Skip to main content

Fitness questions and answers for August 30, 2004

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.

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.

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.

Eddie Monnier (www.velo-fit.com) is a USA Cycling certified Elite Coach and a Category II racer. He holds undergraduate degrees in anthropology (with departmental honors) and philosophy from Emory University and an MBA from The Wharton School of Business.

Eddie is a proponent of training with power. He coaches cyclists (track, road and mountain bike) of all abilities and with wide ranging goals (with and without power meters). He uses internet tools to coach riders from any geography.

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.

Current riders that Steve has positioned include Davitamon-Lotto's Nick Gates, Discovery's Hayden Roulston, National Road Series champion, Jessica Ridder and National and State Time Trial champion, Peter Milostic.

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.

Pam was an All-American in track while at the UW. She started cycling competitively in 2003 and is the defending Missouri State Road Champion. Pam writes a nutrition column for Giana Roberge's Team Speed Queen Newsletter.

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.

Scott Saifer (www.wenzelcoaching.com) has a Masters Degree in exercise physiology and sports psychology and has personally coached over 300 athletes of all levels in his 10 years of coaching with Wenzel Coaching.

Kendra Wenzel (www.wenzelcoaching.com) is a head coach with Wenzel Coaching with 17 years of racing and coaching experience and is coauthor of the book Bike Racing 101.

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.

Through his highly customized online training format, Steve and his handpicked team of coaches at Colorado Premier Training work with cyclists and multisport athletes around the world.

Brett Aitken (www.cycle2max.com) is a Sydney Olympic gold medalist. Born in Adelaide, Australia in 1971, Brett got into cycling through the cult sport of cycle speedway before crossing over into road and track racing. Since winning Olympic gold in the Madison with Scott McGrory, Brett has been working on his coaching business and his www.cycle2max.com website.

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.cyclecoach.com) is an Associate Coach with Richard Stern Training. He holds a Masters degree in exercise physiology and is USA Cycling Expert Coach. Michael has been a competitive cyclist for over 10 years and has experience coaching road and off-road cyclists, triathletes and Paralympians.

Kim Morrow (www.elitefitcoach.com) has competed as a Professional Cyclist and Triathlete, is a certified USA Cycling Elite Coach, a 4-time U.S. Masters National Road Race Champion, and a Fitness Professional.

Her coaching group, eliteFITcoach, is based out of the Southeastern United States, although they coach athletes across North America. Kim also owns MyEnduranceCoach.com, a resource for cyclists, multisport athletes & endurance coaches around the globe, specializing in helping cycling and multisport athletes find a coach.

Advice presented in Cyclingnews' fitness pages is provided for educational purposes only and is not intended to be specific advice for individual athletes. If you follow the educational information found on Cyclingnews, you do so at your own risk. You should consult with your physician before beginning any exercise program.

Fear
What kind of carbs?
IT band and fixed vs floating cleats
Power based training
Seatpost with setback
Tapering
Thyroid issues
Nutrition and base miles
Rotated hip
Correcting BMI
Q factor for women
Knee circles
New cleats and bike fit
Upper knee pain

Fear

I'm a 22 year old female cyclist and I've been competing in road races for the past three years. Rather than a physical problem, I would call this a mental problem: FEAR. There are three things which hold me back in cycling: cornering, downhills (especially twisty ones with potholes) and being in a group larger than two cyclists. In each of these situations I slow down tremendously feeling sure I'm going to fall. So in a race with a neutralised start (especially with a few sharp corners), I'm usually right at the back so that I've lost the race before we've even started racing!

My question is, is there anything I can do to feel more confident on the bike. I know I'm quite strong as I tend to do quite well in time trials and hilly races. But I'm far too in love with my brakes!

Michelle Wood
Malta

Dave Palese replies:

The feeling and weakness with skills that you cite are common issues for many riders.

Kim Morrow replies:

Dave offered some great advice. Let me add briefly to his comments.

What kind of carbs?

I am 42 year old female recreational rider. Always working to improve my speed. You have so many articles talking about consuming carbs for fuel, well okay, but what kind of carbs? What kind foods should they come from, fruit, pasta, vegetables? Or how much of each if the answer is all of the sources.

