Cyclingnews Fitness Q&A - April 1, 2010

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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.

Knee tracking when pedaling

I am a competitive 23-year-old category 2 cyclist with a history of IT band problems. I have been fit professionally several times and feel that my overall bike position is good. However, I have always had a tendency for my knees to track inward greatly while pedaling, with the right knee coming inward more so, in a knock kneed fashion.

I feel that this could be contributing to my IT band problems along with limiting my power output since I am pedaling at an angle instead of straight up and down. I currently ride speedplay pedals and have recently experimented with the lateral movement of the cleat to attempt to get my feet more under me and get my knees to track straight up and down better.

My questions are:

1) Could changes to my cleat position help alleviate this knock kneed pedaling style, or is it more likely a biomechanical issue?
2) Is there typically a significant power loss from such a pedaling style in comparison to the knees tracking straight up and down?

Owen

Steve Hogg says

Owen,

The info you have provided is too scanty to give you a definitive answers but I'll give you some general information that may help.

Knock kneed pedaling can be normal for some people. It depends on how your hips and lower back function. If it is causing pain, then there is a problem that needs to be resolved. Is you ITB pain more acute on one side or does it occur more or less evenly on both sides?

If is mainly on one side then there is some sort of functional asymmetrlcally at work. It may be that you a not sitting squarely on the seat; it may be that your seat is too high or too far back, causing you in turn to favour one side over the other. It could be that there is a leg length difference. It could be many other things but none of them should stop you from riding a bike more or less how you wish to.

You mention being fitted several times and feel that your bike position is good. My concern here is that if your bike position was complete, you wouldn't be having these problems OR you would have been given advice about the nature of the problem and what you had to do off the bike to resolve it. Are you using wedges or corrective insoles of any kind with your cycling shoes?

If the answer is no, that is where I would start. My experience is that 99 percent of riders need some sort of correction at the foot. Get hold of some Speedplay compatible BikeFit Systems wedges and after reading the instructions, start experimenting. With a bit of care, they should make a substantial difference to that discomfort component of your perceived problem. The knock kneed pedaling technique may, or may not be a problem.

Owen then responded:

Steve,

Thanks for replying to my email. I have been thinking about what you said during my riding and I have noticed that I do not sit equally on my sit bones. I tend to favor the left sit bone a lot and the pain is mostly coming from my right leg. Could my left side being tighter than my right cause this? You also asked about my lower back and I actually do have lower back issues in races but it is my entire lower back and not specifically one side or the other.

I ride with speedplay pedals and custom molded insoles. When I was fit recently to try to alleviate my it band problems the fitter suggested bringing the cleats all the way back and pushing them all the way in (toward the bike)so that my feet are farthest apart. Would you agree with this suggestion? Would the lateral position of the cleats affect knee tracking significantly?

Steve Hogg says

Owen,

To answer your questions:

"I tend to favour the left sit bone a lot and the pain is mostly coming from my right leg. Could my left side being tighter than my right cause this?"

Yes. You are likely loading your left sit bone because either you have a short left leg that hasn't been compensated for in form of a shim OR you have a functionally shorter right leg because you are, as you say, tighter on that side and this hasn't been compensated for either. Either way, your right leg will have to reach further. Additionally, did your bike fitter use a goniometer; i.e, a joint angle measuring device, to determine the included angle of the knee at the bottom of the pedal stroke?

If so, beware, because many people who use these devices only focus on the included knee angle instead of focusing on what the pelvis is doing from where all the action starts. If you are loading your left sit bone preferentially, I will guarantee that you are dropping the left hip and resolving or moderating that tendency should be your bike fitters focus.

"When I was fit recently to try to alleviate my IT band problems the fitter suggested bringing the cleats all the way back and pushing them all the way in (towards the bike)so that my feet are farthest apart. Would you agree with this suggestion?
What was his/her rationale?

Your original query was about "knock kneed pedaling". If that is how you pedal, then the centre of your instep should be more or less under the centre of the knee as it descends in most cases. I see no value in trying to force your knees outwards by moving your feet further apart.

Again, the focus of your fitter's efforts should be on moderating the pelvic asymmetries of function that the info you have provided strongly implies you have. The 'knock kneed' pedaling may or may not be the problem. For many it isn't. Originally you asked if the knock kneed pedaling technique contributed to your itb problems. The likely answer is that the structural issues that cause your itb problems contribute to you pedaling knees in, not the other way around.

Would the lateral position of the cleats affect knee tracking significantly?"

