Fitness questions and answers for July 29, 2008

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.

I continued racing, but my legs were gone and I DNFed the next few and came home. I saw another doctor, took 10 days of antibiotics for a sinus infection because at this point the mucus had moved to the back of my throat with constant post nasal drip and plugged nose that had turned nasty colors. The greenish color went away, but not the clogging, post nasal drip or the constant throat clearing that I needed to do all the time now.

At this point I had cut back training drastically but my legs were still not good and were empty. I also started having extreme cases of what felt like I was bonking, even off the bike and especially after eating. This would happen 4-5 times a day and I would be extremely lethargic and spacey. Any type of carbohydrate I ate would cause this to happen and I could not even ride my bike to work without feeling like I had bonked and extremely lethargic.

This has continued in cycles for the last two seasons and my legs have never come back. I can ride OK at times, even race in the late fall and winter during the cross season with some success, but still with a plugged nose and what feels like hypoglycaemia shortly after eating or beginning a training ride. Sometimes after a large breakfast of eggs and oats I can ride OK for 30 minutes, but then my heart rate will drop more than 10 beats for a steady wattage and I will feel hungry and lethargic, eating a gu or bar will help slightly but will not take away the feeling completely.

I have been gaining weight the last 2 years now because I am constantly eating to stop from bonking and have gained about 12-15lbs even though I continue (or try) to train and be competitive - with very little success compared to what I had previously. My legs rarely feel good, even while training and my recovery is slow. I have taken extensive time off both winters to try and recover from this, but both years after starting to train all the symptoms reappear right away.

You probably have one or both of two potential problems. As background, my experience is that usually the leg with the knee replacement ends up 20 - 25 mm longer than pre operation because typically, the length of bone removed is shorter than the length of the artificial joint. This is because the femur and tibia taper from their diameter at the knee joint fairly quickly. A certain diameter of bone is necessary for the spigot on either end of the artificial joint to be hammered into securely. Usually the upshot of this is that the affected leg increases in length. Initially this tightens muscles as they are now stretched but rehab can sort that out over time. Also flexion of the knee is limited to about 110 degrees maximum providing the rehab is done conscientiously which can be painful.

The research supports the idea that there is an optimal road crank length for each rider, but not that it is proportional to height or leg length. I don't know of any conclusive studies to explain why crank length should not be proportional to leg length. I have seen a very tall rider with very small feet who could not ride smoothly on the expected crank length for his height and had to go down a full cm versus the cranks that would be proportional to his height.

In addition to what Scott says, don't expect pro cyclists to be any better than the general population in a structural sense. My experience is that they are not. As a group they tend to have the same problems and asymmetries as occur in the wider population of active male cyclists in their 20's and early 30's.They also have bigger engines that allow them to do what they do. If you watched the first week of the Tour you would have seen some fairly 'interesting' positions, Piepoli for instance.

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