing experience. I want to train by power but don't want to spend hundreds of dollars on a power meter. It seems that power training is most beneficial in intervals and in HR zones 4 and 5, and that training strictly by HR is fine for endurance rides and efforts in HR zones 2 and 3. It is hard for me to do intervals safely on the road, since I live in a heavily populated suburban area, so I do my interval training indoors.

With that in mind, if I keep variables on the trainer under control, like keeping tire pressures consistent, and the resistance unit is pressed to the tire by a spring, then doing intervals turning a specific gear, like 105 rpm in the 53x15, or maintaining a specific speed, is essentially training by power right? For instance a ladder workout of 1,2,3,4,3,2,1 turning 53x15 at 100 rpm, my HR will be in zone 4 by the end of the second interval and in zone 5 in the longer sets. But I'm putting out the same power because I'm maintaining speed throughout. And I know that four minute intervals turning 53X17 at 105 rpm puts me squarely in zone 4 each interval. (Yes, I know I'm weak, but it is still December.)

So how can I convert that to the percentage based power zones? Would you recommend plotting HR to speed or gear inches and rpm and then increasing rpm a certain amount each week? Are the new "trainer only computers" that estimate power from speed accurate enough?

Carl Lyda
USA

Dave Palese replies:

To truly train using power as your guide, you need some kind of power meter. That being said there are options items like SRM cranks and Power Tap wheels (although these are the best options since your can use them in every situation, whether on the trainer or the road, and most important, during races to get real world data.

The system you propose in your question is a valid training protocol though as well, and I wish more athletes would take such a detailed look at their trainer training. They could use what they have on-hand some much better.

What you propose isn't "power-based" training as defined in cycling circles and that's OK. So trying to convert, and extrapolate to get power levels, I believe, would just be a waste of your time. Because you might, if you are lucky, get to see what you have done during a training session, but not really be able to use "power" or watts to set goals or give you a deeper insight into the other aspects of your performance. It's apples to oranges.

That said, you can use HR and the inputs that you cite, like cadence, speed, trainer resistance setting, and gearing, to chart your progress and set goals during interval sessions.

The ways in which you can use these inputs to keep you progressing is only limited by your imagination. The example that you mention ("...plotting HR to speed or gear inches and rpm and then increasing rpm a certain amount each week") would be a great way to use the inputs that you have. So I think you are on a great path.

I mentioned options to the more expensive power meters. Several companies make trainer set-ups that give power output as feedback on the display. The three that pop to mind and that I have some experience with are the Elite Fluid Adjustable trainer with the Plus Unit display (~$599 total); the Cateye Cyclosimulator (~$350); and the different systems from Tacx. In my opinion, the Elite system is worth the extra cash just because of the smooth and reliable resistance created by the fluid load generator.

If you had either of these units, you could perform a testing protocol with a friend on-hand to record the data, and then establish power-based training levels to use during your sessions.

Hope some of this helps.

Fit for track cyclists

I am a 23 year old track cyclist from Brazil. I've been reading tons of info and discussion on bike fit, most of all about saddle height and fore/aft position. My question is, is there any difference between track and road position? I remember reading many books that would say a sprinter's saddle should have its tip aligned with the bottom bracket, but that's not the case when you see the bikes at the Olympics or the worlds. And the same with the height: the top class riders seem to use it much higher than the books would recommend for a sprinter. Is there any kind of magic equation for the fitting? I know the best is the way one feels comfortable with, but I wonder if there's any way I could improve my performance, given that for the kilo and sprint high cadence is fairly important. If that helps, I am 1.78m (5'10'') tall, 80 kilos, my leg length is 85 cm (up to the crotch) and my bike is set with 90 cm from the pedal to the top of the seat (I use 170mm cranks). I would consider myself fairly flexible with my back, given that the drop between saddle and handlebar is 15cm for sprint and 17 for the kilo/pursuit. should you think it's important, I could send pics from my position in the bike. Thank you.

