Form & Fitness Q & A
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Fitness questions and answers for August 23, 2004
The Cyclingnews form & fitness panel
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.
Dave Palese (www.davepalese.com)
is a USA Cycling licensed coach and masters' class road racer with 16
years' race experience. He coaches racers and riders of all abilities
from his home in southern Maine, USA, where he lives with his wife Sheryl,
daughter Molly, and two cats, Miranda and Mu-Mu.
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.
Eddie Monnier (www.velo-fit.com)
is a USA Cycling certified Elite Coach and a Category II racer. He holds
undergraduate degrees in anthropology (with departmental honors) and philosophy
from Emory University and an MBA from The Wharton School of Business.
Eddie is a proponent of training with power. He coaches cyclists (track,
road and mountain bike) of all abilities and with wide ranging goals (with
and without power meters). He uses internet tools to coach riders from
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
Current riders that Steve has positioned include Davitamon-Lotto's Nick
Gates, Discovery's Hayden Roulston, National Road Series champion, Jessica
Ridder and National and State Time Trial champion, Peter Milostic.
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.
Pam was an All-American in track while at the UW. She started cycling
competitively in 2003 and is the defending Missouri State Road Champion.
Pam writes a nutrition column for Giana Roberge's Team Speed Queen Newsletter.
Dario Fredrick (www.wholeathlete.com)
is an exercise physiologist and head coach for Whole Athlete™. He is a
former category 1 & semi-pro MTB racer. Dario holds a masters degree in
exercise science and a bachelors in sport psychology.
Scott Saifer (www.wenzelcoaching.com)
has a Masters Degree in exercise physiology and sports psychology and
has personally coached over 300 athletes of all levels in his 10 years
of coaching with Wenzel Coaching.
Kendra Wenzel (www.wenzelcoaching.com)
is a head coach with Wenzel Coaching with 17 years of racing and coaching
experience and is coauthor of the book Bike Racing 101.
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.
Kim Morrow (www.elitefitcoach.com)
has competed as a Professional Cyclist and Triathlete, is a certified
USA Cycling Elite Coach, a 4-time U.S. Masters National Road Race Champion,
and a Fitness Professional.
Her coaching group, eliteFITcoach, is based out of the Southeastern United
States, although they coach athletes across North America. Kim also owns
a resource for cyclists, multisport athletes & endurance coaches around
the globe, specializing in helping cycling and multisport athletes find
Advice presented in Cyclingnews' fitness pages is provided for educational
purposes only and is not intended to be specific advice for individual
athletes. If you follow the educational information found on Cyclingnews,
you do so at your own risk. You should consult with your physician before
beginning any exercise program.
Persistent finger numbness
Lots more knee/spindle and fit questions
Technique vs position
Mountain vs. road pedal position
Persistent finger numbness
I have persistent numbness in my little finger that sometimes extends to my
ring finger/wrist area. It seems to be caused by riding (I ride 150-200 mi/week).
On a recent 80 mile ride it led to a weakening of my hand to the point where
I could no longer shift gears with the brake lever. When I'm on the bike, I
feel "crooked" in my position, as if I have more weight on the problem hand.
I am a big rider (6'1" 195 lbs) and thus support a good deal of my upper body
weight with my hands. It seems as if the position of my elbow effects this (i.e.
locked vs bent). I've tried more padded gloves but that does not seem to make
a difference. Apart from time off the bike, do you have any suggestions how
to alleviate this?
Scott Saifer replies:
Almost certainly you are compressing your ulnar nerve when you ride. This
nerve runs down your forearm, enters your hand through the notch at the base
of your palm and carries messages from your pinky and ring finger to your
brain. In order to eliminate the numbness and maintain strength, you have
to stop compressing the nerve, and there are several ways to do that.
The best thing would be to reduce the weight on your hands. This might be
done by moving the seat back or raising the handlebars. Both of these would
cause changes in your position that might require other adjustments.
