Fitness questions and answers for February 18, 2009

Form & Fitness Q & A

Got a question about fitness, training, recovery from injury or a related subject? Drop us a line at Please include as much information about yourself as possible, including your age, sex, and type of racing or riding. Due to the volume of questions we receive, we regret that we are unable to answer them all.

Carrie Cheadle, MA ( 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 ( 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.

Dave Palese ( 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 ( 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 ( 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 ( 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 ( 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. Clients range from recreational riders and riders with disabilities to World and National champions.

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 ( 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 ( 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 ( 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 ( 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.

Richard Stern ( 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 ( 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 ( 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.

Earl Zimmermann ( has over 12 years of racing experience and is a USA Cycling Level II Coach. He brings a wealth of personal competitive experience to his clients. He coaches athletes from beginner to elite in various disciplines including road and track cycling, running and triathlon.

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.

Crohn's disease and cycling
Refuelling on the bike
Riding at altitude
Arch cleat positioning and shimming
In-shoe wedges
Recovering cardio function
Stationary bike

Crohn's disease and cycling

I'm a 28-year-old recreational rider who likes to ride four to five times a week, I start by building up easily and when I'm in shape, my longest rides are about 160 km (ore about 100 miles). I also like climbing the French mountains, but also at a recreational pace. As you notice, I'm not exactly a pro, but I always like to get in better shape.

I've been recently diagnosed with Crohn's disease, which is also a cause of anaemia (lowest hematocrit ever measured was 27, most of the time it's about 35). This of course doesn't help my riding. The doctors at the hospital were very helpful and gave me all the medicines I need to control my disease, but they couldn't give me much info about Crohn's and sports.

There are two big issues:

My body refuses to absorb iron. I take iron supplements (each day I take 3 times the dose a normal person should take and extra vitamin C, because it helps the iron absorption (both on doctors prescription), but my hematocrit and haemoglobin levels stay low

Because of the disease, my body doesn't absorb much proteins either. I take protein supplements after hard trainings, but would it help if I would drink protein drinks on a more regular (daily) basis?

So, apart from more training, what could help me to get in a better shape? Proteins? More iron supplements? Any other training tips for Crohn's patients?


Pam Hinton replies

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.

Refuelling on the bike

I previously suffered tummy problems and declining levels in longer events (three hours), so for the last six months or so I've been mixing my own sports drink. Based in no small part on the advice provided on Cyclingnews by Pam Hinton (thanks Pam!).

Here's my recipe: 50g glucose powder, 1.25g white sugar, 1.25g salt and 50ml lemon juice, made up to 700ml with water. (The lemon juice is to make it drinkable.)

If I've got my sums right, that equates to between seven and eight percent carbohydrate (of which between two and three percent is fructose and the balance glucose) and 500mg of sodium per bidon. I try to down one bidon every hour (constant sipping). I also take 200mg of caffeine about five minutes before an event or hard ride and another 100mg every three hours thereafter.

Assuming I've done the maths correctly (which is far from a certainty), am I right in thinking that I'm taking in more-or-less as much as my body can handle while exercising? The reason I ask is that despite the amount (of fluid) in my gut, I find myself craving solid food. Is there anything I else I can eat/drink that isn't going to upset my carb uptake?

Any advice would be greatly appreciated.

Vince P
Melbourne, Australia

Scott Saifer replies:

It sounds like your mix contains about 200 Calories. You didn't say how big or fit you are, but most riders can absorb something closer to 250-325 Calories per hour, with larger and fitter riders able to absorb more, so you've made a good start but could indeed add some solid food to the regimen.

Riding at altitude

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.

In the past I have not had issues with altitude - whether biking or snowboarding - other than being careful to stay hydrated and that it is more difficult to sleep. I will be 50 on race day, I would be viewed as pretty fit for a serious recreation rider, I have broad experience with long distance rides involving numerous mountain climbs and I train in a very structured way using a power meter.

My questions are: given that I basically live at sea level, what can I do to either modify my training or otherwise prepare myself for the event and the unique challenges posed to athletic performance by the altitude of this race?

Mike Weinstein

Scott Saifer replies:

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.

Kelby Bethards replies

About the acute acclimation. Dehydration is a real problem, but within a day or so at altitude the body begins up-regulation (makes more) of a chemical 2,3-DPG. This is a chemical that allows the haemoglobin to hang on the O2 molecules with less affinity. Simply put, it allows the body to release more of the oxygen circulating bound to haemoglobin, "easier" to the tissues.

Arch cleat positioning and shimming

I think I've read every question and response on your site regarding arch cleats, and am looking at taking the plunge - or at least picking up the drill - to try it out myself. I am curious about several comments you've made about mid-foot positioning eliminating or significantly reducing the need for shimming or wedges.

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.

I'd prefer to try midfoot positioning, but would like to understand more about what I might expect regarding my leg length discrepancy and stability on the pedal. What might I anticipate in terms of eliminating the need for leg length adjustment and wedging with a midfoot position?

Jeff Hahn

Steve Hogg replies:

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.

In-shoe wedges

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.

Dan R
Virginia, USA

Steve Hogg replies:

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.

Recovering cardio function

I stumbled across your site by accident and was impressed. Maybe you can give me some of that good advice, too...

I am 67 (female) and was a keen cyclist and hiker until a couple of years ago, when something went wrong in my lower back. Spinal claudication or some such condition fits all the symptoms, but unfortunately does not show up on the scan, so I cannot be physically attacked by people with sharp knives.

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.

I'd appreciate some advice on how to go about it. Obviously, I don't want to drop dead in the saddle (romantic as that might sound) and am planning to start very gently, but how gently is gently, and what would be the safest increment to aim at?

I'd love to be able to consult my doctor about such things, but all they seem to know about is medication in the form of pills, injections and horse liniment. Any advice most gratefully received.

Chris Madsen

Scott Saifer replies:

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.

Stationary bike

I am a 49-year-old woman, 5'6" at 325 pounds. My left ankle is fused (only toes move) and I've had my left knee replaced (both due to a MVA). About all I can do for exercise is swim. But that costs for membership and it takes time to travel and I've difficulty getting in and out of the pool.

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.

Sandra M. Welchert

Scott Saifer replies:

Good for you for deciding to do something about your overall health situation. I'd suggest you make sure you can get reasonably comfortable on the Schwinn 202 before buying it. If you can, it will be a good choice for you. Don't worry about the fused ankle. Pedaling with a fused ankle would not make you a great candidate for a win at the Olympics, but is fine for what you need to do.

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