Cyclingnews Fitness Q&A - May 18, 2011

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.

Cleat positioning and seat height affecting power output

Panel,

I'm a 6'1" 168 lb 45 year old Cat 1 mountain biker, triathlete, and masters road guy. I've found without question (powermeter HR etc.) that I am more efficient with lots of saddle setback and my cleat directly under the ball of the foot and utilizing more of an ankling motion, dropping my heel a bit around 3 o'clock. When I move my cleat all of the way toward the heal of my Specialized shoes(and lower saddle) to alleviate some foot numbness as i occasionally do(2 centimetres back), power drops, heal is way more elevated in stroke at 3 o'clock position.

Here's the bummer. Within 5 hours of riding with the "more powerful position", pedal at ball of foot, I begin to get a sharp uncomfortable feeling on the front/tip/top of my patella. Had it bad last year and thought it was from lots of hill running. Didn't make the connection until this season and I am 100% sure the cause now. Two side notes, I have huge feet, 48cm, and I use 170mm cranks, have for as long as I can remember. That could be a topic for another day. Paul, California

Steve Hogg says:

G'day Paul,

Your letter illustrates that using power as a reference point is only part of the performance picture. When talking about power, you need to talk about duration at the same time. If you can't sustain the power output without running excessive risk of injury, and it sounds like you are in or close to that, then I would choose a position that is kinder to your body and removes or largely reduces the risk of injury, even if that means producing less power.

There is no benefit long term if more power = more injuries. I would move the cleats back as you have previously done if that solves the problem. If you do so, seat height will almost certainly need to drop to account for the likely greater extension of the legs caused by the more rearward cleat position.

Scott Saifer says:

Hi Paul,

I agree 100% with Steve. If your powerful position causes injuries, it's not a "good" position anyway. I'd be surprised though if you can't get the higher power and freedom from injury in one and the same position though. It may be a matter of refining the fit farther in the cleat-back position, or simply a need for more training in the new position. How much have you trained in the lower-power but less injurious position? Is it possible that your more powerful position is more powerful because you have trained there more? I'd expect you to need several weeks of decent volume training to get your muscles adapted and running at full power in a new position.

Paul’s followup:

Hey Scott,

I think you're exactly right! Old position, i.e. ball over spindle felt better because it was familiar and muscles adapted to it. I raced this weekend with pretty good success in the alleged "less powerful rearward cleat postion" and of course had no knee problems but my glutes were so sore I still feel them! This never happens, leading me to believe you're correct that I need more condition in the knee friendly set-up. To answer question directly, I had never gone more than a couple of days at less than race intensity with the big saddle setback-rearward cleat position. I'm sticking with it and letting my body adapt. I think ultimately what created more power for me was moving the saddle offset rearward and dropping my heal slightly during powerphase of stroke (yes I did lower the seat, I know what you're thinking). Bonus is no more numb feet too.

Saddle sores

Panel,

I’m hoping you can help me as I am at my wits end and close to packing in this sport I have loved and been committed to for over 20 years. I’m a 34 year old cat 3 road racer, who usually rides between 8 and 10 hours a week.

I am experiencing chronic saddle sore; it is basically any skin that is in contact with the saddle, the discomfort is mainly in the form of chafing. I have seen the two best people in the UK for bike fitting, including Scherrit Knoesen, after a previous recommendation from Steve Hogg. I have tried endless saddles, shorts, chamois creams and washing detergents. Nothing seems to help.

However, over the past 8 months it has become such a problem I can no longer ride for more than 2 hours and even that leaves me very sore and fed up by the time I get home. The discomfort starts almost as soon as I start riding and gets progressively worse the longer I ride.

I have had fungal infections in that area before, caused by the chafing from riding, so regularly use anti-fungal creams after riding. Currently the skin looks fine and healthy, other than after riding, when it is very red and sore.

My doctor can see no problem with the skin either. I have considered going private to a Dermatologist, but this is very expensive, and probably a waste of money as there are no obvious skin problems.

I am at a loss as what to do next, it is making training and racing virtually impossible and I am very close to calling it a day.

Matt

Steve Hogg says:

G'day Matt,

I can 'hear' the frustration in your mail. I'll say at the outset that I'm not a health professional. I spoke to Scherrit and he says there is nothing particularly unusual about the way that you function on a bike so we can discount that. You can't discount some sort of skin irritation or sensitivity and it would be worth your while consulting a Dermatologist to get to the bottom of that.

One comment that I will pass on that falls under the heading of 'boxes to tick'. I've had several customers over the years who have experienced similar issues to yours and in each case chamois cream and even antiseptic creams exacerbated an existing problem,probably because they provided a warm, moist environment for bugs to grow in. What solved the problem was antiseptic talcum powder applied before each ride and after each shower or bath. It has germicidal properties, promotes low friction contact between you and your chamois but more importantly is dry. In Australia, the most common brand is Medi Pulv though that may not be the case in the U.K.

