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 Form & Fitness Q & AGot 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. 
  Fitness questions and answers for April 11, 2005 
    | The Cyclingnews form & fitness panelCarrie 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 
        any geography. 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.  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 
        MyEnduranceCoach.com, 
        a resource for cyclists, multisport athletes & endurance coaches around 
        the globe, specializing in helping cycling and multisport athletes find 
        a coach.   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. |   Sore rear end questionMore Upper Calf Pain...
 Converting road bike fit to MTB fit
 Position for Long TTs
 Pedalling efficiency
 Bone Density
 Immune System
 Cramp
 Exercise Induced Asthma
  Sore rear end questionI have been having a problem with the edge of the chamois in my shorts (Pearl 
  Izumi) cutting into my buttock where it contacts the saddle (Selle Italia Prolink 
  Genuine Gel). I enquired at the (reputable) bike store where I bought the shorts 
  and they said they had not heard of this before. Is it a problem you have encountered 
  previously, and if so do you have any suggestions how I could fix it? Many thanks 
  for any advice you can provide. Rob Bishop Scott Saifer Replies  
  Hi Rob, I have not had that issue with Pearl Izumi shorts. From your description 
    of the problem, I judge that you need to get a different brand of shorts that 
    has a pad that extends farther over the edge of the saddle. The edge of the 
    chamois should be beyond the edge of the saddle so that your butt contacts 
    only smooth pad, not edge. I can't recommend a particular brand since I haven't 
    studied pad shapes. This is your chance to make yourself an expert on an esoteric 
    aspect of bike tech.Are you certain that you are contacting the edge and not a seam or a fold 
    in the pad under the cover layer? Those could feel like being cut by and edge 
    as well.
 More Upper Calf Pain...My pelvis is tilted, functionally making my right leg shorter. If you stand 
  infront of me looking at me the right side of my pelvis is higher than my left. 
  I hope that clears things up. Thanks. Timothy Applegate Steve Hogg Replies  
  G'day Timothy, From what you say, it is very likely that your rightleg is overextending. 
    In your original email you suggested that you are prepared to sort out the 
    structural problems you currently have which is far and away the best long 
    term solution. From what you have said previously, your right sacro iliac 
    joint is either restricted or jammed totally. This is likely to need more 
    than the Kit Laughlin book, some manipulation is almost certainly necessary 
    as well. The enlarged left spinal erector suggests that you drop the right 
    hip forward and down on every pedal stroke. In so doing, and because the restricted 
    right SIJ causes the right ilium to drop with the right downstroke, the left 
    spinal erector is loaded simply because it is trying to stay where it is. Here is a suggested plan of action. Firstly, mount your bike on a trainer 
    and have someone observe you from behind to confirm that you drop the right 
    hip under load. Everything you have said earlier suggests that is the case 
    but it is wise to confirm or otherwise. Proceeding on the assumption that 
    you are, twist the nose of the seat to the right a little. This will bring 
    the right hip back so that it is more or less square with the left one. If 
    you point the seat nose too far, your body will not untwist with it, but rather 
    the right hip drop will become even more exaggerated. Once you have a satisfactory 
    level of seat twist, you may still need to build up the right rear of the 
    seat where you bear your weight. This is to limit how far the right hip can 
    drop. Properly done this will provide some level of benefit. However, no amount 
    of stuff like this is a substitute for a pelvis that functions symmetrically, 
    so the best of luck with your future improvement. There is a small chance that once you have resolved the asymmetry off the 
    bike, it will still occur on the bike. If this ends up being the case, get 
    back to me and I will point you at the right people. Converting road bike fit to MTB fitThanks for leading an extremely useful discussion of bike fit in recent months. 
  After much tweaking, the moment when I made the final adjustment and felt my 
  midsection relax was inspirational! A final question (apologies if you have addressed this already and I missed 
  it): if you have your road bike dialed, what modifications do you make to set 
  up a mountain bike? Thanks for your thoughts. Nathan  Denver, Colorado (where MTB season is upon us!) Steve Hogg Replies  
  G'day Nathan, I'm happy that you feel you are getting somewhere with your road position. 
