Fitness questions and answers for January 9, 2007

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.

Steve, I have read with interest your take on optimal positioning, particularly as it relates to pelvic asymmetry. I'm a practicing podiatrist and avid cyclist with pain in the right knee of 21 months duration. At this point there may be something intrinsically wrong with the knee although it was scoped in November 2005 with no evidence of arthritis. My pain is patellofemoral in nature and localized to the inferolateral aspect of the patella.

Most likely you are pulling up with your ankles dorsiflexed (trying to keep your ankles closer to 90 degrees). The shin muscle or tibialis anterior is a tiny muscle with virtually zero-ability to deliver power. It is good for getting your foot in position for the downstroke, but not if you ask it to work under load. If you ask it to flex the ankle under load, it quickly gets tired and then sore. Try relaxing your ankle during the early part of the up-stroke, allowing the ankle to stay extended until the upper dead spot and then dorsiflexing with no resistance.

I took time off the bike and when I started riding again I noticed some pain right where my sit bones make contact with the saddle. I replaced the SLR with the SLR XP and the pain has continued. It feels like there is a small marble right on the end of my sit bones. When I feel it, there is something hard that moves right up against the bone. I have been told that it might be scar tissue from the 10 hour bruising that happened in the race.

About myself: I've been riding seriously for 9 years now, starting at age 21. I've never raced and I don't want to. What I have accomplished is that I've ridden my bike to work more often than I've driven. For five years I carried my lunch and clothes to work with a messenger bag, thus destroying any pelvic symmetry I had. I need it back. Yoga and chiropractic treatments are helping somewhat but I want a bottom bracket that isolates my left leg effort from the right.

I am a 29 year old male racing cyclist, 5'10" and 155 pounds. I suffered Perthes disease from 10-15 years of age and as a result, my right leg is 8mm shorter than my left leg. The entire discrepancy is in the femur and this has been established from x-ray images. In addition the hip joint and supporting ligaments and muscles are often very tight which creates a further apparent leg length discrepancy, but this element is variable depending on the condition of the joint - if it becomes inflamed as it regularly does, the apparent leg length discrepancy will worsen for a time, sometimes for days or weeks.

I have been using cleat stacking to aid more balanced pedaling throughout my cycling career. I also have my seat nose rotated to the left side slightly (the nose is 8mm approx from dead centre), as my left hip is forward through my pedal stroke in comparison with the right hip. I also tend to drop my right hip. Both of these symptoms have been confirmed by an observer while I pedaled on a turbo trainer.

My thinking is that while cleat stacking is effective when the crank is at the bottom of the pedal stroke (and the leg is fully extended), it doesn't seem to do anything to help when the crank is at its foremost position within the pedal stroke (with the knee at its highest position). This is because the cleat stacking is in the vertical plane only, assuming the shoe remains more or less parallel to the ground throughout the pedal stroke. Indeed the rocking torque effect seems to simply introduce new problems. I think this is exacerbated by the cleat stacking as there seems to be an exaggerated feeling of 'not pedaling in circles' and a difficulty in achieving a strong driving power at the very top of the pedal stroke. The effect seems to be a specific weakness in parts of the pedal stroke where a pushing forward (from the top of the pedal stroke) or pulling backward (from the bottom of the pedal stroke) force is involved.

If I used a 170mm crank on the shorter side, rather than simply stacking the cleat, I think this would help ameliorate not just impact of the leg length discrepancy in the vertical plane, but in the horizontal plane also, and without creating the same rocking torque problems that the cleat stacking has introduced. Lastly the hip joint tightness I experience might also be relieved somewhat as the impact of this is felt most at the top of the pedal stroke.

Thanks for a fairly complete description of your issues. With Perthes disease and inflammation of the joint capsule, the key to minimising the impact of this is to gain best possible control of the pedaling movement. As you suggest, the key to this is how far the leg has to extend but also and more importantly, how far the knee rises at the top of the stroke. By all means try the shorter crank as I have seen many instances of this working fine in similar situations.

It first arose 3 years ago and I spent over 4 months off of the bike, with no improvement. I had testicular scans, x-rays, etc. and nothing came up. Rest did nothing. I even visited a physiotherapist who did testicular massage, but without any results. Finally I saw my osteopath who diagnosed a misaligned pelvis, a regular ongoing problem of mine. After re-alignment the problem subsided for a few months and I raced a full season on the road. However it is now back again.

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