I mean really, given the choice I'd like all of mine from ice cream but I know better and would like to make smart choices.

Pam Hinton replies:

If you want to improve your speed, you don’t necessarily need to dine with faster people, you want to ride with them. But making those smart choices you mentioned will help. So here’s the deal on carbs. The word carbohydrate is a broad term that refers to substances in food that can be broken down into single sugar molecules (monosaccharides). The most common forms of dietary carbohydrates are starch, sucrose, lactose, fructose, glucose, and indigestible fiber. Starch, sometimes referred to as “complex carbohydrate,” is a polysaccharide, which is many sugar (glucose) molecules linked together. Grains, bread, legumes, fruits and vegetables are sources of complex carbohydrates. The terms “simple carbohydrates” and “sugars” refer to carbohydrates that are made up of one or two sugar molecules (i.e., the mono- and disaccharides). Glucose, fructose, and galactose are all monosaccharides. Fructose occurs naturally in honey and fruit. Galactose results from the breakdown of the sugar found only in dairy products—lactose. Sucrose (glucose + fructose), more commonly referred to as table sugar, and lactose (glucose + galactose), which is milk sugar, are disaccharides.

IT band and fixed vs floating cleats

I've had an IT band problem for years. I was recently fitted with orthotics and in the process was changed to a fixed cleat (new Dura Ace pedals) from floating (Speedplays). When sitting on a table with my feet hanging loose they point straight ahead, therefore the cleats were set at 0 degrees. My saddle was also raised about 3/4 inch.

After 6 weeks with this setup and a lot of riding and racing, my problem has gone from bad to unbearable. I was told that it would take some time getting used to the fixed position because of muscle memory so I ignored some minor pain. However, I can't ride at all now and the pain is almost constant.

I noticed when I sit on a table and bend forward my left foot (problem side) turns outward. Am I better off going back to a floating system so my foot can go where it wants instead of torquing my hip and knee? Was the saddle height increase a contributor?

Dave King
Boston, MA

Steve Hogg replies:

In my view the advice you have been given about using fixed cleats without freeplay, given your injury history is just plain bad. Freeplay in pedal systems is cheap insurance against the potential for injury or the exacerbation of existing injuries. If you don't need rotational movement, you won't use it. If you are using it, then you need it. Everyone wins with a freeplay cleat. Judging your foot on pedal angle on a bike by looking at you with legs hanging from a table is a bad joke. There is only one way to judge an appropriate foot on pedal angle and that is under reasonable load on your bike!

Power based training

I read a great article by Ric Stern on power based training, which I think was written back in 2002. I am hoping that with the passage of time that more experience has been gained with power based training to perhaps provide an update on the web. Thanks for your excellent column.

Bruce Williams
Australia

Ric Stern replies:

Thanks Bruce. Glad you liked the article. The zones that i prescribed in that article are the zones i still use! What sort of article are you now interested in? If you're looking for specific advice on how to build a training programme or for actual coaching advice, it'd be best to contact a coach, such as the RST group or one of the other coaches here, who would be able to tailor advice accordingly.

Eddie Monnier replies:

If you're looking for more general reading on power-based training, then you might want to check out the articles in the library section of my Web site.

Seatpost with setback

I just wanted to drop you a line regarding seatposts with setback. In a recent Fitness Q&A response, you mentioned a Time seatpost that's no longer available. Although I'm not familiar with the Time post, from your answer I gather that it had significant setback.

I've been using a Titec 'Hell Bent' MTB post on my road bike. Sure it's heavy (it probably weighs twice as much as some light road posts), but it has more setback than any other post I've found. It won't help someone who doesn't have much exposed seatpost, but it's worked for me. And given it's heft, I can't imagine it ever breaking. I just thought I'd pass it along.

