Fitness questions and answers for April 24, 2005

Form & Fitness Q & A

Got a question about fitness, training, recovery from injury or a related subject? Drop us a line at fitness@cyclingnews.com. Please include as much information about yourself as possible, including your age, sex, and type of racing or riding. Due to the volume of questions we receive, we regret that we are unable to answer them all.

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.

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.

Fiona Lockhart (www.trainright.com) is a USA Cycling Expert Coach, and holds certifications from USA Weightlifting (Sports Performance Coach), the National Strength and Conditioning Association (Certified Strength and Conditioning Coach), and the National Academy for Sports Nutrition (Primary Sports Nutritionist). She is the Sports Science Editor for Carmichael Training Systems, and has been working in the strength and conditioning and endurance sports fields for over 10 years; she's also a competitive mountain biker.

David Fleckenstein, MPT (www.physiopt.com) is a physical therapist practicing in Boise, ID. His clients have included World and U.S. champions, Olympic athletes and numerous professional athletes. He received his B.S. in Biology/Genetics from Penn State and his Master's degree in Physical Therapy from Emory University. He specializes in manual medicine treatment and specific retraining of spine and joint stabilization musculature. He is a former Cat I road racer and Expert mountain biker.

Since 1986 Steve Hogg (www.cyclefitcentre.com) has owned and operated Pedal Pushers, 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.They include World and National champions at one end of the performance spectrum to amputees and people with disabilities at the other end.

Pamela 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 assistant professor of Nutritional Sciences at the University of Missouri-Columbia where she studies the effects of iron deficiency on adaptations to endurance training and the consequences of exercise-associated changes in menstrual function on bone health.

Steve Owens (www.coloradopremiertraining.com) is a USA Cycling certified coach, exercise physiologist and owner of Colorado Premier Training. Steve has worked with both the United States Olympic Committee and Guatemalan Olympic Committee as an Exercise Physiologist. He holds a B.S. in Exercise & Sports Science and currently works with multiple national champions, professionals and World Cup level cyclists.

Richard Stern (www.cyclecoach.com) is Head Coach of Richard Stern Training, a Level 3 Coach with the Association of British Cycling Coaches, a Sports Scientist, and a writer. He has been professionally coaching cyclists and triathletes since 1998 at all levels from professional to recreational. He is a leading expert in coaching with power output and all power meters. Richard has been a competitive cyclist for 20 years

Andy Bloomer (www.cyclecoach.com) is an Associate Coach and sport scientist with Richard Stern Training. He is a member of the Association of British Cycling Coaches (ABCC) and a member of the British Association of Sport and Exercise Sciences (BASES). In his role as Exercise Physiologist at Staffordshire University Sports Performance Centre, he has conducted physiological testing and offered training and coaching advice to athletes from all sports for the past 4 years. Andy has been a competitive cyclist for many years.

I'm from a climate that temperatures are frequently 60-70 degrees. I dislike these temperatures because if I wear knee warmers I am too hot, and without them my knees get a little cold and ache. I tried cutting up a pair of old shorts and taping a small piece of them to my knee, but it has not worked very well. I've seen pictures from the Eddy Merckx era of guys have small bandage-looking covering on there knees. I'm not sure if warmth was their reason, but it looks like a good idea. Are there any good products or alternate ways to stick a thin piece of cloth to the kneecap area? Any suggestions (even long shots) are welcome. Thank you

Hi, I'm a 28 year old cat. 4 racer here in NYC. I raced as junior but quit when I was 22. I returned to the sport late last season and have gradually increased my work load. My problem is with my left knee - when I ride in my 53 for even over two or three minutes I undoubtedly feel a pain on the upper part of the inside of my knee after the ride. The pain continues through the next day. After an anti inflammatory and elevation and ice the pain goes away.

I've worked on my cleat positioning, saddle for/aft and height, and make sure I stretch properly before training. My pedals have a proper amount of float. Here's the strange part: I don't have any problems when riding hills (neither short and steep nor long and gradual) though, and I can't make sense of it. Wouldn't the lower rpms and stress on ligaments and tendons affect me equally on hills as they do when riding bigger gears? I am quite lean: 5'10 and 140 lbs, and I imagine that the lack of more muscle mass may contribute to my problem.

I can do three hour plus rides in hilly terrain without problems as long as I don't push a gear bigger than a 53 x19 on the flats for anything but a short amount of time. I'm extremely frustrated that I can't take my training to the next level. I have even put off racing so far this season because I know I can't hang by riding in my 39x17. I started increasing my training beyond roller sessions quite late (late Feb.) and I'm thinking maybe it is related to doing too much too soon. The upside is that I can spin high Rpms very smoothly! The advice your team has given in the past has helped me considerably.

I race my road bike at the collegiate level. However, I've been having recurring pain in the lower back, 2-3 lumbar region of the spine, right-side. It usually kicks in around 1 hour into the ride, depending on the intensity, and becomes much worse when climbing is involved. The pain is a shooting pain that feels like a nerve is pinched. I've been to multiple bike fitters, who have adjusted my fit to the point where I feel like the fit is great (sitting squarely on the saddle, in a not-overly aggressive posture, all the other usual stuff - knee over pedal spindle, hands relaxed on the handlebar, legs extended at the bottom of the stroke).

