Fitness questions and answers for June 6, 2005

Stretching the hip flexor (Image credit: Dave Fleckenstein)

Form & Fitness Q & A

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.

We recently purchased the Lactate Pro blood lactate test kit and have scheduled a test session with our race team. I would appreciate your sharing with me the best test protocol(s) for determining Lactate Threshold HR and Power using blood lactate testing. There are many tests based on perceived exertion, ventilatory threshold, HR/power breakpoint etc, however these are estimated testing methods that involve too many variables rather than true science - that is why we purchased the blood lactate kit. The company from whom we purchased the kit promotes the FACT method which can be found at http://www.fact-canada.com/LactatePro/FactTestInfo.html We have a Cycleops Electronic trainer that has a LT test mode which allows us to dial in specific power loads and increase them at prescribed intervals, so hopefully we have the equipment we need. Now we need the correct testing protocol. Thanks for your help.

I'll jump in here and hopefully also avoid stepping on toes. I agree with Andy's comments except I use much smaller increments than 40 watts when doing a ramp test. If I'm interested in the athlete's power when lactate is at 4 mmol/L and this point falls between two test increments - as it usually does - then if I use 40W increments I can only say, for example, that their 4 mmol/L point is between 260W and 300W. That range is too broad both for diagnostic purposes and for setting training zones, in my opinion.

Your observations about the powercrank are very interesting and I may be making some of the same conclusions. I originally purchased the powercranks because I thought they would be a novel way to improve core strength by recruiting my hip flexors...and I'm a glutton for training gadgets...haven't bought a new bike in 10 years but serious glutton for training gadgets. Anyway, the first time you swap the powercranks out for normal cranks the almost unconscious tick of your legs through the top part of the pedal stroke seems like undeniable proof that the PC is a magical training tool. However, over the course of using my powercranks (~1year) I have noticed as my hip flexors became more active my glutes and quads slowly became less active.

With my normal cranks the unconscious tick over the top stroke continued but was also accompanied by a set of burning quads-glutes. Whenever I describe what it's like to ride the powercranks I always tell people this..."It's like starting to roll a ball downhill and trying to stop it at the same time," ie; one pulls the crank over the top (rolling the ball downhill) and then on the down stroke you have to pull-back to prevent yourself from accelerating out of control (stop the ball rolling down hill). These events become more and more apparent the faster you spin. For example, in my experience, riding downhill is probably the most difficult time to pedal because spinning so fast you're basically can only use your hip flexors to pull up and back.

However, Frank Day makes the case that as you become stronger one begins to pedal on the down stroke more and dependence entirely for the hip flexor will fade. This is an interesting idea in that it hypothesises that hip flexor musculature must catch up before the glutes and quads can be used aggressively again. Even if this is hooie I believe over-recruitment of the hip flexors is at least situational. As I said before, when I'm spinning I'm forced to predominantly use my hip flexors. In contrast, when I'm hill climbing or hammering on the flats I'm not forced to pull back on the down stroke quite as much.

Instead I find myself having to push and hence I'm able to recruit more of my glutes and quads. Alas, since I'm wimpy (140lbs) and I spend most of my time trying to spin at fairly high cadences I feel that my hip flexors will continue to be over-recruited, resulting in the switching off of my quads/glutes. Hence, I feel that the ultimate value of the powercrank and me will be in those situational events: hill climbing and hard on the flats.

In any event, I would also like to question some of your reasoning on how you feel about the powercrank for exercising one's hip flexors and share my experience with it and stretching. In your response you make the case that because of our largely sedentary lifestyles we have tight, underutilised, and underdeveloped hip flexors and so most people shouldn't overtax them with the use of powercranks. Wouldn't it make sense that if modern society has taken its toll on our hip flexors we should seek exercises to off-set these deleterious effects? Provided it wasn't overdone(as discussed earlier), shouldn't improvements in hip flexor strength be considered beneficial and an improvement in overall core muscle strength? Isn't that why you suggest Kit Laughlin books to so many, to help improve structure. Couldn't Powercranks be considered a novel 'on the bike' exercise to treat..."Overly tight hip flexors [which are] are directly implicated or a pre condition or associated factor for much back pain and many of the structural ills that plague Western society".