Mitch Kelly
Philadelphia, PA, USA

Steve Hogg replies:

thanks for the positive comments and your interest in seat posts with more than average set back. For others interested, here is a list of some of the seat posts that have more than standard set setback. Standard setback I would define as when the front edge of the seat rail clamp is in line with the centre of the seat post shaft as viewed from the side. Common examples of standard posts are Campagnolo and Shimano seat posts. By that standard the below posts will give you more rearward adjustment.

Tapering

Maybe my last question was expecting too detailed an answer so Ill be more simple. When tapering many people talk of reducing volume while retaining intensity. The question is how intense? The answer is often "race pace". For long road races there is no race pace - there are race paces. Should a variety of intensities be riden or just the most intense that will not lead to race day fatigue?

Andrew Gannon
Australia

Scott Saifer replies:

I've read with interest the suggestion to maintain intensity while cutting volume. I have spoken with two Olympic medalist track cyclists who say that is exactly what they did before their moments of glory: Continue all out sprints but very few of them.

Thyroid issues

I have been dealing with a roller coaster thyroid problem for 1.5 years. First I was hyperthyroid and then fell into hypothyroidism. Since I was not climbing out of hypothyroidism, I have been on thyroid medicine. I have been taking the same dose for six months and now, after a recent blood test, I am in a hyperthyroid state. As an expert mtn. bike racer, I train 12-15 hours a week and am wondering if my cycling is not allowing my body stabilize. Does anyone have any suggestions?

Meggan Flaherty

Scott Saifer replies:

I also have a history of odd thyroid measurements and lots of bike racing. Was your hypothyroidism diagnosed by your T4 (Thyroxine) level or your TSH (thyroid stimulating hormone)? If it was diagnosed by a slightly elevated TSH level, you may never have actually been hypothyroid. It's common for highly trained endurance athletes to be euthyoid by T4, but still have elevated TSH. If you actually had low T4 measured when you were diagnosed as hypothyroid, then it sounds like you need to adjust your dose downward. That you would only do with your doctor's supervision of course.

Nutrition and base miles

I am a 35 year old, current Cat4 crit racer ready to upgrade to Cat3 in 2005. I continue to read up on base training at aerobic levels as both preparation for more specific training periods and the value of burning body fat. My question may seem a bit unorthodox, but a concern to some low body-fat cyclists. Can burning too much fat be detrimental? Taking a look at cycling athletes and other active individuals like myself with already low body fat, about 6-8%, what happens when you run too low on fat to burn? especially during base miles when the body is burning on average 80% fat and 20% sugars. If we "carb up" for more intense training and racing, how should we nutritionally prepare ourselves for the "base" period.

John Mattio

Pam Hinton replies:

The answer to your question is very simple in a complicated sort of way. The short answer is don’t worry about running out of fat, carb-up before, during and after you ride, then eat a balanced diet thereafter. For the long answer, get out your calculator.

Rotated hip

Several of your recent questions remind me of a personal injury I've been dealing with for a couple years. I've been experiencing recurring weakness in my left leg. MRI and angiograms have not discovered any obstruction or injury, however I have demonstrated a tilt and forward rotation of my hip on the left side. The result of this is loss of power in my left leg, and to date a rather obvious difference, increase, in hypertrophy on the right side.

Recently you addressed a complaint of Persistent finger numbness which also reminded me of my own situation; I also have had hand and finger numbness on the left side too. Would you be able to offer an explanation as to why this might be recurring, the pelvic tilt,? And could you recommend some form of strength training and or stretching routine that might help keep my hips from falling over?

I do not have a leg or foot length discrepancy and I have had a professional fitting.

I'm pretty sure this situation isn't unique, I think I've heard of a couple pros who have had a similar problem. To date I've seen a PT who swore I had a torn hamstring, a vascular surgeon who thought I needed a stent, and I finally resorted to seeing a rolfer who offered some relief.

Steve Hogg replies:

I am not a health professional but have an interest in developments in various health specialties. This is because of what I do for a living, but also because a combination of youthful stupidity and misadventure has caused me to be a fairly heavy consumer of the services of various health professionals at different times in my life. I too, have been on what I term the 'medical merry-go-round'. In my case it took nearly 20 years to find long term solutions to my problems. Essentially, the orthopaedic/biomechanical model of the way humans function can only go so far. For the majority of people that is far enough, for some it is not.

