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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 June 13, 2005

Thyroid issues
Hypertension treatment and racing
Training for more speed at LT
Getting back on the bike
TT setup on normal road bike
Pelvis support with a new saddle
Powercranks question
DVT concerns
Issues in the sensitive tissues
ITB Friction
Question about foot numbness
Blood lactate measurement

Thyroid issues

Hi Folks,

I would really appreciate your feedback on thyroid issues. I am a 33 year old category 2 male with a good sprint but muscular endurance and recovery as limiting factors. I had a blood test 2 weeks ago and was told I'd have to see the doc because my thyroid numbers were a bit out. I wasn't too alarmed by this because I remembered Scott Saifer from one of your previous articles saying racing cyclists would typically have a normal thyroxine (T4) level but a thyroid stimulating hormone (TSH) level higher than the general population.

However it turns out that my T4 level is ok at 17 (normal 8-27), but my TSH level is LOW at 0.05 (0.15-3.5). So this together with a family history of thyroid problems means I have to go to the hospital to be injected with, and asked to drink, radioactive iodine then they x-ray my thyroid to see how it handles it!

Also this is 2 days before a target race. However, I phoned the consultant and he said the test would not affect my performance (though he was surprised that I was a bike racer as someone with overactive thyroid would have weak legs!).

Previous blood tests have come out fine and I have not felt any different lately. However, my family has always suspected I also have a thyroid problem and my energy levels have always been up and down. What do you guys reckon - I'd love to know your thoughts before I see the doctor.

(Extra information: I sleep an average of 7hrs/night with one or two 10-minute naps through the day, train an average of 7 hrs/week with a mix of easy and hard rides. Been training now for five years. Four years ago food poisoning put me in hospital for two days, then three months off work and the bike with post viral fatigue.)

Ross

Kelby Bethards Replies

Ross,

I would be surprised also that you do well in races given a thyroid problem...do you have a confirmed diagnosis yet? The ups and downs make me think a bit about Grave's Disease - autoimmune thyroid troubles. It can give you a waxing/waning picture of energy and TSH and T4, and so on would vary over time. TSH can be varied among people and although it can be higher in some, the fact yours is lower than the population warrants looking into, which you are doing.

It may be that there is nothing wrong and your TSH is just lower than the populations, but the Iodine study and so on are definitely worth while to prove or disprove various conditions.

Hypertension treatment and racing

Hi,

I am a 55 year old rider who has been racing MTB for the last three years. In January I was hit by a car and had damage to my kidney that resulted in hypertension. According to my doc and the literature, this kind of damage sometimes repairs itself and the hypertension eventually subsides but until it does it needs to be managed medically.

My nephrologist has me on an ACE inhibitor (lisinopril, 40mg/day) and this dose has kept my bp in a normal range (125/75 vs 190/96). Prior to the accident my normal bp was in the 130/75 range. Two weeks ago I rode my second race of the season, it was pretty hot, 85-90 F, but I was riding reasonably well for the first hour of the race, however after that I progressively lost strength to the point that I had to abandon the race with less than 1/2 mile to go. I was very dizzy and almost couldn't lift my bike onto the rack after the race. The symptoms felt like low BP, so I checked it and it was about 95/55, which for me is way low. It remained low for 48 hours after the race. My questions are: what happened, can I do something to avoid it happening again? Is racing not compatible with treatment for hypertension?

Gary

Boulder, CO

Kelby Bethards Replies

Gary,

So, from what I gather, you are having some hypotensive episodes and it may be necessary to cut your dose in half of the Lisinopril. Treating HTN is possible to race with and you would not be the first to race on meds for HTN. Unfortunately, the low BP episodes can be a problem. A lot of BP meds work by decreasing the effective circulating volume and by relaxing smooth muscle in the blood vessels. SO, if you become dehydrated (further lower circulating volume), low BP ensues.

I would go see your doctor about this and see about decreasing your dosage - your kidney may have recovered enough function that the BP med is causing trouble.

Training for more speed at LT

Guys,

I'm a weekend cat 5 racer mostly interested in TTs and the occasional road race in NJ. My resting HR is 48 and my max is 185. I am 42 years old. I train with an HRM (no power) and have noted the following in my training as far as HR zones then 148bpm is zone 1-2 my recovery rides:

148 - 158 zone 3
159 - 168 zone 4
168 zone 4a ++

185 is the highest I've recorded my HR (a weekend club ride) in the last year.

