Form & Fitness Q & A
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we regret that we are unable to answer them all.
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
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.
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Fitness questions and answers for May 9, 2005
Arm length discrepancy
Fitting a new bike
Back-calculating power
Borderline cholesterol
Sodium phosphate
Saddle discomfort through structural imbalance
Achieving a high heart rate
Loose knee
Post-Tib pain and bike fit
Shoes and stress fractures
AHR
Cycling for fitness and pleasure
Hammertoe and cycling
Cycling with a fever
High heart rate
Arm length discrepancy
Hello, I'm a male cyclist of 46 years old with an arm length discrepancy. I
ride mostly for pleasure with some cyclosports. The difference in length is
approximately seven inches (the left is shorter); if I pull on my left arm I
can reduce the length difference to about four inches. I would like any ideas
on how to minimise the discomfort I have during a long ride.
I thought that one solution would be special handlebars, where the left side
is modified in the appropriate way: the left side of the bar could drop almost
immediately after a space for the brake lever so it should be easier to be resting
on the brake hood. The drop should be longer on the left so I'm able to be in
the drops easier. What do you think of this and do you know people or company
that can make customised handlebars.
Michel Jalette
Montreal, Canada
Steve Hogg Replies
I have in the past encountered people with similar issues though not as marked
a difference as yours. I have investigated having custom handlebars made in
the past for this purpose but there is not enough demand and I didn't have
any luck with finding anyone who could make asymmetric bars at a reasonable
price. Don't worry though as there is a solution.
Before going into that though, DON'T stretch the left side further to minimise
the difference which would still be substantial anyway. Overreaching on the
left side will over time cause painful problems to your back, shoulder and
neck. I have seen several instances of this and would not recommend it.
To solve your problem you will need a pair of Cinelli Spinaci bars which
are a small pair of aero bars without cups or pads, and the services of a
good machinist or toolmaker. That is someone with access to lathes and milling
machines and the skills to use them.
Fit one Spinaci bar horizontally behind the top of the left side of the top
of your road bar. The bracket allows it to be adjusted in/out and up/down.
With some experimentation you will be able to have a comfortable position
to grip with hand on the shorter arm side when riding upright on the top of
the bar with the Spinaci.
For using the drops and brake levers hand positions things get a bit more
interesting. Given amount of your discrepancy you will be able to mount the
other Spinaci vertically behind and probably above the drop of your bar on
the left side. The Spinaci shape when turned vertically is similar to that
of a drop handlebar. If you can get an appropriate bracket fabricated to allow
this, you will be able to have a drop position using the second Spinaci with
enough room in front of it to mount a STI or Ergolever without fouling your
road bar. I hope this helps. If you need further clarification, please let
me know.
Fitting a new bike
Hi all.
Here's my situation - I have the potential to get a Lemond at a very good price;
the problem is that I can't sample one. So I have to base it on some information
I currently understand. My previous bike was a Giant TCR1 (2003) size medium.
The overall fit was barely small. It had a giant 110mm stem. I had it set to
a positive rise and the distance from seat to bar was signifigant at 3.5"
I've demoed a Trek Madone 5.2, and in the 58cm size it felt amazing. Couldn't
find any problems with fit, and the bike was set up pretty much neutral (seat
fore/aft etc). My measurements are: 177.5cm tall, 146.5 to sternum, 85cm inseam,
44cm shoulders, 74cm arm reach, (give or take a bit, it's awkward to figure
out). I'm 38 and a masters age racer at a weight of 165lbs. I'm looking for
a 'do-it-all' bike. I race road/crit (as well at mtb/cross/track). My choice
is between a 55 or 57cm Lemond Victorie 2005 bike. I guess I'd rather be a bit
on the smaller size if I have to choose. I sat on a 53cm belonging to another
racer this weekend, and it was simply too small. Any very quick input would
be greatly appreciated!
Don Ricker
Steve Hogg Replies
You have left out a lot of pertinent info, but given me something to go on.
