Cyclingnews Fitness Q&A - October 5, 2011

The peloton in action during the Sparkassen Münsterland Giro. (Image credit: Bettini Photo)

Topics: Upper Calf/Knee pain, Unequal leg power, Left Quad issues, Illness after travelling, Using weight vests or heavier bikes in training, Multivitamins and Training

I have recently started doing higher mileage (300km/week, previously ~120km) on my new bike and have developed a very irritating pain below my left knee at the top of my calf muscle, behind and under that bony protrusion on the outside. It feels like a length of fibrous tissue when I press on it. Most people I have spoken with say it's ITB syndrome but I am quite sure that it's not as it's actually below the knee. It doesn't hurt when I am off my bike and it's not an acute pain i.e. tolerable, but it sure is irritating, especially when climbing. I overpronate mildly when running, more so on my right foot, which confuses me even more.

I don't think it's to do with the new bike as I started having this problem before I got my new bike. My increased weekly mileage is actually the main reason I got myself this new bike. I have tried a number of things: lowering the seat height by 6mm, reducing the Q factor, pointing my toes in and out but none of those helped. I am thinking about giving the varus shim kit a try as deliberately canting my left foot outwards seem to alleviate the pain.

This is likely a simple problem to diagnose but maybe not so simple to fix. The pain is at the outer hamstring tendon or ITB insertion. From your description it isn't clear which, but that doesn't matter, the cause is the same. You are not sitting squarely on the seat and are hanging or twisting to the right. This is forcing you to compromise the plane of movement of the left hip and left knee as well as overextend it. This is why you feel better if the foot is canted outwards. This mimics what would happen if you sat squarely on the seat.

If that doesn't sort you out, the next most common reason is that most people favour and protect their right side on a bike at some cost to their left side. You say that when running you pronate more on the right foot. If you are doing the same thing on the bike, and it is likely, then you are probably self protecting the plane of movement of the right knee but paying a price for that on the left. This link will give you more general info.

This test was severely limited in a number of ways - I was wearing jeans and trainers, the saddle was too low, the frame too small and I was only on it for about two minutes - but the percentage split was consistent from 70-110rpm and from 80-210W. When I adjusted my effort to make the display show 50/50 I felt like my right leg was doing almost no work at all. Other people used the demo set-up and saw normal splits of near even, so I don't think there was a calibration issue.

I've been riding for four years since an injury stopped me running. This year I've started dabbling in racing and I now want to train properly for next year with the intention of top 10s in cat 3/4 road races and top 200 in a Euro sportive or two. This year I placed 322nd in the Etape du Tour pt1. I recently had a performance evaluation which produced these numbers: 1140W max, 540W max 1min average, 239W FTP, 3.1W/kg FTP. In a good week I ride about 160 miles and I can fit in a couple of strength/core sessions at home.

My concern is that the weakness in my left leg stems from the injury in 2007 - I fractured the left side of my C7 vertebrae in a motorcycle racing accident. In the weeks after, I experienced ghost pain in my left arm which I'm told was due to swelling around the nerves from my arm where they meet the spine. For many months my left arm was weaker than my right - this was especially noticeable doing dumbbell presses. It never occurred to me that my left leg might be similarly effected because cycling seems to hide the problem.

The good news is that a 40/60 split is not too bad. That means that even you weaker left leg is doing more work than many less fit riders can do with either leg. The left leg is most likely trainable. I'd suggest a two-pronged approach to doing so. First, head to the gym and check the actual strength of the muscles of each leg by doing one-legged calf raise (for calves), one-legged leg curls (to test hamstrings), one-knee extension (for quads) and one-legged hip extension (if you have the machine) or one-legged leg press (for gluteals). For each exercise, pick a weight you can do at least 20 times with your right leg. See how many you can do with each leg. If the results are within 2-3 repetitions, you leg strength balance is as good or better than many people who don't think of themselves as injured or imbalanced.

