Fitness questions and answers for October 9, 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.

The main thing that I had not cleared up was the fact that, due to my years of riding in the incorrect position, my left leg is built up a lot more so than my right (size wise, but also power wise). The new position had started to start to build up my right leg, which was great, and I thought that they would eventually balance out, but it seems that I've reached some kind of plateau. Due to the stresses that I'm putting on my legs now in the end of season races, it seems like my body is trying to give everything it can for me and using my left leg more so than my right.

Now the size difference is becoming downright annoying to the point where I want to take a long time off, so that my body can forget about cycling/how to pedal, etc., and start all over again, but I honestly don't want to do that either. Would taking some time off help readjust everything? Or is it because of a difference in foot size? Is the difference in size due to the fact that, since my cleats aren't in the same position, my legs won't be used the same way, hence difference in quad/hamstring/calf size? Any thoughts on this matter would be greatly appreciated.

It is unlikely that differential cleat position is the problem, providing they are in the correct relationship to foot in shoe for each foot size individually. Think of your body as a whole. You have differently-developed legs and differently-sized feet. This means that, at some level, you have been operating asymmetrically for a long time as foot size doesn't change much once you stop growing, unless an arch collapses or your weight changes drastically or something like that.

I am a 50 year old male with over 30 years of cycling experience. I ride around 6000 miles per year on the road, mainly by myself at speeds of 15-18 mph. I wear a 10.5, A-width shoe. In the last few months I have had pain in the first metatarsal joint of my left foot. It has become a significant pain. I had this pain several years ago as well, and my doctor gave me cortisone shot which cleared the problem. My podiatrist has previously said the joint is arthritic and has adjusted my walking orthotics to reduce the range of motion of the toe.

I have Sidi Genius shoes size 45.5 narrow shoes (plastic soles) with custom cycling orthotics that are about four years-old with about 20,000 miles. The Time Impact cleats are adjusted so that the first metatarsal is about even with the Impact pedal axle. My pain may not be caused by cycling but I can feel it while cycling. Can 10mm of cleat movement cause a lot of problems? I have thought about looking at other shoes like the Specialized carbon road shoes as they seem to have a good fitting process with wedges and different insoles but the Sidis are the only shoes that come in widths. My understanding is that the 2007 Sidis will all be carbon soles but I have not confirmed that. The price of shoes has certainly gone up so I don't want to buy them unless I need them. I am not sure what to do first so I'd appreciate some advice.

Alan Fishman

Assuming your position is reasonably sound, move your cleats back the 10mm, drop your seat 3-5mm to compensate for that (3mm should be about right, but many people who ride with the ball of their foot over the pedal axle have their seats set too high), and you should be fine. If you are not a reasonably flexible person, just ride easy for a couple of weeks to get the hang of the changed pedaling style.

I enjoy reading all the articles on fit issues, but this particular article seems to closely mimic my problems. My right leg is about half an inch shorter than the left (confirmed by manual/visual manipulation not x-ray). My right foot is also supinated. For my 40+ years of riding and racing, I compensated for this mostly by pointing my right foot in comparison to the left. I also turn the right hip in towards the top tube. As I'm sure you can imagine I've never felt like I have used the legs equally and this is borne out by my legs' muscular development: left thigh slightly larger diameter, right calf slightly more defined. I have been 'fitted' in the past, but not really in a professional manner.

This past year I finally had a more complete fitting done by a very reputable east-coast (USA) shop noted that has been reviewed on several cycling web-sites. They prescribed a 5mm right-shoe flat wedge under the cleat, orthotics (BIG help) and some minor position tweaking to the cleats and brake handle which was intended to push the right hip back to be more in alignment. I have also turned the tip of the saddle slightly to the right which I would think would help to hold the right hip back (however, this seems contrary to what you note in the answer to Bill) I have noticed an improvement but I'm sitting more on the left ischial as there is a pronounced divot or dent on that side of the saddle (Selle Italia SLK). It's almost as though the right cleat build-up has pushed my left hip further down.

The bottom line is I still do not feel balanced on the saddle nor do I feel like I am pedalling equally with both legs (I seem to use the left leg more). I consciously try to drop the right heal to be more like the left side but when going hard to higher rpm (120+), I find myself slipping back to the old toe-down technique. Any suggestions? Would it help to move the saddle off-center as noted in other responses? Should I point the saddle differently?

Rex D responded:

They did not measure the forefoot angle- do you have a recommendation on how to do this? I know in ski shops they had a device for determining LLDs and I was measured. This is what they found: as noted, left leg is 0.5 inches longer and they stated it is a tibial difference and structural. Right foot supinates while left is pronated as also previously noted. They did measure the valgus of the right foot and it is 10 degrees. They noted fairly good flexibility, but tight ITs. I was off on the right shoe build up. It's four Lemond wedges: two up on either side so it's even. And my saddle is an SLR not SLK.

