Fitness questions and answers for May 22, 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.

I have been following the cleat and saddle positioning threads of the last few months with interest. I am a recreational rider who tends to get sore hands and a bit of shoulder pain on long rides, and I also have a non-cycling related injury to the musculotendinous junction of my achilles/gastrocnemius in my left calf. I am 5 foot 8, 150 lbs. I wear SIDI Genius 4 shoes, Speedplay pedals, and have a cycling inseam of 33.25 inches. I ride a steel frame with 56 cm seat and top tubes in order to have a tall enough head tube to allow me to bend my elbows and relax my my arms while I ride. I have a fairly flexible lower back and hamstrings-- I can touch my palms to the floor with some effort while in a straight-legged standing position. I'm 38 years old, do mostly recreational riding and some racing.

When I got more serious in cycling several years ago, I set my saddle fore-aft position according to KOPS (Knee Over Pedal Spindle), which I thought was standard cycling dogma at the time. In order for me to achieve KOPS on a frame with a 74 degree seat tube and a seatpost with a fairly standard amount of setback, I had to have the saddle shoved all the way forward on the rails. With this setup and a saddle-to-handlebar drop which I varied from 3-4 inches, I would frequently get hand and shoulder/trapezius pain on longer rides. I had begun moving the saddle to the rear and the bar up a little bit about a year ago to try and reduce the pressure on my hands. Your saddle setback balance test (which mirrors the philosophy of Peter White, see his ideas here: http://www.peterwhitecycles.com) advocates being able to take your hands off the bar while riding and still maintain your forward lean without falling over, or being at the point of teetering if done indoors on a trainer. My current position nearly meets this test, but places me at a position where a plumb line dropped from underneath my kneecap falls approximately 3 cm. behind the pedal spindle.

Also, are there other issues other than fore/aft weight distribution and bar height to address a problem regarding sore hands/trapezius? Regarding cleat position, I recall that in one of your previous responses, you mentioned that you would be addressing ways to move the cleat rearward when using Speedplay cleats. Currently my cleats are as rearward as possible without modifications. I was considering either grinding off the rear corners of the cleat or enlarging the screw holes which mate the top plates (4-hole) to the intermediate plates (3-hole).

Which method have you used and what comments would you make about the process? I also have recently been using Sole moldable footbeds in my Genius 4's. Even with the Ultra model, which is thinner, they do add a bit of heel lift. For shoes my size (43), would you recommend trying to move the ball of the foot about 10mm ahead of the center of the pedal spindle, or even further? I am not sure can identify that spot (center of first metatarsal) that accurately through the shoe, but I note that experienced fitters such as Paul Levine have suggested measuring from the second metatarsal, from the base of it if I recall correctly. It seems that your philosophy of putting the ball of the first metatarsal a bit ahead of the pedal axle would put the base of your second metatarsal very close to the spindle of the pedal axle, which I believe is Paul Levine's starting point for cleat fore/aft placement.

I'm a 35-year-old male cat 3 / 4. I'm 5' 7" and currently 132lbs. My inseam is 32.5 inches, so I'm more leg than torso. Max HR of approx 202. I'm suffering from lower back pain for the past two months. It appears as if this was done while I was moving. I relocated from the Northeast to the Southeast. I'm now in South Florida. The pain has been present ever since and would not subside. I visited a Chiropractor a week ago. After doing a few x-rays the results were as follows:

The right tibia is approximately 11mm shorter. I had the owner of my local bike shop observe me on the bike. His findings were that I'm not square on the bike. My right hip is forward. He measured my arms from the elbows to middle finger and found the right to be 1 cm shorter than the left. He took the angle of my leg on the lowest point of the pedal stroke. The right leg was 32 degrees and left 34 degrees. He also said it doesn't appear as if my hip is dropping. Hope this is helpful. Looking forward to hearing from you.

