Fitness questions and answers for April 18, 2005

Form & Fitness Q & A

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.

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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.

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.

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.

Steve Owens (www.coloradopremiertraining.com) is a USA Cycling certified coach, exercise physiologist and owner of Colorado Premier Training. Steve has worked with both the United States Olympic Committee and Guatemalan Olympic Committee as an Exercise Physiologist. He holds a B.S. in Exercise & Sports Science and currently works with multiple national champions, professionals and World Cup level cyclists.

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.

I have read lately about the some the possible adverse effects of taking extra vitamin E, which along with vitamin C is something I've been taking for about six years because of their antioxidant properties. Because intense training and racing produces free radicals, and because I want to limit the damage they cause, can I be safe (and content) with a simple daily multi-vitamin and not go to the supplements I've been using? Many thanks for your help.

I am a 48 year old masters racer (cat 1) who has been racing for the better part of 25 years (five year break in the early 90's). I am 6' tall and 200lbs (very proportioned, about 6% bodyfat, maybe a little too much time in the gym). I start training in late February (because of winter conditions and other sports) and finish my season in late October. I do approximately 25-30 races per year (mostly crits). I follow a reasonable training schedule, starting with a base of about 800 easy miles over 4-5 weeks before I start any build phase. Then I do a progression from 8 up to 20 hours per week (adding two hours a week) in a 7 week cycle.

My problem is that for most of last year I experienced slight to major pain in my left hamstring area. It is on the inside of my leg (closer to the inside than the outside) about 3 inches from the centre hinge of the knee (poor description?). I have looked on a chart and the closest I can figure is somewhere around the semitendinosis. It feels like a cramp coming on, but never quite gets to that major pain of a cramp. I know it is not a pull, because I don't feel it other than on the bike.

I have heard of this happening in one other case (obviously hamstring cramps are more common than that but usually on both sides) and it was an interesting scenario. This cyclist was having the asymmetric pain, in the hamstring, but would cramp at higher intensity levels and long training rides. At first, I wondered about leg length discrepancies, but that wasn't it. So look into leg length differences.

My legs are exactly the same length. I use Time shoes with Look cleats (and have for the last 10 years or so). I am a fanatic (way to much so) about riding and cleat position and have multiple bikes (RR, multiple crit,TT, etc) that are all measured exactly (with a slight change for the tt bike). I have my shoe soles marked for replacing cleats. I am in a good position with relation to shoe vs axle. Bottom line is - everything has been the same and worked well for years, until last year. I pedal pretty good circles (spent too many years on the track) with a fairly flat follow through. I did some experimenting yesterday and found that when the pain came on, if I tried to push through the downstroke even more with my heel, the pain would go away! Does this give you any more clues? Thanks!

In addition to Kelby's reply and your response, it is unlikely that you will be able to solve the problem by changing your pedalling technique as you have described, under race type conditions-ie-high load and heart rate. Under these conditions we will typically revert to what comes naturally to us as we cannot think about every single pedal stroke we take. Additionally the nerve pathways are different. When you are consciously changing your left leg technique to minimise the discomfort you are using the right side of your brain to do so. For autonomic activity such as bike racing the left leg would be controlled by the left side of the brain, not the right, as for automomic activity we are ipsilateral in terms of brain hemisphere control. None of which helps you get any closer to resolving your problem of course!

I purchased a new road bike a few weeks ago and have an emerging problem with my feet. The outside of my foot at the base of the small toe develops a hot spot that is quite painful after riding in large gears (such as on local 'power climbs', or after riding in fast groups for extended periods of time). I've experienced this pain on rides as short as one hour but the pain goes away quickly after a half-hour or so.

The pedals are Shimano SPD-SL and I use Nike Poggio II shoes. I used to ride a 51cm Cervelo Soloist, but have switched to a 50cm Cannondale R5000. I should also mention that I have changed saddles (SSM Concor to a Fizik Arione), added one cm (9 to 10) to my stem and widened my handlebars from 40 to 42 (c-c) after going through a fit session (with the same shoes and pedals) prior to buying the new bike.

A week ago, however, my right knee (the one I've never had trouble with), has started to tingle during the day. The tingle feels like it is below the knee in the patella tendon. This seems to happen regardless of whether I rode the previous day or not. I don't feel it while riding, just while I am sitting at work or walking around. It's not constant; instead, it is a wave of tingling that comes on for a few seconds and then goes away. It can be a few seconds or a few minutes before the next wave of tingling. It's localised and is only a very mild annoyance, but it's been persistent now for a week, so I am wondering if it's OK to continue to ignore it.

I can only guess at the cause of your knee tingling, but do not ignore it. As someone who works around a bad knee injury reasonably well, the best advice I have is to never ignore any unusual feelings in or around knees. Knees have a lot of fibrous tissue in the form of ligaments and tendons. These have very little blood flow. What this means is that knees are hard to injure but once injured are hard to recover from.

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