Cyclingnews Fitness Q&A - May 25, 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.

1) Your cold weather shoes should be one size larger than your warm weather shoes (in particular, toe box must be roomy). If you like wooly socks, then perhaps consider going one and one half sizes larger. Consider getting a pair of winter cycling shoes. Summer shoes are designed to allow for air circulation, and winter shoes are not. I ride the Lake winter boots when it is about 0 deg C - down to around minus 10 deg C or so (add booties for colder). My Lakes are about one size bigger than my summer shoes, and I usually wear thin-ish wool socks with them. I have loads of toe-wiggle-room, and my feet stay quite warm.

2) You must get off and walk BEFORE you lose circulation. The goal is to keep circulation going - not attempt to regain circulation. Regaining circulation takes about ten times the effort of maintaining circulation (at least it feels that way). Get off at all red stop lights and many stop signs and walk around 20 steps... If you do this BEFORE your toes go numb, you will greatly extend happy toe time. If you are into cyclocross, this is a great way to keep your dismount/remount sharp.

I've been an avid road cyclist for around five years now. I usually ride 6-7 days a week, with mileage in the 150-250 range. I also ride 12 months a year. Overall I feel great on the bike, but the one issue I have not been able to cure is neck pain. After about an hour in the saddle my neck starts to get sore at the base, where my neck meets my upper back. Putting my chin to my neck alleviates it a bit, but when I first do this the pain in the base of my neck is pretty bad, I'd say a 5/10. I try to roll my neck, swing my arm, roll my shoulders, but the pain never goes away completely.

I did see a chiropractor for six visits this fall and he noted my neck was out of alignment, a bit cocked to one side with the muscles tighter on that side. He helped out and I felt improvement immediately, but I also don't want to spend the rest of my life going to a chiropractor. I'm 31 years old, 5'8", and 145 pounds. I should also mention that I played sports in college and injured my neck pretty badly, chipping the C-5 vertebrae when my head was snapped back abruptly and forcefully.

I wonder what to do next. Stretching? Strengthening? Chiropractor? I could flip my stem, but I do a lot of fast group rides/races and do prefer the slightly aggressive position on the bike. The pain isn't horrible, but it is bad enough that I'd like to solve it. Some days I do have neck pain off the bike. I should also mention that I do a lot of reading, with the book on a table, so my neck is straight down in that position or back, when on the bike, for most of the day.

Stretching and strengthening your neck are great ideas, but do take a look at bike fit and make adjustments in the meantime, so you can ride pain-free until you gain flexibility and strength. The majority of base-of-neck pain situations are caused by having the bars low enough that you have to strongly contract the muscles in that area to keep your head high enough to see down the road. Here's a test to see if that's your particular problem:

11) You are now looking as far down the road as you'll be able to look for more than a few minutes without getting a sore neck. If you are looking comfortably to the horizon or close to it, bar height is not the source of your neck problem. If you are looking at the ground a few bike lengths out or any nearer in that you'd like to be able to see when you are riding routinely, your neck is getting sore because your bars are too low and you should raise them.

NB: I am not a complete beginner to exercise as I have been a recreational runner for the last 20 or so years and over that time I have competed in marathons, half marathons, cross country and mountain running. Back in the mid 90’s I competed in a few Triathlons and a few TT’s. My knees are starting to suffer from the running and I have some neck and back problems, I now just do a few mountain-running events which I really enjoy.

If your idea of a training plan is just writing out the times and intensities you plan to ride each day, then programming for older riders is quite different since you have to allow for that extra recovery time. If, as I advocate for riders of all ages, your plan includes alternatives to be executed depending on your current state of energy or fatigue each day, then a plan for a 20-something will work great for a 50-something as well.

The studies specific to Bupropion (Wellbutrin) showed a positive effect on time trial performance in the heat, but no effect in temperate conditions. Another study in 2009 to determine the effects other SSRI's had on the level of fatigue in time trial performance, but did not find a significant effect. An additional study of SSRI's showed exercise time was less, but no impact to cardiac response. Overall, they don't seem to significantly impact performance, but much of the research has been done on very small groups of athletes and often with doses less than a therapeutic dose.

You may try and figure out if there would be any other reason for you to be experiencing a decrease in power. Other panelists may be able to chime in on other factors that could impact this. Since the new medication is the biggest change, it's easy to define it as the culprit, but don't let it mask something else that may be to blame. If you have ruled everything else out, then you can start looking at Plan B. The side-effects one person encounters with medication may be different than what someone else experiences. If you continue to have issues with your performance, you could work with your doctor to try a different anti-depressant or a different dosage until you figure out what works for you.

Carrie's right. We get questions regularly from people whose power has gone missing who aren't even on any medication, so your loss of burst power may well have nothing to do with the medicine. The only way I can see to determine for sure would be to have your doctor help you cycle on and off your Wellbutrin (using something else to keep your mood stable at the same time) and see what happens to your power.

Just to get you thinking, some other things that can cause a sudden loss of high-end power: chronic under sleeping, seat post sinking into frame, overtraining, recent head-cold or other illness, under-eating carbohydrate, increased ride volume, increased stress at home or work, reduced motivation et cetera. If any of these could be the problem, fix them. If not - check with the doc about trying different meds.