My HR zones are based on current experience and the occasional 30m test ala Joe Friel

I have a very simple training schedule that adapts easily to a lifestyle dictated by home life. With early Nov-Apr mostly indoors on the trainer 1 to 1.5 hours 3-4 days per week doing mostly zone 2 work with some low cadence big gear intervals thrown in 1 -2 days per week during the regular workout. I also do a mostly upper body workout in the gym 2 days per week all year that may include running when off the bike Once I can get out on the road more I start an interval schedule that gets progressively harder over a three week phase.

One day near the beginning of the week I do 170-174 bpm for 3 sets of 3mins on and 1.5 off repeating 3 to 4 times. ( I increase the number of sets or time on during the 3 week phase). One day near the end of the week I do 2 3 or 4 steady state intervals of 20 to 30 mins at 162 - 168 bpm on and 5 mins off. again increasing over the 3 week phase. The usual duration of any one ride is 1.5 to 3 hours. Any other day I can ride is a recovery ride mixing in short hill climbs (they are all short here) or into the wind big gear power work. The 4th week is a recovery ride only that might include some phonepole sprint intervals in. 8-9 hours per week is really the max that I can train when I can get on the road.

I can ride at what I think my LT is of 168 for the 40k TT's. My goal is to break a one hour TT on a mostly flat South Jersey course. To do this I have to produce more power at LT what do I need to change? My current personal best is 1:06.11 in a 40km TT.

Mike B

Michael Smartt Replies

Mike,

To improve upon your past 40km TT performance, the first thing we need to do is look at the specific demands of the 40k TT so that your training can head in the right direction (which isn't to say that you need to ignore other aspects of cycling performance, it just needs to be your priority in your long term planning). So, just what does that mean?

First of all, by definition, a 1-hr effort is equal to your maximal steady state intensity (88-92% of max heart rate) or Long TT power, as we define it at RST. Training your Long TT power involves maximizing your aerobic adaptation and steady state performance at your Lactate Threshold (1-mmol above baseline or ~2.5mmol), your Maximum Aerobic Power/VO2max - see this article - and your specific Long TT intensity. Performance in all road cycling events is highly correlated with LT and MAP, however, steady state training needs to be your priority for maximizing your ability to time trial; as opposed to criteriums that demand the ability to repeatedly surge for extended periods.

It's hard for me to comment on the heart rates and zones you are using, as determining your maximum heart rate and zones are protocol specific. But based on the logistics of your workouts, I can say this: your 3min intervals w/1.5min recovery are likely to be more intense than your Long TT intensity (as you noted in the heart rates you see), but not as intense as your MAP due to the short recovery period. Your 20-30min intervals are really just 5min intervals repeated several times, so to improve the benefit of this workout, that is, presumably at your Long TT intensity, you need to increase the duration of these intervals to 15min+ without stopping and accumulate 30-60min in one workout.

The other factor that is perhaps even more important is how you set up the periodisation of your long term program, beginning in the winter and taking you right up to your goal event. From the information you have given, this likely means adding some higher intensity training during the winter and following a progression of more specific training phases that better builds your physiologic capacities (as mentioned above) before moving to 40km specific training.

Also, aerodynamics, nutrition, recovery and your attitude will all contribute to your ability to break an hour.

Getting back on the bike

To recount the statement of the people in the ICU; "here we have a 52yo male cyclist who crashed during a recent racing event, with multiple fractures and a query pneumothorax". As a result of this I had over 28 fractures of my left rib cage, and clavical and lung damage requiring one week's hospitalisation and a painful eight weeks convalescing. 10 weeks on I am 99.8% and was back at the gym at four weeks and on the bike at six weeks. At 10 weeks doing 300km/week and thinking about racing.

I am 71kg and come from a 25-year competitive running background but now seriously addicted to riding. I have only been on the bike for three years, and have really only been racing for nine months, but find myself with very skilled/experienced riders in A grade Vets.

I have a few questions:

1. I have a titanium plate on the left collarbone should this be removed (my surgeon says no)? I have heard people say that if you break it again the screws can make a hell of a mess as it disintegrates.

2. From what I've heard the number of broken bones sounds like a bit of a record - should I be concerned about bone density considering age?