Given that you state the 58cm Trek Madone felt the best and reiterated that
fact in your attachment, I will assume based on what you have told me that
that is the ideal bike and position, or close to to it. The implications for
the two Lemonds are as follows: Firstly, I would go back to the shop and measure
the head tube length of the Trek Madone 58 cm frame. All of these frames will
have similar bottom bracket drops and by buying the Lemond with the closest
head tube length to the Trek you are getting a similar height frame in terms
of front end height. If it is the 55 cm Lemond, the seat tube angle is the
same and the top tube is 7mm shorter. This means that if you had the seat
centred in the seat rail clamp of the seat post, you would need a stem 7mm
longer set at the same relative height to have the bars in the same position
relative to seat.
No one makes stems with 7 mm differences between sizes. Some brands are longer
than their stated nominal length by 3-4 mm, so if you played around and measured
a few, you would end up with a stem of 5-10 mm greater nominal length for
the same reach and drop from seat to bar. For the 57 cm Lemond, the seat tube
angle is 0.5 degree more relaxed and the top tube is 3mm longer than the Trek.
Making an assumption regarding your likely seat height, you would have to
move your seat 6mm further forward in the seat rail clamp of the seat post
to maintain the same seat setback as the Trek. This 6mm factored down to the
top tube would approximate 5mm.
In effect, you are reducing the effective top tube length by 5mm moving the
seat 6mm forward. Given that the Lemond has a 3mm longer top tube, the distance
from seat to bar is now 2mm shorter on the 57cm Lemond than on the 58cm Trek.
This is hardly worth worrying about and you could use the same stem length
as on the Trek. All of the above assumes that you are comparing like with
like. That is same seat and handlebar type and shape. If this is the case,
what I have said is accurate. If not, then the picture becomes somewhat murkier.
In summary, the Trek position could be duplicated easily on either Lemond.
I would buy the one with the head tube length closest to the Trek.
Back-calculating power
Is there a way to reverse calculate a racer's wattage average wattage distance,
course profile, an individual's average speed, and pace, time? You could also
make assumptions of their weight and efficiencies. The end game is I would like
to find out the wattage of the winner, and then potentially train to that output
for that amount of time. Thanks for your help,
Kenny Deemer
Lakewood, Colorado
Eddie Monnier Replies
Kenny,
You can go to www.analyticcycling.com and click on Power & Speed, then choose
"Power, Given Speed." You won't need to know anything about anyone's efficiency,
but you will have to make assumptions about effective frontal area. But solving
for their power doesn't help you much. What you really want to do is figure
out what wattage you would require to better their average speed, right? Whatever
your intent, you should find the models there relatively helpful.
And don't forget, for a time-trial, you want to optimize watts/aerodynamic
drag which means you can either improve your power output and/or reduce your
drag.
Just a quick comment that if the difference between your current power output
and what you determine to be your goal power output is 10% or more, it probably
won't make sense to just start doing intervals at the goal level because you'll
accumulate very little training time before becoming utterly spent. Search
our archives for "time-trials", "functional threshold power" and "lactate
threshold power" and you'll find discussions about training for time-trials.
You might also see "Go Hard, Go Easy, Go Hard: The How and Why of Interval
Training" which is available in the library on my website (www.velo-fit.com).
Borderline cholesterol
I enjoy reading the fitness section for the insight into all things cycling.
Your panel is very well rounded and their service much appreciated. Just received
my CHO results form the Doc and it's a tad high. LDL is 146. HDL is good at
60. He's prescribed 500mg daily of niacin. I know the better type is Inositol
Hexaniacinate. So I'll try that one. Will this affect my cycling in any way?
Thanks for the forum.
Jon H
Arizona
Kelby Bethards Replies
Jon,
Perhaps one of the dietary oriented panelists has a better answer to your
question, but I do not think it should have an impact on your riding. You
may have a very common side effect; hot flushing soon after taking the medicine,
but this can be alleviated somewhat by taking a baby aspirin 1/2 hour prior
to your niacin dose.
The sustained release Niacin formulations tend to do this less so than the
others. As your doctor may have pointed out, we are getting much more aggressive
in treating Hyperlipidemia (high cholesterol). You have a very good HDL, for
a male, likely from your cycling. The LDL is too high, and in the long run,
its better to get it controlled now.