Since your LLD is in the tibia, I would correct half the distance for starters. One inch = 25.4mm, so 0.5 inch = 12.7mm. Correcting for half this would mean 6.3mm of correction. I use LeWedges which are 1.5 mm thick. I would use eight LeWedges stacked thick-to-thin, which would provide 6mm of correction. Now, you originally wrote that you supinate. If you supinate, then your forefoot is mostly like varus, which means that the inside of the foot is higher than the outside. Valgus, which is what you wrote, is the opposite. That's when the inside of your foot is tilted down relative to the outside While some studies have shown that about 8% of the population has a forefoot valgus, my experience in doing hundreds of fits is it's less common than that. Assuming your right foot is 10 degrees varus, then I would add two more wedges to the stack. These should be oriented so that the thick part is on the inside of the cleat, as the intention is to fill in the gap which allows the foot to roll in under force. I also suggest you point your saddle straight ahead for now. If you still turn in your left hip, then I would rotate the saddle slightly to the left. I know a pro cyclist who even after correcting his significant LLD, sits with one hip forward when he rides. He won an NRC race this season. Try the correction I've outlined above. Keep your first few rides short and easy. Let me know how it goes.

I am a 46 year-old male, 5'11", and 175 pounds. I started riding road bikes two years ago. I typically ride 150-200 miles per week. I had some pain come on this summer for the first time very slowly. I can ride a flat century in four-and-a-quarter hours to give some example of my health.

I have a 56cm carbon bike with traditional frame. I know there are herniated discs in my back (MRI and epidural shots over the years) but while riding a bike there is typically little to no pain in my lower back. I find many times that my left hand will go numb, probably from carrying my weight on the left arm, shoulder and hand since my back is so weak, and I believe I am leaning to the left or rotated to the left. My hips are never sore, however.

The knee problem came on gradually. I first noticed it on a century ride. When I would sit up on the bike to eat and pedal, I would have a sharp, stabbing pain on the back side of the right leg, just below the bend of the knee. I would have to stop pedalling while sitting up or bend back over the bike and into the drops to get the pain to cease. As long as I was bent over at the waist while pedalling, the problem would go away to just a very small area (size of a pea), where I can feel a small bump that is sore to touch sometimes. It seems to be on a tendon or ligament in that area. I feel the same small bump on my left side but no pain, so I think the small bump is normal.

I have lowered my seat to see if that helps, but it does not. Moving it higher causes rocking problems, so I feel the seat height is not the culprit nor the fore/aft positions since I have no other knee or leg issues. I've also moved the cleats around, but to no improvement. Does it make sense that, since I am probably leaning to the left, I am putting some strain on the outside right leg? Could I be trying to compensate the balance of the bike by having my right knee/leg further away from the top tube?

Ed,
Suwanee, GA, USA

I can't say with certainty, but it is likely that your leaning to the left is the basic cause for your right knee problem. If you are leaning and rotating to the left, the right leg has to reach further than the left and will end up with tighter hamstrings than if this wasn't the case. That is probably where you are feeling the pain. Find a sports doctor or physio with cycling experience, and sort out some sort of stabilisation or core-strength program so that you can end up riding your bike without having to heavily favour your left side. That is the best solution. Any other may solve the existing knee problem at the expense of causing another elsewhere.

I am a veteran road racer, doing about 200km per week. I switched from mountain biking after a serious accident. I am feeling good at the moment, although I need to drop some weight. What I would like to know is the correct position of the pedal in relation to the shoe (I use Sidis) and the correct position of the pedal in relation to the knee. I've read much about it and I would appreciate your advice. I don't experience any problems, but I would like to know the optimum power-transferring position.

My question is in regards to comparing Power Data and heart rate. I have been riding a road bike for a little over two years. I am 37 years-old, 5'8" and 148lbs. My maximum heart rate is 193. I recently began training for a local ride in the area covering 100 miles, with many hills requiring my maximal output. Before I began to train for this, I followed Ric Stern's training schema on establishing heart rate zones based on his ramp test with a power tap. I borrowed a power tap and did his test twice in a two and a half-month time span. The first time I did it was to establish my heart rate zones and the second was to see what kind of progress I was making.

Downloading the information on the first test showed that at 174 bpm I was at 210 watts. 240 watts were produced at 188 bpm. The second test showed that when I hit 174 bpm, my wattage was 240. At 188 bpm I was at 280 watts. The training I am doing is in zones five and six. The training in these zones has shown improvement but would like to improve some more.

My question is this: has the 40 watt increase at the higher heart rate been the result of being able to stay at the higher heart rate for a longer period of time?

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