I agree the powercrank is a brutal exercise and one could easily injure themselves if they did not begin slowly. For example, when I first got my powercranks I took them out of the box, strapped them on my bike and went on a two hour ride, which resulted in me practically destroying my hip flexor. But, in my own defense, I'm not really this stupid (stop laughing) I was trying to impress a girl (I said stop laughing) and since her body now keeps me warm at night, it worked (told you I was smart). My original plan was to 'take it easy'. Thinking my hip flexors were too tight I immediately began stretching. two months later, I began riding the powercrank, and 'taking it easy' and now I'm quite proficient with them. However, in a little less than a year of stretching I have achieved what I believe to be no gain in flexibility.

My lack of improvement in flexibility may be due to the fact I'm very flexible in my hips already from a previous running career were I had developed a 'very large stride'. As my flexibility hasn't changed since last year my own conclusions are stretching and flexibility don't seem to play much a role in the use of powercranks. Also, since, my glutes and quads under-recruit regardless of my flexibility it seems likely that my squished 'unit' problems are due to the powercrank. This is even more apparent when you review part of an email Frank Day sent me Monday morning in response to your and my postings...

Frank Day: "Regarding your saddle sores. This is a common problem with almost every user. It is impossible to ride the PC's without putting more pressure on the saddle. Users have commented on two different saddles as really making a difference here. The fizik Arione being one and the Flow saddle from Saddleco. The Flow seems like it is the most likely to solve the problem IF you can ride it without your legs significantly rubbing it, which is the case for 90% of us. If your legs hit the saddle when you ride then this will probably not be the best one of the two."

Thanks Frank...so basically, it seems that flattened monster is a result of powercranking, not seat height - and saddles might help... One last question before I leave. Have you ever considered conducting a study to compare improvements in power production with a Steve Hogg fit and powercranks use? I'm sure you have pretty healthy pre/post- power reading data bank and maybe some long-term data too. So all you would have to do is recruit a few people who just bought powercranks. Could be very interesting. Anyway, thanks for your time.

Before I go any further, you have taken an inference from my reply that was unintentional on my part. You say that I infer that the hip flexors are "underutilised and under developed". This is not so; the problem with many people is that they are just too tight. As humans have evolved upright bipedal posture, hip flexors had to lengthen to allow that - ie - to allow our legs, pelvis and torso to be more or less in a single plane. Look at how much the average person sits in their life. More than six hours a day for 11 - 13 years at school; in a car, bus, train or similarly on the way to work; at work for lengthy periods; eating meals; riding a bike; etc, etc. I am sure that you get the picture. All of that sitting shortens hip flexors.

Hello. I have read several of your articles regarding cleat position in attempt to make sense of my recent foot injury. I have diagnosed myself with peroneal tendonitis (I'm an MD) which I've had for approximately 4 weeks. Although it could certainly stem from hill running, I am an efficient runner and have bought stability shoes - thus I believe the injury stems from my cycling and cleat position. I have spent more time training on my tri bike (a QR Typhoon) and in my Sidi T1 carbon soled shoes with Look cleats with float (than on my road cycle Seven with Sidi road shoes and Look cleats with float). I feel that my foot goes from the 3o'clock position downwards (point of greatest torque) in a relatively horizontal manner, ie, not plantar - nor dorsi-flexed. While this certainly feels to generate more power (than on my road bike/road shoes with more flex), it also seems to place more strain on my outer peroneal tendons.