    I think that I covered this once before but I can't find it in the archives 
    so here goes. How an Mtb position compares is an interesting problem. Let's 
    assume that you are happy with your road position as you seem to be. With 
    an Mtb, you want the same pedalling dynamics but the seat position will be 
    measurably different to varying degrees because of A. Suspension effect B. Different pedal system and wider Q factor
 C. Totally different bar set up
 A. Suspension effect: The ideal is that when pedalling an Mtb, it should 
    feel the same as that road bike that you are already happy with. If the Mtb 
    has a rigid frame and fork and you are using the same seat and pedals as your 
    road bike then it is simple to set up the seat position the same as your roadie. 
    All you need is an indoor trainer to lock the bike up in, a 4 foot level to 
    help with seat set back [don't ever use plumb lines, it is too easy to make 
    a 10mm error!] and a measuring tape. Unfortunately it is unlikely that you 
    are using a rigid frame and fork. If you are using a hard tail, the act of 
    sitting on the bike will compress the front fork to varying degrees depending 
    on the fork and how hard you have the preload set. As the fork compresses 
    the seat will move forward and the nose of the seat will move down. Now the 
    problem is that you want the same seat position as the road bike but you can 
    only measure the Mtb when you are off the bike which of course negates the 
    suspension effect. Typically, to counter the forward seat movement when the 
    bike is weighted with rider caused by the sag of the front fork, the seat 
    should be somewhere between 0.5 and 1.0 degree of seat tube angle further 
    back. This means from 5-10 mm further back for a small frame and 7-14mm further 
    back for a large frame assuming an average seat height relative to frame size. 
    On a dual suspension bike the rear end will sag much more than the front end, 
    moving the seat further back than it measurably is when the rider dismounts 
    and hence unloads the suspension. There is wide range of suspension systems 
    and linkages out there for duallies and so the effect varies as it also does 
    depending on the rider's weight and how much preload is dialled in. As a rule 
    of thumb [not a phrase that I'm ever totally happy with] the difference can 
    vary from 1.0 degree, to sometimes up to 2.0 degrees of seat tube angle. In 
    mm this would mean a seat setback between 10 mm commonly, but up to 20mm further 
    forward as measured with rider off the bike for a small Mtb, and for a large 
    frame, 14mm commonly, and less commonly up to 28mm further forward with rider 
    off the bike to mimic the same position as that same person has on a road 
    bike. With some of the dual suspension systems around, not only does the seat move 
    backwards when the rider mounts but it also drops down somewhat as well. Assuming 
    that you ride with your seat dead level [and you may not], on a hardtail you 
    would need the seat nose slightly nose up off the bike to have it level on 
    the bike. With a duallie the converse is true. All of this assumes that you 
    are using the same seat as on your road bike. If not, things get a bit tricky 
    as seats can vary up to 40mm in length and the design of different seats and 
    where they have their width means that many seats of similar length force 
    the rider to sit in different relative places fore or aft. B. Pedal systems. The total height of your shoe sole and pedal and cleat 
    system may vary between your road bike and Mtb. Many of the more recent road 
    systems are very close or the same overall height as SPDs, but if using a 
    non-Keo Look pedal for example, you would have to drop your seat 6-10 mm depending 
    on what shoes you use, to get the same amount of leg extension when using 
    SPDs on your Mtb. Mtb cranks have much wider Q factor measurements than road 
    cranks. This forces the rider to a more heel in/toe out foot angle on the 
    pedals. The feet are further apart but the hips stay in the same place. This 
    in turn means that the ball of the foot moves forward as the heel is rotated 
    in. If duplicating a particular cleat placement on your Mtb as on your road 
    bike, always measure the cleat fore and aft position with the shoe in the 
    pedal at the angle you would actually pedal at. As I said this is likely to 
    differ somewhat on both types of bike. If using a Crank Bros Mtb pedal, the 
    Q factor will be even wider again. They position the foot further apart than 
    SPDs and their clones do. C. Bar set up: Assuming the same seat is used as on your road bike and that 
    you are using an Mtb 'flat bar', the overall distance from seat nose to handlebar 
    is similar to what it would be on the road bike. On an Mtb the distance that 
    the bar is below the seat is often 50-75 mm less than on a road bike for best 
    control in a variety of terrain and conditions. In my view Mtb handlebars 
    are poorly designed. With the 'flat bars' in their normal position the elbows 
    are cocked and the shoulders carry unnecessary tension. Try rolling the bar 
    back in the stem clamp so that the sweep of the bar is back and slightly down 
    rather back and up. This is not a total solution but it makes a difference. 