A short profile is that I'm 59, weigh 205lbs and have a height of 6'3". I was out of cycling for 15 years but stuck my toe back in the water a couple years ago. About 25 years ago I was a mediocre racer at best. The highlight of my career was winning two "B" category (versus A where the cat 1 & 2 guys were) training series crits on a flat closed circuit (by being shrewd rather than good). At that time I weighed about 180.

When I decided to get back into cycling I went to a respected bike shop (that advertises with Cyclingnews) and was carefully fitted to a new Colnago Dream B stay with good components. I was fitted using a Serotta fitting cycle. While I was totally satisfied with the buying experience I later found it was very difficult to get comfortable on the bike. Not to sound like a total cycle hypochondriac but we're talking lower back pain, numb hands, saddle making male areas tingle,... I couldn't get comfortable enough to ride more than half an hour without issues.

I then made an appointment with a shop that specializes in fitting issues and training for triathletes and racers. One that came very highly recommended. I spent more than half a day with them. I was measured every which way, video taped, power output measured, put on another Serotta machine, interviewed and whatnot. New saddle, new stem, adjusted geometry, footbeds, and encouragement. The changes helped noticeably with comfort, and my speed went up a little, too.

A year later I find myself with the discomfort symptoms back. After an hour of pedalling it becomes less fun. After more I need to get off the bike to stretch to continue. I'm more than a little frustrated. Now that I have time to put into cycling comfort has become a limiting factor. Rather than having a specific question I'm wondering who you might suggest I speak with about a plan for how to get back on track in general. Did I buy the wrong frame? If so what do I do now? How do I get it fitted perfectly? Are my comfort issues solvable or am I so brittle, inflexible and "experienced" that the lack of comfort is unavoidable? Do I go back to the fitting service I've used for more work, or do I find a cycle guru with experience dealing with someone with my specific 'resume'? Thanks in advance for your advice.

Hi Guys,
I am a 25-year-old male and have been cycling since I was 14. I race both track and crits here in Adelaide. I have a serious back problem and looking for some advice on what do. November last year I hurt my back, not sure if it was from training/racing or in the gym. CT and MRI scans revealed a protruding disc in my L5-S1 causing major pain with the sciatic nerve in my right leg. I have had two Foraminal Injections in my L5-S1 neither giving me any relief, constant physio and neither giving me any relief and looks like an operation (discectomy) is the only way im going to get relief.

After several weeks off the bike the problem went away. This year starting in January I noticed my heels were dry and peeling. It hurt to walk on them barefoot. The area around my tendons would always be a mild red. Towards the end of February I had mild pain and could produce no power. One of my other biking buddies said Achilles tendonitis. The doctor concurred. He couldn't understand how I could do it biking. I didn't bike for three weeks. I still had pain.

I decided to move the cleats in a sort of desperation. I moved the cleats all the way backwards. I had them previously in20 middle. This puts my ball of the foot very close to the center of pedal axis. I did not experience any pain in my ankle after riding some short trips. I noticed a slight sensation after the group ride on Sunday of 50 miles. I rode in the small chainring with various gears and I went a little nutty once in the 14.

I do not think that I get maximum power from my current seat position in the drops, but I haven't really tried to judge it. I also want to have a good position to avoid pain and damage. I've attached my training log for the past three years. I did not have any goals other than riding around for the past few years. I was considering of trying a local criterium or two, but I don't know if I can do it at my current state.

Here is my situation: I recently was able to pick up the amount of riding (time and distance), and my legs (quads mostly) have felt like they never recover (i.e. always feel sore). I have also noticed that my heart doesn't seem to rise to the level it used to before I feel the effort. I was riding previously in North Carolina (flat to slight rolling), riding about 2-3 times per week (about 20 miles, no long rides). Upon moving to South Korea, I began riding 3-4 times per week, and lengthening my weekend ride. Terrain changed significantly with flat terrain spotted with 8%-12% grade hills. I began an aggressive effort to be able to tackle the hills, and while I can tackle them (and at a quicker pace), my legs always feel tight, especially the next day. Previously in riding, I only experienced that for a short bit, and then my body felt like it caught up. The tightness does not seem to go away.