So, I don't think you should notice the Niacin (also called Vitamin B3) with
regards to cycling. But, if you do, talk to your Doc about it...we have plenty
of other things to try. It does have a rare side effect of rhabdomyolysis
(muscle breakdown at rest...but you would know if this was happening; you
would hurt).
Sodium phosphate
Hey,
Any thoughts about sodium phosphate loading prior to a few races per season?
Joe Friel has a bit on it in the Cyclist's Training Bible and it's sold as 'Race
Day Boost' by e-caps.com. I recently tried it, but it's hard to know if it really
made any difference. I've read some of the research and it seems pretty equivocal,
but I wondered if you had any thoughts.
Steve Smith
Ric Stern Replies
Steve,
I have no idea where JF's loading regimen originates from as there is no
research to substantiate his loading protocol (which, if I recall correctly,
uses a very low dose every day). Although at first it appears that phosphate
loading is equivocal, it appears that many or all of the studies that used
tribasic sodium phosphate showed a significant ergogenic effect. Currently,
we are unable to explain why it is only this phosphate that appears to work.
In our study (Folland, Stern & Brickley, 2001, A, CJAP) (see http://cyclecoach.com/articles?article=Phosphates&ext=.htm)
we found an ~8% increase in power output compared to a control and placebo
trial.
We used 4 x 1g/day for six days. This led to a reduction in time during a
10-mile TT of ~ 40-secs. Currently, no one has determined the exact mechanism
which improves performance via phosphate loading (although there are a couple
of hypothesis) and it hasn't definitely been determined that it always works.
It's important to note that phosphate loading isn't for everyone, and in
some people it can cause instantaneous vomiting or diarrhoea. With this in
mind, and with all new supplements and sports drinks etc you should always
try these out in training first and not directly prior to, or during a race.
It is strictly recommended that phosphate is not taken on a regular basis.
Some research suggests that it may cause calcium to be leached from the bones
if consumed regularly. Current advice is to not take it more than four times
per year.
Saddle discomfort through structural imbalance
I am a 34 year old male who has been riding competitively for 15 years. I have
trained in the gym for six years. The last couple of years I have been suffering
from saddle discomfort and a really stiff neck. I have tried almost every saddle
on the market to get comfortable and nothing has worked, even though the saddle
has always been set up with correct fore/aft adjustment. The saddle height,
bar and stem adjustments were also in the correct range.
The discomfort from the saddle always comes from the middle right hand side
of the saddle edge. The right hand side of the saddle digs into my groin as
opposed to the left side which does not. Its been observed that when I ride
I don't sit in the middle of the saddle but more pushed out to the left hand
side .The left hand side of my shoulder also looks like it's pushed up more,
relative to my head. There is obviously some fundamental muscular imbalance
going on. What action can I take?
Oliver Romov
Steve Hogg Replies
I would gently take issue with your contention that you have been correctly
set up. If you had been, you would not have the comfort issues that you speak
of and/or would have been referred on to whatever type of health professional
was deemed appropriate.
First things first, however. Your problems sound acute, and so you need to
know the structural state of play of your own body. Do four things. First,
buy a book called " Overcome Neck and Back Pain" by Kit Laughlin. It has a
very good chapter on self assessment which is ideal in the sense of self education.
If you choose to follow the recommendations in that book, it is hard to injure
yourself providing the instructions and cautions are rigorously observed.
Secondly, enlist the help of a GOOD structural health professional to assess
you and plan a way to address the problems that give rise to your on-bike
asymmetries.
Thirdly, find someone to position you who takes a structural approach to
positioning, not a measurement or predictive tables based system as I suspect
you have been using. Though I am happy to be corrected on that.
Lastly, as with any acute problem, take responsibility for it yourself. Enlist
the help of whatever professionals you deem fit, but make sure that you always
know what is going on and that this is explained to you in terms that you
understand so that you know what your options are.
Achieving a high heart rate
I have been cycling for two years, mostly to train for Half Ironman triathlon
distances. For the first time I have been incorporating interval sessions in
my cycling program.