The next best thing would be to simply change your hand position to take
the pressure off the notch at the base of the palm. Avoid gripping the bar
with much force and move your hand so the bar does not touch that area. If
you tend to ride with your wrist bent back, strive to achieve a more neutral
position in which your wrist and hand are more a straight extension of your
forearm, rather than going off at an angle. Doing this comfortably may also
require a change of stem.
Steve Hogg replies:
I think Scott is absolutely on the money re seat set back and bar height.
You mention that you feel crooked on the bike. I would just about bet that
you have a rotated hip on the numb hand side. This is common and will cause
the hip to drop and or rotate forward on every pedal stroke on that side.
The body's unthinking response to this challenge to pelvic stability on a
bike, is always to thrust forward the shoulder and lock the elbow on that
side to brace against this pelvic wobble. The result: the hand on that side
is loaded more. This is very common, though the degree of discomfort varies
from person to person. Do what Scott suggests but also get a hands-on health
professional (physio, chiropractor, osteopath) to assess you and work towards
a permanent solution.
I'm a 62 year old competitive cyclist that rides around 5000 miles/year. This
year after particularly hard rides for me (100k @ 21 mph e.g.) , I've experienced
intense calf soreness, which I can't recall happening before. I'm riding the
same bike for the last 4 years with the only change being perhaps cleat placement.
I don't get the soreness on shorter (25 miles), faster rides. Do I have a possible
Steve Hogg replies:
The health professionals on this site can advise you regarding effective
calf stretches and it is a good idea for you to stretch them. You mention
that your cleat placement may have changed. Cleats that are too far forward
can cause the calves to be worked harder than is ideal. Check out the posts
about cleat position from last month. Positioning your cleats as instructed
there will minimise unnecessary strain on the calves. If your combination
of shoe and pedal does not allow the cleats to be positioned that way, get
back to me with your shoe brand, model and size and the type of pedal that
you are using.
Lots more knee/spindle and fit questions
I've been enjoying the ongoing discussion about KOPS and its associated virtues.
Recently, I started playing with my position because I felt like KOPS had me
too far forward. After making small adjustments and riding several days after
each change, I find that I am comfortable and relaxed in a position that has
me a few cm behind the KOPS ideal. I have no numbness. Arms and shoulders never
get tired. Nice aero position. No pain in knee of any kind. Can do the hands
off the drops test...etc. So I feel like I've hit the jackpot... except I am
worried I am now too far behind the spindle. It is more than 2 cm. I'm using
Shimano pedals with zero float cleats.
One of things I've noticed in playing around is that I like to sit far back
on my particular saddle. So now I'm worried that I've overdone it. That I've
found a great place to sit on my saddle (slightly far back) and that before
I figured that out I'd moved my seat back in an effort to find the right fit.
In other words -- I've done too much of a good thing.
How far behind the spindle is too far?
Or to be more realistic, how far behind where the alarm bells should go off?
It is quite difficult to tell fore/aft saddle adjustment because it is difficult
to judge whether or not you end up sitting in the same place on the saddle after
you move it. So I guess my other question is?
How can you tell if it is your saddle or the saddle's fore/aft position?
Do riders tend to naturally settle into the most comfortable saddle position
(where you'd sit on the saddle even if it weren't on a bike) or do we settle
into the best position on the bike even if it is at odds with the saddle?
Steve Hogg replies:
The positives you have found with your positional change are exactly what
I have been talking about. There are a few traps however.
1. Once you have unloaded the upper body to a reasonable degree a majority
of people can reach further to the bars comfortably. This can be anywhere
from a few mm to a few cm. Often though, bar position needs to be reassessed.
Slightly higher is common and stem length may need to change.
2. There is no magic number as to know how far behind the pedal axle your
knee should be. I stopped measuring this quite a few years ago as I came to
believe based on experience, that the number had no relevance other than in
a individual sense. Bear in mind that this is a static relationship that we
are measuring, but that what we are doing is a dynamic activity. When I did
measure for this, the range was between 5 and 50 mm with the majority being
between 10 and 25mm. Bear in mind though that this is from a period of 5 plus
years ago and that my thinking and practises have evolved and improved since
3. If you are too far back 2 things will become obvious. The transition from
on the seat pedaling to off the seat sprinting will be ponderous and deliberate
rather than near instantaneous. The belly of the hamstrings can get very sore
on tough hilly rides and become a limiting factor.
