Fitness questions and answers for June 13, 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 would really appreciate your feedback on thyroid issues. I am a 33 year old category 2 male with a good sprint but muscular endurance and recovery as limiting factors. I had a blood test 2 weeks ago and was told I'd have to see the doc because my thyroid numbers were a bit out. I wasn't too alarmed by this because I remembered Scott Saifer from one of your previous articles saying racing cyclists would typically have a normal thyroxine (T4) level but a thyroid stimulating hormone (TSH) level higher than the general population.

My nephrologist has me on an ACE inhibitor (lisinopril, 40mg/day) and this dose has kept my bp in a normal range (125/75 vs 190/96). Prior to the accident my normal bp was in the 130/75 range. Two weeks ago I rode my second race of the season, it was pretty hot, 85-90 F, but I was riding reasonably well for the first hour of the race, however after that I progressively lost strength to the point that I had to abandon the race with less than 1/2 mile to go. I was very dizzy and almost couldn't lift my bike onto the rack after the race. The symptoms felt like low BP, so I checked it and it was about 95/55, which for me is way low. It remained low for 48 hours after the race. My questions are: what happened, can I do something to avoid it happening again? Is racing not compatible with treatment for hypertension?

I have a very simple training schedule that adapts easily to a lifestyle dictated by home life. With early Nov-Apr mostly indoors on the trainer 1 to 1.5 hours 3-4 days per week doing mostly zone 2 work with some low cadence big gear intervals thrown in 1 -2 days per week during the regular workout. I also do a mostly upper body workout in the gym 2 days per week all year that may include running when off the bike Once I can get out on the road more I start an interval schedule that gets progressively harder over a three week phase.

One day near the beginning of the week I do 170-174 bpm for 3 sets of 3mins on and 1.5 off repeating 3 to 4 times. ( I increase the number of sets or time on during the 3 week phase). One day near the end of the week I do 2 3 or 4 steady state intervals of 20 to 30 mins at 162 - 168 bpm on and 5 mins off. again increasing over the 3 week phase. The usual duration of any one ride is 1.5 to 3 hours. Any other day I can ride is a recovery ride mixing in short hill climbs (they are all short here) or into the wind big gear power work. The 4th week is a recovery ride only that might include some phonepole sprint intervals in. 8-9 hours per week is really the max that I can train when I can get on the road.

To recount the statement of the people in the ICU; "here we have a 52yo male cyclist who crashed during a recent racing event, with multiple fractures and a query pneumothorax". As a result of this I had over 28 fractures of my left rib cage, and clavical and lung damage requiring one week's hospitalisation and a painful eight weeks convalescing. 10 weeks on I am 99.8% and was back at the gym at four weeks and on the bike at six weeks. At 10 weeks doing 300km/week and thinking about racing.

4. Part of the reason for my accident is my in-experience - my bike handling skills are not brilliant (and probably out of step with my excellent fitness!), and my confidence in this department is down. Do you know of any publication that has exercises for developing balance and skills on the bike? I marvel at people and the way descend or put on or take off clothing as they ride - It seems like everyone is supposed to know how to ride a bike it does not seem to be taught. Is there anything for the older/new rider? Thanks - but highly embarrassed by it all

Have a look at this post. That should cover what you need to know. The only question mark in my mind is that Bio Arms are not as adjustable as some other aero bars, and even when pulled all the way back can still be too long for many riders on a standard road bike with drop handlebars. The taller you are the less it is likely to be a problem. If once you have read the above post you have any follow up queries, let me know.

4.In your article you mention that the bodyposition should remain the same when switching between the drops and the TT-bars. I'm a bit unclear on this one. What I've always done, is to drop my stem by about 50mm, to compensate for the added height of the TT-bars. Should I compare bodyposition in my normal Road racing setup with the position on the TT-bars, or should I check that my position remains the same from the drops in the lowered handlebar position to the position when switching to the TT-bars.

Hi - I am a 6ft, 180lbs, 36-year-old rider doing 8/9 hours a week training. Turns out that following a recent osteopath (who treats cyclists) visit that my pelvis was out of kilter - one side higher than other. This had also compounded poor flexibility in my middle back and loaded up my neck so I got very tense up top when on longer rides. My osteo corrected the alignment and gave me some new (and already effective) stretches. However, he commented that my saddle may be too narrow - I have been using a Fizik Arione and felt that my pelvis moved around a lot but wasn't sure.

Also, I was getting pretty numb in the perineum on that saddle. So I went to my LBS and they measured me using the Specialized Body Geometry system. They recommended the 143mm Alias which I have been using. After a few rides this saddle definitely supports my sit bones - I have never felt that so clearly. More importantly to me, the numbness has completely gone which is great. What's not so good is that I am getting sore where the sit bones meet the saddle. It does seem to be getting easier after a couple of weeks but it's still sore. Is this just because my sit bones aren't used to supporting my weight?