3. I high sided at 50kph and smacked the bitumen very hard, landing on my shoulder with little, or no sliding involved. As people said there was plenty of air but not much style. Is there an art to falling?

4. Part of the reason for my accident is my in-experience - my bike handling skills are not brilliant (and probably out of step with my excellent fitness!), and my confidence in this department is down. Do you know of any publication that has exercises for developing balance and skills on the bike? I marvel at people and the way descend or put on or take off clothing as they ride - It seems like everyone is supposed to know how to ride a bike it does not seem to be taught. Is there anything for the older/new rider? Thanks - but highly embarrassed by it all

Alistair Muir

Adelaide

Kelby Bethards Replies

Alistair,

Well, it sounds like you did a number on yourself…

1. No, you do not need to get the plate removed. Your surgeon know better than I, but in general, they leave them in place.

2. Given your age, bone density is a concern, but all bones will break with enough impact. So, it is not like you had a fracture for no reason, and I don't know how anybody can have 28 fractures in one side of the rib cage…unless they were counting every crack.

3. Some will say, YES, there is an art to falling, but it is a reflex that is learning with cycling over time.

4. Bike skills - lots of ways to do this, even going way back to the olden days...set up cones in the grass and have a "play" criterium, that way if you fall you hit grass. (BE CAREFUL, make sure you are healed first).My college roomies and fellow racers would have bumper bike "contests", where we would ride around in a grass field trying to knock each other over and the last one upright wins.

5. MORAL of the story - any pack riding is a skill...look to more skilled/experienced riders for advice on what you need to improve.

TT setup on normal road bike

Hi guys,

Can someone please give me a few pointers with regards to the ideal setup for using your standard road bike in a short distance TT, 20-30miles (30-40kms)?

I realise that everyone is different, but surely there must be a few general do's and dont's. My frame is a Giant TCR Carbon frame 2003 Team ONCE gold edition, so it has compact frame geometry. I use a set of 3T BIOARMS clipon bars onto my ITM Millenium handlebar.

I have a few questions that I'd like to get some feedback on:

1. Do I keep my existing saddle position, or should I take it a bit forward and drop the nose a bit?

2. As a general rule, how low should you drop you handle bar below the existing position to accomodate the added height of the TT bar arm rests?

3. How wide or narrow should the arms rests and the TT-bar extensions be.

4. Should the bar extentions be narrow and paralel to each other, or should the pads be a bit wider with the bars extentions pointing inwards?

5. What's the ideal position for your arms to rest on the pads, ie which part of your forearms should be resting on the pads? I realise there can be many different settings for various people, but some pointers would be very welcome.

The 3T BIOARMS are very adjustable, so almost any position is possible to achieve with these TT-bars.

PS: Oh, and another interesting question. What would give a better rolling resistance combined with aerodynamic advantage. A 23, or a 20mm tyre on the back wheel? (They will be sitting on a set of Spinnergy Rev-X Superlight clincher wheels). I'm also already assuming that a 20mm tyre on the front wheel will be more aerodynamic than a 23mm tyre?

François Esterhuizen

Worcester, South Africa

Steve Hogg Replies

Have a look at this post. That should cover what you need to know. The only question mark in my mind is that Bio Arms are not as adjustable as some other aero bars, and even when pulled all the way back can still be too long for many riders on a standard road bike with drop handlebars. The taller you are the less it is likely to be a problem. If once you have read the above post you have any follow up queries, let me know.

François Esterhuizen Responded:

Some further comments relating to the post and your comments:
1. I do make an effort to get out on the road on my TT-setup at least two weeks prior to any TT event to get accustomed to the different riding position.

2. With regards to the Bio Arms; what I've already done, was to cut off a short segment of the bars that usually would extend past the bottom of the handlebars.

3. Before I started cycling I used to be VERY flexible, and even now after neglecting my strecthing a bit, I'd say that I am definately a lot more flexible than most cyclists, especially in the lower back and hammies region. (I still take time out once a week for a good stretching routine or a yoga class), so flexibility on the bike is not a problem.

4.In your article you mention that the bodyposition should remain the same when switching between the drops and the TT-bars. I'm a bit unclear on this one. What I've always done, is to drop my stem by about 50mm, to compensate for the added height of the TT-bars. Should I compare bodyposition in my normal Road racing setup with the position on the TT-bars, or should I check that my position remains the same from the drops in the lowered handlebar position to the position when switching to the TT-bars.