    With riser bars this can be accomplished better because many of them droop 
    towards the outer edge. This means that as the bars are rolled back in the 
    stem a much more comfortable position can be gained providing of course that 
    you want the extra width of a riser bar. You are likely to have a few queries 
    after reading this so let me know and we'll go from there.  Position for Long TTsI've been crazy enough to be roped into the 80km bike leg of a Run-Cycle-Paddle 
  event, and wondered whether setting up the bike for a TT (when you don't have 
  a dedicated TT bike) is as simple as bolting on the aero bars. In club TTs of 
  25-40km this is all I've ever done. I've also completed a 63km and 57km TT with 
  the same setup. I've done this more through ignorance of a better alternative 
  than anything else, but would like an expert opinion on whether any other elements 
  of the bike setup (eg, seat forward/backward, seat higher/lower) should be changed 
  when going onto aero bars and if this could benefit me. Unfortunately I'm a bit short (165cm) so my ability to gain an aerodynamic 
  advantage through a more bum-up position is limited by the seat-to-handlebar 
  height relationship. Is it worth investing in a stem offering a lower position? 
  I have excellent flexibility in my hamstrings (take up yoga all you riders with 
  back pain!), so getting lower isn't a problem from that respect, but I also 
  understand that over 80km comfort might be more important than the benefits 
  of a better aero position. Quentin Melbourne, Australia Steve Hogg Replies  
  G'day Quentin, Firstly have a look at the post: http://www.cyclingnews.com/fitness/?id=2004/letters11-08#Bike. 
    Most of your question is answered there.Next, don't worry too much about aerodynamics until you are convinced that 
    your position allows good leverage on the pedals, good control of movement 
    and the ability to breathe to the greatest capacity [a relaxed upper body 
    is the same thing].
 Once this is achieved then you can prioritise aerodynamics. Your greatest 
    priority is to do a good time. An aerodynamic position is one of the means 
    rather than an end in itself.
 If you have further queries after reading that post, let me know.
 Pedalling efficiencyI'm a masters-age cyclist, reasonably fit, been at it fairly seriously for 
  seven years. I've been told I tend to hammer unevenly on the pedals - or make 
  them go round in squares as some would say. I've had some advice from the bunch 
  and tried a few things but my technique is still off the pace. I know this costs 
  me in terms of power and overall efficiency. Can your team suggest appropriate 
  exercises to make the right technique second nature? Many thanks Mike V Melbourne, Australia Michael Smartt Replies  
  Hi Mike, Before you decide if your pedal stroke needs to be significantly changed, 
    let's look at some of the issues you have brought up. First of all, efficiency 
    refers to the ratio of external work going out of the body (in cycling, we 
    measure this as power output) to how much oxygen is being metabolized to perform 
    the work. Since a cyclist is attached to the bike at the feet, saddle and 
    hands, and movement (i.e.: pedaling) takes place in only one plane of motion, 
    simply pedaling a bike does not require any significant level of technical 
    skill (a good contrast would be swimming, where technique and physical capacity 
    are almost equally important in achieving top performance). As such, there 
    is little difference in efficiency between cyclists of varying levels, largely 
    because of these "confines" the bike puts on the cyclist. Several research 
    studies have demonstrated that over a large range of abilities, cyclists typically 
    have an efficiency rate of 22-24%. Furthermore, the idea of losing power due to a presumably inefficient pedal 
    stroke is not supported either. Research comparing the abilities of state-class 
    and national-class cyclists (Coyle, 1991) showed that the national-class cyclists 
    had what is often incorrectly referred to as and "inefficient" pedal stroke. 