Potentially yes, but I reiterate, moving the feet outward in the hope that this will bring the knees with them, pain free, is a high risk approach. Have you tried any wedging yet as I suggested in my original reply?

Hip pain

Hi,

I'm a recreational cyclist, age 33, about 6'3" 215 lbs. I've never been terribly flexible, especially from the lower back through the hamstrings. I had a down year for mileage in 2009, maybe 1200 miles total (the two years before were probably double to triple that total). A home improvement project ate up most of my training time over the winter, but I've recently started riding the trainer again, about 5-10 hours a week.

Bike-wise I'm on a Klein Reve road bike with Shimano SPD-SL pedals, sidi Genius 5.5 shoes, Selle An-Atomica Titanico Saddle, 46cm Easton EC90SLX road bars with an anatomical bend.

I've had a minor problem ever since I began riding about four years ago (I honestly can't recall if I had it on the hybrid I rode for a few months, but I know I've had it since that fall - I got the Klein during August of the summer that I started riding). After harder efforts I experience a diffuse pain in the front and outside of my hip.

It's not a terrible pain, but it's annoying. It doesn't happen during or immediately after riding. I notice it when I go to bed at night. The pain is generally worst when I'm lying flat on my back or stomach with the leg fully extended.

Sunday I put in the hardest effort of the year so far. Two hours of zone 3 at 90+ cadence. Following that ride my legs were burning most of the night and the following morning, so I did a 45-minute recovery spin in zone 1 at 75-80 cadence during lunch yesterday. The pain in my hip has been bad enough both nights to wake me up.

Earlier this winter, when I had nowhere to set up the trainer I tried running for a few weeks. I was eventually forced to stop running after a few weeks when I had bad pain in the same hip. That pain lasted a few days and was more acute than this is, but it did seem to be a symptom of the same problem.

The pain seems worse now than it has before, and with spring coming and a relatively clear schedule I was hoping to put in some more serious miles in the coming weeks. I thought I'd write and see whether there were suggestions that you might have about how I might address the problem before I really exacerbated it.

Any advice about what sort of doctor to see, exercises to try, fit adjustments, etc. would be appreciated.

Thanks in advance,
Doug MacDonald

Steve Hogg says

Doug,

You say 'hip' not 'hips' so I assume this pain affects you one one side only? Any chance that it is the right side?

What you are feeling is almost certainly tight iliacus or psoas or both. They are flexors of the hip and lift the upper leg upwards if the torso is fixed or help bend the torso forwards when the legs are fixed.

In quadruped mammals, the angle between torso and femur is rarely more than 100 degrees. With humans and our upright posture, this angle is close to 180 degrees. In evolutionary terms, we haven't been standing long enough to have perfectly adapted hip flexors and tight hip flexors are very common.

My experience is that more people have issues with this on the right side than the left side and there are neurological and sometimes dietary reasons for this. In the short term I would suggest visiting a masseur/physio/chiropractor or similar for a psoas release and in the longer term I'd suggest starting a well informed stretching regime to improve your posture and flexibility in general. You may need some professional help with that.

Crankarm length

As a junior in the '80s I road a 170 mm crankarm length. After some time away from the bike, I returned and purchased a bike with a 172.5 mm crankarm length. I've been ridding that length now for over nine years. Now I'm looking to upgrade cranks and trying to decide which length to purchase.

I'm 5'9" with probably a little longer legs than normal but not much. I primarily like to climb on the road and keep a high cadence. What are the considerationns for chosing the correct crankarm length? What would you suggest.

Thank you for your time and suggestions.

James B.

Scott Saifer says

James,

There are a number of theories of crank arm length and some scientific evidence. The research says that for peak power, ideal crank length is in fact proportional to leg length, but that the ideal cranks for most people are not within the range that most people race. For metabolic efficiency (minimizing oxygen consumed per joule of work generated), each person has an ideal crank length but that length is not proportional to leg length. The ideal lengths are in the range that most people race.

I suggest choosing crank lengths to the longest that will allow truly smooth, powerful spinning. When cranks are too long, either the top or the bottom of the pedal stroke will be compromised depending on how the saddle is set up. Put the saddle low, and the rider can't get the pedals smoothly over the top of the stroke. It's hard to feel this when pedaling with two feet since one foot will drive the other over the top of the stroke.

Put the saddle high and there's a weak spot at the bottom of the stroke. Too high is relatively easy to see and maybe feel. The ankle and knee extend smoothly to a certain point near the bottom of the stroke and then suddenly but loosely the ankle snaps out a bit farther while the knee bend pauses at it's greatest open angle.