4. Every thing you say seems positive so don't worry unless there is a problem,
it is only a number. I'll tell you a story. I used to race against a bloke
who was always asking for positional advice in middle of races! I always replied
that he looked awful, and that his seat tube angle was too steep. After not
seeing him for a few years (I'd started a family) he contacted me and told
me that he had bought the largest size Trek OCLV with a 72 degree seat tube
angle and wow what a difference, that it looked to him that I had been right
all along. He was sure that his position was now good but wanted my opinion.
When he came in, and with the help of a Time seat post (no longer available)
I moved his seat back another 30 mm again and he was in raptures telling me
how powerful and smooth he felt. In fact if I worked out a set of dimensions
he would give me a deposit on a custom frame now. When I told him that his
effective seat tube angle was 69.5 degrees (he was NOT Joe Average!)his exclamation
of ' I can't ride that !' was somewhat at odds with his previous statements.
I told him to go away and ride the bike and that as he lived in a hilly area
he would soon know the rights and wrongs of the position. I told him to ring
me in 4 weeks so I could either tell him how much he owed me, or if he was
unhappy ,that he could return the seat post. He rang me later and told me
how much better he was riding than ever before but that he did not want to
buy a new frame because the seat tube angle did his head in. He is still happily
riding his OCLV with the Time seatpost. IT IS ONLY A NUMBER
5. The above does NOT mean that everyone else reading this should go out
and shove their seat back as far as they can. If there is one thing that experience
has taught me about bike position is that there are only INDIVIDUAL solutions
and that any blanket approach is inherently flawed.
6. Another cross check is that if you feel increased leverage, which you
will, but that it is only at the expense of losing the ability to spin fast,
then you are too far back. If you have it right, you will feel increased leverage
which comes from not being able to push harder, but rather from being able
to apply force through more degrees of crank movement, and you will be able
to spin more smoothly than before.
From what you have told me, it doesn't sound like you have anything to worry
about. Should that change, get back to me.
[Dean then responded:]
What is really apparent is how difficult it is to determine what is a great
saddle for one's body. For example -- what I'm finding now is that this new
position allows me to slide forward for a nice change of muscles every now and
then -- even if I'm not hammering. However, the saddle is becoming a limiter
now, I think it has too much bend and thus makes it hard to move on it very
much without suddenly squishing all the wrong things.
I've done hard hill rides and noticed a nice even feel to my legs afterward,
as opposed to "too much quad" which is what I used to feel. I am still using
95 for cadence for most of my long rides so no problems in that area either.
Certainly, the further back one goes the cadence does naturally drop a bit,
but it seems to me that is simply because the length of the leg lever is longer,
I'll let you know how it feels after a few hundred kms more.
Steve Hogg replies:
Of all the equipment choices we make, the seat is the most personal choice
of all. We should be bearing our weight on the middle of the sit bones. Most
seats on the market do not allow this unless the nose is 1 - 2 degrees above
horizontal. If your seat has sagged noticeably, then it is time for a new
seat. Otherwise over time, the lighter shelled seats become hammock like in
cross section meaning the rider is forever sliding into the hollow, and as
you have experienced, putting pressure on areas not designed to be loaded
like that, on the rise out of the dip towards the nose. Of the popular seats,
Selle Italia's Flite in its' variants are particularly prone to this over
time, though they are not on their own. With the elite riders that I deal
with who are Flite users, we lay a straight edge along the top of the seat
when new and measure to the lowest point in the upper. This is usually 3 -
4 mm. When this distance increases by more than 2mm, we replace the seat.
As to your last point, I am not sure what you mean as leg length and leg
segment length is not going to change once a given person is fully grown.