    In a 40k TT test, the national-class cyclists put more of their power into 
    their downstroke, while the slower, less powerful cyclists distributed more 
    of their power in all directions of the pedal stroke. Yep, the more powerful 
    cyclists mashed (at least more than the other cyclists) their way to 40k times 
    that were 10% faster. One way to potentially change the efficiency of your 
    stroke is by manipulating cadence. This is where it gets interesting, because 
    if you pedaled with the intent on being as efficient as possible, you would 
    ride around at a cadence that is much slower than the typically freely chosen 
    cadence of most cyclists (~90rpm). As cadence increases, so does the oxygen 
    demand for a given power output. I personally don't know any top cyclists 
    who pedal all day at 60rpm, so one has to wonder why having an efficient pedal 
    stroke is a desirable goal at all. While many cyclists, and coaches, will talk about having an "efficient stroke", 
    that concept is really not supported when the variables of cycling efficiency 
    are directly studied. There still might be some good reasons for you to work 
    on your pedal stroke (e.g.: limiting the work done by the rest of your body), 
    and I've yet to find a better way than by using a good old set of rollers.  Bone DensityI am a 44 year old Cat 3 racer. I'm 6 feet tall and weigh about 155 lbs, bodyfat 
  ~ 5%. I've been cycling for about 15 years now, but only racing for the last 
  four years (lots of miles, commuting, touring in the previous 10 years, but 
  no high intensity training/racing).  Presently I train about 12-15 hours/week, and lift weights three days per week 
  off-season, and two light days per week during the season (I am 'in-season' 
  now). I recently had a bone density test during an annual exam. The test consisted 
  of putting my foot in a device that put two probes up against my heel, and took 
  some readings. The results said I had low bone density (BMD = .359, Tscore = 
  -2.0, if those numbers mean anything to you). I have also had blood work done, 
  and found to have low testosterone levels (I don't know if these are related). Can you tell me anything about low bone density, why it occurs, and what I 
  can do about increasing bone density? Thanks. Craig Long Mesa, Arizona Pam Hinton Replies  
  Hi Craig, First of all, here's a bit of information about measuring bone mineral density 
    (BMD) and the results of your test. Interpreting the results requires a brief 
    explanation of statistics, so bear with me. There are two general methods 
    available for measuring BMD: central bone density machines measure BMD of 
    the hip, spine, or whole body; peripheral machines measure BMD of the heel, 
    wrist, shin, finger or kneecap. The central BMD assessment provides more accurate 
    and complete information than the peripheral measure. For the peripheral method, 
    BMD of one site (e.g., heel) is used to estimate BMD of the whole body. Either 
    method gives you bone mineral content per bone area. This absolute BMD is 
    then compared to two standards: "young normal" (T-score) and "age-matched" 
    (Z-score). The T-score compares your BMD to the mean (average) BMD for 30-year 
    old males and is used to determine your fracture risk. The Z-score compares 
    your BMD to the mean BMD of males of your age and body size. Because BMD decreases 
    with age, the Z-score is not very useful in assessing fracture risk. Everyone loses bone mass and increases their risk of bone fractures as they 
    age. Your fracture risk is determined by comparing your bone density to the 
    mean BMD of the young adult population. Your T-score is the variation between 
    your BMD and the mean of the young adult population, expressed in standard 
    deviations (each standard deviation [SD] is about a 10-12% reduction in BMD). 
    The World Health Organisation defines normal BMD as a T-score of ± 1 SD. Osteopenia, 
    or low BMD, is a T-score of -1 to -2.5 SD. Osteoporosis is a T-score of less 
    than -2.5 SD. For each SD below the mean, the risk of fracture increases 1.5 
    to 2.5 times. To put the significance of low BMD into perspective, the relationship 
    between low BMD and fracture risk is stronger than that between cholesterol 
    and heart attack. So, at this point, you are probably realizing that your T-score of -2.0 puts 
    you in the "osteopenia" category with an increased fracture risk of 3 to 5 
    fold. Your low BMD may be a surprise to you because osteoporosis is typically 
    thought of as a disease that afflicts elderly women. You have probably been 
    asymptomatic as well, which is why osteoporosis is called a "silent disease". 
    This apparently bad news really is good news--now you can take actions to 
    increase your BMD. If untreated, your osteopenia would have progressed to 
    osteoporosis.  There are three main factors (other than genetics) that affect BMD: nutrients, 
    hormones, and mechanical stress. Any one of these or all three may have caused 
    your low BMD. Many nutrients are needed for bone health, but calcium and vitamin 
    D are the key players. With inadequate dietary calcium, the body has to use 
    the calcium that is stored in the mineral matrix of the bones to keep blood 
    calcium levels stable. Over time, insufficient calcium in the diet can lead 
    to a significant loss of bone mineral, making the bones less dense and, thus, 
    more fragile. The recommended daily intake of calcium is 1000 mg. Dairy products 
    (~250-300 mg calcium per serving) are excellent sources of calcium. Other foods, like breakfast cereals, orange juice, and soy milk are sometimes 
    supplemented with calcium, so check the food labels. Vitamin D is critical 
    for calcium absorption from the intestine. The body can make vitamin D from 
    cholesterol; the process requires skin exposure to ultraviolet (sun) light. 