The pain is only on the right side, but it can become unbearably painful, to the point where I only want to pedal with my left leg. Like I said, it's a nerve-type pain, possible the sciatic nerve getting pinched. I went and saw a sports doctor, who said I may have a slipped disc, so I took it easy for two months, doing physical therapy; after feeling pretty good and returning to the bike, it felt good for a month, but the pain is starting to return. X-rays are negative for any bone issues (MRI is fairly cost prohibitive). I've noticed (as you discussed with a previous reader) that my right knee turns in towards the top tube when riding, and am wondering if this has anything to do with it; strangely, I have little/no knee pain. In any case, I feel like I've been to doctors, physical therapists, and bike fitters, all of whom are puzzled. Do you have any insight? Any response is appreciated. Thanks.

I'm Swedish, male, 30 years old and quite new to road cycling. I'm only into my second season as a road cyclist. By the end of my first season I started getting pain in my right shoulder. It's located in the tendon that I guess is either "infraspinatus" or "supraspinatus". It started getting more and more inflamed so I took a long break. The pain stayed for several months - I could not swim properly or lift heavy stuff without making it worse.

My general practitioner has just ordered rest and some gymnastic exercises, but now I'm eager to get on my bike again as spring is coming (even to Sweden.) I've been doing short rides on rollers; 30 minutes maximum, but I can feel the tenderness the day after. (Although not even near as bad as last fall). I've tried to pay attention to my position on the bike, ("experts" tell me the size is right and the saddle position is correct) the pain is located to my right shoulder, but I can feel the tendency in my left shoulder as well. I'm left-handed and my left arm is stronger than the right. Could be a clue to why it's worse on the right side?

I'm a 38 year old woman new to bike racing. I've been biking forever and last year finally trained for and completed a couple of centuries. I joined a racing team in January for the coaching and training plans. So far it's been great - it's gotten me off my trainer and I'm putting in the miles outdoors, which has cleared up some overuse issues with my right hamstring. I'm averaging about 200 miles per week right now - although its more about the hours than the distance. I've done two races, a crit and a road race, and had a good time. Actually did OK in the road race. I'm starting to work on developing [some, any] explosive power.

My problem is this, I developed an ache in my right arm just above my elbow, below my tri, in early March - about a week after getting my bike fit. My ART guy [Active Release Technique - it did wonders for my overuse injuries] advised me to do more tri stretches. In late March, I rode for a few days or a week with my seat too low without realising. The ache developed into a pain on the outside of my elbow that hurts sharply if I pick things up in a certain way or when I twist my arm. My wrist began to ache as well.

I'm in school for acupuncture and get massages; I seem to gain muscle but for some reason that doesn't translate to more calories burned and less body fat. I went to the nutritionist and she says eat more! I was only doing about 2,000kcal per day; I try to eat 500kcal a day less and lose nothing. I'm a smart guy but for some reason I may feel real fit and ride strongly and yet I can't seem to lose weight.

When I was in Italy a few years back I was down to 143 and was like 6% body fat - the thing is I ate bread all day and it was so hot I was sweating all the time. I live on the central coast of California and its always a bit cool, I'm thinking the body does not want to give up the fat do to the cold? Am I way off? Anyhow, if you had any ideas on what might help I'm all ears. I'm a cat 2 masters rider - 35 years category.

I'm a 26 year-old male road racer who's been riding for almost three years. During this time I have been using a powdered energy drink (CyctoPower by a local company) during my rides but I have recently decided I'd like to cut down on sugars and I'm also not sure about some of the ingredients found in energy drinks. Last weeked I decided to try a ride with water mixed with a bit of fruit juice. The ride was about 2hr20 mins and I felt fine up until the last 20 mins when I 'bonked' for the first time in my life. I am pretty sure this must have had something to do with not having my usual energy drink with me.

Hi there, I am 24 years old, 6'2, 185 lbs. I am in decent shape considering I am almost eight months out of complete ACL/Meniscus reconstruction. I don't believe I have been overtraining, but for over a week now, I have been unable to stay above 85% or even 80% of my max. I ride about five times a week, taking two active recovery days of 70% maxhr or lower. My average HR is generally 160, but recently, my max hasn't been going any higher than 177, whereas last summer I was consistently averaging 170. I think I know the answer, but I need to read it from someone else...am I overtraining? If so, is it best to just stay off the bike for a while? If so, how long? Thanks for your time.

