Cyclingnews Fitness Q&A - July 28, 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.

Returning to cycling

Two questions which may, or may not be of interest to your column:

1) I was a national squad rider as a junior, competing internationally and then riding full-time for a year. However, I haven't ridden much for the last 10 years and am now getting back into cycling again. Will my fitness return quicker given my previous level, or is a 10-year gap pushing it a bit too much?

2) A slightly more involved question relating to physiology. Below are my lab test results at various times, all done on a bike ramp test:

18 years old - GB National Road Cycling Team member (63kg)
VO2 max - 4410ml/min = 70ml/kg/min
Max HR - 200
LT - 181

26 years old - almost no fitness, post-torn cruciate ligament in right knee (83kg)
VO2 max - 4380 ml/min = 53ml/kg/min
Max HR 194
LT - 155

28 years old - training for marathon (having recently run a 1:22 half marathon) (73kg)
VO2 max - 4420ml/min = 60ml/kg/min
Max HR 192
LT - 161

You'll notice that my actual VO2 max (irrespective of weight) is virtually unchanged in all of these tests. Is this a product of improper training during my racing days? Was a high LT the only determinant of my success when racing? Are these typical results?

Many thanks,
Sam Collins

Scott Saifer says:

Sam,

Physiologically, after 10 years your heart and muscles are about what they would be had you never been a racer before. You'll need to train up quite a bit.

You do have several advantages though, that should make the training go quicker than it would for a true beginner. You already know about appropriate cadence and training intensity. Since you made it to the national squad, you probably know how to listen to your body so as to avoid setbacks. You already know better than to ride hard through an injury or illness.

While you may have the body of a non-athlete, you already know how to be an athlete. That's probably enough to shorten training time from here to top form by a third, at least compared to an average new rider.

Thanks for the absolutely awesome data points on your VO2-max. In the physiology text books it says that absolute VO2-max (the one measured ml/min) is genetically determined and changes very little once one has done a few months of training. I've never seen such a perfect example as yours.

Your VO2-max barely changes as you gained 20kg, lost all your fitness, lost 10kg and got fit again. You are text-book normal in that sense.

You didn't say what your specialty was back in the day. Your VO2-max was okay but not stupendous for a road racer, fine for a trackie or crit specialist. If you did well in high-calibre road races with a VO2-max of 70 ml/min/kg, you must have been extremely well trained and had an excellent LT as percentage of max.

Leg length issues

Today, I was looking on the internet for some sites that talks about bike-fitting and I found this site. I don't expect you to solve my problem by email because I know that a good bike fit needs a visual observation but I'll appreciate any advice. Thank you in advance.

I don't know how to start. Well, I'll give you some measures that will help to understand my pains:

Height: 1,79 cm
Inseam: 82 cm
Right leg: 90 cm
Left leg: 89 cm
Foot: 45 (EU size)

Here, you can see that I have none-symmetrical leg lengths.

One year ago, I visited a bikefitter and they diagnosed a varus: 9 degree and 12 degree (left and right). However, I'm pretty sure that my right leg has more degrees (around 15 degrees).

Everything started with pain in the calves or soleus (especially the right one) but as I increased the training the pain appear also in Iliotibial fascia lata. I attribute both of them to the varus.

On the other hand, I have also a pain in the left Ischium. This is very painful, if I ride more than three hours, it hurts a lot. I think it could be caused by my non-symmetrical leg lengths because it is the shorter leg.

As I've told you before, one year ago I visited a bike fitter in Spain, and he proposed the following changes:

Two cleat wedges and two ITS wedges in the right leg
One cleat wedge and two ITS wedges in the left leg
Rotated the cleats in 7 degrees

My feeling after this changes were:

- The calf or soleus pain almost disappeared.
- The ischium pain didn't improve.
- The iliotibial fascia lata pain even increased.
- Moreover, I got a new pain: tibial anterior. The pain even gets up until the knee.

As the pains didn't dissapear I started to prove different things, in other words, I self-medicated, using the method that proves if something doesn't work, change it.

For example, after reading bikefitpro.blogspot.com, I found a case that was very similar to mine. So, I put two more cleat wedges in my right foot. My knee and iliotibial fascia lata has improved but it another pain appeared: biceps femoris.

