Fitness questions and answers for May 30, 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 just sprained my right ankle while stepping off of a curb. The ankle rolled to the inside. There's almost no pain and I can walk with just a bit of pain running along the top of my foot towards the outside. I got an x-ray, which was clear, so they put me in an air brace. My doctor was not very helpful when I asked about cycling and rehabilitation. His answer to all of my questions was "just ease into it over the next couple of weeks," so I'm hoping you can help me out. I'm still in the early part of the season due to a prior injury, and I'm racing 2-3 times a week. I'd like to get back on the bike as soon as possible. How long should I wait to start riding? Should I take it easy for a while? Should I wait longer to race?

I'm 19, 6 foot 4, 82 kilos, doing around 400 km per week. I've done the road and crit seasons the last two years with mixed success. Approximately a month ago I started a new job - it is by no means strenuous, but just involves standing up all day, three days a week. Ever since I began working I've had absolutely no form. I just seem to have nothing in my legs and 40km solid ride makes me cramp, where as before I could do 120km cramp free.

I can't seem to raise my heart rate above 140 either. At the moment it's just impossible to go hard. My racing is extremely important to me so this has really got me feeling like crap, mentally and physically. I can't give up the job; I don't think I should because surely there are plenty of successful local riders who have for more physical jobs than I do. For the past month all my rides have been terrible and nothing seems to help. Any advice you could give would be much appreciated.

I'm a 38-year-old masters racer. I started preparing for this season in November, and have been training consistently since then, doing weeks of 12-18 hours with rest weeks every fourth week, in a periodised structure. Due to a couple of bouts of the flu, I never completed a cycle of VO2 intervals, and I haven't done any training over my threshold since March. However, I've been feeling burned out, even though spring illness cut my racing and hard training short. Is it the right time to take a break, even though I haven't done much intense training this year?

I am a 25 year old, 6'4", 175lb Cat 3 road racer who has been training and racing for six years. I have been having trouble with my right lower leg, only while cycling, for the past five years and up until recently have not been able to figure out what the problem was despite seeing several doctors about the problem. The injury started when I raised my saddle height too quickly but never lowered it significantly despite the injury. The injury was focused mainly on the peroneal muscles, but the soleus, calf muscles and tibialis anterior were also affected.

The pain in the lower right leg usually starts at the beginning of a ride and goes away if I start to ride hard. However, the pain returns after the hard ride is over and sometimes lasts into the next day. Strangely the pain is worse and more noticeable when I am just spinning easily. I have very flat feet so I originally thought that the problem was caused by pronation, and so in response I had custom orthotics made for my cycling shoes. The posting in the orthotics only made the peroneal muscles more inflamed because I tended to pedal only using the outside of my foot.

Unfortunately, I used this insole for 2½ years before removing them just recently. Probably as a result of pedaling using the outside of my right foot I have also noted that the outside muscles of my lower right leg, the soleus and calf, are very large while the inside portion of the soleus and calf are very small and appear to be only slightly developed. However, recently I was diagnosed with having a right lower leg that was about ½" shorter than my left lower leg, probably the result of breaking the right lower leg when I was very young. I have read your tips about shimming and cleat position for other riders with short legs and have changed my cleat position using Steve Hogg's advice as well as shimming up the cleat by a little more than half the leg length difference. I have also lowered the saddle significantly which has resulted not only in slightly reduced pain but also in more power.

I have now been riding for about three weeks with the changes made but am still having trouble lower leg mainly with the peroneal muscles, both the brevis and longus, but especially where the tendon runs underneath the lateral malleolus. My question is does my injury sound like the result of a short lower right leg and if so how long should it take to notice an improvement from making up the leg length difference using shims and the new cleat technique and should I be doing anything else such as strengthening exercises to strengthen the entire lower right leg to counter balance the overly strong outside portion of the leg? I apologize for the long-winded question. Thanks.

The short answer to your question of how long your recovery would take is that you should pose this to a health professional who can see and advise you based on examination. I would ease right off in intensity for sometime and ride and train at a level that gives you no grief. Which side is affected or is it both? When you look down between your legs while pedalling, is there a larger gap between inner thigh and seat post on one side than the other. If so which one? Let me know and I will attempt to advise further.

I'm a 29 yr old cat 3 racer. I'm 5'10" and I weigh 173. I have a decent muscular build and tend to develop muscle mass easily. I don't have any health problems relating to my biomechanics and/or movement. In my past I've had no surgeries and I've always been injury free, although I tend to have tight muscularity and stretch 30 minutes a day five days a week to overcome tightness. I typically race crits and I have a decent sprint. Assuming my fit is correct, I've had a hard time being comfortable with my position. When I ride, my right foot points away from the bike and my left foot points towards the bike. I sometimes feel like my hips are sliding on my saddle to get comfy. What gives? Could my core, hips, abs, and back, need strengthening? Oh, I also wear arch supports at work but not on the bike. I tend to walk and run that way as well. Please help.