Correcting BMI

I am an avid cyclist, at 53, I still get in between 100 and 150 kilometers a week... I recently was in a discussion with a few friends, and we started comparing BMI's and I ended up on the overweight scale compared to my more sedate friends... since I have been researching this I find out that BMI is not an accurate indicator, and did find a site that used waist circumference in the formula, but my BMI is still 25.5... I am 5 foot 9, weigh 172 most days, some weeks I get as low as 168, I have a 32 inch waist... when I look at my body, I can see muscle definition in all parts of my body, especially legs, shoulders, arms and back, I have a little extra "skin" on the abs, and "very small love handles"... Why am I scoring higher, and what formula can I use to correct the BMI?

'Dusty One'

Scott Saifer replies:

Try getting a body-fat percentage test instead of looking at your BMI. BMI is a "fast and dirty" way to identify overweight people, and of course many very fit athletes score "obese" on BMI scales because BMI does not distinguish fat from muscle from buckshot left over from a hunting accident. If you have visible and defined muscle and over most of your body, you are very lean.

Q factor for women

One for Steve Hogg. Considering women’s wider pelvic and angled femur, how does this effect movement concerning q-factor, cleat placement (rotational, also) . I can picture this statically but have a problem figuring out what is happening when movement occurs, i.e. force on hip joint and torque on knee depending on the q-factor. I think (and this could be way off) that a wider q-factor with a slight eversion on the pedal would be optimal.

With your experience, what are the indications of the proper q-factor for a women’s structure?

Erica Leister

Steve Hogg replies:

There is such a variety of female humanity and morphology out there, that it is hard to give you a general answer that is generally applicable. The wide range of proportion, function/dysfunction, symmetry/asymmetry and technique that exists in the female population means that individuals have to be treated on their merits and that I don't have a 'general' approach to positioning women that in any way differs from my 'general' approach to positioning men. Women are different to men but the range is so great that I approach the task of positioning women using the same basic principles that I've talked about on this site.

Knee circles

I'm 48 years old, 195 cm, 96 kg recreational roadie. My problem is recurring bouts of ITB soreness which may build up gradually during a ride or appear suddenly. The bouts may last weeks or a single ride. I do several ITB stretches in a 20 minute stretching routine after most rides and ice the knee after rides as well. I ride 4 - 5 times a week and the pain seems to occur just as often on light recovery rides as it does on fast group rides. A dozen years ago I snapped my right ACL and in the process injured the ilio-tibial band although this last injury was only picked up months later when I had problems during rehab after the reconstruction.

Apart from the ITB pain which only appears when riding the knee has generally been fine since the op. What I have now is a right knee that moves in circles laterally when riding. The knee moves towards the frame on the up stroke and away from the frame on the down stroke. I have noticed that I also ride on the outside of my right foot. When I force the foot flat on the pedal the knee circles are greatly diminished but the ITB soreness increases immediately.

The advice of my sports physio is to persevere with the stretches/icing/pain or consider a release op. I haven't heard much good said about the op and anyway I don't favour surgical solutions unless absolutely necessary. Some months ago I bought a new, lighter bike and had the shop set it up. I immediately found the ride to be much more comfortable than my old bike but the ITB problem remains the same (I was hoping for a change of one sort or another). My searches for a "cure" have led me down many different paths including one to my local podiatrist and I now ride with orthotics. I still wear the orthotics but I haven't noticed much difference.

When the pain hits it can be severe and I have found that riding with my heel hard down relieves the pain and allows me to get home again. As far as I can tell my left knee tracks "normally", basically up and down with very little lateral motion noticeable and no ITB soreness.

Any suggestions?