Another example: if I put the cleat (right leg) with the tip towards inside (opposite to how I have it now) then the femoris and fascia lata pain dissapear but another pain appears: vastus medialis. It likes the leg pressure directly on this muscle.

Next I give you the bike mesures and the characteristic of some accessories:

- I use Specialized S-Works shoes
- I use Specialized shims instead of ITS wedges (but I also have them)
- I'm using Specialized blue insolate for my right leg and red for my left leg.

About bike measures:

- I have a Specialized S Works, size 55 (top tube)
- Handlebars: 42 centre to centre
- 74cm from saddle to cranks

Thank you so much,
Iñaki Garcia Santapau

Steve Hogg says:

Inaki,

Based on what you have said, I don't understand why you the people you have consulted haven't placed a shim under your left cleat. A 10mm leg length difference is substantial and uncorrected, this is the likely explanation for your painful left ischium and the ITB problems you've experienced on the right side.

I'll explain; the shorter left leg is causing you to drop the left hip. This can only be accomplished by pushing your left ischium harder into the seat, hence the pain. The dropping of the left hip will also challenge the plane of movement of the entire right leg. This is the most likely reason for your right side ITB pain.

Since then you have been trying different solutions but they seemed to have solved some problems at the cost of creating others. I think it is time to tackle the larger problem and place a shim under the left cleat. How high a shim?

I can't give you an definitive answer as there are a lot of individual variables like:

-Whether the difference in bone length is in the upper leg or lower leg or a combination
-What functional differences have evolved between left and right sides after a lifetime of functioning on and off the bike with an uncompensated short leg. These may include differences in the way your feet are proportioned and function; differences in the pattern of flexibility between right and left sides and differences in pelvic function between right and left sides.

I would start with a 5mm shim and work up from there with periodic reassessments of how you feel. It would not surprise me at all if you need a larger shim than 5mm after a trial and error process.

One thing to note; to keep the left foot stable on the pedal with a shim placed underneath the cleat, move the cleat 1-2 mm further back relative to foot in shoe on the left side for every 5mm of shim stack that you use. You can make a shim from any suitable material or buy them ready made. Let me know if you need more info and how you get on with a shim in place.

Herniated lumbar disc treatment

Dear Cyclingnews fitness team

Firstly, I am a 35-year-old cat four road racer who also races mountain bike (hardtail, which may be relevant). I am 1.94m and 98kg and I (used to) ride about eight hours a week depending on other commitments.

Three weeks ago I flew home from the US to Europe overnight so I spent the night sitting upright on the plane. The next day I was tired and stiff as usual after such a flight but didn’t worry too much about it and the following day I did a mountain bike race in which I fell off several times, but apparently without injuring myself.

The following day my back was sore and I had a touch of sciatica so I skipped training and my planned race at the weekend as it gradually got more sore. I did go for one 35-mile fairly hard ride at some point.

I saw a chiropractor after five days for a regular appointment and that is when it really started to be a problem, I couldn't tie my shoelaces and was in general discomfort.

Fast forward another two weeks and I am now completely incapacitated with a herniated disc between four and five. I had an MRI scan which I don't have the results for, but my doctor is telling me to expect six months minimum for recovery and telling me I should decide if I want surgery or not.

I have researched as much as I can and it seems that there is no clear answer and I cannot find anything specific to cyclists for treating herniated discs. I have been doing 2-3 sessions of Pilates of about 45 minutes to an hour each time all year and my core strength is good although I guess I could lose 10kg or so.

I can't really see how rest and phyisio is going to help when I can already see that my muscles are wasting in my legs and back. Perhaps surgery is a better idea so that I can get on with life sooner.

I am in considerable pain much of the time and can't really sleep. I know that this will be a long journey but I would like some advice specific to cyclists relating to whether I should go straight for the surgery to minimise the time off and the damage that is being done to the rest of me by walking badly, abusing pain killers and not sleeping or whether I should tough it out and go for the conservative approach and try to find a physio who understands cyclists.

Should I get rid of my mountain bike altogether or should I change it for a full suspension when I am back in action?