5.Would it be advisable to fit a shorter stem to bring the TT-bar pads closer to my elbows, or rather bring the seat a bit forward, changing the position over the BB / pedals? (And if I move the seat forward, do I keep the same seat angle)

(All these questions are related to doing 30-40km TT events, no big climbs, just a few "drags" and no techincal desents, mostly flat courses.) Oh and by the way. I prefer pushing relatively big gears at about 85-95 cadence, instead of spinning a lighter gear at higher cadences.

Steve Hogg Replies

Re 1: a good idea but the position should be so similar to your normal setup that this should not be necessary.

Re 2: also a good idea so that you don't dekneecap yourself when riding off the saddle. My biggest issue with Bio Arm is there lack of adjustability compared to one or two other bars. Because of the kink in extensions, there is a limit to how far they can be retracted. For many this is an issue, for a minority it is not. Whether it will be an issue is largely determined by the degree of hip and lower back flexibility and length of torso and arms. Generally speaking, for a well positioned road rider using drop bars fitted with aero bars, the front of the aero bars will be somewhere between slightly behind the brake levers to 2 - 3cm in front of the brake levers

Re 4: what I meant is that let us assume the case of a well positioned road rider using drop bars fitted with aero bars with plenty of adjustment potential [ the Profile Carbon Strykes are about the best out there in this regard]. The aero bars should be positioned so that when the rider moves from their normal drop bar position to the aero bars the torso and neck position should not have changed. Only forearm width should change. There is an argument that for a short TT the rider can be a bit lower and I am open to that PROVIDING comfort and respiratory efficiency are not compromised.

If comfort is compromised to any real degree the body will autonomically enlist whatever musculature it has to in an attempt to stabilise or protect itself. This is usually only accomplished at some cost in performance. Additionally, if the bars are too low, a lot of the torso, shoulder and neck musculature that may be put under unnecessary pressure are muscles that are used for breathing. They can only perform one of the two contending jobs really well at a time. It is not uncommon to see riders who are so aerodynamic that they go slower, not faster.

Re 5: This is one of the design problems with Bio Arms; i.e. negligible ability to adjust the cups fore and aft. If your pocket will stretch, get a pair of Profile Carbon Strykes as mentioned above. They have the ability to adjust the cups up/down, in/out, forward/back, angle adjustment of cups is variable, the extensions are massively adjustable separately as well as there angle from vertical where you grip them. If this is not possible, yes you may have to sacrifice your road bar position to achieve a decent aero bar position for your TT. The cups should be closer to your elbows than your wrists

I hope this all helps. Let me know how you get on.

Pelvis support with a new saddle

Hi - I am a 6ft, 180lbs, 36-year-old rider doing 8/9 hours a week training. Turns out that following a recent osteopath (who treats cyclists) visit that my pelvis was out of kilter - one side higher than other. This had also compounded poor flexibility in my middle back and loaded up my neck so I got very tense up top when on longer rides. My osteo corrected the alignment and gave me some new (and already effective) stretches. However, he commented that my saddle may be too narrow - I have been using a Fizik Arione and felt that my pelvis moved around a lot but wasn't sure.

Also, I was getting pretty numb in the perineum on that saddle. So I went to my LBS and they measured me using the Specialized Body Geometry system. They recommended the 143mm Alias which I have been using. After a few rides this saddle definitely supports my sit bones - I have never felt that so clearly. More importantly to me, the numbness has completely gone which is great. What's not so good is that I am getting sore where the sit bones meet the saddle. It does seem to be getting easier after a couple of weeks but it's still sore. Is this just because my sit bones aren't used to supporting my weight?

Secondly, I have started getting "cyclist's palsy" - the pins and needle feeling in the hands and wrists. This leads me to think I have two much weight on the hands but the saddle is as far back as it will go. I tried lowering the saddle but that seemed to effect my pedal action and was not very comfortable on the saddle. I plan to get measured again at the bike shop for overall fit - but does anyone have any suggestions as to what's going on? Thanks.

Stuart Collingwood

London, UK.

