Fitness questions and answers for October 1, 2006

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 am 32 years old, male, and have been road cycling more or less on and off since 2002. I weigh about 80kg (176 pounds) and I'm roughly 5'10" tall. I have always ridden an old, hand-me-down Trek 1200 (size 56 frame), but recently purchased a brand new Trek 1500 road bike (size 54 frame).

The problem is almost each time I have gone out on a ride on the new bike (which seems to be the right size as per the bike shop that sold it to me) my quad muscles cramp (especially when I get out of the saddle to climb hills) and my hips get a little bit sore as well as my hamstrings. I'm worried because I really like the bike but I can't be getting cramps every time I ride. I have never had any problems like this with the old bike.

Since the cramping problem showed up when you switched bikes, it is a near certainty that the fit of the new bike is contributing to the problem. (I'm assuming here that you didn't suddenly stop taking water bottles, change your diet, increase your mileage or decide to never use the small ring again.) Therefore, the simple solution is to do everything you can to make the fit of the new bike match the old bike if you still have it. When I say match, I mean that the seat height, seat setback, seat tilt, horizontal and vertical distance from the saddle to bars need to be within a 1-2 mm of the same. A difference much larger than that is enough to cause problems. If you no longer have the old bike to match, dig through the archives to find Steve Hogg's complete suggestions for fitting a bike and follow them. One other possible issue: If you got new shoes or new cleats with the new bike, set the cleats according to Steve's suggestions as well.

I have some questions about fit. I normally ride a Specialized Tarmac Pro, size 54, with a top tube of 548mm. I got the bike when I was still pretty green and had unresolved tension in my back - long rides or races gave me hard back pain by the end of the ride. I knocked the stem down to 100mm from 120mm, but I'm loathing shortening it much more as our coach told us it negatively affects steering. I just did a couple of rides on a friend's Orbea Onix, size 51, with a top tube of 535mm, and a much smaller stem, in the neighborhood of 80mm. It felt great - despite riding 130 miles and 50 miles, my back felt great. I could reach the drops a lot better and it just felt nicer. I am now very tempted to get a smaller frame, as it is so comfortable.

I wanted to ask if you can have a frame that's too small, and what the problems will be. My feet hit the front wheel if it's turned very far, but that seems to be only a low speed issue. I will probably end up with a lower position; this may actually be nice for criteriums and flat road races, but will it decrement my climbing (already not one of my strong suits-I can't afford to hurt it more)? Is there something I'm overlooking entirely?

Yes, a bike can be too small. It can't really be too short vertically since you can always put in a long seat post on a low bike and get to the same position and weight distribution as on a taller bike. It can be too short in the top tube. As the top tube gets shorter you can put in a longer stem to get back to the same body position, but a short-top-tube, long-stem combination puts more weight on the front wheel than a long-top tube, short stem combination. Weight on the front wheel affects bike handling. The torque with which the front wheel direction returns to center after being disturbed depends on that weight. Changing the weight on the front wheel changes a bike from twitchy to sluggish or vice-versa. Somewhere in between is a fabulously-handling bike.

I've been road riding for four years until this past March when I hurt my lower back moving furniture. A physio diagnosed it as a bulged disc (very low in my back - I don't remember the medical description of the location). I went through six treatment sessions (traction, electrodes, and ultrasound) and I iced it regularly. I do all the exercises prescribed and I have been able to resume all my daily activities - except biking. My back will just not accept the bent-over riding position. I've tried a high-rise stem, a shorter stem and I've tried moving the saddle lower, but nothing helps. I've even borrowed a friend's comfort/pathway bike on which I bend over only slightly, but my back still aches for a few days if
I try to go longer then 30 minutes. I'm 33 years old and I ride for fitness and commuting. I was previously riding about 4000km a year. I would like to get back to being able to ride for up to one hour or so without regretting it the next day.

