Fitness questions and answers for February 20, 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.

7. My right knee has always been very sloppy. A bike fitter once asked me 2 years ago if I ever had any injuries to that leg (Which I have not). My right knee tends to want to move outwards. This is most noticeable when my right leg is at the top of the stroke. When I lean down lower than my normal position on the hoods, my right knee seems to want to move outwards more, and at the same time my hip flexor will feel tight and restricted. Again, this is when I am in the upstroke. On the down stroke on the other had, my heal on my right foot will move inwards towards the bike, and my toes pointing away from the bike. With every pedal system I have owned, I have had problems with this. I feel the need to want to move my right cleat so that there is enough outward play so that I do not feel constricted while pedaling. Meanwhile, my left foot is perfect and not nearly as finicky.

8. I own a Trek 5500 carbon in a 56cm, which I have had for 2 years. I have been hoping to get a LeMond Zurich Steel/Carbon frame for this year, just to have something with different geometry. My saddle for a while was a Selle Italia Flite but I have recently (within the past three weeks) changed to a Fizik Arione but have not noticed any changes/improvements in any of my issues. My current shoes are Northwaves and I believe they are size 43 or 44 (sorry, the size is worn off and I can't remember), in the past I used Answer and Diadora, they were both either size 43 or 44 as well. My current pedals are Ultegra PD-6610 (6 degrees float). I have just gotten these pedals a few days ago. Up in till then, I used LOOK Keo carbons (9 degree of float). Before that I used campy Daytona pedals.

Also, I would like to mention something I noticed recently. When I walk my right leg seems to be turned outwards more than the left. If I were to walk, then stop and look at the position of my feet, my right foot is pointing outwards, just the same as when I am on the bike as I mentioned in question 7 when I am in the down stroke. Also around this time last year I had tendonitis in my right knee, I believe that this happened because of my imbalances in my right side. Another note, before I started cycling (about 4 or 5 years ago) I did weight lifting at my house for about 1 year. I was lifting very regularly, usually 3 days per week. I was unsupervised. Maybe this has some to do with my imbalances. My workouts included upper and lower body stuff. Thank you very much!

I am a 34-year-old category 2 road racer with a history of knee problems. To give you some background, I have scoliosis and my right leg is 1.1 cm shorter than my left (confirmed by CT scan). I started racing approximately 12 years ago, when I made the switch from avid mountain biker to roadie. I never had knee pain prior to making the switch to clipless pedals, but the very first ride I went on with clipless pedals caused really severe knee pain. I recovered from that pain, and then had someone look at my fit, but I was not able to resolve the issue. I was just about to give up road biking and go back to toe straps, when I got a really excellent fit. This took care of some, but not all, of my knee pain, which was essentially limited to my left knee.

The knee pain is hard to describe, but it feels as though my knee is "crunchy," and when I get done with a hard ride it feels as though my knee needs to pop back into place (like the patella is too far to the outside of my knee and needs to slide back to the middle). Once my knee pops, the tension in my knee is relieved. I just joined a new team, which is sponsored in large part by a well known sports medicine center in Pittsburgh (UPMC sports medicine). They offered to look at the problem. They said that my left knee is making a huge loop at the top of the stroke, to the outside and then to the inside. It stays to the inside through the stroke.

Surprisingly, they also said that my seat was approximately 3.5 cm too far back using the KOPS method (they measured from the bony protrusion below my patella). This was surprising because I am 6'1" with an inseam of approximately 33 inches and my seat tube angle is 73.5. My seat isn't pushed that far back, and my femur is long in comparison to my lower leg. I remembered that during the fit that set my old position, the guy doing the fit slid my seat forward but didn't want to go any further, even though he though he could/should have, because he didn't want to alter my position so drastically.

Anyway, what I'm now trying is about .5cm of spacers under my cleat for my right (short) leg, and with my left leg I placed 4 LeMond wedges to tilt my foot to the outside (with the thick part of the wedge toward the frame). This seems to cause my left leg to track...if not straight then a little straighter. But the wedges on my left at least partially offset those on the right. According to this new position I would need a frame with 75 degree seat tube angle to get in the appropriate KOPS position, and a long top tube since I have a long torso. Also, there still seems to be tension in my left knee, but there is definitely less. My knee has been "popping" more easily now, however, which leads me to believe either that a) the position is closer to what it should be, and therefore there is less tension and so it pops back into place more easily, or b) my knee is getting worse, as evidenced by the popping. Any advice you might have, on the physical condition, the KOPS position, etc., would be really, really appreciated.

I'm a 49 year old male, ex-semi-competitive cyclist. I really haven't been able to ride much in the last two years due to a pain that develops in my right lower leg in the peroneal nerve after I've been cycling. The cause of this pain is believed to originate in my lower back. They have found that I have a small hemipelvis on the left side that causes a 6mm tilt to the left. I use a hip pad of 6-7mm on the left side now, when I'm sitting for any period of time.

Over the last few months I am finding that I experience a lot of tightness in my hamstrings when I have been track cycling, particularly if the races (in C grade anyway!) are of a longer distance i.e. over 15 laps. The tightness, in the inside hamstring on both legs, gets to the point where it limits my ability to maintain power to the pedals. I have sought advice on bike set up from a number of people at the club I ride with (and have also had physio and have been stretching daily) but the problem is not going away. I don't have any problems on the mountain bike. Are you able to provide me with any possible solutions?

-My right knee buckles inward and comes much closer to the top tube than the left. Under heavy load it may brush the top tube.
-The left knee wavers in and out a little.
-I sometimes get pain in the medial arch and side of my right foot just in front of the ankle.
-My hips are tight - my right is worse.
-I am noticeably tighter in my left lower back.
-I have tight hip flexors and I have difficulty with good back extension. I recently began to see a structural specialist and started a stretching program.
-My left hamstring is tighter than the right and my structural specialist said that I stand with slight hyperextension at my right knee.
-My right leg/foot is a little externally rotated.
-I suspect that my left leg carries more of the pedaling load.

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