4. There is noticeable lateral movement of my right knee as I ride. My right foot also moves laterally as I pedal. This is probably because I have a slight neurological condition that means my right leg is shorter than my left. The difference is less than 1". I had corrective surgery when I was six years old. As an adult, an orthopedic surgeon advised that any further surgery would have little positive corrective effect. Built up shoes were not recommended, but I use arch supports in my shoes when I walk, although not when I cycle.

Even assuming this is / was good advice; that advice was given for walking which is an activity we have evolved to perform. We have not evolved to cycle and on a bike are in a more or less fixed position in that we have to relate to 5 contact points; bars, seat and pedals. When walking our only contact is with the feet on ground and our pelvis and arms are not fixed in space. The upshot of what I am saying is that there is a greater need for functional symmetry on a bike than there is when walking because are trying to interact well with a positionally symmetrical apparatus in the bike while not compensating for a substantial leg length difference. You are on a hiding to nothing.

One example. I have a customer who is a Navy Clearance Diver. This gent has done all the special forces training, jumped out of plains, walked long distances with heavy packs, done all the other death defying stuff, all with a one inch leg length difference like yours. His LLD is the result of a severely broken leg at a very young age. He has never had a moments problem or any pain performing any of the heavy physical activity he has subjected himself to until he took up cycling. He came to see me complaining of chronic low back and knee pain on the shorter legged side. I was very surprised at how functional he was off the bike but he needed an 18mm shim under the foot of the shorter leg to resolve his issues.

One example doesn't make an argument. I've seen other examples of similar uncompensated for large leg length differences who were in chronic pain during ALL activities, so you are lucky. But you are asking one leg to reach 25mm further to the pedals than the other. There is a price to be paid for that and you are paying it. You need to compensate for the difference at least partially. Doing so with clip and strap pedals is nigh on impossible. What is possible is for you to change to MTB style clipless pedals, buy a set of high quality MTB shoes with a discrete sole (not a moulded around the upper type sole as many less expensive MTB shoes have) - your current shoes might be of this type already, and have a boot maker remove the sole and insert a full length dense EVA foam build up of the appropriate height and re-glue the whole thing back together. Competently done, it looks like the shoe left the factory like that.

I am a 31 yr old road cyclist. I have been told by 2 physiotherapists that I have developed ITB Friction Syndrome in my right leg. The physio clinic is heavily associated with a large number of elite AFL players amongst other athletes and private patients. I am currently working in a remote area of Western Australia and only get to ride on my breaks from work back in Melbourne (where I live), thus I can't get out on the road as often as I like.

My right knee started playing up during a very slow flat 40km (approx 15km/h) charity ride with my girlfriend in February this year (I was frequently turning around to my right to check and see where my girlfriend was and if she was ok during the ride and the pain started towards the end of the ride) and has been unshakeable since then. Prior to this problem surfacing, I'd be able to get out for a few 40-80km (gradually building over the week or two of my break) rides without any problems during my time off. Have been following the prescribed stretches and exercises (including Glute stretches, ITB stretches, Single leg squats, lower back exercises (laying on back with knees bent and then lifting lower back up to form a straight line from knees to chest) and single leg step ups) whilst away at work with a few sporadic gym sessions on the cross trainer for roughly 30 minutes (so as to not overdo it).

I have found that the pain comes back roughly around 30 minutes after commencing exercise on the cross trainer and bike. Jogging doesn't stir it up, but have had some problems with shin splints and near compartment syndrome in the past, so only try and jog on grassed surfaces. On my last trip at home I went to 3 rides, first one was 40mins in duration, and then the second was 30mins in duration with a rest day in between, then was unable to get out until a week after the second ride and only got about 15mins in before the pain started to reappear on the outside of the right leg approximately 5cms below the knee in the area where the calf muscle meets the bone (this has been a constant area of pain throughout this problem). The initial pain was located in this area along with directly under the patella, with some small discomfort transferring to the inside of the right knee.

If you have done all the exercises prescribed and are fine performing other activities but still have problems when riding then something is not right about the way that you relate to the bike. There are so many potential causes of ITB pain on a bike that I can only speculate. One common aspect is that almost always, the rider is not sitting squarely on the seat. That is they are dropping one hip or sit with one hip forward. Usually the dropping or more forward hip is on the opposite side to side experiencing pain. A good bike fitter should be able resolve or moderate the ITB issue on a bike. That said, there aren't many good bike fitters. If you can find someone well credentialed in Melbourne, by all means give them a try. If that doesn't help, get back to me and I'll try and help further.

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.

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/

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.

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.

Alex Hinds, Production Editor

Sydney, Australia

Follow @al_hinds

Alex Hinds is a graduate of Economics and Political Science from Sydney University. Growing up in the metropolitan area of the city he quickly became a bike junkie, dabbling in mountain and road riding. Alex raced on the road in his late teens, but with the time demands of work and university proving too much, decided not to further pursue full-time riding.

If he was going to be involved in cycling in another way the media seemed the next best bet and jumped at the opportunity to work in the Sydney office of Cyclingnews when an offer arose in early 2011.

Though the WorldTour is of course a huge point of focus throughout the year, Alex also takes a keen interest in the domestic racing scene with a view to helping foster the careers of the next generation of cycling.

When not writing for Cyclingnews Alex is a strong proponent of the awareness of cyclists on the road in Sydney having had a few close run-ins with city traffic in the past.