I may not have had experience with people like you because I only know what you have told me which is not a lot. Let's assume that you are absolutely correct though, and there is zero chance of your riding an upright bike with any degree of forward lean of the torso. Recumbents usually work well for this kind of problem as having a back rest to brace against to resist pedalling forces minimises the requirement for stability of the rider and also tends to minimise any pelvic asymmetries as the back rest locates the rider fairly squarely in relation to direction of travel.

I'm about 1.77m tall and weigh 76kg. I wear a size UK10 shoe and ride an Orbea Alma hardtail with a 73 degree seat-tube angle and with 175mm crank arms. Before reading Steve's recommendations the only way I could find the most powerful position was to move my saddle all the way forward on a zero off-set seat post. Needless to say, the biggest trade off was always a very chafed groin area. This steep position was probably because my cleats were way to far forward. It did however help me to stay balanced on steep climbs and climb at a high cadence of 100-120 rpm which I found suited me best on long steep climbs.

My problem is now that I battle with my cadence. Initially when I changed my set up according to your recommendations, I set my cleats and seat about 3mm forward from now. It really felt good and powerful when climbing seated with no cadence problems, but felt less powerful on the flats and when pedaling whilst standing. I then moved only the cleats 3mm back which felt great when turning the pedals out of the saddle but less so when seated on both hills and flats. It felt like I could not get the power behind the pedal on the down-stroke and that my legs were moving up and down instead of circles. High cadence was also a problem.

I then moved my seat also 3mm further back. Now it felt great and powerful whilst standing and sitting on the flats but much less so on the climbs. Fast cadence is difficult and it feels like my hamstrings are taking too much strain. Raising the saddle worsened my reach and lowering it made my hamstrings feel cramped, and worsened the up-stroke. I can move my cleats 3mm forward again but do not want to loose that nice, solid feeling when riding out of the saddle. Do I perhaps need shorter crank arms? All of the above is when cycling at high-intensity levels. I prefer high cadences for climbing and anything from 60 -110 rpm for flats and rolling roads.

How rigid are the soles of your MTB shoes? If they have too much give, as some low end MTB shoes do, then the cleats need to go further back than normal to feel 'solid' under foot. But this limits ankle movement and can lessen ability to ride at higher revs. When you moved the seat and cleats back, did you lower the seat to compensate? Assuming your original seat height was fine, you should have dropped the seat post 1mm further into the frame for every 3mm the seat moved backwards. If the cleat movement rearwards was substantial, then again the seat height needs to drop a few mm as the more rearward cleat position will cause greater extension of the leg.

By trial and error with various seats and seat, cleat and bar positions. Sometimes when positioning someone, an injury or sensitivity of theirs overrides everything else in the sense that the prime requirement becomes, at least in the short term, to relieve strain from an injury or touchy body part. It is impossible to give you more detail than this without knowing a lot more about you, i.e., how the prostate problem affects you, what you ride, how you ride etc, etc.

I've known that I've had a functional LLD since high school. I was using extra insoles for soccer and cross country before I'd ever heard of orthotics. I've always been very right footed (it's hard to kick with your long leg while standing on your short one without digging a hole). I can jump off my left foot much better than the right. I've always felt like my left and right hip/legs work differently. I've often wondered if it started with a dislocated right hip when swimming breast stroke at around 10 years old. I'm pretty sure I have an actual LLD but I suspect my pelvis is the source of most of the functional LLD and other problems.

I currently wear orthotics in my 'other' shoes and in getting them had my LLD confirmed by a sports therapist. I've been messing with homemade spacers (fridge magnets work well) and LeWedges for years with mixed results. Usually I can fix one problem but end up causing another. I've gone through periods of asymmetrical leg soreness and feelings of having a weak leg to having asymmetrical back pain. I've had occasional hand and foot numbness but raising my stem and hoods and the LeWedges seem to have largely corrected these problems.