Steve Hogg Replies

From what you have said, it may be that the tissue covering your sit bones needs a bit of time to cope. Try tilting the nose of the seat up a fraction. Depending on your degree of flexibility, this may load a greater area of tissue and be easier to cope with. With the hand numbness; either the bars are too low or the seat is too far forward [which causes a body weight shift forward so that that weight has to be supported by the upper body] or perhaps a combination of both. Ideally you need to find someone to position you who does not take a measurement based approach to the task of positioning you, but takes a capability based approach. If for one reason or another this is not possible, there is a stack of stuff in the archives.

Stuart Collingwood Responded:

I have tried raising the nose a little and that seems to help - both with the sit bone pressure but also hand numbness. Also bought some Specialized Body Geometry mitts and they have been much better - really padded. My saddle is as far back as it will go - so I'll persevere with the saddle. Another rider on my coaching group said he had similar problems with the Alias but after 500 miles it was sorted. I haven't ridden that many yet - and it does seem to be getting easier.

As for bike fit - do you know anyone to recommend in the UK?

Steve Hogg Replies

I find that for many people a seat doesn't 'feel' level until it is slightly nose up. Re the gel gloves; a good idea but one that only masks the problem. You may now be able to cope in the sense that there is an absence of hand numbness or pain but you are still supporting unnecessary weight with your shoulder complex. This can affect respiratory efficiency when riding hard as a lot of the musculature that you would need to use to support that weight is best used to breathe with. If those muscles are involved in supporting weight unnecessarily then you won't breathe to best efficiency.

In your shoes I would be looking to have someone knowledgeable position you. If this isn't possible, get hold of a seat post with more setback than yours and have a play. Even moving your seat back 10mm can make a huge difference. If you do this there are plenty of posts in the archives that will point you in the right direction. After you have read them, if you have further queries let me know.

Powercranks question

Hi Steve,

Just wanted to say I've enjoyed your contributions to Form and Fitness, and that I think you take a logical, and thus defendable, view of fitting bikes to people which as a science geek I find commendable. I have a long history of back problems which have slowly transformed over the decades. The most recent incarnation has been a twisted pelvis, with both SI joints measurably out of alignment, and a string of L5-S1 disk herniations, once each of the last 5 winters, mostly when XC skiing. Various professionals have pointed out various weaknesses and tightness over the years, but being a bit slow I didn't put everything together until last autumn.

As you know, life is not a symmetrical business and the fridge door handle is on the same side every morning. Multiply that up by everything we do over the course of a day, for nearly five decades in my case and you can end up pretty screwed up. You can take a symmetrical exercise like cycling and do it asymmetrically because of your previous alignment issues and only reinforce your asymmeteries.

A year or so ago, at the start of the last bike season, I took a bunch of the exercises I had been given and did them religiously and that seemed to help. I added a good deal of stretching (I took your recommendation of Kit Laughlin's book) and that helped some as well although I don't seem to gain any functional range from stretching. For complex reasons I bought a pair of Powercranks to try adding a dynamic exercise therapy, and of course now you realize why I might be writing. I should point out that I could envisage the hip flexor problem before I made the purchase but I knew my hip flexors were both wimpy and long, but not symmetrically so.

I fitted them to a bike on a windtrainer (this was last autumn - no light midweek, plus you'd have to be crazy to start these things outside, sorry Kemp) and could only ride them a few minutes at a time before my hip flexors gave out, and it didn't improve dramatically for several weeks. I eventually worked my way up from 5-6 sessions of 5-10 minutes to two sessions of 30 and 60 minutes each week. Why did I stop at 90 min a week? More than 90 min a week on a W/T in the basement? I'm not crazy! But here's the thing - no back problems this winter. I think it took an integrated approach of strengthening and stretching to get the job done and the PCs were definitely part of that. 30mins at 80rpm is 2400 reps. I will never get 2400 stretches done in one session. So now it' been cycling season for a while in sunny Wisconsin, and I tried taking these things out on the road. Well, it's a whole different game. First there's the weirdness to get used to - when you shove off and go to click in the pedal isn't there, it's still hanging at the bottom.

The smooth spin I had down on the W/T is almost impossible to retain on our bumpy tarmac. If you get off-sync on the W/T it's an easy matter to kick the trailing pedal through to catch up, while on a rough road it's hard to even tell where you are, and the road keeps messing you up even while you are trying to correct. I also realize that on the W/T I will tend to sit up relatively "tall" for periods, which takes some of the stress off of the flexors, and I am not able to do that on the road. I'm not sure how to integrate them into mid-season training when I have very limited training time, so what has happened is that about once a week or every other week when I get off work late and don't have much time I take them for a spin through a local park and bike trail- 45-50 min, tops. It's not structured training, but along with the stretching and strengthening exercises seems to be keeping me pretty good.

