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Mont Ventoux
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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

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.

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.

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.

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.

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.

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 August 15, 2007

Bike Size
Insulin pump therapy
Leg Length
Bike fit and cleat placement

Bike size

I live in East London. Is it possible to send you the appropriate measurements for you to assess what size bike I require? Recently I bought a Cannondale Synapse, frame size 47 compact and it is too small for me. I just cannot get comfortable on it. I have consulted several people who are respected in the cycling fraternity who have confirmed the wrong size, but would like your opinion as well before embarking on buying another frame. Which measurements would you require?

Carol
East London, UK

Scott Safier replies:

The short answer is "no", it is not possible to prescribe a frame size strictly based on any body measurements with total confidence that the result will be a bike that is comfortable to ride. I could give you a bunch of questions to answer that might get you close, but I have another suggestion that is almost guaranteed to get you the right size bike. Go to a shop and try bikes. Have the shop employee adjust the bike for you and really test it by riding hard, taking some corners, riding it up a hill and down. Keep trying different bikes until you find one you love. This method guarantees you'll end up with a bike you love.

Insulin pump therapy

I am a 60-year-old cyclist, having been so for 46 years. I raced up to the age of 40, with a little success – a handful of wins and completion of an 8-day stage race as the highlights. At 40 I was diagnosed with type 1 diabetes, and by 50 was suffering from atrial fibrillation, a form of arrhythmia. This curtailed my cycling to 20-mile rides, generally about 90 minutes exercise. In 2002 I started to use an insulin pump to improve my blood sugar control, and removed the pump whilst cycling. In 2006, I had an ablation procedure which cured my fibrillation, and since then with the absence of beta blockers and warfarin, I have improved my ability on the bike, moving up to 3-hour + rides – approx 50 miles.

The downside of my increased endurance is that I finish these rides with high blood sugars, in excess of 15mml/l. I am currently combating this by keeping the pump running on a reduced basal dose (50% of normal, though I can adjust it to any fraction of the standard dose) and stopping every 30 minutes to take a sugar-level reading. I react to each reading by applying more insulin, more carbohydrate, or nothing, as the case may be. Although each stop is brief, I don’t really like stopping at all, and would like some advice from people who have already solved this problem, either for themselves or for others, to help me establish the most effective pump regime for my longer rides.

John Richards
Louth, UK

Carrie Cheadle replies:

You need to come to camp! Check out the Stroke-Spin-Stride camp. It was designed just for you! The director has pulled together some of the top coaches, nutritionists, and med staff in the country to come together and produce an integrated camp to address how to manage diabetes and exercise for optimal performance.

The camp was also featured in Newsweek this week.

If you contact them through the website they may be able to answer your questions more in depth regarding how to regulate blood sugars during a ride.

Leg length

My left leg has been measured by an experienced bike fitter at 3mm shorter than my right leg. My saddle is set up for full extension of my left leg (short leg). However, my saddle feels low. If I raise my saddle 2mm more that puts too much of a strain on my left hamstring. What would be your recommendation for a shim thickness if any and corresponding saddle height change.

Frank DePasquale

David Fleckenstein replies:

Before recommending any shim changes, I have two issues of concern. I would very seriously question the ability of anyone to consistently measure a 3 mm difference in leg length - research shows us that these measurements have poor validity and the only true way to measure leg length is with long leg x-rays. Secondly, I would question whether you have a true leg length difference or a functional difference due to pelvic rotation/shear and would recommend having this evaluated by a PT or chiro. The concern with shimming to make up the functional difference is that rather than addressing the root cause, you are potentially making the original problem worse. I have found frequently that by normalizing length of the hamstrings, hip flexors and hip external rotation musculature rather pronounced leg length differences suddenly are minimal or eliminated.

Bike fit & cleat placement

Thank you for the detailed response last week. I just bought a set of Specialized Body Geometry shims and plan to start experimenting, given your suggestions. However, before I do I wanted to provide some additional information that occurred to me that might help you in your diagnosis.

First off, I mentioned previously that I currently wear a Specialized BG Pro Carbon shoe, which has built in to the sole 1.5mm of varus angulation. Might I need more?

Secondly, in years past when I used to run (before an ACL tear and reconstruction ended that—on my good side by the way) I noticed that on my left foot, the one in question, I was an inside “heel striker,” whereas on my right foot I was a more typical outside heel striker. Is this an indication of valgus angulation on the left and varus on the right—or is the running motion unrelated to cycling?

Before getting my Specialized shoes last year, I wore Shimano. I still wrestled with the same issue back then, but as mentioned earlier it seems more pronounced now. Maybe it is just mental, but then I thought, “what if the varus angulation of the shoe is exacerbating the condition because my foot is really valgus”?

One last thing:

I am very flexible now. I stretch aggressively almost daily. Further, I have been a serious weight trainer for 25 years. I have very good core strength; however, I do know that my dominant right side stabilizers are notably stronger.

Before I start experimenting, can you offer any more insight in light of the additional information above?

Jim Martin
Troy,MI, USA

Steve Hogg replies:

I can give you a general picture but I can't diagnose what I can't see. I can make educated guesses as I do all the time but that isn't the same thing.Regarding whether you need further varus compensation - I don't know. Perhaps, perhaps not. That's why I suggested you visit a podiatrist or someone knowledgeable regarding feet and gait and find out what the situation is with regard to forefoot varus or valgus. Once you have done that you will have information, fact rather than guess work, that will allow me to advise you further based on hard information.

Interesting what you say about the difference in heel strike for each side. Typically, this means that there is either a leg length discrepancy (another box to tick) or a functional leg length difference caused by a lateral pelvic tilt. It can mean other things too, but they are the most likely. What it means too is that your gait isn't symmetrical. Gait plays a part in determining how we function neurally. If you gait is noticeably asymmetric, this will lead to functional asymmetries and in the end the motor control functions of your brain will be asymmetric as well.

Re the Specialized shoes seeming to make the condition worse. Yes, it may be that you have a valgus right forefoot. If that is the case, any shoe with varus compensation would make it worse. I can't stress enough that in an effort to solve your problem quickly, you need to be armed with information. It would be better to see a podiatrist or physiotherapist interested in feet so that you can find out what the story is with regard to your feet. This is infinitely better than trial and error until you eventually eliminate possibilities and stumble over the correct solution.

If you don't want to do that, try building up the outside edge of your shoe insole on your right side. If that improves things on left side, then it is likely that you have a right side valgus forefoot. If it makes the situation worse, or you get pain in the right hip or right knee after doing this, it is likely that you don't have a valgus right forefoot. The only thing that I can be nearly 100% certain of is that you function asymetrically with a tendency to favour the right side. This is the underlying general picture of the problem you have. What you need is more detailed information so that you know your own state of play and can make decisions based on what you find.

It is good that you are flexible and have good core strength. Both qualities will help minimise the effects of the asymmetric way you function in terms of pain or discomfort.

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