I am a Cat. 3 road and cylocross racer, mostly mid-pack, 43 years old. I am 5'10", 150 lbs. This past March I developed pain in the knee, probably "jumpers knee" or tendonitis perhaps. This has happened to me in the past as well. Anyway, I have been noticing that my left femur is not symmetrical with the right. For example, when I lift my legs in the air and bend the legs at a 90 degree angle to do crunches, the left knee is about 1-2 cm longer. I also notice this when I do squats - in the lower position the left knee is 1-2 cm longer than the right.

I am a 23 year old category 2 racer, and in the past two years or so I have often had problems with twitching muscles in my right calf. At the end of hard rides/races, this twitching can lead to a cramp if I happen to point my toes down too much at the wrong time. It's something I've pretty much learned to deal with, and I can still finish well at the end of a race even when my calf is twitching like mad. I've tried the traditional cramp remedies: staying hydrated, using sports drinks, electrolyte pills, etc. and nothing seems to stop it. I am pretty much convinced that I have some sort of positioning/biomechanical issue since the twitching only happens in my right calf and also because it shows up regardless of the weather conditions or type of ride I'm doing. I sometimes even have twitching after something as easy as a one hour recovery ride.

I have seen a professional fitter to try to figure this problem out, and although he did move my position around a bit it hasn't gone away. I also tried moving my cleats back as suggested by Steve Hogg on this site, and again that didn't solve the problem. I recently read a book which suggested angling your cleats so that your feet can take on their natural angle while you're pedaling. By natural angle, I mean the angle that your feet assume when you sit on the edge of a table and let your legs dangle with your feet parallel to the floor. I tried this test and noticed that my right foot assumes a very large angle, with my toes pointing outward and my heed pointing in towards the other foot. The angle is large enough that if it would be impossible to duplicate it on the bike because my heel would rub the crank. What I did try, however, was to angle the cleat as much as possible to try and get my foot closer to its natural position (FWIW I am using Time Impact pedals, and I have them set on maximum float). I did an interval ride like this today, and unfortuantely the problem still showed up.

I'm a 23 year-old Cat 4 racer and triathlete, 5'11" and 155 lbs, who has been having some foot numbness issues. This winter I changed bikes, shoes and saddles - Cannondale CAAD 8, Shimano 215's, and Fizik Arione, respectively - and began training normally. I noticed that my toes were getting colder than usual, but chalked it up to cheap booties. But as the weather has gotten warmer, I've noticed that my toes aren't getting cold so much as they are getting a little numb. It's mostly in my toes and ball of my foot. I have tried going back to my old shoes and saddle, but it hasn't seemed to help. I also notice the numbness on my fixed-gear commuter. It usually comes on after about an hour in the saddle (on either bike), and lasts until I get off the bike.

I'm interested in getting the numbness to go away, but also in knowing if I should be worried about it. It is not painful, mostly just annoying. It also is not so bad that I have to get off the bike, I just ride through it. I'm training for an Ironman triathlon, so I do a good number of 4 and 5-hour rides. Should I be concerned? Am I hurting my legs? For a while I thought it might be a bike fit issue, but I've been fit at the shop I work at, and it was right on. I'm also pretty good about stretching both after the ride and on days I'm not on the bike. Any ideas?

Yet since I have had this bike my hamstrings have at times been irritated. Last week I raced in a half ironman and was in complete agony, all I wanted to do was cry and get off the bike and I have never felt like that before. Where the hamstrings attach to the bones on my bottom felt like there was nails driven in. On the second lap (30km loop) I was sitting un aero (straight up), rolling right forward, any position that was not on the spots.

I just found the forum and am still baffled as to where and why my knee pain is presenting. I am 25 year old male, cat 3 road racer, who also races cross and mountain bike. I average roughly 8 hours/week of training. Earlier this winter I sold my road bike and rode my cross bike at the beginning of my base training then switched to a friends road bike for more intense racing and the first few road races of the season. I was pain free on both these bikes.

