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.

A big welcome this week to two new members of our panel of coaches and fitness experts. Georg Ladig and Benoit Nave are the Numeric Mastermind and Coach/Nutritionist respectively at 2peak.com, a new training website that provides a daily updated, dynamic, personal training plan to help you train systematically like a pro and get in peak shape for the key events of your season. The objective is simple: to allocate your time budget ideally to calculate your individual path to peak performance.

Fitness questions and answers for September 3, 2003

Feeling my oats?
Shoulder Injuries
Top calf muscle problem
Training at altitude
The next step
Phosphate loading

Feeling my oats?

I am a 41 year old male mountain bike racer. 6ft 3in tall at 225lbs. I have been racing in my state's series, (Wisconsin Off Road Series), for 2 years and have a question about oatmeal.

As a sport Clydesdale racer, one might think that oatmeal for breakfast would be apropos. So I decided to try some for breakfast before a race, having read how good a choice it would be. This was eaten roughly 4 hours before my start time. I didn't change anything else in my pre-race race routine that morning or the night before.

The race was a struggle from the start. My legs and lungs never opened up, and I got a bad case of heartburn. The second lap was worse than the first, with me stopping to be sick twice, and not from high exertion. I survived the third lap and finished my race. After warming down I had a good appetite and felt normal.

Is this Clyde oatmeal intolerant? Normal breakfast pre-race is a couple of bagels with peanut butter and sports drink. Is there any kind of blood type related / digestive problems normally associated with oat products? Even if your answer is no, I think I have still lost my taste for oatmeal for a while.

J. Chris Daming
Luxemburg, WI

Eddie Monnier replies:

Sorry to hear that you had an unpleasant race experience but it's not immediately obvious that the oatmeal itself was the source of your troubles. Did you use milk? Could the milk have been bad? But even that I would doubt as a cause because usually when one gets sick from bad food it happens within an hour or so of ingesting the cause. And you didn't get sick for some four hours. Was whatever you put in your water bottles something you had used without incident before?

Personally, oatmeal is one of my favorite pre-race foods though I usually do not add any dairy to mine (may add some soy or rice milk though). I usually have some eggs as well for protein. And I know it's a common breakfast for pro's (eg, Mark McCormack had oatmeal with peanut butter for breakfast the morning he won the US Pro Road Race title this year).

The lesson here is never try anything for the first time the morning of a race. Give it a test run during training first.

Shoulder Injuries

A recent fall during a racing bunch sprint (rider fell under my front wheel) has left me with "acromioclavicular joint dislocation, closed". I took the 50km hr fall on my head and then shoulder. The rotation was so effective my bike only got scratched on the brake hoods and the rear of the seat.

I believe the lay persons expression is that I've buggered my AC joint. If anyone saw Robbie McEwen interviewed in his singlet during the TdF, they'd have seen what I've got - a bloody great lump on the end of my shoulder that makes it look like my arm socket is an inch and a half below where it should be. The feeling is that the end of my collar bone is about to push out the shoulder at any moment. I'm not normally a wimp but carrying a frying pan on my injured right side brings a tear to the eye.

My X-rays show the end of the collar bone sitting about an inch out of the joint where it used to very happily reside.

I'm an amateur racer, aged 37, weight 70.5kg, height 183cm training between 200 and 400 km per week. Race 1-2 times per month and am 10 months back into racing after quite a few years of casual training only.

My question is what is the best way to recover from such an injury? I'm 2 weeks post the injury and have had physio to help reduce inflammation and this has worked. Mobility at day 11 (post the fall) allows hairbrushing but I can't quite shave the left side of my face (opposite the injury), nor can I fully brush teeth with the hand of my injured arm. Can just tie my shoelaces. A surgeon has suggested I have nine weeks off the bike with only walking for exercise and carrying nothing heavier than a mobile in the hand of my injured arm.

I have a desk job (60 hrs pw) and do a lot of keyboard work and travel by airplane on a weekly basis (2-6 hrs pw).

So far my anger to the idiot who touched wheels has meant I've not felt uncomfortable but the bone sitting up off the shoulder is starting to get to me.

Erik Mather

Dave Fleckenstein replies:

Acromioclavicular injuries are one of the most common injuries to cyclists and it sounds as though you have a pretty serious one. The clavicle is connected to the acromion through a dense fibrous ligament. The acromion is the bony "hood" over the shoulder that is actually part of the shoulder blade. The problem with acromioclavicular injuries is that, whereas many other ligament are surrounded by muscle which give integrity to the joint, there is relatively little musculature to help support this important joint. Thus, any motion which tractions the arm will separate the joint. Frequently a step or "piano key" will exist where the clavicle becomes prominent because it is no longer held in place.