Steve Gunn
Australia

Steve Hogg replies:

Steve, you are posing a tough question. Obviously finding the root cause of the issue is the key, and you have been trying to find that out with limited success. On this site David Fleckenstein or Benoit Nave are the appropriate people to ask. The only thing that I can contribute is this:

New cleats and bike fit

1) I recently changed to new cleats about two weeks ago. I use Look cleats and have for years, but this time I have noticed some slight pain to the left and front of the knee cap. Its a dull ache and it seems to go away pretty quick after I'm done riding. During my rides, I find myself wanting to push my heel out away from the bike and toe in almost pigeon toe. I tried adjusting the cleat to allow me to do so, but the cleat is already over as far as it will go on the shoe. For lack of a better description, with my old worn cleats, my foot could float over the pedal and I could move around, but with the new one, my feet are locked in and I can't seem to get comfortable with the left foot. My right foot does just fine. Any clue as to what is going on and what I can try to make it better? Will the new cleat eventually "break in" and give me the float that I had with the old ones?

2) I'm in the market for a new frame this winter and I've been a victim in the past of a poor fit and obviously would like to avoid that happening again. We used the Serotta size cycle, dialed in the numbers until I felt comfortable and voila, instant measurements for a frame. Today, I am the not-so-proud owner of a rather odd shaped frame. Short of traveling to someone who has the reputation as a good bike fitter and is equipped to do the job, what should I look for from my local bike shop in terms of assessing if they can do a good job? How do you qualify who's got the goods and who doesn't?

Dan Reed
Apex, North Carolina

Steve Hogg replies:

In answer to your question 1. There are a multitude of possible reasons for what you are feeling, but given that you had no problems with your old cleats, here is what I would suggest. On the base of a Look cleat there is a black rubber pad. When new this can tend to protrude quite a bit, particularly if the cleat mounting screws are torqued really tight. This means that though there is freeplay, it is has a 'stiffish' quality. Get a razor blade or Stanley type knife and trim most of the height from the rubber pad. Trim it back till it is almost flush with the cleat. This will allow the quality of freeplay to become just that ' free', and solve the problem. The other thing that occurs to me is are you using Look branded cleats or some of the clones?

Dan responded;

I am using clone cleats and I trimmed the rubber pad back last night. I went out on a short ride and the knee felt great; plenty of play like my old cleats!

I would love to travel to be fitted by a specialist, but I would have a hard time justifying the expense since I'm buying a production frame in the $1100 to $1400 range. Hopefully armed with more experience and knowledge now than my first attempt, I can have a reasonable dialogue with some of the shops in the area and determine who will be the best to work with. One last question though, you mentioned that chainstay length and fork offset do not change from one frame size to the next. How much should each one change from one size to the next and why?

Steve Hogg replies:

I am glad that you got a result with the cleat. It is a problem that I have seen often.

Dan replied:

I like the treatise and you make some valid points, but from my experience over the last 10 years, 90% of the people I have ridden with are on production frames. (By production, I mean any frame not made to your exact specifications.) It is the rare individual that is willing to pop for a $2000 to $3000 custom made frame and then add another $1500 or so for components. Its hard to justify the cost when you are a club rider and maybe an aspiring amateur racer and to top it off, the thought that you could trash it on the first ride is almost unbearable. So taking into account that the majority of riders have to ride on what's available, how do you shop for the best frame and how do you evaluate a frame's geometry to determine if it going to be suitable? For instance, given a range of sizes, what range of measurements should you be looking for in say fork rake, seat angle, head tube angle, chainstay length, etc?

Don't get me wrong, I agree with you about the manufacturer's illogical approach to making frames; however, I've got ride one of them (and so do many others), and since its unlikely the manufacturers are going to change, I need to do the best I can with what's available. One last bit, we've never made mention of specific manufacturers which begs the question - "Are there any manufacturers making production frames with suitable geometries i.e. those that can address a midpoint in the range of needs for people of an approximate size." I guess I'm looking for the lesser of all evils.

I have enjoyed the dialogue and will be looking for that link with great anticipation.

Steve Hogg replies:

Your problem is a common one but given that I know nothing about your size, structure or capabilities, it is impossible to be definitive. That said, I want to answer your question. I have data on thousands and thousands of people who have been happy with my approach to positioning them. I have sold custom frames with every seat tube angle between 69.5 degrees and 74.5 degrees, and including those who have not purchased frames from me, recommended a slightly wider range again, as an ideal . About 85% of those fell into the range between 71 and 72.5 degrees. The further in either direction from that range, the number of people requiring a really relaxed or really steep drops dramatically. This is seat tube angles only. In my view, that is the most important frame dimension because it largely determines how you will bear your weight and what musculature you will enlist and to what relative degree you will enlist it.