This is going to take some experimenting to solve, but there's a decent chance we'll get it on the first round. Quads do more than their share of the work when the saddle is too low or too far forward. Since your left leg is longer, it sounds like your saddle is effectively too low for your left leg, but not your right. I'd suggest raising the saddle in 3 mm increments until the left quad burn clears up. If you start to feel you are reaching with the right leg before the left quad burn clears up, increase your shim thickness on the right leg by a few more mm.

I'm a cat 3 racer in St. Louis and while we have a great and very active criterium racing scene here, sometimes there are great races out of town for which I like to take a weekend road trip with my teammates. However, this season I was 3 for 3 with getting sick in the week following out of town races. This has kind of soured me on traveling to race, despite the fact that there are a lot of really great races within driving distance of my hometown. I do try to pay extra attention to eating well and hand hygiene while traveling, but it doesn't seem to have worked so far.

While aerobic fitness is overall beneficial to immune function, there is a period of about 8 hours after any hard work out when you are more rather than less susceptible. During that period, your immune system is suppressed and whatever germs are around have a better chance of getting started reproducing in your body, leading to illness. On top of the post-exercise suppression, missing sleep weakens the immune system. If out of town races mean early morning or overnight drives that may be a factor as well.

3) Avoid germy people and places: After a race, avoid places where large numbers of people congregate at least for a few hours. Avoid traveling to races with people who have kids in preschool or elementary school since they are notorious germ-buckets. (I should know... I'd never been as sick as often as in the time my kid was in grade school). Become unfriendly: air kisses rather than big handshakes...

I have heard for years the mantra of "train heavy race light". To most people that meant just swapping out training wheels with aero wheels for a race. Thinking about the off season and taking the idea to an extreme, are there any benefits to adding weight to yourself or your bike? If I were to wear a weight vest for example in the winter and then shed it for races, would that show any difference in performance? Or would that just make you ride slower? Has there been research done on this topic and could a cyclist possibly do it instead of weight training in the gym? Since most of the off-season training is focused on base miles at first and not speed, would that add to performance once the "weight is lifted" so to speak?

In the mid-90s there was a goofy product called "Porkka's Pig Belly". It was a chunk of iron weighing several pounds that you could strap to your down tube near the bottom bracket to add weight. The idea, as you've suggested is that it would give you a harder workout and when you took it off you'd be faster. As you've noticed, it was so successful that now it's almost impossible to prepare for racing without one, not!

No, adding weight to your bike or body will not in general get you a better workout if you train solo. Your training effect depends on the speed with which you move, the movement pattern and how hard you push on the pedals. Add weight and go slower or remove weight and go faster so long as cadence and pedal force are the same, the training benefit is the same. Others have advocated riding fat tires for added resistance. That also doesn't help if you ride solo.

There are two situations where changing the bike to add resistance could be useful in a physiological way, but not because a harder workout is better. 1) You are going for a ride with a group that is too slow to provide the level of challenge you need, even if you pull the whole time. You could ride away from the group to get your appropriate workout, or you could do something to make your bike slower. Personally in that situation I tend to push other riders uphill rather than bring a slower bike. 2) You live somewhere that wind-chill or frostbite is a major issue. Then a heavier or fatter-tired bike lets you ride slower at the same workload, so you can stay warmer.

First to the weight training aspect. Simply put, training with a weight vest or other weights on your body or bike it is not at all like weight training in the gym. This is because your range of motion when a pedaling a bicycle is obviously limited by the arc of the rotation of the cranks, whereas in the gym, one can undertake movements that exceed the range of motion in pedaling and yet ideally will address imbalances and add more strength than one could get from riding alone.

Let’s say hypothetically that you are doing four minute effort at a given heart rate, cadence and power level. The only way that the addition of weight would affect this scenario would be to force the rider to use a lower gear and hence ride at a slower speed— remember cadence is fixed. If one were to counter by saying that with the weights one is forced to develop more power by riding at a higher power level that too is something that could be offset by simply by shifting to a larger gear in order to maintain the prescribed cadence.