    So individuals who live in northern latitudes are at greater risk for vitamin 
    D deficiency. Good food sources of vitamin D are milk and other dairy products, 
    fatty fish and liver. Your low testosterone levels probably contributed to 
    your low BMD, as growth and maintenance of BMD depend on normal hormone levels. 
    The sex steroids (estrogen and testosterone) and growth hormone stimulate 
    bone formation. For men, part of the normal aging process is a gradual reduction 
    in testosterone and growth hormone production, which may contribute to lower 
    bone mineral density. For both men and women, a chronic energy deficit causes 
    a reduction in the sex steroids. Athletes who severely restrict their energy 
    intake in order to lose weight or body fat may be in negative energy balance. 
    For women, the lower estrogen production may result in irregular or absent 
    menstrual cycles. Unfortunately, for guys, there are no overt signs of low 
    testosterone levels. Mechanical stress on bone is critical to maintaining BMD. Body weight is 
    one source of mechanical stress on the skeleton. The significance of weight 
    on bones is illustrated by the dramatic loss of bone mass that occurs with 
    weightlessness (e.g., during space travel or bed rest). Low body weight is 
    a risk factor for osteoporosis; your relatively low weight for height may 
    have contributed to your low BMD. In general, physical activity increases 
    bone density because of the increased stress on the skeleton. Dynamic exercise 
    has a greater positive effect on bone mass than static exercise because it 
    provides a larger stimulus for bone growth. Fluid shifts within the bone cells 
    are the signals for bone deposition. High-impact activities like running and 
    jumping cause greater fluid shifts than low-impact activities (e.g., walking 
    or weight-training). Non-weight bearing activities (e.g., swimming, cycling) 
    do not increase bone density. A recent study of master cyclists, who had been riding for at least 10 years, 
    found that the older cyclists had lower bone density of the spine and hip 
    than young adult cyclist and age-matched controls who were moderately active. 
    The cumulative effect of hours spent with the skeleton unloaded is the likely 
    cause of the lower bone mineral density in the masters, but not young adult, 
    cyclists. I have several suggestions for you. First of all, consider getting 
    a whole body BMD test, as it will provide a more accurate assessment of your 
    total BMD than the heel BMD test. Be sure that you consume adequate calcium 
    and vitamin D. Follow up with your physician regarding your low testosterone 
    levels, remembering that your testosterone will be low if you are not consuming 
    enough energy to meet your needs. Consider adding some dynamic, weight-bearing 
    activity to your training program. Running, jumping rope, and plyometric exercises, 
    would all be good options. Good luck. Kelby Bethards Replies  
  Again, I agree with Pam. I would add that taking calcium with vitamin D at 
    1500 mg a day is actually considered a treatment of sorts for osteopenia/osteoporosis. 
    Also, in my experience, taking hip and lumbar BMD tests tend to be more accurate, 
    if (and only if) they are interpreted correctly.  Immune SystemI am a 38-year-old recreational cyclist (5'9" - 76kg). I have been cycling 
  on and off for over 26 years but apart from a criterium and a couple of TTs 
  in my teens I have not raced competitively. I am hoping that this year will 
  see me compete in my first road race. My question centres around the issue of 
  the effect of hard riding on the body's immune system. I am still in the early stages of turning my body into a lean mean cycling 
  machine and I'm only averaging about 120km (75miles) a week. This is achieved 
  over five days of riding to and from work (20 km a day) with perhaps a club 
  ride on the weekend. I am pleased with the progress in my fitness level but 
  concerned that I regularly feel 'run-down'. I find it difficult to not ride 
  medium/hard and I regularly feel like my immune system is under pressure and 
  dealing with some mild cold or flu like symptoms. It doesn't stop me riding 
  to work but I just wish my body could remain clear and 'powerful' for a prolonged 
  period of time. When my body is good I go hard. This often seems to result in me succumbing 
  to another bout of feeling 'run-down'. It's like a cycle which keeps recurring. 