I hope this helps.

Panel,

Osteoarthritis and riding

Hi all,

I am an early 50's female who has been riding for 8 years. I've been having thumb joint pain for several years and two years ago saw an MD who after viewing x-rays, diagnosed osteoarthritis with bone spurs in both CMC joints.

I had a good bike fit at Boulder Center for Sports Medicine last year and feel really good on the road bike but I have significant pain in my thumbs both on and off the bike and that is limiting daily activities. I recently had a cortisone injection in each thumb to see whether that would relieve the pain. It helped a little but riding is still quite uncomfortable as are other basic activities of life, like holding a fork, opening doors, and handwriting. I am using Specialized "Bar Phat" to cushion the handlebar and am trying to avoid placing my hands directly on the base of my thumbs as much as I can. Shifting is a problem whether on the hoods or drops (I love Campy but the thumb shifting is getting to be a challenge).

Any suggestions on what I could try to improve the situation? Should I see a physical therapist or perhaps do another bike fit? Please don't suggest switching to a recumbent bike.

Steve Hogg says:

Gday Linda,

The only way that you will get a result on a bike is to reduce or remove the pressure on your hands. Do you feel like there is a lot of weight on your hands?

Or is it that the problem is so acute that placing hands in a more or less fixed position causes pain?

With regard to potentially changing your bike position - Raising the bars, moving the seat more rearwards and moving your cleats further rearwards can all have an effect on lessening the pressure you bear on your hands. If your situation is really acute, and using bike position to reduce hand pain means that you are sitting so far back that you create other problems, through excessive lumbar flexion or cramping up the hip flexors, then you may need to consider a flat bar bike to allow the necessary bar height. If even that is not comfortable, the recumbent option comes back into consideration.

Circulation affected by socks

Panel,

I have a constant issue with the loss of circulation to my toes. This occurs often when the temperature is below about 15C and always when below 8-10C. Compounding the issues is that the post ride warm shower leads to rapid expansion of the restricted blood vessels in my toes and consequently, I have developed chilblains in my big toe. I have tried using winter socks combined with boot covers with no success and this occurs whether I am in my road shoes or my mountain bike shoes, which have a wider last than the road shoes.

I make every attempt to stay warm and even during high intensity repetition sessions where I am perspiring under my jacket, I lose sensation in my toes. I have tried wiggling my toes whilst riding and am sometimes forced to dismount and walk to promote blood flow, but even this doesn’t seem to help much.

Unfortunately I have little choice but to train before work when it is coldest and regardless it rarely gets above 15C during the day for half of the year.

Cheers,

Matt

Scott Saifer says:

Hi Matt,

Don't wear socks that are thick enough that they squish your forefoot in the shoe. Are your shoes wide enough that they leave your mid-foot, ball of foot area and toes free to wiggle? If not, get wider shoes. If they are that wide already, check Steve Hogg's posts on cleat positioning. Having your cleats too far forward can make people squinch their toes unconsciously, cutting off circulation.

Preparing for a L’Etape

Panel,

I’m doing the Etape this year (Modane-Alpe D’Huez stage). I’m very much a recreational cyclist but have done some quite long and hard sportives before.

So, based on my experience I’m questioning the best approach.

Thanks,

Steve McEvoy
Dublin,
Ireland

Scott Saifer says:

Hi Steve,

Preriding key parts of a race is a common strategy for pros, but you are right to be concerned about the effort of the climb and your ability to recover. Pros preride because they are looking for good places to attack the field and identifying the fastest lines for the descents though, neither of which really apply to an Etape rider. It takes a couple of weeks after any particular training bout before you get the physiological benefit of having done it, so nothing you do on Saturday before your Monday event is going to make you stronger on Monday, but doing something very hard could certainly make you weaker and slower. I'd suggest you avoid doing anything exhausting in the 10 days before your event, but ride easily on the flats instead. If you really want to preview the Etape course, drive it.

Just so you know, provided you are able to practice in the cadence range you'll need for climbing, there's no particular need to do long climbs to prepare yourself physically for long climbs. I've seen people from flatter part of the USA do very well at very hilly stage races, at least on the climbs. On the other hand, there is no substitute for fast descending to teach the necessary skills for that, so do be careful on the descents. At high altitude you'll be coasting a lot faster than you are accustomed to at lower altitude on similar grades.

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 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. He can be reached at: stevehoggbikefitting.blogspot.com/

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.

James Hibbard progressed from the junior to the professional ranks as a rider and has over 15 years of competitive cycling experience. He is a former Collegiate All-American track cyclist, trained as a resident athlete at the United States Olympic Training Center, earned international medals as part of the U.S. National Team, and was a member of the powerhouse Shaklee and HealthNet Professional road cycling teams.

He has earned 13 National Track Championship medals, as well as numerous junior, U-23 and elite California State championships on both the road and track. Since retiring from full-time racing in 2005, James has focused on his development as a coach.

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.