They have definitely changed how I pedal a bike. I'm a spinner, never have been able to push a big gear, overload with the whole lactate effect very quickly if I do, and no amount of stomp intervals or power pyramids has fixed that. Maybe I should say "no amount I've been prepared to do". But this season at the first TT I rode unaccustomedly large gears and produced a good time (for me). I think there's something there about the timing of muscle firing altering the recruitment of muscle fibers, maybe delaying the recruitment of fast-twitch bundles. I suspect that Rotorcranks have the same effect, achieved a little differently, but I have no experience with those. As the season goes on and the ratio of normal-bike riding to P/C-bike riding has increased, I find myself reverting to "spinner phenotype". Saddle sores: Definitely! You have to be one with your saddle.

Reason - of course, no cheating a little weight off using the back pedal. And if there's one thing these cranks demonstrate, it's how much weight we leave on the back pedal, even in a fast fluid spin. Of course this meant that I had good calluses before the outdoor season started. I see the major use of these things in my hands will be off-season wind-training, and if I am able to use them to help keep my back OK for the foreseeable future I will feel I spent well, but I guess I wouldn't recommend them to anyone who already had tight hip-flexors. I look forward to reading about your experiences with them. Something I didn't try, but might be worth experimenting with, would be to start with the saddle a bit higher and further forward than your normal position, to open up the hip angle and take the pressure off the flexors initially, and then gradually dropping the saddle back to the normal position as you build strength.

Mike Capp

Steve Hogg Replies

Thank you for taking the time to comment about your PC experience thoughtfully and with insight into your own situation. If, like you, everyone thought about the how's and why's of what they do, they would be a lot better off.

I had better state now that I try hard not to have unreasoned bias against any product, method, thinking or whatever. I am a big believer in the empirical test. If something works and does no harm in other areas, then it is fine by me, at least with regard to that person. What I have posted to date has been the product of my experience and I am happy to be proven wrong on anything, because the worst case is that I have learnt something, which is no bad thing anyway.

You mention that you had loose hip flexors in an otherwise tight body. THAT is unusual. Also you have used the Power Cranks with a commonsense approach. I seem to have come across a majority of PC users who are tight in the wrong areas to start with, and then in many cases don't adopt a commonsense approach to their use. They think they have bought a silver bullet. I have no doubt that there are other users out there who don't experience problems, but the nature of my business is that I get people who have a problem whether it be ache, pain, injury or sub performance. I don't see PC's every day, but invariably when I do the situation is that the rider either had no problems they were aware of prior to PC use OR they had problems that were exacerbated by PC use.

What I am saying is that perhaps it is the nature of my business that has led me to form my opinion of PCs. What your experience suggests to me is that there are others out there with problems that have been helped by PC use [and a sensible attitude to their use]. I have told Frank Day that I will use them exclusively [as my body allows] for a minimum of three months before coming to a firm opinion as he feels that the bane of his life is reviewers who because of time pressures, don't give them a fair go.

I have plenty of problems myself, though well managed in the main and it will be interesting to see what effect PC usage has. One problem I don't have though, is tight hip flexors. Stay tuned. You mention Rotors. I did a review for a magazine over here some years ago on them and the pluses were that you can ride up any hill faster and in a bigger gear, sub 90 rpm big gear riding on the flat is easier than with normal cranks and it only took me 30 - 40 minutes to become accustomed to them. The first few minutes were a worry though!

The negatives are that at any rpm over about 95 they were no advantage, they are heavy, and the chainrings are further out from the centreline of the frame than on anything else out there and so chainline and the number of useable gears suffers. I lent a pair to an elite rider I know for further evaluation and he improved his best time on a VERY steep 3km hill climb by 45secs which is almost incredible. He took them to the Tour of China or maybe Tour of Langkawi I can't remember and didn't like them nearly as much. He is the consumate pedaller though. His most efficient TT cadence is 105 - 108 rpm and this is a sub 50 minute 40km TT kind of bloke. I suspect that his high rpm style negated any potential benefits from Rotors.