  Can you recommend anything to boost my immune system; is my situation common 
  and does the immune system become proportionally stronger as one becomes fitter? 
  I am aware of the impact of sleep, diet, alcohol and daily stress on the immune 
  system. I look forward to your response Jason Perth, Western Australia Pam Hinton Replies  
  Hi Jason, Let me reassure you that what you are experiencing is not uncommon, but unfortunately 
    that won't make your flu-like symptoms go away. In fact, your sluggish immune 
    system is part of the body's normal, adaptive response to exercise training. 
    Exercise, particularly high intensity or exhaustive exercise, causes the brain 
    to signal the adrenal gland to make glucocorticoid hormones. Cortisol release 
    during exercise is beneficial because it stimulates glycogen breakdown and 
    synthesis of glucose in the liver, making more carbohydrate available to the 
    muscle. Cortisol is also a potent modulator of the immune response, which 
    is both good and bad. Cortisol-induced immuno-suppression is beneficial in 
    preventing excessive degradation and inflammation of skeletal muscle after 
    exercise. The downside of the immunosuppressive effects of cortisol is that it increases 
    susceptibility to viral upper respiratory infections (URTIs) by shutting down 
    cell-mediated immunity (see February 21, 2005 Fitness Forum for further discussion 
    of the immune system). The increased susceptibility to infection in the 3-72 
    hours post exercise is the price that must be paid to reduce post-exercise 
    muscle damage and soreness. As you become a lean, mean cycling machine, you may find that your struggles 
    with chronic infections diminish somewhat. Exercise training not only improves 
    cardiovascular fitness and muscular strength and endurance, but it strengthens 
    the immune system as well. Immune cells in the blood of exercised-trained 
    individuals are less sensitive to the immunosuppressive effects of cortisol 
    than the immune cells of sedentary individuals. As a result, the immune cells 
    of fit people are less likely to be shut down by cortisol, increasing their 
    resistance to infection. However, even the pros battle with URTIs after a 
    sudden increase in training volume or following a stage race. As you noted, adequate rest and a healthful diet are also key to staying 
    healthy. If you were to make one change to your diet, consuming adequate carbohydrate 
    during and after exercise, would be the one to make. Carbohydrate is the single 
    dietary intervention that has been shown to reduce cortisol and catecholamine 
    secretion in response to exercise and to maintain immune function after exercise. 
    Vitamins A and C are needed to optimize immune function, so be sure to eat 
    4 servings of fruit (2 cups) and 5 servings of vegetables (2.5 cups) every 
    day. Vitamin D is also needed for a healthy immune system and recent survey 
    data suggests that many Americans have vitamin D insufficiency. We have two 
    available sources of vitamin D; food and synthesis in the skin with exposure 
    to UV light. So, if you live above 40° N or S or if you religiously use sunscreen, you 
    will have to rely more on food sources. Fatty fish, liver, and fortified dairy 
    products are good sources of vitamin D. Of the minerals, zinc is needed for 
    normal immune function. If you eat a normal mixed diet, including red meat, 
    your zinc intake is probably adequate. However, if you follow a vegetarian 
    or vegan diet, you may need to take a supplement. Remember, when it comes 
    to vitamin and mineral supplements, more is not better. Stick with a multivitamin 
    and mineral supplement that provides no more than 100% of the RDA. Staying 
    well hydrated will keep your first line of defense against bacterial and viral 
    invaders - the mucus membranes of your nasal passages, sinuses, and lungs 
    intact. Another strategy is to reduce your exposure to the disease-causing bugs. 
    Use a saline nasal spray to keep your sinuses open and flushed clean of allergens. 