Fun facts: Right foot seems larger by 2-3mm between heel and ball. Right leg shorter by 8-11mm (difference in lower leg). More developed right calf. Typically have right side lower back pain on long ride or ride with lots of climbing. Right side gluteal pain early in rides fades (as other things start to hurt more?) Knees seem even versus the top tube. Left heel seems to come closer to crank. Dropping right hip when pedaling. No apparent varus difference (measured at home, wife thinks I'm nuts). More saddle soreness on right side, frequent numbness of the naughty bits. Looking at my old saddle, it is bent down on the right a little. ITB soreness, mostly on left, less so since pedal spacers added 3 months ago. Current adjustments: ~5mm right shim (6 wedges 4in/2out) (Shimano, Look style) ~2mm left shim (1 wedge, thick side in); pedal spacers: 3mm each side.

From reading your other articles, it sounds like I could benefit from offsetting my saddle (my current post will allow about 4mm) and/or having it point off center. If I need more than the 4mm I'll get a K-force. I've always tried to force myself to be more symmetrical with shims and cleat position but never tried any asymmetrical saddle tricks. I videoed myself and saw that my right hip was dropping lower. I moved the saddle left 4mm and it reduced it considerably. When I looked at my legs vs. the top tube and seat post it seemed square. I feel pretty good on the saddle but 30 min on the trainer isn't going to be the test. If I offset 4mm to the left, I'll need to increase shim on the right, right? What about pointing the saddle? OK, I couldn't wait! I tried my saddle 4mm to the left and the nose pointed slightly to the left. Only rode 20 minutes (in the rain and dark) but my legs felt pretty 'even'. It feels like the pointing of the saddle achieved more than the offset but it's hard to say. It still looks even between legs and top tube. I was moving around on the saddle somewhat, trying to find the spot but I'll have to give that a week or so before deciding anything. I still feel more saddle pressure on the right sit bone but no numbness! The extra right saddle pressure may be a result of a pronounced callous courtesy of a saddle sore from two weeks ago. Please let me know where you would start (or continue). I'd love to be symmetrically sore just once! Even saddle sore!

On the information you have given, I think you are on the right track with what you have done to date. If you have a measurable lower leg length discrepancy of 8 -11mm (and it would be worth having a scan or x ray to nail that down so you are dealing with facts rather than guestimates) then you probably should have a larger right cleat shim than you currently have. As you have described the right stack of wedges, it is 3.5mm high on the outside and 5mm on the inside. The lower leg points more or less downwards when we pedal, meaning that lower limb discrepancies need to be compensated for close to the actual discrepancy. I say that with the caveats that differences in tightness between left and right glutes, hammies and lower backs can change that picture somewhat. Have a play with a few mm extra, reassess, and act on your feelings by adding or subtracting. Pointing the seat nose to the left brings the right hip closer to the pedals and moves the left hip further from the pedals and you felt more even for that. Generally, a right hip drop is accompanied by a twist forward of the pelvis on the same side. If that is what you are doing, moving the right hip forward further by twisting the seat nose to the left and reducing the distance the right leg extends by doing so is probably indicative of you needing a slightly different approach.

Establish that you are twisting the right side of the pelvis forward. To do this you will need an observer standing on a chair above and behind you while you pedal at reasonable load on a trainer with your shirt off and stripped to the waist.
If you are twisting forward to the right, then add more shims to the right shoe (and make sure that you move the right cleat back an extra mm relative to foot in shoe for every 5mm of shim you add) and try twisting the seat nose slightly to the left. The idea, if you cope with it, is to square up the pelvis more and allow you to bear your weight more evenly.