DVT concerns

I was recently diagnosed as having a Deep Vein Thrombosis (DVT) behind my right knee. This is my third DVT - with the first two (1986 upper right leg, 1994 behind left knee) I also had lung embolisims . I am 56 years old, for the past 15 years I have commuted to work by bike - I ride a total of approximately mind. 250-300 km/week. I am 6'2'' and weight ca. 265 lbs and other than old football injuries (knees, ankles, fingers, etc.) and my obvious weight problem, am relatively fit - no heart, respiratory, blood pressure or muscle problems. I am a recent member of Weight Watchers and a non-smoker.

Each DVT has occured in June when the weather was relatively hot and humid. With the latest DVT, ca. 2-3 hours after a 3 hour ride I had pain in the hamstring area and the next day also behind the knee. To date, no reason has found for the three events, although the doctors did discover that I have Thalassimia Minor -ca. 8%. At work I am sitting most of the day, but daily during lunch I go for a 30 minute walk. I have always perspired quite heavily and one thought was that I don't drink enough water.

Until now, I drank a lot of Diet Coke and Pepsi Light. I am currently taking an anti-coagulant (Macumar) which I believe is the German eqivalent to Coumadin and I may have to continue taking this for quite some time. I have been wearing individually fitted compression stockings for years now. I have recently learned that my adult niece and nephew have also had DVTs. My doctors say that I can resume my normal activities - including cycling.

Questions:

1. Isn't it unusual to suffer from DVTs with my level of activity?

2. Any suggestions as to how to avoid/mimimize this problem in the future?

3. I had planned a Trans-Alp tour next year (the relatively flat tour from Munich to Verona), any contra-indications to extended tours?

Thanks in advance for any advice.

Andy Hines

Kelby Bethards Replies

Andy,

I will say that you need to be in continuing your quest with your doctors for answers of why you getting these DVTs. It is unusual for someone this active to be getting recurrent DVTs unless you have a blood dyscrasia or coagulopathy.

Now, I have only had a few patients with Thalessemia...and I am reading up on it. I suppose that it could predispose you to getting clots, but I would also mention that your doctors should be looking into the coagulopathies...Factor V Leiden, Protein C & S deficiencies, etc.

You will likely be on Coumadin for a very very long time...if you were my patient, I don't know if I would ever take you off of it. You have proven, family history wise and personally that you are a "clot former" so you need to be cautious of this. In regards to doing your activities, I think the doctors you have seen are correct in that you can do your activities.

In my simple, monkey brain, I think of DVTs as follows...if blood sits still it clots, if it moves, it doesn't. So, to minimize the future possibilities, I think the compression stocking are good and avoid prolonged sitting without movement. I would also not think there is any contraindication to extended tours...it wouldn't be any different than riding every day after being at a job.

Issues in the sensitive tissues

The Fitness Letters are my favorite part of your web site. I'm seeing a urologist in 2 weeks for aching testicles. Do you experts have any advice for me as I work through this problem?

I'm male, 57, 6'0", 170#. I ride over 5000 miles/year on the road, some TT.

I'm in a comfortable Fit Kit position on my bike with good power and no other aches or pains. About eight weeks ago my testicles started to ache slightly. The problem worsened until I needed an occasional ibuprofen and I made an appointment to see my doctor. He checked for major problems and referred me onwards to the urologist. I think my problem's caused by riding a too-narrow saddle this Spring (since replaced with a medium-width Specialized Alias that gets me up on my sit bones) and worn-out cycling shorts that did not keep the boys up out of the way (since replaced with premium shorts with lots of support).

Could it be that minor battering of narrow saddle and loose shorts, over time, caused my achers? The new saddle & shorts do help. I'm improving and so continuing to ride. I'm hoping that it'll completely heal, but of course my Big Worry is that something else is wrong so I'm still going to see the urologist.

Any advice to give me? Anything to pass on to the urologist?

John Crankshaw
Grand Rapids, MI, USA

Steve Hogg Replies

Assuming that there is no pathological issue, the two things that spring to mind that can lead to symptoms such as yours are a seat a touch too high and a reach out or down to the bars that is just a bit more than the rider can cope with. Had you made any positional or equipment changes in the month or two prior to the symptoms arising? If so, let me know and we will proceed from there.