As you move back, you can apply pressure on the pedals for more degrees of
the arc of crank movement and this lessens the effect of the ' dead spot '
either side of top and bottom dead centre. At the top of the stroke you can
push over the top earlier to some degree, and at the bottom of the stroke
you can pull back through it to a degree as well. This means that the transition
between ' power' strokes is smoother and less pronounced. If too far back
we get to the point where we are getting outside the middle range of hip movement
where we have the best control. Additionally, up steeper hills, where the
effective seat tube angle is lessened and the relationship with gravity changes,
there can be a sensation of pawing forward at the pedal, in that it is difficult
to reach the bottom of the stroke with power and control.
That 'nice even' feel of upper leg muscular enlistment that you mention is
exactly what we all should be striving for. If anyone usually experiences
hammered quads in the belly of the muscles, this almost invariably means that
their seat is too far forward.
Technique vs position
[Following on from the above discussion, Dean then asked:]
One final question -- but it is a whole can of worms. What about technique?
Watching the Olympic swimmers it is very clear that there is a proper technique
to every stroke. This is taught to even basic swimmers... The same is true for
most sports, tennis stroke... golf swing...etc. Even counting for some variation,
much is discussed in terms of an ideal swing...etc.
Why then is there so little of this about a pedal stroke? Watching Lance Armstrong
pedal, wouldn't we all be well served to try and copy him? I realize we all
have different muscle strengths and weaknesses... but in every other sport you
are still in search of proper technique, even at a beginner level. Why do I
read so much about HR and so little about pedal stroke? It seems to me the proper
stroke (whatever that is) would yield a tremendous amount of improvement.
Do your thoughts on position come from a search for that? Should I adjust my
position to my technique? Shouldn't I really perfect my technique instead?
Steve Hogg replies:
Great question. Firstly, I know next to nothing about the technicalities
of swimming but friends of mine who do, say there is a variety of individual
styles within what they would call 'correct' technique. So I am not sure how
good an analogy you have come up with although I know what you are getting
at. It seems to me that there is a much greater range of pedalling technique
out there in bicycle land, than there is difference in swim stroke technique.
When you are swimming, for instance freestyle, there are individual differences
in structure and function but only one ' position ', ie, prone and more or
less parallel to the waters surface. On a bike there are individual differences
of structure and function, the differences forced upon a given rider by equipment
choices, and the differences forced upon a given rider by the parameters of
position that they choose, ie, seat position, cleat position and bar position
and their placement relative to each other. This explains the wider variety
of pedaling styles out there than swim stroke styles. We as cyclists have
more equipment to play with than swimmers.
Now to the relative effectiveness of differing techniques. There are 3 main
styles out there; the large middle group who tend to drop their heel in the
top half of the down stroke and start to lift it in at some point in the bottom
half of the down stroke. I will call this Joe Average. Then there are, at
the extremes, the Toe Dippers and the Heel Droppers. Don't misunderstand me
here, most people fit into one of these categories but within each there is
a spectrum of technique, they are not uniform. The question is, are any of
these more efficient than the other?
My answer is no. Here is why. Every attempt that I have seen to train someone
to pedal in a particular way (and I'm assuming when I say this that there
have been no equipment or positional changes) breaks down as soon as that
rider is in a race intensity situation, ie, 90+% heartrate and hurting. Under
these conditions riders cannot think about individual strokes and revert to
what comes naturally to them. For this reason I think that with the bracketed
qualifier above, pedaling technique for an individual is a given. The best
way to refine it is to ride a lot and undertake off the bike structural maintenance
and improvement so that we function fluidly doing what ever comes naturally
One thing that I have noted though, is differences in seat position fore
and aft and seat height are needed for otherwise similarly proportioned people
with different styles of pedalling. The extreme Heel Droppers are pushing
themselves back in the seat with every stroke under load and so don't need
to sit that far back to achieve that passive pelvic stability that I am always
rattling on about. Also, the Heel Droppers have to have a lower seat height
because their technique causes greater extension of the leg for a given seat
height, all other things being equal. They are also using the foot as a secondary
lever much more than the Toe Dippers, so I will call the Heel Droppers style
' more leverage, shorter stroke'.