Regards
William,

Dave Fleckenstein says:

William,

Indeed, the research regarding 'best practice' for dealing with lumbar disc herniations is conflicting and evolving, and your story is one that we hear on a daily basis in the clinic.

First, disc herniations (and significant ones at that) are normal occurrences in our populations. In our culture, prolonged sitting postures place significant stress on the annular fibres of the disc and promote breakdown of the disc.

The longer that we are in sitting positions, the more this breakdown is accelerated. My first rule in dealing with lumbar herniations is to minimise sitting times - I generally advise that individuals stand for 10 seconds out of every 10 minutes to reduce stress on the disc and improve circulation through the area.

Next, you have a good physician - six months is a normal time to resolution. The surgeons that I work with closely advocate surgery only with intractable pain or neurologic deficit. This is for you and your physician to determine. Otherwise, I would (and have myself) let the disc heal through a normal course.

Regarding your current care, appropriate activity with restoration of deep stabilisation musculature, neural glide techniques, correction of faulty use patterns, and restoration of normal flexibility and motion patterns is essential to improve function and prevent recurrence. I would highly recommend seeking a therapist skilled in treating the spine to guide you through this.

Performance of Pilates is not a guarantee of core muscle strength or correct activation patterns of muscles such as the transverse abdominals and multifidus. Additionally, many patients have some success at reducing symptoms with the use of epidural injections to reduce inflammation. I would stress that reduction of symptoms does not mean normal function, and this must be addressed with therapy.

The unfortunate part of this injury is that the healing time is not convenient, but must be respected. While I anticipate that as your symptoms reduce you will slowly be able to return to cycling, your focus must be first on gaining resolution. A spine that is in dysfunction off the bike will only become much more irritated on the bike.

Q-Factor question

I am wondering, considering modern road bicycles/group-sets and modern pedals if there any rules-of-thumb to determine which Q-factor to use as "close to optimum"? Does it matter much (is Q-factor importance low in fitting process)?

I am a 50-year-old male, 173cm height, fitness road rider. I ride on Speedplay Zero pedals and 2010 10-speed Shimano Ultegra.

My Speedplay Zero pedals allow me about 10mm of Q-factor adjustment, per each foot.

I am very inflexible, tight muscles just about everywhere (tight hamstrings, hips, lower back, SIJ, etc), if this helps to answer the general question.

What are the tell-tale signs of an incorrect Q-factor (location on likely pain, discomfort, etc)?

Thank you in advance.

Yuri
Melbourne, Australia

Steve Hogg says:

Yuri,

The simplest way to answer your question is that the relative separation of the feet on a bike is an individually variable matter. Ideally the centre of the knee should descend over the centre of the midfoot though there are exceptions because of morphological and functional issues that some people have .

Tell tale signs of too great or too little separation of the feet? How long a list have you got time for?

The problem is that when beset by any challenge to a position on a bike from any source (and usually multiple sources) the rider will evolve a pattern of compensation to work around the problem or problems.

Compensations don't inherently solve a problem. What they do is shift the load (pain / discomfort) elsewhere and it is usually the weakest link in the chain that protests.

In my experience it is rare to find serious problems with foot separation alone (if this was the case, road bike riders would not be able to ride mountain bikes which have foot separation values of 30 - 50 mm greater than road bikes) but almost always in combination with other issues such as the angle of the cleat, seat height and setback, foot cant etc.

Saddle fore and aft

Here's one for Steve. I'm a 44 year, 6'1" 163lb cat 1 mountain biker and triathlete - random combo, I know.

In the past my bike fitters have always used the tibial tuberosity, small bump under the knee cap, to set my saddle fore and aft. My new dude has decided to use the lower tip of the knee cap resulting in a HUGE difference in setback, several centimeters rearward.

I went from 8.5cm behind the bottom bracket to 11cm, and about 3mm lower saddle. Anyway, after five weeks of riding and two races, patellar tendonitis has ensued. Does not hurt running, therefore I have concluded this guy hosed me on the bike fit. Is it possible my kneecap is really thick, causing a skewed measurement?