André Aleixo da Rocha Pereira
Brazil

Steve Hogg replies:

There are fairly substantial differences between ideal bike positions for the same rider on track bikes and road bikes. There are some changes necessary as well between different track disciplines. The demands made of the rider differ between track and road. A track rider has only one gear which has to small enough to accelerate well but not so small that the rider is pedalled out in a race. This places a premium on the ability to maintain high cadences for longer periods than is common on the road. Another difference is that there are no hills on the track, so there is little demand for sustained low cadence, high torque pedalling so both cleat and seat position need to reflect this. Bar height can be lower as well because of the emphasis placed on standing starts which is largely absent on the road. Additionally given the shorter duration of track events, what a rider may find comfortable on a track bike for a certain period may not be comfortable for the longer period in a road race. Lastly, and often overlooked, is the effects of a fixed wheel drivetrain versus the freewheel drivetrain of a road bike.

Once a track bike is up to any speed, momentum will carry the rider through the dead spot in the pedal stroke either side of top and bottom dead centre. Because of this it is less important that a rider be able to have good leverage for as many degrees of arc of the crankarm as it is on a road bike. This is a by product of a track bike having a fixed wheel drivetrain. Providing good power is produced somewhere in the stroke, momentum will take care of the rest to a much greater degree than can happen on a road bike. This means in turn that seat and cleat position can be optimised for the sustained high cadences that can be necessary on a track bike. Bar height can be lower as well because upper body comfort is not as much of an issue because track events are typically shorter than road events. Lower bars mean a more aerodynamic position as well as a greater ability to brace against the forces applied when performing standing starts.

The upshot of all of this is the differences I will outline are typical. People vary however so use them as a guide or starting point.

Let us assume a good road position; proceeding on that assumption a track bike will have a seat tube angle of between 1 and 2 degrees steeper than the same rider on a road bike. 1 - 1/2 degrees steeper is typical but sometimes up to 2 degrees steeper is necessary. This means for instance that a rider with a seat height typical of say a 57cm frame measured centre to centre, that the seat will be typically 13 - 20mm further forward but can be up to 26mm further forward assuming we are using the same model of seat.

The bar height will be lower, ideally as low as possible consistent with comfort and performance. There is no rule of thumb here but given that the seat is further forward, meaning in turn that it is easier to reach down to the bars, 30 -40 mm lower is common. What can complicate things here is that if comparing bar height to a road bike, and the rider is using sprint bars on the track, these usually have a deeper drop and greater reach than is the case on road bars. This makes rule of thumb 'rules' a bit difficult to come up with.

If you have read the previous posts on cleat and foot positioning posts then the cleat position I would favour for track events is there. You mentioned interest in sprint and kilo racing. In the above posts I suggest that the ball of the foot should be only half as far in front of the pedal axle for those events as for road riding. This is because when performing standing starts as in a kilo, or starting a sprint from a relatively slow speed as can happen in track sprinting, you are off the seat. This in turn means that you are more or less over the bottom bracket in turn meaning that the relative dead spot either side of top and bottom dead centre in the pedal stroke is larger than if seated. Under these conditions, ripping the lower leg up hard which will cause you to lift the heel of the lower leg with force, is necessary to get the top leg over top dead centre in the shortest time.

The cleat position that I advocate for sprint and kilo will help that. For general track racing this is not as necessary because explosive power from a standing start or near standing start is not as important.

I know this begs the question as to why not have this cleat position for the road if it maximises the jump in a sprint. The short answer is that it will not help you up the hills at all, but hinder the rider if anything. For most people in most road racing there are a few hills to get over before they have to worry about what happens in the sprint.

Andre responded:

Thanks for the input. Another point that I'd like to ask is about the height and fore/aft position of the saddle. What I've seen in the bikes at the Olympics are "real" seat angles of about 76 degrees. By real angles I mean the angle between the bb and the spot in the saddle where you actually seat (I believe Cervelo uses this kind of designation). But what about the height? should it be lower to improve cadence, or higher for "extra leverage" ? It seems to be commonsense to lower the saddle, but from some riders (specially kilo) it seems that they don't follow this rule... what's your opinion on that? From my own experience high seat may be better for high torque, or even things like trying to keep the pace in the kilo, but will handicap you in seated accelerations, while a low seat can help accelerating, but seems to burn my legs faster.

