Fitness questions and answers for November 13, 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.

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've talked with many "fit experts" in bike shops and everyone has their opinion on correct crank arm length. Some say I need to stay with 180mm (which Campy doesn't make). Others say it's OK to go with the shorter length - 175mm. Some of these experts say I can mix a Shimano compact 180mm crank arm with my Campy group (heresy in my book). Others say it is not a good marriage. I've researched Specialties TA who make a crankset called the Carmina that has 180mm and 185mm crank arms. The bike shop that sells Specialties TA swears by them, but all of the "fit experts" either haven't heard of TA (which is surprising) or don't hold TA in high regard.

What are the physiological and performance issues that I will have to contend with if I drop down to the 175mm crank arm length? Or is the 175mm length too short and out of the question? I've been researching this for a long time and just when I think I've got the right answer someone else gives me their expert opinion and I'm back to square one again. Any advice/opinion/expertise on this issue would be greatly appreciated.

Hi. I'm a 24 year old, keen, competitive mountain biker riding for around five years now; however I ramped up my training and was beginning to compete in races last year to gain my fourth category road racing licence. After a break in September 2006, l started to train for the following season however had to stop when l injured my left soleus and posterior part of my left knee. I had noticed a slight weakness in the knee approximately a year previous to the injury, but after some rest the pain disappeared. The pain came on in a ride where l was pushing on into the wind, and I admit, pushing too big a gear.

Much to my downfall, I decided to keep riding. The pain persisted, and so I began to seek treatment through physiotherapy, without much success. Unfortunately the trouble persists to this day, almost a year later. Due to various commitments I have been unable to stay with a single physiotherapist, and as a result I have only recently received a diagnosis that I have flat feet. I have been fitted with orthotics which seems to have cured the pain I was getting in my soleus muscles. The sharp pain in my knee is now in two distinct areas, either side of the centre of the knee as seen from the back. The pain occurs during walking as well as cycling, and so affects my day to day activities. My current physio believes the issue is being exacerbated due to my knees, which are able to hyperextend when walking. This has caused the posterior capsule to become lax, and the popliteus tendon and ligament to strain.

I am a 47 year old male recreational road cyclist, typically riding 4-5000 kilometres a year. I ride regularly with a group of friends, ranging in age from 36 to 60. After the recent and well publicized death of runner Ryan Shay in the New York City Marathon, speculation has risen that the cause of death was hypertrophic cardiomyopathy (enlarged heart). Then last week, a friend of mine who is a strong marathon runner (sub 3 hr) lost consciousness after a 1K jog from the car to the start line of a local marathon. He suffered a concussion from falling, but doctors are at a loss as to why he passed out. Early suspicion is that he may have hypertrophic cardiomyopathy. With all the talk of this condition and sudden death in endurance athletes, our spouses have voiced concern that we may be putting ourselves at risk.

The media did a terrible job of covering the death of Ryan Shay. Hypertrophic cardiomyopathy (HCM) is a genetic disease. You cannot get it by exercising. Individuals with HCM have a mutated gene for one of the contractile proteins in their heart muscle. Because of the mutation, the muscle does not contract as well as it should. As a result, the muscle grows in an attempt to handle the load it is required to handle. The enlarged heart in HCM has a thickened wall and reduced stroke volume because the muscle actually gets so big that it takes up what should be the pump chamber of the heart. There are many different mutations that lead to HCM. Some of them make the muscle so inefficient that it grows so quickly that individuals with that mutation all die in the childhood. Some of the mutations work more slowly and cause deaths later. Some are relatively benign, leading to a slightly thickened heart wall but rarely death.

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