I suspect your self assessment is flawed in that you are confusing appearance with function. What you are saying tells me that whether you have a poor bike position or not, you internally rotate one hip and externally rotate the other on bike. This is likely to be caused by sitting with one hip further forward than the other on the seat, which in turn could be caused by a host of different possibilities, all of which have to do with left/right asymmetries of function or measurement. This is also why your hips feel the way they do on the seat

I've been using Speedplay X-2 pedals on my road bike for about 2.5 years. Last season I had some minor early season knee discomfort that went away as my fitness returned and mileage increased. As autumn approached, I switched to Shimano 959s on the 'cross bike for racing and commuting. I rode with them consistently from September through December. I did plenty of cross racing and commuting and my knees felt fine. I didn't ride a heck of a lot through Jan, Feb, and March with cruddy NE winter and general lack of motivation. As I have started riding again this spring in late April, back on the Speedplays, I've noticed that my knees seem to be less agreeable than last year. They're generally achy a bit while riding, though they tend to "warm up" and off and on while sitting at my desk or walking around. I checked the fore and aft & height to be sure I'm good and I am. I am wondering if going from a pedal system with some float (SPDs) to unlimited float (Speedplays) makes any difference. If it matters, I rode Looks previous to Speedplay. I switched because I heard Speedplays were easy on the knees and I could not stand the summertime Look squeaking I could never seem to eliminate.

The best approach to answering your question is to eliminate variables. Are you positive that you have the cleats for both systems in the same relationship to foot in shoe? Are you using the same shoes for each system? Are you positive that you have compensated for any differences in sole thickness and /or cleat height? Is your seat and handlebar the same shape on both bikes? If so, are they in the same relationship to each other on both bikes? Let me know and we will go from there.

I am a 41 year old female and I have been training for 4 months, one ride a weekend. Various lengths 40-100 miles with various terrain. I have been able to complete (4) 100 mile rides and feel pretty good throughout the ride however some rides, even the shorter ones I notice the outer parts of my knees and the back of my knee area are getting more painful when I ride, as well as my thighs (mostly the left one) get so fatigued I can't see how I can keep riding.

Now the bad news - I have a replaced right hip, have had back surgery and have one leg shorter than the other, which likely all contribute to my riding style or lack thereof and likely causes leg cramps too. I have been trying several things, diet wise, but just don't know what else to try that may make cycling more enjoyable again. I only have 1 more month before it is showtime for my cycling event.

I am happy to try and advise but given your history and the small time you have left before your event, by far the best solution would be to engage some professional help with your position. You need to find someone with positioning expertise that has experience with people new to the sport with a history of problems such as yours. Ideally they need to be someone who takes a structure and capability based approach to working around your issues rather than a measurement based approach.

I have been experiencing foot numbness after about 10 miles on just about every ride this year (I had Guillaine-Barres Syndrome in 2003, but haven't had any other symptoms since being treated with immunoglobulin). The numbness begins to subside immediately after getting off the bike. I did the plumb bob check and moved my saddle forward about ¼ inch. That seems to help, but the numbness still creeps up. While riding, I try to concentrate on wiggling my toes, pulling up on the pedal, anything that minimizes pressure on the feet. I'm wearing Diadora Ergo shoes with (old) Campy pedals and look cleats. Any ideas? Thanks in advance.

Some time ago I wrote in requesting advice regarding sciatica-type problems in my left glute and down my leg, with foot numbness and loss of power as the on-bike symptoms. Kelby kindly replied with some suggestions for exercises which I have followed. I am also seeing a physio at the university where I work. He has diagnosed my problems as being down to a problem with my pelvis/ sacrum. Apparently I 'drop' the right hip and so the left leg overextends and forces the lower back to work harder which results in the symptoms I have.

So far so good, but I'm beginning to think that maybe this is not all there is to the matter and I would welcome any thoughts that the team might have on the matter - particularly Steve. I'm wondering what else I might try since even though my physio has 'put my hip back' and I'm doing core strength exercises, the symptoms remain. I still have the numb foot and leg ache and loss of power. Another thing is that it seems that only my right buttock sits on the saddle - this is something I feel when riding, but someone also observed this the other day. Any thoughts/suggestions greatly appreciated

If your right hip drop is caused by an over tight right iliopsoas, and if there are trigger points present in that iliopsoas [a couple of ifs but quite possible] you have a long term problem that won't be fixed until those trigger points are addressed. If your hip was " put back" and the symptoms remain then the job isn't done yet. Dave Fleckenstein may have some thoughts on this but recommend of a couple of books to your physio called "Myofascial Pain and Dysfunction - The Trigger Point Manual"; and "Myofascial Pain and Dysfunction - The Trigger Point Manual, The Lower Extremities" both by Drs Janet G Travell and David G Simons. They are heavy going for a layman like me but might prompt your physio a bit.