    These sprays are available over-the-counter or may be mixed at home using 
    pickling salt and water. Don't forget the tried and true way to reduce your 
    exposure to germs--frequent hand washing. Take care. Kelby Bethards Replies  
  I agree with Pam completely - the other thing I have seen, anecdotally, is 
    success with echinacea and zinc when coming down with the URI's...and NEVER 
    underestimate the importance of REST in a training program...not that you 
    are overtraining, but when athletes overtrain, they become sick easier and 
    even have mental health changes. So rest well, we don't want you to be a lean 
    mean, whimpering mentally unstable racer.  CrampI'm a 30 year old male - 5'6 and 140 pounds, I train 2-3 times a week for 2-4 
  hours at a time. I am a heavy sweater and I often experience sever cramp when racing. I have 
  been using Horleys Carbo drink powder as it contains 221mg of sodium and 196mg 
  of potassium and this has helped to some extent. Is there something I should be doing before the race besides stretching and 
  drinking (and how much should I be drinking before a big race) Does diet have an effect on cramp and can my position on the bike also have 
  an effect (I usually cramp while sitting). Nine times out of ten I only cramp 
  in my thighs, usually after about 1 1/2 to 2 hours into a hard ride/race. Could 
  this be a seat height problem, and if so what's the best way to determine the 
  correct height? Thanks! Adam Kelby Bethards Replies  
  In my humble opinion, quadriceps cramps will arise from a couple of possible 
    positional problems…all making the seat height virtually too low. But, the 
    most common would be just plain ol' having the seat too low. There are various 
    websites/etc that have seat height "calculators" etc. The one I have used 
    and seems to be the one for me, is on Leonard Zinn's website. Zinncycles.com…they 
    have a bike fit calculator on there. The other two problems that I have seen give quad cramps is a seat too far 
    forward, tilted down too much in the front and cleats positioned on the shoes 
    so that the ball of the foot is behind the pedal axle.  Exercise Induced AsthmaI am a 61 year old male who has been riding and racing for many years. Some 
  time ago I found it difficult to breathe during extreme exercise. This manifested 
  itself in my inability to ride hard either on hills or (my version of) fast 
  for prolonged periods. My nickname became "Puffing Billy". On investigation, I was diagnosed with Exercise Induced Asthma. This was determined 
  after an exercise ECG to exhaustion breathing through a mouthpiece. Oxis, Vicron 
  and Tilade were prescribed. The Oxis and Vicron are taken (two puffs each) 30 
  minutes before exercise and two puffs of Tilade immediately before. Whilst this has provided some relief, it has never been 100% and recently it 
  has seemed to be less effective. My riding is mainly fun-rides in summer and 
  short handicap and massed-starts in winter. I liken the effect to the end of 
  a kilo or a pursuit. I have varied my warm up techniques. Last week I did a short turbo session 
  at home before going out to race. These have helped in TTs but not otherwise. 
  Of course, it could simply be lack of fitness. With the fun rides and TTs that 
  I have ridden recently, I don't think that is it. In the TTs and fun rides, 
  one can back off before the heart rate gets too high but that is not an option 
  racing.  I understand that this condition is quite prevalent in the pro peloton and 
  hopefully your panel may have some helpful comments Colin Evans Auckland, New Zealand Kelby Bethards Replies  
  Colin, I have treated quite a few exercise induced asthmatics…and there is quite 
    a bit of variation in the results. I had to look up the meds you are on, as 
    they have different names in the USA. There is one other thing I think that 
    could worth trying if it is available to you. Trade name: Singulair (generic: 
    montelukast) Also, I couldn't find Vicron, so I am not certain what that is… There are many "pathways" involved in reactive airways disease (asthma). 
    Histamine receptors, beta receptors and leukotriene receptors. Singulair is 
    a leukotriene inhibitor. The way I have used it is to have the athletes use 
    it in the evenings (10 mg pill) for about three days prior to a big effort 
    (hard ride, race, etc.) For easy rides they don't use it if they don't need 
    to. It can be used with the beta-agonist and antihistamines. It just helps 
    to block one more of the pathways responsible for bronchospasm. I have one cyclist that I have treated that has been able to use just the 
    Singulair - the beta agonist didn't give him as good a peak flow and made 
    his legs feel heavy. We increased his peak flow by 30%, which helped him significantly 
    (obviously). There is another thing to consider - it sounds like your testing was extensive, 
    so EIA is likely to be the diagnosis, but if the breathing problem seems to 
    be in your throat, and give you a choking sensation,.acid reflux from all 
    the increased abdominal/intrathoracic pressure is a possible complicating 
    factor. If the reflux is significant enough it can cause laryngospasm and the sensation 
    of shortness of breath and choking…. The way to stop that is with a medication 
    called a proton pump inhibitor.(Prilosec, Nexium, Prevacid, etc in the USA). 
    Hope this helps - I apologise for not knowing the medication names in New 
    Zealand, but your doctor may know the names there and if the Singulair is 
    available.   Other Cyclingnews Form & Fitness articles |  |