Fitness questions and answers for August 13, 2008

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.

Jon Heidemann (www.peaktopeaktraining.com) is a USAC Elite Certified cycling coach with a BA in Health Sciences from the University of Wyoming. The 2001 Masters National Road Champion has competed at the Elite level nationally and internationally for over 14 years. As co-owner of Peak to Peak Training Systems, Jon has helped athletes of all ages earn over 84 podium medals at National & World Championship events during the past 8 years.

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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.

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.

Michael Smartt (www.wholeathlete.com) is an Associate Coach with Whole Athlete™. He holds a Masters degree in exercise physiology, is a USA Cycling Level I (Elite) Coach and is certified by the NSCA (Certified Strength and Conditioning Specialist). Michael has more than 10 years competitive experience, primarily on the road, but also in cross and mountain biking. He is currently focused on coaching road cyclists from Jr. to elite levels, but also advises triathletes and Paralympians. Michael is a strong advocate of training with power and has over 5 years experience with the use and analysis of power meters. Michael also spent the 2007 season as the Team Coach for the Value Act Capital Women's Cycling Team.

Sorry to hear that you hit so hard but happy to hear that you are exceeding expectation while recovering. A shim under the cleat of the shorter leg would be the best solution. There is no magic formula as to how many mm to use. As your problem stems from the hip / femur which doesn't point directly down when seated, you shouldn't have to completely compensate for the entire 10mm that you think you are lacking.

1. I've noticed over the course of this season (my third riding / racing on the road) that when I lie flat on my back, as to go to sleep, my very lower back is uncomfortable, and it seems that my spine is quite curved, as if my hips were rotated forward. I theorize that tightness across the front of my hips (I'm unfamiliar with the muscle(s?) scientific name(s), but the one(s) that would allow you to lift your leg forward) is rotating my hips forward, putting strain on my spine. If, lying on my back, I lift my knees so my feet are flat on the floor, the back discomfort disappears. Also, I have no back pain on the bike, despite a fairly aggressive position.

The pain that's come and gone for over two years now is on the upper-outside of my left knee. IT Band related stuff. I've seen a PT and worked on my flexibility (as related to all the stuff attached to the IT Band) quite a bit, and I'm convinced my flexibility is much better, if perhaps not perfectly ideal. Still, the pain has come back. Rather than dwell on every detail of my fit, I'm going to go to the one weird bit that I think might just be the cause of it all:

The first issue that you describe is hip flexor tightness. Our hip flexors (psoas, illiacus, and rectus femoris) run from the front of the vertebrae and pelvis to the femur (or tibia in the unusual case of the rectus). If those muscles are restricted, they pull the spine forward into an increased lordosis. When you are lying down and you bend your knees, your spine flattens because the hip flexors are now on slack.

The muscles you are talking about are your psoas. If they are overly tight, what you describe can result. Why they don't hurt on the bike and when you pull your knees up in bed is that they aren't being stretched. Why they hurt when you lie on your back in your bed with your legs extended is that you are stretching them more than their current flexibility will allow comfortably. I've got to say that if your psoas are so tight that laying in bed is a problem, you've got some work to do. That's fairly dysfunctional. Do something about them or seek advice on how to do something about them.

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