Thanks again for your response last time. I have since found it in the budget to purchase DMTs, and I'm trying to figure out what to use to build up the right cleat. I think I may be building it up slightly less, actually, though I'm not sure. I've noticed my left soleus has been significantly more sore than the right on most rides when I push hard. I wonder if this is from pointing my toes more on the left in order to compensate for excessive cleat stack on the right, which I had done to compensate for my right leg being shorter. I've also noticed that more padding on my shorts hangs off the right side than the left. I've also figured out that the left piriformis is a bit tighter and perhaps inflamed. So I've been taking extra care with those muscles, but it makes me wonder what else I might do to straighten myself out. Perhaps I've overcompensated?

The flexibility is coming along, but still some crookedness. The longer crankarms have helped, actually. Well, they seem to have helped, combined with the new bike and better position for my size. Regarding your balance test; what if I slide forward on the saddle when unweighting my hands? Does that mean I should move it forward? At this point I'm rather far back, though I do not find my hamstrings to be a limiter. So as for the DMTs, is there anything special I need to do given that the sole is carbon, in terms of buildup? Also, the sidi look plates are too flat for the sole of the DMTs, and le wedges would be too many, given the stack I need. Any ideas? I will be able to get the cleat setback I need, though, so thanks for the advice. Once again, your expertise is much appreciated. Too bad I can't pay you properly with a visit to the shop! Boston's just a tad too far. Best,

The greater gap on the right side strongly suggests that you are hanging to the left, or dropping the left hip on each pedal stroke while riding your bike. This may be because of a short left leg, or probably more likely tighter hip flexors on the left side, particularly iliopsoas. What happens is that by hanging to the left, the right leg then has to reach further and the muscles that stabilise it are under more pressure because of the challenge presented by this. Over time this extra strain presents itself as a seemingly tighter right side while the real culprit is the left side. Find a good structural health professional, one who uses their hands and diagnostic and treatment tools, have yourself assessed to find out exactly what the short comings are and go from there. If you are not a regular stretcher, it would be a good idea to become one.

I have recently moved my saddle back slightly and I have a much better feel in my legs: even fatigue and better power on climbing whereas with KOPS my quads used to burn first. I also used to rotate my pelvis forward casing pain in the perineum region so in addition to the further setback I also undertaken some Pilates to ensure that my sit bones are where they should be. Now my position at the back feels great, thank you for all your previous advice.

Now for the front. Whereas I used to be able to ride all day with saddle pain but no shoulder and neck pain, now my saddle and position at the back feels good but the shoulders and neck are sore. I don't think it is because I put too much weight on the bars: it feels as if I have a relatively light touch on them. They feel as if they may be too far away and too low, causing my shoulders to be hunched or stretched rather than being in a neutral position, which I am having trouble finding now. I think that before it was not such a problem as I slid forward towards the bars whereas now I focus on getting the position at the back correct it is now a stretch. Although I have heard it said that more set back (and better balance) could allow you reach out further, before I splash out on new stems could further set back and a change of pelvis angle mean shorter or higher (or both) handlebars? Also, which stems have the biggest rise without being flipped over: are there any with zero degrees? Many thanks.

This is the $64,000 question...I am a 27 year old roadie and ride scratch races, handicaps, two-day tours and 1 hour long criteriums. I weigh 84 kg and am 180cm tall, when I last had my body fat checked it was approx. 8.5%. I haven't had any other physiological testing done for a few years but I think I'm in pretty good shape and can be very competitive in B grade road races and can hold my own with the A grade boys in the criteriums. All the races I have ever done well in (placed or won) have been sprinting from a small group (1-5 riders) after a breakaway.

I seem to do better if I am sprinting against breakaway companions who are as tired as me but whenever I am faced with the bunch sprint I end up getting swamped in the last 100-200m and cross the line boxed in and feeling fresh physically but very frustrated! I think I am a relatively powerful rider, I can cover gaps and chase down breakaways very well but I lack that last bit of 'top end' speed (and skill) needed to finish off the bunch sprint. Do you have any training tips and/or racing techniques to improve my performance? Thanks.

There have been a few times in the past 4 weeks where during warming up, I've noticed my heart rate to be 15-25 beats lower than what I expect it to be (I tend to gauge this on certain mild hills). I thought that I've read that this can be an indication of "over-reaching". The first time it occurred I chalked it up to significant job stress, and took a week off the bike. Last week my intensity was up a lot, though volume was up less than 10%, and it happened again. Does this sound like "over-reaching"? What's the best way to get back into proper training? Do I need to watch out for time in the weight room (once or twice a week) that can take my heart rate into the anaerobic range? Why does the body respond with a lower heart-rate?

I'm a veteran racer, and do 50 or so races a season of all lengths at the Pro 1/2 level. It almost always seems that it takes me 30 minutes, or even a full hour of racing before I can race effectively. Many times I reach complete failure in my legs after the first hard effort of the race, although after riding through it, I usually ride very strongly (of course lots of good that does after being dropped)

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