Fitness questions and answers for July 10, 2007

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.

That's an interesting question. While you are correct, training at high altitudes will increase your hematocrit (blood count), it does not occur after only one week's time. Generally, your body responds by causing more of a compound called 2,3-DPG to circulate. This compound "allows" oxygen to be released to the tissues easier when in a low oxygen environment. So, for a temporary period of time, you may feel better at low altitude from this, but this will quickly reset when you get back to your home state.

On Sunday I did a five hour MTB endurance race (regular Bontrager race saddle, I have used it for over two years). On Monday I started feeling pressure and pain in the perineal region but I thought it was regular soreness from the MTB race. Tuesday morning I got ready to train and as soon as I sat on the saddle I felt strong pain in that area. That afternoon I went to the doctor and he diagnosed me with postadinia (prostatitis caused by trauma). He told me to take some antibiotics, to stop training for a month and to consider practicing other sports. All the blood and urine tests were fine, no bacterial prostatitis was evident.

I went for a second opinion and the result was the same although this doctor told me to stay off the bike for three weeks and then I can resume my training. He thinks the prostatitis was caused by the new saddle and not having it in the right angle. Do you have any experience on this matter, could a prostatitis by triggered that fast by a saddle switch with the wrong angle? Do you know how long should I wait before resuming training?

This may seem like a bizarre question, but here goes. I'm a 28 year-old male roadie. When riding I tend to be one of those guys whose nose gets a bit more runny than normal; however, when racing sometimes the mucous gets so thick I can't breathe right, and occasionally causes me to gag. It does correlate to my effort though. The harder I end up working the runnier it gets in my nostrils, but the thicker it gets in the back of my throat and it feels all sticky and triggers my gag reflex.

The swelling has not gone away completely in the knee (left) and now my left ankle has some swelling as well. An MRI revealed no structural damage/issues (just overuse ...IT band friction syndrome), but blood tests ordered soon afterwards (due to the pain and lack of swelling reduction) have indicated a very high inflammation in the body due to a high "sed rate". The blood tests have eliminated rheumatoid arthritis, lupus and any infection in the body (good news!) but I am waiting further diagnosis. I am currently taking a prescription anti-inflammatory as well as percoset for pain (it's not helping much!).

Via a little "self-diagnosis" through online sources, one possible result is that I may have polymyalgia rheumatica - an autoimmune response. According the online material, "Polymyalgia rheumatica is usually treated with corticosteroid medicine. This disease usually responds to treatment, with symptoms decreasing within weeks. Medicine may be needed for 1 to 2 years to prevent symptoms from returning".

From everything you've said, PMR (polymyalgia rheumatica) does sound likely. The Rheumatologist obviously will confirm whether this is true or not. I have treated a few people with this, but not athletes. I, personally, don't see why you wouldn't be able to get back to competing. You will need to discuss your exercise regimen with you doctors (particularly the Rheumatologist) as many physicians don't understand what cyclists put them selves through.

After I finished the last of my Paris-Brest-Paris qualifier rides (600 km), I noticed that the muscles on the fronts of my thighs are all very sore, while the muscles on the backs of my legs are hardly sore at all. What does this imply about my bicycle position? (There hasn't been any change in my position; after all my long rides, the same pattern of soreness holds, it's just that after the 600 it is so noticeable that it made me wonder what it implies.)

Current bicycle position: My pubic bone height is about 845mm. With the pedal down, if I measure from the top of the pedal to the top of the saddle where my sit-bones rest, the distance is about 902mm. (If I measure from the center of the BB to the top of the saddle, parallel with the seat tube, the distance is about 718mm.) The saddle is about as far back as it will go on the rails. If I drop a plumb-line from the point on my saddle where my sit-bones rest, it's about 275mm behind the center of the BB. My cleat position is as rearward as it will go without modifying the shoe - I'm intrigued by the arch-cleat idea, but didn't want to change position before a big ride. My reach to the handlebars is consistent with the "balance test," i.e. if I take my hands off the bars then I can easily maintain position without effort.

I'm a 22 year-old Cat. 1 road cyclist that up until this year has been improving quickly and doing very well, especially in time trials. This is my only third year racing bikes and before that I was a rower for some six years. This season has been super frustrating, as I've been performing worse than last, despite taking a semester off of school to train full time. I was progressing well through the fall but the only pivot point I can seem to recall is that I did a VO2 max test in December and my HR got extremely high, up to 215 bpm. Normally my max is around 202 bpm.

Since then, I've not been able to ride nearly as well as I used to and there have been some non-training related issues that make me think it's not just an issue of how I've been training. I certainly have never felt overtrained, like hating it or being really overly fatigued, it's just kind of like something is weighing me down. My resting HR has never been below 60bpm since December (vs ~45bpm before that) despite taking a couple weeks off of training and resting on a couple occasions to see if I'd recover from whatever is wrong.

I'm really not sure what could be going on, though I seem to remember reading that Damiano Cunego had a problem with Epstein Barr in 2005 and it really slowed him down. I'd admit I was doing higher risk activities during the fall 2006, and I've never had mono before, so maybe this is a possibility. Is there anything else that could be dragging on this long? It's definitely different than a plateau, as I've been considerably slower than last year while training less and also in school. I have a powermeter and can only climb at like 80-90% of what I used to and have a problem of blowing up pretty easily and just having to ride really easy.

I have had what I believe to be either gluteal sciatic or piriformis muscle syndrome for nearly 10 weeks now. My symptoms are an increasingly painful sensation in my left lower gluteal extending downwards along just left of the center of my hamstring. The pain is debilitating to the point where I cannot ride more than three hours on my long days. Yesterday I had to stop at just 90 minutes after a week off due to an intestinal virus. I had to drop out of the Mountains of Misery century due to the pain.

Although there is a good deal of information on this condition, I have yet to find a resource, including a doctor, who can tell me what my options are to correct this condition. Do I just take time off the bike and continue to perform mild stretching of the muscle and alternately ice/heat the area to promote healing? How do I alleviate pinching/pressure on the sciatic nerve? I'm at a loss and don't want to face limiting my training and cycling to three hours or less.