Fitness questions and answers for May 8, 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 was recently tested on LT Threshold. My maximum heart rate is 192, I am 5' 7 149 lbs and have been riding for about two years. I plan on doing some racing as a Cat 5. I searched previous articles in the archives but did not see an article regarding my question. I was tested on a veletron with a heart rate monitor. The test was done on 5 minute stages while maintaining same cadence throught the testing. After 5-minute stages, wattage was increased 25 watts on a gradual hill simulation. My results were: 174 beats per minute was my LT.

Power at LT was 210 watts. This was figured out by graphing the stages of my heart rate and where the biggest fluctuation was. My question is this: what are some intervals that help develop one's power at LT if you do not own a power meter? I have read that power is the main objective in training in this area because of the outside factors that can affect heart rate (temperature how you are feeling, etc). Any information on this would be helpful, 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 Xrays 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 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.

First, I have been able to move the cleats back and have them stay in place. I just needed to move them back significantly to keep them from slipping forward. What I thought were 5mm markings on the shoe were in fact 1/4 inch markings, so I needed to move them back farther than I initially thought anyway. The right side feels fine, but I think my left cleat might need to move back even more relative to the right.

Second, the lateral foot pain is only present on the right foot. It's the most pronounced at the attachment of the peroneal tendons in the foot, but occasionally the pain will appear on the top of the foot near the base of the outer 3 toes. (Pain at the attachment point in the upper calf has been alleviated by therapy). I feel discomfort on plantar flexion and dorsiflexion more than when I engage the peroneals to move the foot laterally. I've been using massage and ultrasound therapy on the tendons, and I have just started strengthening exercises for the ankle. Unfortunately, I am limited in the exercise I can do in that regard, because several resistance based exercises aggravate my talar dome injury. I've found that pedalling with my toe pointed more and with slightly more weight on the lateral foot alleviates some of the pain. In general, though I only feel the foot pain on the bike when I stand on the pedals (which I do not do often).

Third, I forgot to mention that these problems slowly arose after I moved the seat one notch higher. I don't think I am sitting too far back. I moved the seat, because I felt that I relied too heavily on my quads and the downstroke when I sat lower. I am not overextending my knee at the new height. (I initially felt my original position on this brand of bike was about 1/2 notch lower than where I had sat on the previous brand I used last fall). From reading postings, I think this move made the cleat position problem more noticeable, which is why I've mostly been playing with cleat position. I tried cycling with my orthotics in my cycling shoes, but that didn't seem to help apart from providing some more arch support.

Fourth, the left hip is quite tight. I think it's accurate to say it is a "snapping hip," because I frequently feel a pop when I walk, in the part of the stride where the left leg is the farthest behind me. With stretching and myofascial release techniques, that hip can move as much as the right (in fact, the right hip will crack more under these pressures), but I can't make it move this well on a regular, functional basis without assistance. When I was a baby, my left foot was turned inward (I think - it could've been outward, I can't remember for sure), and I had to sleep in a brace to correct the problem. This could be the root of my asymmetry.

The lower glutes and hamstrings on the left side are consistently underdeveloped compared to the right, while the hip muscles and glutes higher up near the top of the pelvis are more developed on the left compared to the right. Since the foot pain has begun, I have noticed that my left quads are becoming much more developed than my right, and my left upper thigh is slightly larger overall. (yet the appearance of the right leg is better in terms of lean muscle tone). I don't know if I'm favouring the right leg because of the injuries or whether this indicates a different problem.

My physio realized that my right SI joint was out of alignment, as I have suspected for the past 16 months (my doctor had said I was fine). This problem has been fixed, and we are working on strengthening the pelvic area so that the muscles will continue to hold it in its proper place. The right hip and leg is more curved outward, while a comfortable position for the left leg on the bike would point my knee slightly inward. (I do not position the cleats such that I toe-in, because then I definitely overload the outer head of the left quadriceps). When I am on a horse, I tend to have my right stirrup slightly longer than my left, despite my sitting slightly off the left side of that saddle, which is why I feel that I have better reach and function with my right leg. That said, my left is more stable, and is my dominant leg. It is sometimes too still and stable, in that when I ride horses, I tend to rub the fur off a spot on the left side of the horse's belly with my left spur, and on the bike, when I pedal with one leg at a time it's harder to pedal with my left leg, particularly in the upstroke.