Conversely, the Toe Dippers use their foot less as a secondary lever, can
sit noticeably higher because their technique allows them to reach further.
Regarding seat position fore and aft, they need to sit further back than the
Heel Droppers, because their toe down technique means that the major vector
on the pedals is to the rear. This in turn tend to tip their weight forward,
and so more seat setback is required to maintain pelvic stability passively.
We can call this 'less leverage, longer stroke'.
Most of us however, fit between these extremes in the Joe Average category.
Men generally (plenty of exceptions) tend to drop the heel more and women
generally(again plenty of exceptions) tend to toe the pedal more.
If you look at the great champions, Merckx was the Heel Dropper, Hinault
was Joe Average and Anquetil was the Toe Dipper. They were respectively, the
greatest bike rider ever, probably the second greatest, and with Anquetil
probably the greatest time triallist ever. They all won 5 Tours de France
and were pretty handy otherwise. I think Anquetil won 10 Grand Prix de Nations
in something like 14 years, when winning that TT gave you bragging rights
as the strongest pro rider on the planet.
In short, my advice to all, is that assuming you are happy with your equipment
and position, do what Eddy Merckx is reported to have answered when a boy
asked him how to become a World Champion, " ride a lot ".
If we perform an action hundreds of thousand or millions of times as we do
when we ride a bike, you can bet that within the constraints of structure
and position, we will become very refined at it.
Mountain vs. road pedal position
I am a 5'10 135 lb. 28 year old male cat 3/expert level racer. I spend most
of my time training and doing races on my road bike, but when I do training
or races on my fat tires I don't feel as powerful while pedaling. I have narrowed
this feeling down to the difference in Q-factors and different pedals. I am
very comfortable on my road setup with Look pedals and Specialized Carbon Pro
shoes; but I feel as though when I am on my mountain bike the pedals are a mile
apart and there is way too much pedal float. I use Egg Beaters and Specialized
Pro shoes on my mountain bike and even with new cleats and shoes it feels like
I am standing on ice when I pedal. Are there any other pedals that offer a feel
similar to my road setup? Does the wider pedal stance on a mountain bike effect
power output (even for extremely narrow hip riders like me) or are there any
other tweaks to setting up my mountain bike.
I have the leg extension, knee over spindle distance, and cleat position between
the two identical.
Are there any advantages to spending more time than once a week on the mountain
bike (on or off-road) to adapt the muscles to the wider position?
Steve Hogg replies:
There are 3 separate issues here.
1. The Q factor of your Mtb cranks is likely to be 24 - 30mm greater than
your road cranks depending on what equipment you run. There is nothing you
can do about that in the short term.
2. As measured from the crank arm, the centre line of where the cleats engage
in your Eggbeaters is another 5 - 6mm wider per side than your Looks. This
you can do something about. With SPDs and similar clones, the cleats can be
adjusted across the shoe. If you adjust the cleat as far as possible to the
outside of the shoe, this will move your feet 4 - 6mm closer to the crank
arm per side than the is possible on the Egg Beaters.
3. The amount of freeplay that you don't like. On your Looks, the rubber
pad on the cleats means that the quality of the freeplay that the system offers
is of the stiffish variety. This can vary depending on how worn the cleat
is and the radius of curve in the shoe last where the cleat is attached. I
have noticed that with some combinations of Shimano shoes and SPD model PD
- M545 (the spud with the large aluminum platform around the pedal body) that
the shoe tread blocks partially foul the aluminium cage making it hard to
enter the pedal. It is easily resolve by slicing away some of the tread block
width. It is a bit fiddly, but if you try this combination, you should be
able to come up with the feel you wish to have. I have also noticed that the
combination of Sidi Mtb shoes and Ritchey SPD clone (I think Trek sell the
same pedal branded Icon) give plenty of freeplay but definitely with a stiff
If you choose to spend the money and do something about this you will still
be left with the difference in Q factor between road and Mtb cranks. Usually
the transition feels fairly ordinary for anything from a few rides to a week,
then most riders become used to the more splay footed, heel in shoe angle
this forces upon us. To try and minimise the problem of having to adjust to
your Mtb when ever riding, it is probably a good idea to do more training
on the Mtb so the feel is less foreign.