Look at any group of cyclists and, inevitably, a number of them will have one clavicle (or both) prominently raised. They are graded in severity from I to III. Grade I tears rarely limit riding other than pain and some initial but decreasing clicking present at the shoulder. The Tyler Hamilton approach (suffer but still ride) is appropriate, although some German director sportif may question if you truly have a tear... Type II injuries are moderate tears and should have minimal pressure put on them for 2-3 weeks - the turbo trainer is the training equipment of choice. Type III tears are complete tears that yield an unstable joint. While surgery is definitely an option for these individuals, it doesn't always guarantee a stable shoulder. While the pain will eventually calm down, the concern is that the joint will be unstable, have early arthritic changes and lead to a surgery known as a distal clavicular resection, where the shoulder-end of the clavicle is removed.

Having had two grade II AC ligament tears on each shoulder (I have since learned to keep a bike upright) and having worked with numerous athletes with this problem, I can say that your options are limited. Taking time off may allow the acute injury to heal, but if the scar formation is not adequate or occurs with your clavicle in a displaced position, you will have long term difficulty. Your injury sounds severe enough that I would consider having a sports medicine-based orthopedic surgeon examine it - I have two cyclists currently as patients that have done very well with stabilization procedures and are progressing back to cycling very well.

Top calf muscle problem

I am 33 yrs old, 5ft 7in tall and weigh 8st 10lbs (maybe a little underweight) and I have had a nagging calf muscle problem since about the start of the year.

It centers around the top left hand corner of the left leg, (the leg is just slightly longer than the right though not massively so my physio says) the feelings I get in are hard to describe, I know if you massage the area with fingers you get the feeling as if being winded, or just tighter than the other side.

I have been to my physio about the problem (brilliant physio - former pro cyclist Martin Earley) he massaged it and generally freed it up, he asked me to bring my bike along to check the position. The position turned out to be too low and we agreed to raise it and see after a few weeks if the problem would go away.

It didn't, I intuitively thought the height might be a little too high (because if I peddled backwards I could feel it in the ham-string top calf muscle area) I lowered it and after 2 weeks the problem has eased.

When I do feel it on the bike it's during hard efforts. I stretch afterwards, but I've a feeling the quad stretch maybe irritates it (bending the leg back towards the buttocks) & like many cyclists I don't have a great degree of flexibility. On only a few occasions just lifting the leg into certain positions the next day (getting into drivers seat in the car, lifting the leg up I can feel it in the calf muscle ham-string area).

I ride on average about 3-4 times a week and average about 30miles a ride, I will do about 2 full on rides and 2 easygoing rides in that week, I don't ride competitively though I want to, but this ain't helping!

I would be grateful for any advice you could offer.

Neil Mchugh
UK

Dave Fleckenstein replies:

This doesn't sound like the normal calf problem to me, and I would be suspicious of two possibilities.

First of all, I have concern that your pain may actually be radicular pain generated from an issue in your low back. More than once (in fact more times than I can count!) I have had a patient come in with unresolving calf or hamstring pain, a long history of treatment to the apparently affected area, only to find out that the pain is due to a disc herniation or nerve root irritation. The hint for me is that the pain you have getting into the car or extending the leg puts minimal stress on the calf, but significant stress on the disc and nerve root. There are actually a number of medical tests based on this phenomena that assist in determining the root cause of the pain. The calf is a frequent area for nerve related pain to exist, and the upper, outside portion of the calf is a very frequent area.

The second issue could be a local hamstring strain. The hamstrings (actually 4 muscles) insert at the upper part of the calf and can often be mistaken for the calf. Again, your symptoms are related more to straightening your leg (hamstring tension) than flexing your ankle (calf tension). When the saddle is raised (which increases hamstring tension but decreases calf tension) you feel worse. When you lower it, reducing hamstring tension, you feel better.

Either way, I would consider having this reevaluated from both a neurological perspective (neural tension testing, reflexes, spine testing) and a flexibility perspective , paying close attention to the hamstrings.

Training at altitude

Here in the Rocky Mountains, many of us live and train at high altitudes, sometimes as high as 9,000 feet above sea level. I understand that living at such high elevations is beneficial, but training here can be detrimental, especially when it comes to higher intensity work. Sometimes we can travel quickly to lower elevations for training sessions, but often times this is either not possible or not convenient.