The process for actually determining crank length is time consuming, but worth while since tool long cranks are likely to give you injuries and too short leave power that could be yours wasted.

So, to check crank length, sit on the current bike with the current cranks on a trainer. Pedal with one foot. If you can pedal smoothly over the top of the stroke 20 cycles with no clunk, try the other foot. If you can do it with both feet, drop the saddle 3 mm and try again. If you can't, raise the saddle 3mm. Keep going until you've found the lowest saddle setting that lets you pedal smoothly over the top. Measure the saddle height.

Now it's time to work on the bottom of the stroke. This part requires extreme sensitivity or a skilled observer. If you are currently pedaling smoothly through the bottom of the stroke with no sense of reaching, rocking or stretching and with pressure all the way to the bottom, raise the saddle 3mm.

If you are already reaching, rocking, stretching or losing power at the bottom of the stroke, lower the saddle 3mm. Again continue until you find the lowest saddle position that lets you pedal smoothly through the bottom of the pedal stroke with both legs. Measure the saddle height. (and if the high or low position seems to be different for one leg or the other, consider that you may have a functional or anatomic leg length difference).

Now, if there is one saddle height that allows you to be smooth through both extremes of the pedal stroke, your current cranks are okay or too short. If there is no one saddle height that lets you be smooth at top and bottom of the stroke, your current cranks are too long. If your current cranks are okay or too short, the highest height for the bottom of the stroke to be okay is higher than the lowest position for the top of the stroke to be okay. If the difference is less than 5 mm, keep your current crank length. If it is 5-9.9 mm, add 2.5 mm. If it is 10-14.9 mm, add 5 mm and so on.

If your current cranks are too long, the highest position for the bottom of the stroke to be okay is lower than the lowest position for the top of the stroke to be okay. If that is the case and the difference is less that 5 mm, subtract 2.5 mm from your cranks. If it is 5.1-10 mm, subtract 5 mm and so on.

Just one extreme example to shake the idea of cranks being proportional to leg length. I have a client who is 6'4" (193 cm) with 36" (91 cm) inseams who was unable to pedal smoothly on anything longer than a 172.5 crank. He has very small feet for a guy so big (size 39), suggesting that ideal crank length might be influenced by foot size at least in certain cases.
Good luck with your quest.

Regaining stamina

Hi,

I am 82 years old and have been riding for many years, an average around 100 miles per week. Circumstances (an accident) have kept me from riding for three months. My stamina is gone and on the first hill of a ride I drop back.

An obvious question: how do I get it back? I've got no other health problems.

Paul Lippert

Scott Saifer says

Paul,

Congratulation on maintaining your riding habit. Like anyone who has been off the bike for three months, you need to rebuild your aerobic base before you are going to feel good on the bike again. That means riding gradually more hours, starting from a very easy load, and always at an easy pace.

Take a guess at how long you can currently ride at a mellow pace before feeling worn out. Subtract about 15 minutes and call that your current endurance limit. For the first few weeks, ride to your current endurance limit (about 15 minutes before you think you'll get tired) every other day. Then start adding 15 minutes per week to the rides, building up until you are either getting tired or using up your available time.

Every ride during this rebuild period should be mellow. If you are using a heart rate monitor, keep the heart rate under 80% of your maximum. If you are not using an HRM, just ride at a pace that feels like a stroll rather than a jog or harder workout.
Good luck with your recovery and return to fitness.

Sleep medication

Looking for a bit of help here, I'm 39, male, stressful job, recession, etc, etc. I was having problems getting quality sleep, so I saw my doc who gave me a prescription to help. It's called Zolpidem, and he prescribed 10mg. This was about two years ago!

I started to cut them in half about 6-7 months ago and take 5mg/night. I feel ok, don't seem to have any issues, but I'm thinking this can't be the healthiest! Have you heard of any long term effects?

I know this issue may be a bit sensitive; I'm not looking for medical advice, just what you've seen/observed amongst pros/elites. I read on pro blogs "Took an ambien for the long flight..."

Ideally, I'd like to stop, but I've tried and it's very difficult. 5mgs is considered a very small dose. I'm 165 lbs. Any feedback greatly appreciated.

Tommy

Kelby Bethards says

Tommy,

So, I can't say I have looked into or found any long term effects from this, however dependency can be a problem, but it sounds as though you were able to reduce your dose.