As to the power issue, I have only noticed a drop off when on an Mtb, when
riders were not used to riding them. With greater familiarity, there doesn't
seem, in my experience, to be a large difference.
I am a 40 yr old recreational rider about 150-220 miles/week and my right leg
which is my dominant leg is much bigger (quad and calf) and significantly stronger.
My hamstrings are always tighter on the left. My legs are anatomically different
with the left more bowlegged than the right and my left foot needs a significant
heel in posture (at least thirty degrees) which is achieved by kneesavers. I
have been fitted for my present bike 3 times by three different people and have
never been told I have a pelvic twist or tilt. Any ideas what is wrong and how
can it be fixed?
[In answer to some questions Steve asked, Mike replies:]
I have not had a detailed structural assessment. I live in rural North Carolina
and have to drive an hour to the nearest bike store. Each fitting I have had
has produced bad results such as left quadraceps tendonitis and then iliotibial
band syndrome. I sort of gravitate to a position that does not hurt. I have
no idea who would do the assessment or where to get one done.
As far as I can tell by measuring myself , the AC joint is the same vertically
and anteriorly. No evidence of scoliosis or kyphoidosis. Both iliac crests are
the same height and neither anterior. I have never done plain films or CT to
determine leg length.
My right arm is about 1.5-2cm longer than my left.
Both legs are bowed but the left much more so. Varus feet, left slightly more
When standing with feet shoulder width apart and toes pointing forward and
performing a knee bend my left knee will cross the midline and all my weight
on the left will be on the medial side of my left foot. In order to prevent
this I have to rotate my left foot about 30 degrees outward to keep my knee
straight. This is the same setup I have on my bike. A kneesaver is a titanium
spacer which is placed between the crank and the pedal to give another 2cm of
q factor in order to give my heel clearance and not hit the crankarm or chainstay.
I know the info is incomplete but if you tell me how to get the measurements
and what professional would be able to do it or who you could recommend in North
Carolina I will certainly get it done.
Steve Hogg replies:
Based on the information you have given me, here is an approach to try. What
you have to do is get the foot contacting the pedal in more or less the same
plane that the lower leg approaches the pedal platform. Given your bowed leg,
this is likely to mean a substantial medial lift under the left cleat or inside
the left shoe. Possibly a combination of both, as the degree you have to evert
the left foot is likely to be large. Correctly done, this should have the
effect of de rotating the leg to a fair degree wihout knee pain. As you live
in a rural area, podiatrists with cycling related experience may be thin on
the ground. It would be preferable to consult one, but if the self help approach
is the only viable one here are a few tips. Start with a generic arch support
insole with the greatest amount of eversion you can find. This may have to
be modified to some degree for comfort against the foot. They are available
here in what we call chemists and what you call drugstores if the business
types are a direct comparison. The insole is likely to be not enough. You
can add to the medial edge of the insole to increase height. The stuff I use
here is an adhesive backed felt that I get from a printers. It is black and
comes in 50 metre long by 24mm wide by 3mm thick when compressed rolls. I
don't know what it is called as a customer who manages a print shop supplies
it to me, but I will find out the name and pass it on.
At some stage you are going to run out of vertical space inside the shoe,
particularly in the forefoot. The next step, if you need more eversion, is
to start adding Lemond wedges underneath your cleat. I assume you are using
clipless pedal. If not something may have to be fabricated. I had a customer
some years ago who needed 15 degrees of eversion under one foot and 13 degrees
under the other and by following the process described above we got it. Long
term however, the wedging was much more secure when he got one piece aluminium
wedges machined up to suit.
Your shorter left arm may be adding to the problem by forcing you to twist
to that side to reach the bars in the upper and possibly lower body. If this
is the case, the basic solution is to pack up the left handlebar and raise
the left brake lever to compensate.
At some stage if the opportunity ever presents, get proper structural assessment
done. With the knowledge of exactly what the root cause issues are, the solutions
are a little easier to come by.
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