1) What are the consequences of long term high altitude training?

2) What types of training should be done at lower elevations, when possible?

3) During an indoor trainer workout, would supplemental oxygen overcome the problems associated with high-altitude training, or would it create more problems? If supplemental oxygen would help, how might a cyclist gauge and control the amount of oxygen necessary to simulate lower elevation training?

W. Lane
New Mexico

Brett Aitken replies:

The effects of long term altitude training are still highly debatable but many studies have shown that there are some negatives to altitude training. These include a reduction in muscle mass along with lower levels of oxygen uptake, lactate levels, heart rate and power compared to sea level.

All this points to the fact that there is an overall reduction in the quality of sessions which focus on intensity. It is therefore recommended that when you do have the opportunity to train at sea level you should predominantly focus on sessions which will test your limits of power output and raise lactate levels beyond what you'd normally experience at altitude.

For an endurance cyclist these would normally include efforts/intervals focusing on increasing Anaerobic Threshold power output and VO2 Max power.

Those Ric Stern workouts - the next step

I wrote a while back about interpreting lactate threshold power level measurements from a trainer and how to plan training around that knowledge. Ric has been consistent in advocating multiple 15-30 min sessions at or a little below LT for improving sustained power (like for climbing or TT) and ~5 min sessions above LT for VO2max (for accelerations or shorter hills). These have been very effective for me (20% increase in sustained power in 3 months) although very taxing mentally (because it can REALLY hurt for most of the interval). (It's also demonstrated the need for periodization to recover physically and mentally from several weeks of very high intensity.)

Taking some CTS advice as well, I've tried varying my cadence in different training blocks down to as low as 80 rpm one month and up over 95 rpm the next. Doing 300W for 20 min in the low 80s rpm consistently results in a HR at least 10 bpm less than an interval in the high 90s rpm and is almost a pleasant experience compared to 95+ rpm (which after a few minutes feels like being skinned alive). What's the physiology behind these different cadences and how should varying cadence best be used to improve performance (flats vs. rollers vs. hills)? If power is power, why aren't we all pedaling at 80 rpm?

Darrel Stickler
San Mateo, CA

Ric Stern replies:

I'm not sure that these are 'my' workouts, I can't take credit for them as many sport scientists would advocate such a session based on the physiology of certain goals (e.g., 1-hr TT). As an aside, these intervals are actually performed at what I term "TT power", as LT is a much lower intensity. Within the scientific literature, LT is generally referred to as a 1mmol/L increase in lactate over exercise baseline level. Thus, the intensity of LT would be something that could be sustained for a good few hours (depending on fitness level) and is usually ~ 20 % below TT power.

As you've noted, they're very effective at raising power output, although somewhat boring! Glad to see such a big improvement.

The reason that your HR is lower at a lower cadence at a fixed workload, is that efficiency increases (perhaps paradoxically) at lower cadences versus higher cadences (as you've noted). As the absolute power increases the most efficient cadence increases (e.g., at 200 W it might be 50 revs/min, at 400 W it might be 80 revs/min).

Efficiency is a measure of the work done divided by the energy cost. To spin faster (at a fixed workload) requires you to expend more energy (higher VO2) as you are having to provide more energy to move your legs at a faster velocity. As HR and VO2 are related the higher cost of faster spinning means a higher HR.

Power is power, but it's often useful to ride/train at different cadences as you'll encounter varying cadences under different conditions. Often when cycling uphill, because velocity is low it can be difficult to pedal within a normal range so some low cadence work is good. On the other hand during a pan flat TT, some riders might find a moderate cadence (e.g., ~ 80 revs/min) the most efficient and optimal. During (e.g.) road races, cadence needs to be kept higher (e.g., ~80 to 105 revs/min) so that you can react to changes in pace quickly (try accelerating in 53 x 12 to keep up with the bunch!).

Bottom line is that the most efficient cadence is quite low (and generally lower than cyclists like to use), but the most optimal cadence is usually a lot higher.

Phosphate loading

I was wondering if you could send me the reference for Ric Stern's phosphate loading article, as I can't find dosages anywhere.

Is it in the Canadian Journal of Applied Physiology, or the Canadian Journal of Physiology and Pharmacology?

Tom Wilson

Ric Stern replies:

Good question about the phosphate and the journal! For some reason, I've missed out the "applied" in the journal name on my website! Most remiss of me!

The actual amount of phosphate was 1000mg, four times a day using tribasic dodecahydrate sodium phosphate (Na3PO4.12H2O).

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