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
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Upper Calf/Knee Pain
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.
I have asked a lot of people and have done a lot of research on the internet without success. I am only a student so can't afford an expensive bike fit or physiotherapy. I hope you guys can help.
Steve Hogg says:
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.
The most common reason for what you are experiencing is too high a seat height. I suggest you try dropping your seat further. See here for more detail.
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.
You need to address the pronation issue on both feet and the best place to start is arch support. There is specific advice here.
Once you've worked your way through those suggestions, let me know how you get on.
Unequal leg power
I'm hoping you can help with some advice to correct unequal leg strength. I've sometimes felt that my right leg is doing more work when standing and recently had a chance to try out a demo set of power meter pedals on a turbo trainer, with a display showing the power split. The results were shocking - a 40/60 split left to right.
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.
Any suggestions and advice you have would be very gratefully received.
Scott Saifer says:
First, it would be good to confirm the impression that what leg is making more power than the other. Having the saddle too high generally forces riders to favor one side and sacrifice the other, and it's possible that saddle too low might have a similar effect in certain circumstances.
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.
If there is a larger difference between the endurance of the two legs on any of the above exercises, develop an exercise plan that works both sides separately, and has the left doing a bit more than the right. The exact amount is not important. Don't exercise the left to the exclusion of the right as that will cause new problems later.
On the bike, make a habit of counting cadence on the left leg for a minute or two several times throughout the ride. The extra thinking directed at one leg is often enough to get it to do it's share of the work.
Get the left-right power balance rechecked periodically. I have a friend who had an imbalance like yours. Since she raced at the top elite level, she was concerned and she worked on improving the balance for a couple of years, at the end of which she still had an imbalance, but in the opposite direction!
Steve Hogg adds:
Just one thing to add. To my knowledge, there is no nerve exiting C7 or near by that goes to the legs. The innervation of the legs stems from much further down in the spine.
Left Quad issues with unequal leg lengths
I’m 55 years young, still race road, mountain bike and cyclocross, and have ridden on avg. 6000-8000 miles per year for the last 22 years, 5’8” 165lbs. Due to a broken hip as a child I have a 1cm leg length difference (Rt. leg being the shorter one)
I use time attack pedals with no shims, on my mountain and cross bike with no problems, but I figure that’s because I’m moving around so much on the bikes???
On my road bike, which I ride the most (75 per cent +/- of the time) I use Speedplay XO pedals and have used 6mm worth of shims on my Rt. Shoe for the last couple of years.
My fit seems to feel pretty good while on the road, but when I’m riding my trainer indoors, and wanting to do any type of workout greater than endurance pace (tempo, intervals…) my Left quad starts burning to the point where I have to stop the effort.
Any suggestions as to why this is happening would be greatly appreciated.
Scott Saifer says:
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.
If you end up feeling that you are reaching with the left leg before the quad burn clears up, put the saddle back down to the highest position that gave no sense of reaching and write to us again.
Illness after travelling long distance to or from a race
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.
Any advice on how to travel and race while staying healthy?
Scott Saifer says:
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.
There are three strategies for avoiding getting sick despite the post-race immune suppression:
1) Minimize suppression by staying well fed and hydrated, racing efficiently to minimize energy use, napping or at least relaxing immediately after the race, getting plenty of sleep leading up to the travel races, keeping daily stress levels low...
2) Hygiene: Wash hands often and especially before eating or drinking, keep hands away from your face always
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...
It is possible to do travel races without getting sick. Good luck.
Using weight vests or heavier bikes in training efforts
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?
Thanks for your input,
Scott Saifer says:
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.
Adding weight or resistance to the bike also changes how it handles, when you need to shift, what happens when you stand up... things that you should be practicing often so your skills will be sharp come race season.
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.
There are other reasons to trade out your wheels, but not because the heavy ones give you a better workout. Trading your wheels lets you save the good ones for racing, assures that you won't have road-debris working it's way through to your tubes before you start racing, and gives you the psychological boost of knowing that you have the good wheels on for the race.