Another thing: when my seat is a bit lower, I tend to suffer with the dead spot in the top of the stroke, like if the angle between my lower leg and thigh was too shallow, making it hard to accelerate my leg speed. By the way, using my ordinary (road) bike position I've reached cadences up to 205 rpms in a sprint (of course with a low gear), so how low should I sit?

Also, my right foot is ok, but my left one tends to pull out of the shoes when the cadence goes higher... It's like I start pedalling with the tip of my toes. my feet moves inside the shoes (they are almost brand new Shimano R125), and I tend to lift the heel. Needless to say it takes all my pedalling efficiency... Sometimes I also tend to "open" my knee while pedalling, like if I couldn't pedal with my leg parallel to the frame, can you understand this problem? It seems that my knees are closer to the brake levers than to the stem while on the top of the stroke.

Steve Hogg replies:

You raise a number of points that I will work through one at a time. Before that, while you are offering to send me photos of you, static pictures can be misleading in the sense of attempting to guesstimate what is happening dynamically in any particular case. I cannot position you via email but will attempt to advise based on what you have told me.

1.Seat tube angles at the Olympics: I would not worry too much about what others do and worry more about what works well for you. Measuring effective seat tube angles from photos or still video frames is tricky and it is quite easy to make relatively large errors of measurement. You may or may not have done this, just be wary of drawing conclusions using this method. Don't get hung up on numbers, there is no magic seat tube angle in other than an individual sense.

2. Seat height: Experiment till you find the height that allows you to sustain the cadence you need to in competition but affords good leverage. In practice this means that if too high you will struggle to be smooth at high rpms and if too low you will, as you say struggle with on the seat accelerations. To sustain the cadence you need to achieve in racing, I would make sure that I could pedal fluidly at a cadence 10% higher than that with ease. I am not a coach and it is worth your while getting specific advice about the best way to train with regard to cadence. Generally speaking, and assuming you are using the same type of seat, shoes and pedals as on your road bike, then the seat height of your track bike will be lower than on your road bike. The question is how much lower?

6 - 12mm is not uncommon but how flexible and functional a given rider is can make large differences in what is required. Some mainly track focused riders have low-ish seat heights on their road bikes and so there is little or no need to drop the seat height on their track bikes. Again, experiment. Your comments about legs 'burning' with the seat low and struggling through the dead spot suggest that with that setup either the seat is too low, or the bars are too low or a combination of both. This is very likely to be the case if the 'burn' is largely focused in the centreline of your quads or at the junction of the front of your upper leg and torso at the front of the hip

If you can reach 205 rpm on your road bike on the road, then pedalling fast is unlikely to be a problem.

3. Cleat position: Have a look at the cleat posts again. To use size 44 as an example; I suggested for road riding that the cleat be positioned so that the centre of the ball of the foot is 10mm in front of the centre of the pedal axle. If your current cleat position is with centre of the ball of the foot over the centre of the pedal axle as is commonly [and in my view mistakenly recommended] then you would need to move the cleat backwards on the shoe to get the foot forwards over the pedal. For sprint and kilo racing, I suggested in that post to halve the amount of foot over the pedal. In the case of a size 44 shoe, that would mean that the centre of the ball of the foot would be 5mm in front of the centre of the pedal axle.

4. Your left leg not functioning well and both knees moving outwards at the top of the stroke. The possibilities are: a. that you are tight in the muscles that externally rotate the hips; b. that your bars are too low for your degree of flexibility in hips and lower back. This is particularly likely if you don't have this problem on your road bike. If you have the same problem on your road bike point a is more likely; c.That you are restricted in the right sacro iliac joint.If this is the case and you are dropping your right hip as a consequence, then the left leg has to reach further and move around a bit laterally to accommodate the right side hip drop. If this is the case it would help explain the pedalling with your toes feeling and the lesser efficiency of the left leg. If your left leg is measurably shorter than the right leg, this could also explain what you feel and observe.