ITB Friction

Hi Steve,

I'm a local A grade rider both cross country and road (motly road), and up until recently I have had no knee problems whatsoever. However, roughly four months ago, while completing a series of strength effort intervals on the road bike, I started to develop lateral knee pain in my right knee. This was subsequently diagnosed as severe Iliotibial band friction syndrome, and put me off the bike for a number of months.

What has me confused is that my bikes (road and mtb) and shoes / cleats had both been set up professionally roughly 9 months prior to this injury and I had trained and raced on them heavily with no worry, including strength effort intervals. On the road I ride Time RXS pedals, and off road I use Shimano SPD.

I know you answer a lot of similar questions regarding fit and knee pain, but none specifically regarding the mechanism of injury resulting in ITB friction. Thus, my question is two fold - Why now? And what have I done wrong to suddenly induce such an injury?

Any insight would be great as I'm only just now climbing back on the bike after 4 months, and definitely do not want a repeat performance.

Matt C.

Perth, Western Australia.

Steve Hogg Replies

The short answer is 'I don't know', but perhaps between us we can come up with something. You had been trouble free for some time and then bang - problems.

What if anything changed shortly before that?
Were you training harder than normal?
Were there any equipment changes, seats, bars, shoes, new cleats etc?
Were there any positional changes?
Were your cleats particularly worn?
What shoes do you use?
Where is the ball of your foot in relation to the pedal axle?
Where you stretching less or under more than usual pressure or stress in other areas of your life?

Let me know the answers to these questions and anything else that occurs and maybe there will be something to advise on.

Question about foot numbness

Hi - I have been experiencing foot numbness after a couple of hours into a ride. Once I notice numbness, I wiggle my toes and the numbness seems to go away. I wear Sidi G4 road shoes with Look pedals/cleats. Any idea what can be root cause?

Thank you for your advice.

Steve Hogg Replies

There are a number of reasons. Sidi Genius shoes with their ratchet system are very easy to inadvertently overtighten. Sometimes this is not evident until you have ridden some distance and the feet swell slightly and numbness results. Try not tightening the ratchet quite so much and see whether this is of help.

Next, is there any feeling of lateral compression in the forefoot? If so, it may be that the shoe is not quite wide enough and the nerve plexus between some of the metatarsal joints are being loaded. If this is the case ease off the adjustment of the front two straps slightly.

If after you have done this and there is no improvement, check this cleat positioning post, and this one. Having cleats too far forward on the shoe is a common reason for toe numbness on a bike.

Blood lactate measurement

Sir,

In response to your reader's question about blood lactate measurement, I agree with your experts that 30 second stages are far too short to obtain meaningful blood lactate data. I would suggest that stages have to be at least 3 - 4 minutes to obtain any meaningful data as it is paramount that the blood lactates in the early stages of a test achieve near steady state values (i.e. the mechanisms of lactate production are balanced by the mechanisms responsible for lactate removal). If this has been achieved then one often sees the blood lactate concentrations for the early stages of a test equal, or very close to, the resting blood lactate concentration.

One is then able to plot the blood lactate concentrations against power and visually identify a point at which blood lactate dramatically rises above these near to resting state values. This is your lactate threshold (LT) power output, although I would warn you there are a number of different definitions of LT.

The only problem with these continuous tests is that if the stages are too long the subject can become very fatigued, so the stages have to be short enough for the test to be completed in a reasonable amount of time and not too short that near steady state is not achieved. Although I use protocols which combine VO2max testing with lactate profiles for convenience, if I have sufficient time, I prefer to separate the two tests so longer steady state stages can be obtained without worrying about the subject becoming too fatigued to obtain a meaningful VO2max score.

An alternative test is to determine the maximal lactate steady state (MLSS). There are protocols available for this, but basically this is a discontinuous test where steady state blood lactates are obtained over longer duration rides (approximately 20 minutes) at a constant power output. During these rides blood lactate is monitored and plotted. The test is repeated following sufficient rest (this may have to be performed over a number of visits to the laboratory) until a power output is reached where the athlete cannot maintain a steady state lactate. The highest power output where steady state can be achieved is MLSS. This method has greater practical application because it identifies a power output that can be maintained for extended periods and should be more closely related to the lactate response during a time trial. The disadvantage of this test is that it is very time consuming.

Mark Walker, Applied Exercise Physiologist

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