James Hibbard adds:
You indeed would notice a difference if were you to wear a weight vest or train with weights on your bike and then remove them when you race. Fundamentally though, I think that the benefits that you would gain would be predominantly psychological— but this is not at all to dismiss the psychological as somehow less than a “real benefit”. First, to the mechanical and physical aspects though.
On this front your question really breaks into several components. First, is training with weights a substitute for gym training? And second, will wearing a weight vest increase one’s ability to develop power on the bike akin to doing over-geared efforts of some other form of “on-bike strength training”.
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.
In terms of how it would work to develop on-bike strength, that would depend upon how one structured their riding and efforts, but generally, I don’t think that there is a lot of benefit to be gained here either.
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.
Where you would notice a difference would be a huge uptick in how fast you are going (even at the same fitness level) once the weights have been removed and there is some real benefit to this boost right ahead of the racing season.
Best of luck,
Multivitamins and Training
Hi Fitness Team,
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!
I hope you will be able to shed a little light on a slightly confusing issue for me!
Pamela Hinton says:
Thank you for your question about the use of supplemental B vitamins during training and competition. First, let’s look at your question about whether additional vitamin B complexes will affect performance, and then address the specific needs of athletes.
The B vitamins are water-soluble compounds that play essential roles in cell metabolism, and are therefore necessary for life. The eight different B vitamins are known by both number and chemical name: B1 (thamin); B2 (riboflavin); B3 (niacin or nicotinic acid); B5 (pantothenic acid); B6 (pyridoxal, pryidoxamine); B7 (biotin); B9 (folate, folic acid); and B12 (cyanocobalamin).
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.
Now that we’ve established that the B vitamins are essential for biochemical pathways that might impact athletic performance, let’s look at the question of whether supplemental vitamin B will enhance performance, and if so, how much is necessary to derive a benefit.
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.
However, large doses of the water-soluble vitamins, including the B vitamins, can also be harmful. For example, megadoses of vitamin B6 can cause degeneration of nerves, resulting in unsteady gait, numbness in the extremities and impaired tendon reflexes, and high intakes of nicotinic acid can interfere with fat metabolism.
The bottom line is that you can easily get the B vitamins in amounts needed for optimal performance by eating unprocessed foods. The only individuals who will derive a performance benefit from supplemental B vitamins are those with a clinically diagnosed deficiency, which is very rare given the B-vitamin content of the food supply.
The Cyclingnews Form & Fitness panel
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.
Scott has helped clients to turn pro as well as to win medals at US Masters National and World Championship events. He has worked with hundreds of beginning riders and racers and particularly enjoys working with the special or challenging rider. Scott is co-author of Bike Racing 101 with Kendra Wenzel and his monthly column appears in ROAD Magazine.
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
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.
Pam 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 associate professor of Nutrition and Exercise Physiology at the University of Missouri-Columbia where she studies the effects of energy balance on bone health. She has published on the effects of cycling and multi-day stage racing on bone density and turnover.
Pam was an All-American in track while at the UW. She started cycling competitively in 2003 and is a three-time Missouri State Road Champion.
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.
He has earned 13 National Track Championship medals, as well as numerous junior, U-23 and elite California State championships on both the road and track. Since retiring from full-time racing in 2005, James has focused on his development as a coach.
David Fleckenstein, MPT, OCS (www.physiopt.com) is a physical therapist practicing in Eagle, ID and the president of Physiotherapy, PA, an outpatient orthopedic clinic focusing in orthopedics, spine, and sportsmedicine care.
His clients have included World and US champions, Olympic athletes and numerous professional athletes. He received his Masters degree in Physical Therapy from Emory University and is currently completing his doctorate at Regis University.
He is a board certified orthopedic specialist focusing in manual medicine and specific retraining of spine and joint stabilisation musculature. He is a former Cat I road racer and Expert mountain biker.
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.
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.
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