On a vaguely related note, I have big feet 48cm (size 13), and I have found that having an all of the way rearward cleat has helped with my power, most notably not pedaling toes down all of the time, and saves my calves for the run session. This causes a more fore saddle position... right? Any thoughts on that would help too.

Thanks.

Paul,
Wrightwood, CA

Steve Hogg says:

Paul,

You've asked several questions. Firstly, I'll tell you that my experience is that KOPS is irrelevant which means that kneecap thickness plays no part. What's relevant is that neural function precedes biomechanics in importance (if we separate the two which isn't really possible because they are so intertwined).

Neural function has priority because every action on a bike starts with a signal from the brain or elsewhere in the central nervous system that in part or in whole is based on a constant flow of proprioceptive feedback from the body. This process needs to be optimised within the constraints exhibited by the rider's functional makeup.

Simply, seat set back needs to such that the upper body is largely unweighted. This allows the higher priority (in a neurological sense) muscles that act posturally and allow us to breathe and maintain a position to be largely relieved of load so that the lower priority, power producing muscles that act phasically to have best chance to do their job efficiently.

More to the point, when you seat was moved further back that may or may not have been the way to go. When seat setback increases, hamstring enlistment increases and hamstring engagement places a natural limit on seat height. Your bike fitter may well have moved your seat too far back and / or he may have not dropped your seat enough to compensate for the increased hamstring enlistment. The 3mm lower seat height you ended up with doesn't seem like nearly enough to effectively compensate for the 25mm of increased set back.

Regarding a more rearward cleat position needing a more forward seat position: yes, no, maybe.

What is important is that the upper body is largely unweighted. The picture changes somewhat with TT's and tris because there are four less major joints to stabilise (elbows and wrists) and aerodynamics potentially assumes a larger importance than for mtb or road riding.

Moving the cleats further to the rear c will usually mean increased stability of foot on pedal. Whether this results in the rider being able to move their seat forward for optimal positioning depends entirely on where it was in the first place. For some the answer will be yes and for others no.

Training periodisation

As I understand it, the strategy of periodising training involves building different kinds of fitness at different times of the year, I believe, on the basis that anaerobic training either depends upon or interferes with aerobic training. My first question is whether this is a widely-accepted view.

This separation becomes more difficult in the middle of the season. Now, mid-summer, after one peak, I need to build both functional threshold power and anaerobic capacity, and I'm not sure how (whether) to do that at the same time, given the relatively short period in which to do it.

My plan is include in a single week one 1.5-2.0 hour tempo rides and one 5:00 minute intervals well above threshold power (to rebuild aerobic fitness) as well as one workout of one-minute or 30-second intervals (to build anaerobic fitness).

Is this possible? Advisable? Or do I need to separate the aerobic workouts and the anaerobic workouts into separate multi-week training blocks?

Thanks in advance,
Mark Freed

Scott Saifer says:

Mark,

Coaches used to say with confidence that anaerobic training un-did the benefits of aerobic training, though little or no specific research backed that up. There is specific research on the changes that occur in a muscle when it is trained aerobically or at higher intensity.

They are different and in some cases are in opposite directions, as in one sort of training decreases things that the other sort of training increases.

I'm not aware of good research on what happens when the different modes are combined, so it is possible that both shifts would be maintained. This is unlikely though, as performance studies have shown decreases in VO2-max and aerobic power in elite endurance athletes as they indulge in more supra-LT training.

There is a another way to think about periodisation that makes it make sense even if harder training doesn't directly undo the benefits of aerobic training. Consider how many weeks of training at a particular intensity are required to optimise that aspect of physiological performance.

One can continue to benefit from aerobic training for several years, while the adaptation to extended supra-LT training seems to play out in just a few months. That means you can mix hard and easy training all the time, or do only easy training for part of the year and add the hard stuff just a few months before racing season and end up in the same spot.

But skipping the hard stuff in the months long before the racing season leaves much more time and energy for the long, endurance stuff, or more time for recovery. Since most athletes are limited more by available time or the ability to recover than by any other factors, that in itself is enough reason to periodise.

Provided that you have enough base to be able to handle the workouts you describe and still have a few long rides per week and still recover, your plan looks good as a way to build to a second peak.

The Cyclingnews Form & Fitness panel

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.

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.

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.