I'm a 46 year old, 5'7" 132 lb male who started time trialing about four months ago after coming from a competitive running background that left me with a meniscus tear in my left knee, for which I had surgery about a year ago. I currently log between 120-200 mi per week, all on my TT bike, which still has Speedplay X pedals. My orthopaedic doctor tells me I don't have a leg length difference (but there was no CT to back this up). I have four questions:

(1) Riding my rollers, I recently noticed some asymmetric heel movement. While my right heel remains pretty stable in neutral position, my left heel rotates inwards on the downstroke, and outwards on the upstroke. The Speedplay X's do not limit or centre this, but I'm a bit concerned there are forces at work that might further harm my vulnerable left knee. Assuming forefoot varus would be an explanation for this, I got some Specialized BG shoes that definitely have more varus compensation than my old Shimano R151's. It seems to have reduced the heel rotation a bit, but there still is some. Shall I add shims even though there seems to be no leg asymmetry, or is the heel rotation less of a problem than I think? With the old shoes, I also noticed a pressure point on my right foot outside that went away when I turned the heel slightly inward. This effect seems to be gone with the new shoes. Does that mean the real problem is not sitting square enough on the bike? Unfortunately I can't turn the saddle to find out, since the bike has an aero seatpost.

My friend has just purchased a road bike with Look pedals, and I was searching cyclingnews for an article that would help him set up his cleats and his riding position. I live in Tennessee and he lives in North Carolina about 5hrs away. If I were there I could do it for him, but since I'm not this would be the best way of helping him. This is his first road bike and first set of Look cleats ( he as SPD's on his MTB). It seems like I read an article about this a few years ago, but I've searched for 30 minutes and haven't found anything for the beginner setting things up for the first time. The frame appears to be the correct size for him, but he needs to be as comfortable as possible. He is 45 and was in the Army for 20 years and broke his back parachuting several years ago, so an extremely low, more aerodynamic position wouldn't be good for him. I hope you can help me, thanks.

I am a 25 year old female. I am not a road cyclist yet, though I'd like to be in the near future. I'm currently just riding a Spinning bike 4 times per week for 1-2 hour sessions. I started biking because it was the main exercise approved by my doctor following a diagnosis of lesions on the cartilage of the right talar dome. I would like to do more endurance riding than is typical of spinning training. Currently, access to equipment is a problem, though I do use the same bike nearly every time. I can therefore tailor my shoes to work with that bike's pedals. I followed the same routine on one brand of bike from Sept-Jan, and I changed brands in January (changed gyms). My lower leg and lateral foot pain started in mid February. I find cycling to be good cross training for my main activity, equestrian sports, and I'm worried the problems I'm developing will affect both activities.

I do own road cycling shoes by Specialized. They are supposed to have a slight medial wedge, which I thought would be helpful for my chronic medial tibial stress syndrome (10 years). Because of the MTSS, the ankle injury, and a slight curvature of my right tibia, I have become a strong supinator on the right side. I have more range of motion in my right hip than my left, and I tend to sit slightly off the left side of the saddle. I am conscious of this and have been working on correcting my pelvic positioning in the saddle (the same happens with a horse's saddle). Despite sitting to the left side, I feel that I have greater reach with the right leg (I would ride a horse with a slightly longer right stirrup. I do not have leg length discrepencies). I wonder if I am reaching too much with the right, especially with the toes and the outer side of the right foot. I tended to get hot spots, cramps, and calluses on the ball of the left foot; maybe because I am putting too much pressure on that pedal (the hip function is weak at the top of the stroke).

My main question concerns lateral foot pain. It seems to be some type of tendinitis, because the pain is worse after rest, particularly first thing in the morning. A new stress fracture is possible but there are no signs on the X-rays yet. It doesn't quite fit plantar fasciitis, and it doesn't quite fit peroneal tendinitis. My doctor is leaning towards peroneal tendinitis, though the pain is only at the attachment points. The peroneals function fine with little or no pain. Standing and walking are the main triggers, though after several steps, the pain lessens dramatically. It seems more likely to be the peroneus brevis, because the pain is the worst at the fifth metatarsal.

I've read what you've posted about cleat position. I have tried several times to move the cleats back farther under the balls of my feet. They felt like they were too far forward, even with the base of the big toe rather than at the first metatarsal joint. Perhaps this is just a problem with spin bike cleats or these shoes, but the cleats keep moving towards the toes within an hour of riding after having moved them back towards the arch. I tighten the screws as much as possible. So, I haven't been able to conduct a good experiment as to whether the cleat positioning is to blame.

My physical therapist wants to correct the supination by changing my orthotics. Since I would not wear orthotics with cycling shoes and I'm not sure I necessarily supinate in them anyway (due to my equestrian background, I am more prone to anchoring my weight on the pedals under my big toes. I just feel that I may be trying to grab at the right pedal with my right foot). I can tell that my right ankle dorsiflexes a little more on the upstroke, but it also feels more relaxed overall than the left during the entire motion. Since this problem started about a year after I was banned from weight bearing exercise other than moderate walking, I suspect that new orthotics in my street shoes will not be the answer.

I should mention that my illio-tibial bands and hip flexors are chronically tight. I have slight palpable right lateral calf pain near the upper attachment points for the peroneals. I wonder if my right hip and pelvic joint problems are the primary problem. Do you have any suggestions for how I can make my shoes cooperate? I am interested in getting answers not only to figure out how to alleviate this pain but so that when I invest in a road bike and a training bike I will know what my needs are. Or if there is no fix, I will know that this is another sport I have to avoid before making such an investment.