Now, in medicine, usually we make decisions based on risk/benefit. For example, what is the risk of the medication? Allergic reaction, dependency, sedation (although this is the desired effect) and so on.

What is the benefit? Good rest. Good sleep patterns if used correctly, etc.

What is the risk of not having the medicine? Poor sleep hygiene (funny to me its called hygiene - clean sleep). Increasing fatigue from insomnia. Not being able to perform at work or train adequately, etc.

Thus, you need to decide with your doctor's help, what is the best for you. Do the risks of the medicines outweigh the benefits? Doesn't seem like it. Do the benefits of sleep outweigh the medicine risks? I'd venture to say it likely better than self-treating with alcohol to rest.

Testing body fat percentage

Excellent coverage of overreaching. And perfect timing! I'm into my sixth week of training and I was just starting to feel the same symptoms poor Mr. Wylie experienced. You mentioned being underfed as a possible reason for his experiences, and I'm here to get some clarification.

You might remember that I'm a tall, lanky dude who has to watch his weight because at age 51, it's too easy for me to burn fewer calories on a ride than I replace with eating when I'm done.

At the moment I'm essentially at my target weight. But due to training, I'm quite sure I'm adding muscle and it seems natural that if muscle mass is growing but my weight is staying the same, I'm losing fat, right? But I'm already skinny (6'2", 161lbs), and to try to maintain pre-training weight the whole season could lead me to under-eat.

Without getting dipped and having body composition measured regularly, are there general rules an enthusiast like myself can apply to ensure that weight gain is the right kind, and not the 'pizza' kind?

Thank you, as always, for your kind assistance.
Andrew

Scott Saifer says

Andrew,

Congratulations on hitting your target weight! That puts you in a tiny minority among cyclists. At 6'2" and 161lbs, you weigh as much as professional bike racers who specialise in climbing. You certainly should not lose more weight and especially not more muscle. You are right of course that if you are adding muscle while maintaining weight you are losing fat.

There are two easy, "at home" methods of tracking body-fat percentage. One is to buy yourself some skin-fold calipers. The ones that use a plastic spring are not particularly dependable, but any that use a metal spring, even if the rest of the unit is plastic, are pretty good. If the skin-folds are staying the same or getting thinner, you are not adding fat.

Buying calipers is appropriate if you are a bit obsessed with this question. If you are merely concerned, noting the extent to which veins stand up above the skin on various parts of your body is pretty effective too.

If you see veins on your forearms, that's pretty normal for healthy people. Veins standing out on the upper arms is getting skinny. Veins standing out on the thighs and belly is super thin, okay for bike racers in season but too light for year round health. If your veins are standing out more than before, you've lost body fat. If they start to get harder to see, you are adding fat.

The Cyclingnews Form & Fitness panel

Steve Hogg (www.cyclefitcentre.com) has owned and operated Pedal Pushers since 1986, 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. Clients range from recreational riders and riders with disabilities to World and National champions.

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.

Scott has helped clients to turn pro as well as to win medals at US Masters National and World Championship events. He has worked with hundreds of beginning riders and racers and particularly enjoys working with the special or challenging rider. Scott is co-author of Bike Racing 101 with Kendra Wenzel and his monthly column appears in ROAD Magazine.

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.

Pam was an All-American in track while at the UW. She started cycling competitively in 2003 and is a three-time Missouri State Road Champion.

David Fleckenstein, MPT, OCS (www.physiopt.com) is a physical therapist practicing in Eagle, ID and the president of Physiotherapy, PA, an outpatient orthopedic clinic focusing in orthopedics, spine, and sportsmedicine care.

His clients have included World and US champions, Olympic athletes and numerous professional athletes. He received his Masters degree in Physical Therapy from Emory University and is currently completing his doctorate at Regis University.

He is a board certified orthopedic specialist focusing in manual medicine and specific retraining of spine and joint stabilisation musculature. He is a former Cat I road racer and Expert mountain biker.

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.

Dave Palese (www.davepalese.com) is a USA Cycling licensed coach and masters' class road racer with 16 years' race experience. He coaches racers and riders of all abilities from his home in southern Maine, USA, where he lives with his wife Sheryl, daughter Molly, and two cats, Miranda and Mu-Mu.

Dario Fredrick (www.wholeathlete.com) is an exercise physiologist and head coach for Whole Athlete™. He is a former category 1 & semi-pro MTB racer. Dario holds a masters degree in exercise science and a bachelors in sport psychology.