I'm a 36 year old Cat 4 road racer and I've been riding a bike for about two years. I have a left knee problem that started long ago in my teens while playing basketball. When I went to the doctor back then it was diagnosed as chrondomalacia. I've always been active, but I got really active again when I started riding. Initially the bike was helpful, but as I've built up miles and hours it tends to hurt regularly again. My right hip has also been sore, and it seems like the pain is at the rear of the ball of my hip. In addition, I've recently noticed a blue spot above my kneecap when I'm pedaling, especially when I'm pedaling hard. It appears to be a pool of blood or blood vessels. My questions are: 1. Is this 'blue spot' normal? 2. I'm assuming the knee and hip pain are related to my positioning on the bike. How do I close in on fixing the positioning problems? 3. Is there any proof that glucosamine and chondroitin work for issues such as mine?

Matthew Cain

Hi Steve, and thanks for getting back to me. I really appreciate all that you do. What shoe brand and size do you use? Specialized w/carbon soles, size 45. They're two years old, and I think they're called something like 'Pro Comp'. What pedal system do you use? Look Keo Carbon pedals. What brand, model and size of bike do you ride? Cervelo Carbon Soloist, size 56. Can you be more specific about where the knee pain is and under what circumstances it comes on? The pain seems to be underneath the upper area of my left knee cap. It is usually the worst when I first begin to ride until I get warmed up, and also when I'm climbing or pushing a large gear. Also, there are times on and off the bike when, if I turn or move in the wrong way, something seems to happen and my knee aches for a day or two. My right hip aches generally, however there is a main area of pain at the rear of the ball of the joint. Neither the knee nor hip have an acute or sharp pain, they're more achy and stiff than sharp.

If you set your bike up on an indoor and pedal under load with your shirt off, do you drop one hip? I couldn't do this as I'm away from home this week, but I'm going to assume that I drop my left hip, as there are many times that I finish riding when I have a crease from my cycling shorts on the right side of my butt. Does this make sense? My wife says that in fact I really don't have much of a hip drop, but the right side seems to hang over just a little bit. Which knee (if any) sits closer to the top tube than the other? My right knee is definitely closer to the top tube. If you look back between your legs while pedalling, on which side (if any) is the gap between inner thigh and seat post greater? The gap is greater on the left side. My right thigh is closer. If you need to wait until I'm home over the weekend and I can give you definite answers on the hip drop and seat post/inner thigh situation, just let me know and I'll resend the e-mail on Sunday. I'm not sure which pieces of the puzzle are the most important. In any event, I'm thrilled with any help you can offer. Thanks again. You're spectacular.

No, I'm skinny, bald and am peeved that I can't find time enough to ride my bike. Regarding the further info you have provided, the big picture is that you are hanging or rotating to the right (wife's observation, larger gap between left inner thigh and seatpost). A lot of people who do this end up with a left knee problem because the plane of movement of the left leg is constantly challenged by the right hip drop/rotation. The pain behind the right hip I'm not sure about but if you are tighter in general in and around the right hip, then that is the likely reason you hang that way.

Forefoot varus is a measure of the plane of the forefoot versus the plane of the rearfoot. A perfect foot has forefoot and rearfoot in a single plane. Unfortunately, that describes about 3- 4% of the population. 90+% have a forefoot varus meaning that the forefoot rolls inwards relative to the rearfoot. The implication is that when load is applied (walking, pedaling etc) the varus forefoot causes a lateral or rotational load to be placed on the knee, at least in theory. I say in theory because most people with a notably varus forefoot or forefeet don't experience knee pain under most circumstances. This is because at some autonomic level they evolve compensatory self-protection mechanisms.

I've tested this 'theory' in so far that I've moved my cleats as far back as they can go on my Specialized body geometry MTB shoes (ball of foot around 2.5cm in front of pedal axle). I've tested it on one ride so far and the comfort levels are unbelievable. I found it was a lot easier to use a high cadence 100+. I normally ride with a cadence between 95-110 rpm. I found that I didn't fatigue as quickly and I was surprised about my out of the saddle efforts where I could apply a lot more power and had no problem with the high cadence out of the saddle. I'll let you know in a month how things are going. One thing I did feel during the ride that I wanted to change is that I wanted my foot to be a bit further forward on the pedal, but the cleat holes in the shoe won't allow that. I'll test my road bike next weekend which should be interesting as I'm more sensitive to my road bike set up.

