Fitness questions and answers for February 18, 2009

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.

As you are well aware, Crohn's disease is a type of inflammatory bowel disease. Although the inflammation and scarring can affect any region of the gastrointestinal tract, typically the ileum (part of the small intestine) and colon are affected. The inflammation caused by Crohn's disease damages the mucosa, where nutrient absorption occurs. As a result, the ability of the intestine to do its job is severely compromised.

I think to my general excitement I have successfully made it through the lottery and I am now entered in this year's Leadville 100 MTB race. The key distinguishing feature of the event is that it starts at 10,200ft above sea level, eventually hitting a max elevation of 12,600ft. While potentially desirable I cannot move to CO three weeks ahead of the race and acclimate nor will my will my wife let me modify our bedroom for a bariatric chamber.

There are two issues here: Acute and chronic altitude adjustment: While three weeks of altitude exposure before the event might be ideal, as little as five days is enough to get you past the acute dehydration stage of altitude adjustment and improve your performance beyond what you can do if you arrive the day before the event. The acute dehydration stage takes about 18 hours to kick in so if you can't get there most of a week early, getting to altitude at the last possible moment, just hours before the race, is better than getting there a day or two before.

I'm a 54 year-old male, 6'0" and 220 lbs. I'm using Shimano size 46 shoes with Speedplay cleats on the baseplate extender in the rearmost position. My left leg is 10 mm shorter than my right (lower leg disprepancy), and I have 6mm of shim underneath my left cleat, and I have custom orthotics (not cycling specific) in both shoes. I'm considering having a Specialized BG fit session done to see if shimming will provide more stability/power, but wonder about trying too many things at the same time.

You mention, "I'm considering having a Specialized BG fit session done to see if shimming will provide more stability/power..." Just so I know we're talking the same language, I know Specialized manufactures in-shoe wedges but wasn't aware that they make shims. Wedges cant the foot medially or laterally to correct foot plant on pedal, and shims lift the foot as a whole further from the pedal platform to accommodate measurable or functional leg length differences.

Quick question for Steve. I have found that using two cleat shims under Speedplay cleats and one Specialized varus shim IN my right shoe has made a huge improvement in my hip dropping and back pain. My question is, why are the Bike Fit In Shoe Shims better than the Specialized in shoe shims? I am not doubting you as I follow your fit advice and have helped with many fit issues, just curious what the difference is and if it is worth replacing the Specialized shim with the Bike Fit shim.

It depends on what you expect from an in shoe wedge. If you want to use an in shoe wedge to cant a foot, either brand of in-shoe wedge will do that. I expect more than that from a wedge though. There is a constant flow of proprioceptive feedback being generated by the body and sent to the brain. Far more arrives than can ever be processed in any given second .We apply force to a bike via our feet and so it makes sense to me that we need the proprioceptive feedback from the lower limb to arrive at our brain loudly and clearly instead of 'background noise' that we don't pay a lot of attention to moment to moment.

Upshot is that I can't now walk far without grinding to a halt and having to wait for legs to start working again. It is boring, but more importantly I am now aware that this lack of exercise has affected my cv function. I am about to start work on an exercise bike, as I have discovered that it allows me to give the legs (& more importantly, the heart) a workout without setting off the spinal probs brought on by walking.

Since I don't know your total situation, I'll give the most conservative possible advice. No matter how unfit you are and how long it has been since you last exercised, if you have been cleared by a doctor you should be safe to do 15 minutes every other day the first week on the bike. Then add about 15 minutes to each session the second week. Same for the third so you are up to one hour per session, total of four hours per week. That's enough to improve and maintain cardiovascular health. If that is going well and you want to add more time, put in about 30 minutes on one of the in between days. The following week and after you can safely add 30 minutes per week somewhere, either as one longer ride or lengthening the shorter rides.

I think bariatric surgery is drastic. I'd like to exercise in my home and am considering the Schwinn 202 recumbent exercise bike. How can I get the fused ankle to push the pedal? Please say it's possible. Oh, my leg is also about 2.5 inches shorter than the other leg, due to bone loss from multiple surgeries and bone death. Should I consult with a physical therapist about their making me something? Go to an orthopaedic shoe specialist? Other than depression (understandable at this weight and situation), and a low thyroid, I have no additional health problems.

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