I take a supermarket A-Z multivitamin supplement daily containing around 100% RDA ( EC Recommended Daily Allowance) of Vitamin B6, Thiamin, Riboflavin etc, as well as a 1000mg Omega 3 Fish Oil Caplet and a 30 mg Co-Enzyme Q10 Caplet. On race days I take an additional B vitamin supplement, essentially doubling the dose of the B vitamins and Iron found in the aforementioned Multivitamin, taking me well above 250% of RDA for most of the component vitamins. I have found that this supplement makes a huge difference to my performances, especially well into longer events (3/4hrs plus). However, I was concerned about doubling my RDA% as I had heard that this can be unhealthy, until recently I noted that a Swiss vitamin specialist has launched a sports multivitamin specifically for endurance athletes which contains over 1000% RDA of some of the aforementioned B vitamin complexes!

In general, the B vitamins are key components of enzymes that catalyze various chemical reactions in the body, some of which have the potential to affect performance or adaptation to training. Thus, to evaluate the potential for supplemental vitamin B complexes to affect performance or training, we can identify the functions of the B vitamins that impact the body’s response exercise. Metabolism of carbohydrate, fat, or protein into ATP, the high-energy molecule that is used for muscle contractions and other essential energy-consuming processes requires the B vitamins. Synthesis of proteins from amino acids is dependent on biochemical reactions that require B vitamins. Vitamin B12 and folate are needed for production of red blood cells; a deficiency of either of these vitamins limits production of red blood cells, causing anemia. Likewise, several of the B vitamins are needed for normal neurological function.

Athletes often believe that their vitamin and mineral needs are significantly higher than the average non-athlete and that if they consume only the RDA they will not get what they need for optimal performance. Regular training appears to increase vitamin requirements, but only slightly. What athletes do not realize is that RDAs are set above the mean requirement for the general population, so that there is a “safety factor” built into them. For example, take the RDA for iron for women 19-50 years of age, 18 mg per day, and compare it to the mean requirement, 8 mg per day. You can see just how large the margin of error is. Yes, athletes might require slightly more of some nutrients than non-athletes, but the increment is small relative to the safety factor. So there is no performance benefit to consuming more than the RDA.

In addition, the RDAs for most vitamins can easily be met by eating a well-balanced diet that consists mostly of unprocessed foods. This is especially true of the B vitamins because they are widely available in the food supply. Unprocessed whole grains, legumes, and meat are good sources of most of the B vitamins. Moreover, wheat flour must be “enriched” with the B vitamins thiamin, riboflavin, niacin, and folate in the United States and most European countries, so grain-based products are good sources. Likewise, most breakfast cereals also are fortified with the B vitamins. Thus, supplemental B vitamins are not needed because the RDAs can easily be met through food sources. The one exception is vitamin B12 for athletes who follow a vegan diet (no meat, fish, dairy or eggs). Because vitamin B12 is found only in animal-derived products, strict vegans might require a supplement.

Of course, any athlete should eat a balanced diet of whole grains, lean meat and dairy products, fresh fruits and vegetables. But, if you want some insurance against suboptimal intakes, your best bet is to take an over-the-counter multivitamin that provides no more than the RDA. It is important to remember that vitamin excesses can be just as dangerous as vitamin deficiencies. The potential for toxicity is greater for fat-soluble vitamins than for water-soluble vitamins because, rather than being excreted in the urine, excess fat-soluble vitamins are stored and can accumulate to toxic levels over time.

Scott Saifer (www.wenzelcoaching.com) is head coach, CEO of Wenzel Coaching.com and has been coaching cyclists professionally for 18 years. He combines a master's degree in Exercise Physiology with experience in 20 years of touring and racing and over 300 road, track and MTB races to deliver training plans and advice that are both rigorously scientific and compatible with the real world of bike racing.

Steve Hogg has owned and operated Pedal Pushers since 1986, 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. Clients range from recreational riders and riders with disabilities to World and National champions. He can be reached at: www.stevehoggbikefitting.com

James Hibbard progressed from the junior to the professional ranks as a rider and has over 15 years of competitive cycling experience. He is a former Collegiate All-American track cyclist, trained as a resident athlete at the United States Olympic Training Center, earned international medals as part of the U.S. National Team, and was a member of the powerhouse Shaklee and HealthNet Professional road cycling teams.

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.