Cyclingnews Fitness Q&A - November 27, 2009

Got a question for the fitness panel? Send it to fitness@cyclingnews.com. Emails may be edited for length or clarity, but we try to publish both questions and answers in their entirety.

Ruptured Patella Tendon

I am a rider/racer on the road and mountain bike. I have been training for fitness for the past 10 years and compete in about 10 races per year as a Cat 3 racer. I recently ruptured my left patella tendon on my left leg playing basketball. I am a male and will be 34 in January. I had surgery to repair it two weeks ago and am in a brace and on crutches for seven weeks without physical therapy to allow the tendon to heal.

Left patellar tendon rupture? OUCH! I would most certainly talk this over with your orthopedic surgeon. I know it seems like a long time to be immobile. BUT, that is the same with downhill ski racers and so on. The key here is to let the patellar tendon heal completely prior to stress. That tendon takes a large burden of stress and tension and at this point, a re-injury would be a even larger set back.

Let me start by providing a brief explanation of Excess Post-exercise Oxygen Consumption (EPOC). During exercise, oxygen use (i.e., volume of oxygen consumed, VO2) is increased above resting values due to the increased rate of ATP production to meet energy demands. After exercise, however, VO2remains elevated above the resting rate for several hours, and this post-exercise increase in VO2 has been termed 'EPOC.'

EPOC shows a curvilinear relationship with exercise intensity. That is, at intensities less than 50% of VO2max, EPOC is negligible. However, at intensities greater than about 50-60 percent of VO2max, EPOC increases exponentially with exercise intensity. Exercise duration also increases EPOC, if the exercise intensity is sufficient - about 70 percent of VO2max. Because the magnitude of EPOC depends on both the intensity and duration of the exercise session, EPOC might, as you suggest, be used to quantify the stress or training load of a given workout.

Accurate measurement of resting VO2 is actually much more involved than it sounds. Variables such as feeding, activity, and menstrual status - even whether the subject is seated or laying down-must be carefully controlled, as they all affect resting metabolic rate and, therefore, resting VO2. Needless to say, direct measurement of EPOC for the evaluation of training session intensity is not feasible.

A mathematical model that estimates EPOC from heart rate has been developed based on previously published studies that measured both heart rate and EPOC in response to exercise of varying intensity and duration. This model has only been validated in one study that included 32 adults, only 8 of whom were relatively fit, and that used short-duration exercise (10 min at 40 percent of VO2max, 10 min at 70 percent of VO2max, and an incremental max test). Moreover, use of heart rate to estimate EPOC requires a specific heart rate monitor and the corresponding software.

I'm a keen male racing cyclist riding at elite level on the road here in the UK, aged 32. Over the last few weeks I've developed a cyclist nodule/perineal nodule/biker's nodule. It is basically a 1/2" by 1/4" lump of fibrous tissue positioned at the bottom of my perianal which becomes irritated as I ride. This is now impacting my riding as I can't manage longer training rides and have to have days off between rides.

Now, I know the idea of being "operated" on in that region is not appealing. I'm pretty sure nobody wants to be cut near their nether regions, but you DO NOT want an abscess in the region. So, with that being said (written I should say), go to your physician. If it is an abscess or cyst, it can be drained relatively easily before it gets out of control. If it is scar tissue or a nodule, that will need removal.

Scott Saifer (www.wenzelcoaching.com) is head coach, CEO of Wenzel Coaching.com and has been coaching cyclists professionally for 18 years. He combines a master's degree in Exercise Physiology with experience in 20 years of touring and racing and over 300 road, track and MTB races to deliver training plans and advice that are both rigorously scientific and compatible with the real world of bike racing.

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.

Pam 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 associate professor of Nutrition and Exercise Physiology at the University of Missouri-Columbia where she studies the effects of energy balance on bone health. She has published on the effects of cycling and multi-day stage racing on bone density and turnover.

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.