Fitness questions and answers for May 1, 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.

Obviously, this has resulted in a very inefficient pedal stroke as every time I pull up on my right pedal, get out of the saddle to sprint, climb, etc, my right foot drops resulting in an inefficient pedal stroke. As you might have guessed, with foot drop on the right I have all kinds of muscular imbalances from 12 years of cycling. But, surprisingly, with two back surgeries and a ton of scar tissue to deal with, I have zero back pain and typically ride 250-400 miles per week.

The thing that has helped the most by far is purchasing a set of Rotor Cranks. With the crank arms being offset and the right one coming through quicker to help eliminate the dead spot, these things have almost made my pedal stroke as if I did not have foot drop at all. I am just curious though from your expertise, between moving my cleats all the way forward and the addition of the rotor cranks, is there anything else I should be doing to make my pedal stroke more efficient?

Are there any set up options that would be of benefit to minimise impingement?
Have you heard of similar cyclists with this problem and have they had symptom resolution with arthroscopic surgery?
Are there off bike training exercises that would be of benefit and maintain race fitness?
If hip replacement surgery is offered would racing be possible still. I assume a total hip replacement will be an option and not a Birmingham resurfacing type replacement?

To add to Scott's reply, you want to have both your hemoglobin and ferritin tested. If your hemoglobin in low (<13.5 g/dL for males) than your fatigue can be attributed to anemia. Serum ferritin is used as an indicator of iron stores. Following a vegetarian diet, even one that includes lots of plant sources of iron, can result in iron-depletion. Your ferritin level will tell you if your stores are adequate (normal range: 20-300 ng/mL).

Dave noted that rowing "will not improve your cycling". I would challenge this. The rowing motion, when done properly, is 80% reliant on leg strength. I know that many people incorporate weights into an off-season regimen, including leg presses. The majority of the force created in the rowing stroke is from exactly this motion. This of course assumes that one uses correct technique, which many people do not.

As the muscle comes back to life (after a probable 20 years of injury and inactivity), I can feel an ache or dragging sensation in the muscle during pedaling. I have not felt this before, and it is clearly the sensation one gets when an injured/recovering muscle is being exercised. It is getting less all the time as function improves. So I am therefore using the piriformis muscles continually when pedaling, and I am wondering as to what their role is.

I will let Kelby and Dave advise you on the specifics of who you should see but I want to relate something. I see a lot of people with various asymmetries and accidents of birth and development. They fall into two categories - the larger group for whom their structural shortcomings limit their ability on the bike and the smaller group who have the same issues on the surface, but it doesn't limit their performance on a bike.

You would do well to get connected with a coach local to you where you are. Meanwhile, the key to getting fit is having a plan you can stick to. That generally means one that starts out very easy and builds up very gradually. Since you are currently pretty inactive, any activity you take up will be an improvement and bring improved fitness, so feel free to mix several aerobic activities as you get started even though the main goal is cycling.

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