Paul Nielsen-Mazewski

Subsequent to our previous emails being posted I was contacted by Gotz Heine from Switzerland who is the gent behind SL's cleat position and the shoes that allow it. He made the offer to provide more info and I have taken him up on that but have not had his reply yet. I was also contacted by a gent from South Africa named Ian Rodger who had some previous interaction with Gotz Heine. He sent me the torque curves that Gotz Heine had sent him comparing a rider with unspecified conventional cleat position and the foot over arch position. The foot over arch position showed higher peaks and lower troughs on both legs. That would translate to more power at the same rpm with more un-weighting of the pedal on the rising crank. One example does not make an argument, so I await more info from Mr. Heine. I will post or pass on as I receive it.

That's fantastic news; I look forward to the info from Gotz. I've also received an email yesterday evening from Klas Johansson (Susanne Ljungskog's partner) saying that they will also send me their data from their tests. Naturally I'll forward these on to you when I receive them. I've responed to Klas and Susanne providing a link to the Cyclingnews.com fitness Q&A page. One question that has been popping up in my brain over the last couple of days, with the riders that you used the forward shoe position for (backward cleat position), why did they change back to their 'normal' cleat position?

Why did I move their cleats back to my more usual centre of the ball of the foot in front of the centre of the pedal axle from waaaay back? Firstly I have to stress that my experience with 'arch over the pedal axle' cleat positioning is limited to probably a dozen people total, may be a couple less, over quite a few years. In each case they had a significant problem (torn calf muscles, really bad plantar fasciitis, recently ruptured achilles tendon or similar) and had posed the question "is there some way I can ride even slowly rather than get off the bike for a period" to me. In each case my reply was "possibly, let's find out". By moving the cleats radically back to the arch of the foot (which is a pain on most shoes because the shape of the sole is all wrong for a cleat, meaning substantial modification as well as drilling new holes and fitting threaded eyelets), ankle movement is much reduced. This relieves strain on calves, achilles tendons and plantar fascia. I also found that it meant that forefoot varus/valgus compensation in the form of wedges or fittings inside shoes was more or less unnecessary.

I recently saw this question from Viktor in Sweden about getting cramps after time off the bike. I happen to have the same symptoms, and I am not entirely comfortable with the reply of Steve Hogg. In particular, I wonder how the cause could be a high saddle and/or not enough foot over pedal when I only experience the symptoms when I take a break after longer periods of regular training. In certain cases, I even experience the pains while walking. I have been experiencing muscle pains that no one else in my riding group seems to have had before.

I am a 46 year-old male road rider and I have been riding for over 10 years, the last 4 years of which have been pretty competitive. Over the last 4 months, I've followed a very structured training program based on Joe Friel's cycling training bible. It peaked with a 4-day 500km stage race, with lots of climbing over the last two stages. I did very well in the prep races and the stage race, surpassing the goals I had set.

After the stage race, I started to taper off my riding frequency and intensity, and about a month after the stage race stopped riding completely for about a week due to work commitments. About 4 days into the week when I did not ride, I started to experience severe muscle pains in my thighs when I would walk even relatively short distance. Now that I am trying to resume riding, I get the same pains. Even with the lowest intensity rides, my thighs hurt so much that I can't pedal after just 10 minutes. What is causing this problem, and how can I prevent and treat it?

I have had two riders in last five years that have reported odd cramping (only both of them experienced it in their quadriceps) and did not respond to any mechanical or nutritional changes. They were subsequently diagnosed by two excellent rheumatologists (who also ride) with true muscular myopathies. I would highly recommend having this further examined - not all musculoskeletal pain is truly mechanical and there is an odd pattern present in both of these cases.

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