The above assumes that there are no simple problems like a cleat angle that is inappropriate.

Have someone observe you from behind and see if you sit square on the seat or if you drop one hip.

Weight training

I have not seen much regarding training for body type. I am 6'1" and 160lbs. If I lift weights hard for several months in the winter, I only gain 2 to 3 lbs but 20 to 30% in low rep max testing as well as higher rep tests. When on the bike I just feel much stronger, like I am using less resources for the same effort. I can also deal with hi wattage surges in group rides. This is all without much change in aerobic training.

I can see someone who is 5'8" (muscle not fat) at my same 160lbs in a fairly natural state that would not benefit much from weight training. Because they have plenty of muscle mass and ultimate strength, not seeing this same benefit.

Tyler Pilger
Madison, WI

Scott Saifer replies:

I believe that you are correct that some riders will benefit much more from strength training than others. If you have felt that strength training benefits you, it almost certainly does. At the very least you have an improved confidence that allows you to stay calmer and make better decisions in races. Your perception that you are able to surge and recover more effectively after strength training is also consistent with the scientific evidence.

Ric Stern replies:

The only evidence that shows a positive benefit is in untrained or low fitness subjects. Additionally, sprint power is increased with weights (as it can also be with on the bike training), however, in the former there are disadvantages associated with this type of training (i.e., a decrease in mitochondrial and capillary density).

Moreover, recovery from surges/anaerobic efforts/sprints etc are entirely dependent upon aerobic metabolism, that is those with a high LT and a large VO2max recover at a faster rate. It has nothing to do with strength (or weight training).

Supplement rating

I would like to know if there is a site that rates all the cycling supplements. Which is the best and which one not to waste your money on.

Larry Pelt

Scott Saifer replies:

I don't know of such a site. I do have a suggestion for filtering through the marketing hype though. Look for these two items in any product sold by a company: any form of chromium sold as a fat burner or lean-mass builder, and carnitine sold as a fat burner. Both of these substances have been shown by thorough testing to be without benefit to athletes, and this has been known for years. In fact, ingested carnitine does not even get to the parts of cells where it would work and chromium actually made obese women gain weight compared to controls in one study.

If a company pushes either chromium or carnitine in their marketing materials for any of their products, you know that they are willing to lie to make a sale and so you should not trust any information you get from them. That wipes out all but a few companies that you need to consider and should make your job much easier.

Hamstring?

I'm a 38 yo male performance-oriented recreational cyclist that mt bikes and road rides. My problem is with my hamstring. I woke up one morning and my left hamstring was hurting to the point that I was limping, a sharp pain. As it warmed up, in 4 or 5 minutes it felt better but I could tell something wasn't right, more of a dull pain. It mostly seems to be about 5 inches up from the back of my knee but sometimes shoots up higher and sometimes down to my calf. This happens after sitting or not moving for awhile (driving, work, sleep, etc) and it's going on 4 weeks now. I'm still able to ride without pain unless I stand when climbing. The worst part is that I don't know how it happened. You see it happen to athletes (baseball, basketball, etc) and they know it happened immediately! Maybe when one of my kids was jumping on me when playing on the floor? I've heard hamstring injuries take a long time to heal and was wondering if you had any ideas.

Luis

Andy Bloomer replies:

It sounds like your pain might be generating from a lower back injury similar to the one I suffered a while ago. If your hamstring was the source of the injury then it's possible to say that the symptoms would remain there but as you suggest they radiate into your calf then it may be due to impingement of the sciatic nerve which could come from one or more of several sources. You need a specialist diagnosis to confirm this from an appropriately qualified professional. They will prescribe exercises to alleviate the pain and then remedial exercises to keep it at bay.