Secondly, I have started getting "cyclist's palsy" - the pins and needle feeling in the hands and wrists. This leads me to think I have two much weight on the hands but the saddle is as far back as it will go. I tried lowering the saddle but that seemed to effect my pedal action and was not very comfortable on the saddle. I plan to get measured again at the bike shop for overall fit - but does anyone have any suggestions as to what's going on? Thanks.

From what you have said, it may be that the tissue covering your sit bones needs a bit of time to cope. Try tilting the nose of the seat up a fraction. Depending on your degree of flexibility, this may load a greater area of tissue and be easier to cope with. With the hand numbness; either the bars are too low or the seat is too far forward [which causes a body weight shift forward so that that weight has to be supported by the upper body] or perhaps a combination of both. Ideally you need to find someone to position you who does not take a measurement based approach to the task of positioning you, but takes a capability based approach. If for one reason or another this is not possible, there is a stack of stuff in the archives.

I have tried raising the nose a little and that seems to help - both with the sit bone pressure but also hand numbness. Also bought some Specialized Body Geometry mitts and they have been much better - really padded. My saddle is as far back as it will go - so I'll persevere with the saddle. Another rider on my coaching group said he had similar problems with the Alias but after 500 miles it was sorted. I haven't ridden that many yet - and it does seem to be getting easier.

I find that for many people a seat doesn't 'feel' level until it is slightly nose up. Re the gel gloves; a good idea but one that only masks the problem. You may now be able to cope in the sense that there is an absence of hand numbness or pain but you are still supporting unnecessary weight with your shoulder complex. This can affect respiratory efficiency when riding hard as a lot of the musculature that you would need to use to support that weight is best used to breathe with. If those muscles are involved in supporting weight unnecessarily then you won't breathe to best efficiency.

Just wanted to say I've enjoyed your contributions to Form and Fitness, and that I think you take a logical, and thus defendable, view of fitting bikes to people which as a science geek I find commendable. I have a long history of back problems which have slowly transformed over the decades. The most recent incarnation has been a twisted pelvis, with both SI joints measurably out of alignment, and a string of L5-S1 disk herniations, once each of the last 5 winters, mostly when XC skiing. Various professionals have pointed out various weaknesses and tightness over the years, but being a bit slow I didn't put everything together until last autumn.

A year or so ago, at the start of the last bike season, I took a bunch of the exercises I had been given and did them religiously and that seemed to help. I added a good deal of stretching (I took your recommendation of Kit Laughlin's book) and that helped some as well although I don't seem to gain any functional range from stretching. For complex reasons I bought a pair of Powercranks to try adding a dynamic exercise therapy, and of course now you realize why I might be writing. I should point out that I could envisage the hip flexor problem before I made the purchase but I knew my hip flexors were both wimpy and long, but not symmetrically so.

I fitted them to a bike on a windtrainer (this was last autumn - no light midweek, plus you'd have to be crazy to start these things outside, sorry Kemp) and could only ride them a few minutes at a time before my hip flexors gave out, and it didn't improve dramatically for several weeks. I eventually worked my way up from 5-6 sessions of 5-10 minutes to two sessions of 30 and 60 minutes each week. Why did I stop at 90 min a week? More than 90 min a week on a W/T in the basement? I'm not crazy! But here's the thing - no back problems this winter. I think it took an integrated approach of strengthening and stretching to get the job done and the PCs were definitely part of that. 30mins at 80rpm is 2400 reps. I will never get 2400 stretches done in one session. So now it' been cycling season for a while in sunny Wisconsin, and I tried taking these things out on the road. Well, it's a whole different game. First there's the weirdness to get used to - when you shove off and go to click in the pedal isn't there, it's still hanging at the bottom.

The smooth spin I had down on the W/T is almost impossible to retain on our bumpy tarmac. If you get off-sync on the W/T it's an easy matter to kick the trailing pedal through to catch up, while on a rough road it's hard to even tell where you are, and the road keeps messing you up even while you are trying to correct. I also realize that on the W/T I will tend to sit up relatively "tall" for periods, which takes some of the stress off of the flexors, and I am not able to do that on the road. I'm not sure how to integrate them into mid-season training when I have very limited training time, so what has happened is that about once a week or every other week when I get off work late and don't have much time I take them for a spin through a local park and bike trail- 45-50 min, tops. It's not structured training, but along with the stretching and strengthening exercises seems to be keeping me pretty good.