At this point I got a new pair of pedals, Crank Bros. Quattro SL's and they felt off. Within two days my new road bike showed up and I put the new pedals on and began to ride. Within a few days I was getting some good irritation in my knee (the pain seem to alternate from the inside of the knee, to the top of the knee, to just above my tibia). I then went back to my old pedals, Looks, and kept riding and racing but still was getting pain.

I then took a few days off, went and got an official bike fit. They raised my seat, moved it back and put me on a shorter stem...at the fit I felt better but was still irritated in the knee. We ended up going to a Speedplay pedal with 3 shims for the bad leg. We also noticed that my IT band was extremely tight. At this point we agreed upon a combination of the new setup and some aggressive stretching and massage. I also took a week away from the bike. But since then I have started riding again and the knee pain is back. I have measured the geometry of my new bike vs. my friends and they are very close, the main difference I notice is that my new bike has 175 mm cranks and my friend's road bike and my cross bike both have 172.5 mm cranks. Can this difference in crank length be causing the agony?

I have been suffering on and off the Bike for many years with a sorish lower back (on the LH side), it has got worse over the last year or so. I have followed many of your postings and bike set up procedures plus had medical checkups done by various Doctors, including physio and related core exercises, all of which made very little difference. The only thing the Docs could find was that my left leg is about 1 cm shorter than the right. This was not measured by x ray but by a visual assessment of my left and right hip bone height, how I walk and adding thin plates under my feet until the hip bone heights were equal. As a result I am now wearing a 5 cm heel raiser in my RH shoe, in a few weeks I will progress to a 7.5 cm raiser. So far I must say that my sore back feels better, albeit only 1 week since I started wearing the raiser.

The Doc said I should also add the heel raiser to my shoe, my question is - Would a heel raiser be effective in a cycling shoe for correcting leg length discrepancies? I have been trying to find ready made shims locally (Switzerland) without success, can you recommend anyone on line who makes and sells shims? If I decide to manufacture my own what easily available material would you recommend using?

I've measured forefoot varus, noting slightly more on the right side with one wedge as the recommended range. My physio has noted the same with a temporary orthodic mold to see if that is a direction I want to go. I've tried varus wedges with some success, but using more on the right side doesn't seem to feel natural. And the temporary orthodics hurt my reasonably high arches as they are not padded. I have not decided to throw down $300 for these yet, as I am not convinced this is the solution.

Over the past few years, I've developed a very hard muscle knot about 3 inches about the patella just to the lateral side of the quad betweem the rectus femoris and vastus lateralis. The knot, surrounding muscles, and IT band have been worked on thoroughly by both a massage therapist and physical therapist. I suspect it has to do with using excessive force pulling over the top and early stages of the downstroke on the left side, all whilst moving around for some compensation happening on the right side.

In terms of stability and cleat position, I can't seem to find what stance width and toe in/ toe out arrangement is appropriate. I seem to want to have the left cleat slightly more toe in then the right, and I would assume this is due to reaching a bit more from hanging to the right. When the left cleat is positioned a fractioned toed in too much, and my seat is a bit too far forward, my IT band/vastus lateralis is a war zone for more than 24 hours post ride.

The last time I had really ridden with any sort of intensity was about 10 years ago. About 5 weeks ago I determined to get back on the bike and lose some weight/get in shape. It's difficult where I live to avoid hills, so about 5 days in, I rode a couple of small hills. My ankle troubled me after that a little: stiffness, lack of strength through range of motion, soreness causing me to limp while walking...etc, but it was manageable. I started taking 500mg of Ibuprofen 3-4 times a day, and re-doubled me efforts to stay away from the hills. The pain slowly went away over the next week.

After two weeks, I felt comfortable riding for 90 minutes, so I went for a group ride. Put in about 2-1/2 hours over flat to slightly rolling terrain. Felt fine (if not a little tired/sore in the crotch). A day or so later, the soreness was back. I rode a little bit (15mins) the next day to try and stay loose. It got worse the day after that, to the point where I couldn't walk on it. I started on the Ibuprofen regimen again, but it had no effect.

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