Upper knee pain

I am a 33 year old recreational road rider, 6’1”, 164 pounds. Two years ago, I had reconstructive knee surgery on my left knee for an ACL tear, in which a patellar tendon graft from my left knee was used to replace the ACL. After the surgery, I began riding for rehab. I ride four to five days a week on rolling terrain. Most rides are after work, about 1 to 1.5 hours (20 to 25 miles), with longer rides on the weekends (40 to 50 miles).

I have begun to experience moderate pain directly above my left patella, slightly to the left (or “outside”) of the knee. Of course, it is worse when going up hills (especially seated), and in pushing larger gears any time. I have no pain in other parts of the knee, and it does not swell during or after riding. It does not feel as though there is any rubbing or popping going on; it just feels moderately painful, and is a nuisance. I would love to eliminate it, and I am slightly concerned that it may worsen over time.

I made a frame change about three months ago, at which time I replaced a Thomson straight seat post with a USE Alien set back post, and replaced my 120 mm stem with a 130. I really like the more stretched out position, as it is more comfortable for my neck, and it allows me to stay in the saddle longer without discomfort and/or the beginnings of numbness. The frame change was from a 57 to a 58. I ride Shimano Dura Ace pedals with float, and use Sidi shoes.

My questions are; what is the most likely physical problem causing the pain, and what are some suggestions for easing (or hopefully eliminating) the pain? What parts of the bike or equipment do I need to address?

Thanks in advance for your help.

Steve Hall

Eddie Monnier replies:

It's unclear to me if your pain began only with the recent bike change or if it preceded that. Pain toward the outside of the knee is often caused by a cleat angle that sets the toes inward too much. To check to see if this alleviates the problem, mark the current position of your cleat (fore/after and angle) and then turn your cleat in a few degrees (yes, turning the cleat in moves your toes out). In most cases, if your problem is related to cleat angle, you will notice immediate relief with the cleat correctly repositioned. If it doesn't help, then return your cleat to its original position. Pain in the front of the knee is often caused by having the seat too low or too far forward, so I would check your fore/aft position (see Steve Hogg answers to previous questions for guidance on this) and your seat height.

Steve Hogg replies:

Do as Eddie has suggested and if the problem is still present, here are some other things to think about.

Steve Hall responded:

Thanks for your further advice; I have already turned the cleat in a little to give that a go. In answer to your first question; yes I have the SPD – SL Dura Ace pedal. I switched to these pedals about a year ago from Time Impacts, and have been generally happy with them. The knee pain has certainly developed well after the switch. I definitely have a waver in the left leg through the pedal stroke (in both legs, actually;) I developed the habit of riding with my knees pulled inward toward the top tube from watching Chiappucci ride long ago, as well as because it feels like it brings stronger quad muscles into play. However, my sense is that this would, if anything, cause the inside of the knee to become agitated. What do you think? And for what it’s worth, I’m right side dominant, and obviously, my left leg took quite some time to get back its strength after the ACL surgery. I definitely have the sense that it is the weaker leg, and work on evenly distributing the load while I ride - particularly during the upstroke in the pedal stroke up hills.

Steve Hogg replies:

I have no problem with your knees-in pedaling style providing it comes naturally to you. Double check your angle of cleat placement. Ride along on a quiet road putting a bit of effort in, and then coast with the left leg forward. Twist the heel outwards, is there movement before you hit the stop?

Thank you for reading 5 articles this month*

Join now for unlimited access

Enjoy your first month for just £1 / $1 / €1

*Read 5 free articles per month without a subscription

after your trial you will be billed £4.99 $7.99 €5.99 per month, cancel anytime. Or sign up for one year for just £49 $79 €59

Join now for unlimited access

Try your first month for just £1 / $1 / €1