Firstly I apologise for the delay in replying. Not enough hours in the day unfortunately. There are a number of questions where it occurs to me to ask - you imply that this problem only occurs on your tri bike. Is this correct? If this is so, is a QR Typhoon like the QR's that I am familiar with in the past; ie steep seat tube angles of 76 degrees and more? Is the problem present on both sides with similar severity? Have you tried your road shoes on your tri bike? If so was the problem still present? If so was there any reduction or increase in severity? Do you have a noticeably varus or valgus forefoot on either side? Are your feet unusual in any way; flat or perhaps unusually high arch and instep? Let me know the answers and I will do my best.

On May 23, Steve Hogg, wrote: "Hip flexors, particularly iliopsoas [iliacus and psoas], are poorly adapted to upright human posture, and very susceptible to overload for anyone with a job involving a lot of sitting, or bending forward, or repetitive activity. In our society this would be the case for a majority, probably a large majority, of people. Overly tight hip flexors are directly implicated, or a pre condition or associated factors for most back pains and many of the structural ills that plague Western society." I was hoping Steve or any of the panel could explain one or two effective stretching exercises for the hip flexor. Is there a resource you recommend for this?

I don't claim any expertise advising on stretching and would not try to advise on specifics via email anyway. There are a lot of stretching books out there with step by step instructions and photos. Alternately, find a good yoga class or similar. The book I recommend to anyone interested is " Stretching and Flexibility" by Kit Laughlin. For anyone with current issues with back pain, I would suggest " Overcome Neck and Back Pain" by the same author. If you elect to buy either, the best advice I can give is to read the instructions and cautions thoroughly, and don't just follow the pictures. They are good books but other panellists may have additional recommendations.

I was recently on a long ride and decided to refuel about three hours in. I watched with interest as, for the next hour of the ride, my HR was 10 beats higher per minute for the same power output. (Note to self: easy on the mid-ride burritos). While this didn't surprise me, it did get me thinking about what that meant about HR, blood flow, and lactic acid. My basic question is - should I drop the intensity so the HR goes down, or should I keep at my endurance power and ignore the higher HR? My underlying question is - how does the fact the body is re-routing some of the blood to the digestive system change the body's ability to clear lactic acid, etc. How does the relationship between HR and lactic clearance change? I would assume lactic acid clearance is really about amount of blood (and ability of blood cells to carry oxygen) your body can deliver to the muscles, so then your 'Threshold' would correspond to a higher HR during times like eating. In others words, your 'Threshold' would still be the same power, but not the same 'HR' - but is this right?

At the beginning of the week I was startled to notice browny-red urine. It has continued throughout the week although a little better today. (I raced yesterday and put on 80 km commuting. My stomach is a little queasy when pushing it hard on my commutes and a little off during the day. Otherwise everything is normal. No pain etc. I am a 48 year old commuter putting on around 300-400 km a week. I have been pushing it on my bike as I am doing a little racing for the first time in my life and I took off 15-20 lbs since Feb. to hopefully improve performance. I have noticed that I am not as thirsty as normal. Is this just dehydration? Too much weight loss too fast?

I'm writing because something quite worrisome happened to me yesterday a few minutes into a local race. The weather was sunny, hot (31 C) and somewhat humid. The pack started off at a fairly brisk pace; no problem there. But after 10km, we hit the first climb of the race: a steep and sharp wall of about 1.5km. And that's when IT happened: I seriously ran out of breath. I mean I just simply could not get enough air in my lungs, like they were tightened by some vice, or not "expandable" enough. And it hurt! This lasted for several minutes, and when I saw that I couldn't get back to "normal", I quit the race.

I am asthmatic, and on occasions such as these, I use my Ventolin pump. After a few minutes, I'm able to get going again. But this time, it just didn't work. Going 25km/h on the flats was tough, so imagine what it was like climbing. Was it too much too soon? I'm a fairly good climber and "rouleur". I'm 39, have a good winter training base, and apart from asthma, I'm fit and healthy and an experienced amateur racer. Thanks for your comments.