Watts per kilogram redux

I know that a lot of people say that if you can hold a certain number of watts uphill you can beat the competition, right? But is Watts per kilogram what matters, more than just training at a certain amount of Watts while climbing? Lets say I am 68kg, then if I can produce 350-400 Watts while climbing that will make my Watts per kilo around 4.7-5.3. What kind of Watts per kilo would I need to be competitive at the Tour? Is power output in Watts per kilo a better indicator of success? And does it also matter for endurance races and other types of racing?

Shaun Keenan
USA

Michael Smartt replies:

Ed Monnier brings up an excellent point (2 in his original reply) for racing in the much of the United States (and certainly other places) where long climbs are not a regular part of racing, either due to terrain or level of competition. As Ed points out, watts/kg is the best measurable metric for comparing climbing ability, but when long climbs are not a part of the course profile, W/kg becomes a less effective tool. In events such as track, criterium and flat to rolling road races, allometrically scaling watts/kg can give a better comparable measure of cycling ability. This is simply done with the following equation: W/kg^0.67, where mass is raised to the power of 0.67 and is then divided into watts. In a nutshell, the difference between the two measures is a matter of accounting for the influence or gravity vs. the influence of wind drag, respectively, on the power to speed relationship.

Energy replenishment for the Etape

Could Pam expand on where the "missing" energy comes from. I've always been curious about the difference between the 60g/hr carbo consumption guideline you often read and the 700-800 kcal/hr I know is burned at moderate intensities (at 270W, my power meter says I'm burning a smidge over 1000 kcal/hr, but that's not my 9 hr--or even 5 hr--pace).

She says "As long as you maintain blood glucose levels, creating an energy deficit during the event should not be problematic." Well, where does the ~500 kcal/hr come from if only 240-ish kcal is hopping into the blood stream from food you're eating? 500 kcal/hr seems like too much to come from basal fat metabolic pathways. Muscle lactate? But doesn't the lactate come from the same energy aerobic pathways use?

Darrel Stickler
San Mateo, CA

Pam Hinton replies:

You are correct; we cannot violate the first law of thermodynamics. The "missing" energy is derived from muscle glycogen, muscle triglycerides (fats), and free fatty acids that are released from stored fat into the blood. So let's do the math. Here's what the typical, 70kg lean (8 % body fat) male starts with: 2000 kcal of glycogen in liver and muscle; 80,000 kcal of triglycerides in adipose tissue; 2000 kcal of triglycerides in skeletal muscle. At moderate intensity exercise (about 55-60% of max), our typical 70-kg cyclist will consume around 900 kcal/hour. Fat will supply about half of the energy and carbohydrate will make up the difference. Consuming 60 g of carbohydrate per hour will supply 240 kcal of the 450 kcal of carbohydrate that are needed. Glycogen provides the additional required 200 kcal per hour. So, if we start with 2000 kcal of glycogen and burn it at a rate of 200 kcal per hour, there's enough for 10 hours of moderate intensity cycling.

Seems pretty straight-forward, huh? Now if you could get the actual riding to go by the numbers like that, then theoretically you could devise a formula that would get you an Olympic gold medal, but if that was the case, there'd be no such thing as an Olympic gold medal.

Broken collar bone

Further to last week's Q & A, I am an emergency doctor and see a lot of people with broken collar bones. You'd have to check with an orthopaedic surgeon, but my understanding of them is as follows.

Operative intervention is rarely indicated as the operation itself is potentially tricky. Immediately behind the collar bone (clavicle) are a number of large blood vessels that can easily be damaged by operating on the bone. If anyone has ever seen orthopaedic surgery they will know that large forces and big tools are involved. Plus, there are the risks of any surgery, ie. infection, anaesthetic etc..

On the other hand, these fractures almost always heal well within about 6 weeks and cause little long term limitation.

So unless you are a professional athlete who needs to get back to 'work' ASAP, or have a complex fracture (3 parts is not too uncommon), it is unlikely that taking the risks associated with the operation would be worthwhile. Add to this that most of us only have access to surgeons who don't do these operations every day.

Good luck healing!

Darren Powrie
Australia

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