Fitness questions and answers for February 25, 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.

While I stretch regularly, I'm the last person to consider myself an expert on stretching but here is the best answer I can give you.Use the book as a self discovery tool. By that I mean you will have found that it is structured as a series of stretching lessons for different parts of the body. Perform the stretches in first chapter most days and once, twice or three times per week, do a longer session of the stretches you have found yourself to be poor at as you have worked your way through the book.

In addition to Steve's comments, perhaps I can recommend some yoga-based stretches and techniques that I have found essential in teaching yoga to cyclists over the past 12 years, and in my own experience as a cyclist. One of the most important aspects I teach in yoga poses that provide increased flexibility and mobility is to first mantain alignment of the joints - particularly when moving them through their potential ranges of motion. This includes both proper orientation of the joint and allowing appropriate space. Stretching just to increase flexibility without proper alignment can increase the risk of injury, which has unfortunately become a concern in yoga classes these days.

Returning from a right fractured patella six months ago, I find my left leg inwardly angled and brushing the top tube in my normal position. My right leg is good although still without regaining normal muscle size after injury. I have left anterior hip and left low back/gluteal soreness after riding. I also notice significantly less power from the left, (my polar power readings confirm this). I notice if I rotate my saddle slightly to the left my left leg appears straighter.

Thanks for all your tips in Cycling News. I emailed you recently about whether a fixed cleat position might not be preferable at times to a floating one, and you encouraged me to continue exploring options before I would accept that conclusion. Indeed you were right: changing cleat position and adding a wedge really made a difference and I'm riding completely knee pain-free in the cold months for the first time that I can remember.

2. That the recommendations on most energy bar products about calorie uptake are on the generous side. My brand, for instance (240 calories per bar) suggests eating one every half hour and supplementing it with gel packs every 15 minutes. That would total something like 800-900 calories per hour - more than the body can process (for, say, a relatively fit rider, 6'2" and 168 pounds) than you suggest.

I will add a few points to consider to Scott's thoughts. I generally recommend for longer races / rides (3+ hours) that athletes who have stomach distress eating too many bars or gels, consume "real food" early in the ride, then graduate to bars and then to gels (roughly first third for real food, bars for middle third, gels for last third of duration). The types of real food that work for riders will vary, so you need to experiment in training, but things such as jelly or honey sandwiches (some people like to add a bit of almond butter), fig bars, etc.

I train about 12 hours a week divided over five or six days. I do about two interval sessions a week and the rest is primarily base training now during wintertime. I am wanting to supplement my current regime with a bit more powertraining. I feel that it could benefit my TT and max power output, and give me that little extra that I need to take teh next step. However when I try to do powerpedaling with low cadence and high resistance I tend to get knee problems after a couple of weeks. I figure it is probably better to drop it if it is hurting me more than it is gaining me. Is there anything I can do to replace this training, or any other way I can do it that is more gentle on the knees?

First off let me say you are smart to drop the low-cadence work if it is making your knees hurt. Each time you ride in a way that makes your knees hurt, you increase the chances of doing some irreversible damage that leaves your knees sensitive for the rest of your riding career. That being said, it sounds like you have enough base that you should be able to handle some low cadence riding so most likely one of two things is wrong.

First, you are a hero for making a donation of blood or any party of blood. Donating plasma can be done more frequently because replacing plasma is much quicker than replacing red cells. When you donate plasma you reduce your blood volume which decreases the amount of blood your heart can pump. It's sort of like being dehydrated but not exactly since plasma includes proteins and electrolytes that need to be replaced along with water. So long as you are getting generous amounts of protein and the needed electrolytes, you should be back up to speed in a week or less. If you give frequently, your training is impaired in the few days after a donation each time so you could be compromising racing performance. I'd suggest giving not more than once a month and just planning to give at the beginning of what would be an easy week anyway. Then you can save lives and race well too.

1. This injury first cropped up a few weeks ago on the rollers. I've never experienced a knee injury of this kind before, and I've had a few. Thanks to previous experience, I've avoided making this one worse by pushing too hard, so it's been irritated rather than painful. The damage isn't too serious yet. I have already raised my saddle a bit (I stupidly dropped it when the injury first appeared).

4. I noticed on my ride home today that, while my left ankle remains relatively stable and my foot angle relatively consistent throughout the pedal stroke without effort, I have a distinct tendency to drop my right heel on the down stroke of that pedal. It takes some focus to maintain a relatively stiff ankle and avoid dropping my heel - that is, I must activate the muscles of my lower leg to do this. On the left, no such effort is required. Focusing on not dropping my right heel makes pedaling feel better.