They have definitely changed how I pedal a bike. I'm a spinner, never have been able to push a big gear, overload with the whole lactate effect very quickly if I do, and no amount of stomp intervals or power pyramids has fixed that. Maybe I should say "no amount I've been prepared to do". But this season at the first TT I rode unaccustomedly large gears and produced a good time (for me). I think there's something there about the timing of muscle firing altering the recruitment of muscle fibers, maybe delaying the recruitment of fast-twitch bundles. I suspect that Rotorcranks have the same effect, achieved a little differently, but I have no experience with those. As the season goes on and the ratio of normal-bike riding to P/C-bike riding has increased, I find myself reverting to "spinner phenotype". Saddle sores: Definitely! You have to be one with your saddle.

Reason - of course, no cheating a little weight off using the back pedal. And if there's one thing these cranks demonstrate, it's how much weight we leave on the back pedal, even in a fast fluid spin. Of course this meant that I had good calluses before the outdoor season started. I see the major use of these things in my hands will be off-season wind-training, and if I am able to use them to help keep my back OK for the foreseeable future I will feel I spent well, but I guess I wouldn't recommend them to anyone who already had tight hip-flexors. I look forward to reading about your experiences with them. Something I didn't try, but might be worth experimenting with, would be to start with the saddle a bit higher and further forward than your normal position, to open up the hip angle and take the pressure off the flexors initially, and then gradually dropping the saddle back to the normal position as you build strength.

I was recently diagnosed as having a Deep Vein Thrombosis (DVT) behind my right knee. This is my third DVT - with the first two (1986 upper right leg, 1994 behind left knee) I also had lung embolisims . I am 56 years old, for the past 15 years I have commuted to work by bike - I ride a total of approximately mind. 250-300 km/week. I am 6'2'' and weight ca. 265 lbs and other than old football injuries (knees, ankles, fingers, etc.) and my obvious weight problem, am relatively fit - no heart, respiratory, blood pressure or muscle problems. I am a recent member of Weight Watchers and a non-smoker.

Each DVT has occured in June when the weather was relatively hot and humid. With the latest DVT, ca. 2-3 hours after a 3 hour ride I had pain in the hamstring area and the next day also behind the knee. To date, no reason has found for the three events, although the doctors did discover that I have Thalassimia Minor -ca. 8%. At work I am sitting most of the day, but daily during lunch I go for a 30 minute walk. I have always perspired quite heavily and one thought was that I don't drink enough water.

Until now, I drank a lot of Diet Coke and Pepsi Light. I am currently taking an anti-coagulant (Macumar) which I believe is the German eqivalent to Coumadin and I may have to continue taking this for quite some time. I have been wearing individually fitted compression stockings for years now. I have recently learned that my adult niece and nephew have also had DVTs. My doctors say that I can resume my normal activities - including cycling.

I'm in a comfortable Fit Kit position on my bike with good power and no other aches or pains. About eight weeks ago my testicles started to ache slightly. The problem worsened until I needed an occasional ibuprofen and I made an appointment to see my doctor. He checked for major problems and referred me onwards to the urologist. I think my problem's caused by riding a too-narrow saddle this Spring (since replaced with a medium-width Specialized Alias that gets me up on my sit bones) and worn-out cycling shorts that did not keep the boys up out of the way (since replaced with premium shorts with lots of support).

I'm a local A grade rider both cross country and road (motly road), and up until recently I have had no knee problems whatsoever. However, roughly four months ago, while completing a series of strength effort intervals on the road bike, I started to develop lateral knee pain in my right knee. This was subsequently diagnosed as severe Iliotibial band friction syndrome, and put me off the bike for a number of months.

In response to your reader's question about blood lactate measurement, I agree with your experts that 30 second stages are far too short to obtain meaningful blood lactate data. I would suggest that stages have to be at least 3 - 4 minutes to obtain any meaningful data as it is paramount that the blood lactates in the early stages of a test achieve near steady state values (i.e. the mechanisms of lactate production are balanced by the mechanisms responsible for lactate removal). If this has been achieved then one often sees the blood lactate concentrations for the early stages of a test equal, or very close to, the resting blood lactate concentration.

The only problem with these continuous tests is that if the stages are too long the subject can become very fatigued, so the stages have to be short enough for the test to be completed in a reasonable amount of time and not too short that near steady state is not achieved. Although I use protocols which combine VO2max testing with lactate profiles for convenience, if I have sufficient time, I prefer to separate the two tests so longer steady state stages can be obtained without worrying about the subject becoming too fatigued to obtain a meaningful VO2max score.

An alternative test is to determine the maximal lactate steady state (MLSS). There are protocols available for this, but basically this is a discontinuous test where steady state blood lactates are obtained over longer duration rides (approximately 20 minutes) at a constant power output. During these rides blood lactate is monitored and plotted. The test is repeated following sufficient rest (this may have to be performed over a number of visits to the laboratory) until a power output is reached where the athlete cannot maintain a steady state lactate. The highest power output where steady state can be achieved is MLSS. This method has greater practical application because it identifies a power output that can be maintained for extended periods and should be more closely related to the lactate response during a time trial. The disadvantage of this test is that it is very time consuming.