In an experiment this week, I tried sitting more off to the right side of the saddle, and I felt that this actually freed up the movement of the left leg some, though I still felt some weakness on the upstroke. This makes me face the left handlebar more. Do you think I should try lowering the seat again? Or do you think I still haven't found the proper cleat position for this seat height? My doctor doesn't think an MRI is indicated at this time, but my physio and I are at a loss, because the right peroneal does appear strong and the pain is generally localized at the attachments. It's possible, but not probable, that I have a stress fracture of the 5th metatarsal. Given the problems with my left leg (old tibial stress fracture, worse ankle drawer test, and tight hip) I can't understand why I keep injuring my right leg (OCD-talus, SI joint misalignment, more painful medial tibial stress syndrome, and the new foot pain).

After treatment, my range of motion in a forward bend or hamstring stretch was dramatically improved, especially on the right. On the bike, I can feel increased activity in my left hamstrings and my right quads. My adductors on the right side are still tight as are the abductors on the left, and I continue to slip out of alignment easily. The right hip still feels internally rotated at the front of the pelvis. This may be a result of being born with my left leg outwardly rotated (I may have said the opposite before, but I checked with my parents).

You've said a lot about foot varus in other threads. I may have a plantar-flexed 1st ray or forefoot valgus (the first metatarsal has "dropped", though it will dorsiflex normally). My physiotherapist has added a slight wedge under the outer forefoot. Since my hips have been adjusted, it feels that the medial wedge I already have under the arch needs to be raised slightly to help the motion of the first metatarsal. I am leaning this way, because a day of cycling and walking caused some pain and swelling around the talar dome injury, the deltoid ligament, and the rear, medial part of the arch under that ligament. Although I supinate to compensate for my problems, with my hip and knee more aligned, I could be overpronating more at the ankle. I have trouble balancing on my right leg. When I've put my orthotics in my cycling shoes, however, I haven't noticed any difference in my pain level.

Although the peroneal tendons have been the major site of foot pain, the pain was alleviated by almost 90% after the tibialis anterior muscle and the tendons between that muscle and the ankle were manipulated with deep tissue massage and ultrasound (compared to maybe 30% temporary improvement with treatment of the peroneals alone). The foot pain returns in the morning, but analgesic salves and self-massage has helped. When the hips slip back out, however, the foot pain returns in full force.

I am a 23-year-old cat 3 with a couple of questions about geometry, muscle groups and wattage. I currently ride a carbon Felt with a 75 degree seat tube angle and pretty aggressive positioning - I am considering switching to a regular 73 degree geometry and have ridden both in previous years...I am curious if there is any information out there as how wattage, pedalling efficiency (spinscan) and muscle efficiency is affected by the hips being rotated in the more aggressive position similar to a time trial bike.

I'm wondering if the 73 angle would produce more watts, but the steeper angle seems to be a more natural race position because of how the body naturally roles forward on the saddle and rotates the hips when the body is on the rivet; I know there is a lot of info for triathletes as to why seat tube angles assist in running after the bike ride, but how does it effect power and efficiency? Thanks for any help.

Could you please tell me what the pros and cons of having shaved legs are? I'm a 35 year old male second season club rider who is struggling to entertain the idea of shaving their legs. I was told by one guy the only reason to shave your legs is for massage purposes, and by another, if you were to have an accident on your bike wether it be racing or training the wound(gravel rash) would take longer to heal because your hair follicles carry bacteria which stay in the wound prolonging the healing process. If the main reason is the latter then fair enough I will shave my legs. I see all the pro riders have shaved legs and practically all the other club riders but that does not make me feel the need to shave my legs unless there is a practical reason for it. Any advice will be greatly appreciated.