So, here's my hypothesis: my injury is the result of this tendency to drop my right heel under power, which of course puts more strain on my hamstrings. My over-pronation might explain why the injured part is my medial hamstring group, rather than the strain being more evenly distributed. My saddle being so much further back would explain this not being a problem in the past, since this would effectively change the vector of the pedaling force through my leg and require me to pull my heel up as I pushed the pedal over the top and through the downstroke, making both for a reduced "cantilever effect" on the end of my foot (so less force for my ankle to resist) and causing me to keep my toes pointed enough to avoid straining my hamstring.

The tendency of my ankle to "give way" when balancing on the ball of my foot or just behind it, as you effectively must do when putting the power down on the pedal, would explain the unbalanced feeling of my right foot, even with the cleat rammed all the way back on the shoe. If this is correct, sensible treatments would include raising the saddle even a bit more to encourage me to keep my heel higher than my toes, and more importantly, strengthening whatever it is that is deficient in my right ankle, be it muscles/tendons or just the neural pathway involved in keeping that ankle immobile. Continuing to improve hamstring flexibility would also be a smart preventative measure.

First I would like your help recommending shims to correct a leg length discrepancy. This will be my 4th year racing, I'm 6' 0" with 34.5" inseam, 165-175lbs, Cat 2, a little bit flat footed, and very flexible. I ride 8-10,00 miles a year, usually in two or three 3-5 month blocks with long breaks in between; I'm inconsistent. I need the cleats right under the ball of my foot to feel that my leg is aligned. I've always had recurrent knee pain, especially ITBS on my right knee, though with a lot of stretching I can usually ride pain free for a month or two. This time of the year in the build up to the racing season is always hard. My right leg is stronger than my left (as evidenced through one-leg pedalling drills), and in the past I know I was guilty of dropping the right hip. I've been working deliberately to keep my hips level and pedal smoother circles for a year now, and I am much more stable on the bike, but still have periodic swelling of the right IT band. I have had left knee pain but only once or twice and goes away quickly.

I had suspected a leg length discrepancy because I used to need the right cleat further forward than the left to ease the IT stress. I finally had my girlfriend look at my legs with my back/hips against a wall and it became very obvious that my right leg is slightly less than a centimetre shorter, just in the lower leg. My femurs are the same length. So it adds up to me that since my right leg is overextending, the LLD is causing the IT stress, even now that I'm not dropping my hips so much. I'm nervous about experimenting with shims now because I have some heavy weeks planned and racing starts in April. On the other hand, I feel like shimming my right cleat could end this chronic issue and so I'm very interested. I think I've read that shims should be as thick as half the leg length difference. What can you recommend about this process?

Secondly, I have a little to share about my experiences with shoes. I started Specialized road and mountain shoes with a varus wedge. I had to pedal with my heels in, so much so that they brushed the crank arms, and my knees were far from the top tube. I never could get the cleats in a comfortable place for my knees, though after a painful winter of adjustments I could usually be stable for the duration of the spring racing season, as I mentioned above.

Three seasons later I bought Shimano mountain bike shoes to replace my Specialized mountain bike shoes, and was able to ride with my feet straight and experienced much less knee pain, so I avoided my road shoes until I could buy a non-varus wedge pair, which were Adidas, a few weeks ago. These shoes had a foam shim under the insole on the lateral side of the shoe, creating a valgus wedge. Wearing these shoes, my knees were so far in that they brushed the top tube and my heels wanted to be significantly further out than neutral. I removed the lateral shim and they now feel flat and neutral like the Shimano shoes, my knees move straight up and down. I feel like there's a very linear relationship for me between knee and foot position and the angle of my shoe's sole, is this the case for the majority of riders? I see clearly how you could use this to correct positions for some riders, but my experience leads me to be very cautious with any canting of the foot.

I think your choice is pretty simple. You can struggle on the way that you have been or you can fix the problem. If you are convinced that your right lower leg is shorter, then no amount of training yourself to sit squarely on the seat is going to change that. The likely cause of your right side ITB issues is that you are overextending the right leg or compromising pelvic symmetry on seat so that the right leg can reach the bottom of the pedal stroke.

I have a son, just turned 13 in Feb '09, that has an interest in cycling. He raced in a mountain bike series in 2008 and won his age group for the series. He entered one road race - Tour de FCC in PA - and came in third overall and winning the crit stage (race consisted on a road race, TT, and crit). I just found out that two of the kids he beat in the crit came in second and 18th in the nationals, for 2008.

I run a junior development team with kids of similar ages and abilities as your son, so I can personally relate to your question. What I recommend is that you find someone locally with experience, who is good with kids and who recognises the importance of keeping it fun. It's useful to teach him the fundamentals of riding and racing and even gently guide him in training, but he is a young kid after all, and maintaining the joy of riding is most important. I can see if I can find a good local mentor/coach to recommend.

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