Last year I averaged 22 mph for the 56 mile bike leg of the 2 Half Ironman
races I did on rolling courses. I would like to improve my speed on the bike
and this is why I'm doing intervals. During running intervals of 1/2 mile to
1 mile in length my heart rate gets up to 180-185 bpm. Using the same HR monitor
for my cycling intervals, my heart rate won't get any higher than 165 bpm -
regardless of interval length - at my maximum perceived effort. I have been
doing intervals of 2 minutes, 10 minutes and 20 minutes. During the cycling
intervals I have tried using big gears and lower rpms and smaller gears and
higher rpms but the resulting HR is about the same.
My heart rate is also much lower during longer rides (145 bpm for 3.5 hours)
than it is during longer runs (170 bpm for two hours) of equal perceived effort.
The only time my heart rate while cycling has risen close to my heart rate while
running was when I recently rode to the top of Brasstown Bald while in Georgia
for the TdG. I live in Chicago, so I am challenged any time the road tips up.
Should I try to achieve the same HR during cycling intervals as I can during
running intervals? If so, how should I try and do it?
Dan Litwora
Andy Bloomer Replies
Hi Dan
Nothing to worry about on this one; it's quite common for multi-sport individuals
to report the same problem and it is down to the amount of muscle mass used
for each sport. During running you use a lot more muscle mass than cycling
and the heart rate responds accordingly with a slightly higher heart rate.
I wonder - do you use your heart rate monitor for the swim training? You would
possibly notice a lower heart rate in the pool/ocean than in cycling as you
use a slightly smaller muscle mass again.
If you were to visit your local university or sports performance laboratory
for tests you would also see the same phenomenon for oxygen uptake with lower
values on the bike than on the treadmill, again due to the lower muscle mass
in activation. Cross country skiers are reported to have the highest oxygen
consumption of all athletes and at a guess I'd say it's because that unlike
for running, where you use the arms more for stability, in cross country skiing
they actually use them for propulsion as well.
In your case you shouldn't try to achieve the same heart rates for cycling
as you do for running. My advice would be to complete two maximal heart rate
tests for the different sports and use heart rate training zones for each
sport separately. Hope this helps.
Loose knee
Hi,
I am a 40 year male Cat 3 who has been riding competitively for the last 10
years. I am 5'10' and 168lbs with a stocky build. I ride 10 to 15 hours a week
depending on the season; commuting to work, doing team rides and racing. For
our team, I have been the one to set up for the final sprint and have been working
to develop my time trialing. In 1985 I had surgery on my right knee to reconstruct
both the inside collateral and the anterior cruciate ligaments. The surgery
was a result of a motorcycle accident and included repairing the bottom of my
left tibia (two screws to re-attach). Ever since the surgery there has been
"play" in my knee, allowing it to move forward and back about an inch when it
is relaxed.
I have seen two doctors recently because I have developed what they call a
'baker's cyst' behind my knee which is about the size of a large marble and
to assess the overall health of my knee. An MRI was done to identify that it
was non-cancerous. Surprisingly, there is no damage at all to any of the cartilage
as confirmed by x-ray. One said that all I have to do is to keep my quads strong
and I shouldn't have any problems, and didn't advise anything for the cyst.
The other suggested more reconstructive surgery.
Considering that these two opinions are at the opposite sides of the spectrum,
I would like any opinion or information that any of you could give me. At this
point, my inclination is to have the cyst removed, but that's all. Thank you
very much.
Patrick Edenfield
Pacific Northwest, USA.
Dave Fleckenstein Replies
Patrick,
A Baker's cyst results from fluid in the knee pushing out the posterior joint
capsule. Since the cyst is simply the result of inflammation, accurate resolution
of the cyst requires us to determine the source of inflammation. Typical sources
of inflammation that result in a Baker's cyst are meniscal tears and arthritic
processes. I want to stress that treating the cyst rarely results in resolution
- the real problem generating the inflammation must be resolved for the cyst
to resolve.
Given your history of having an ACL injury with significant laxity still
present, I would imagine that you have translation at your knee (that a normal
ACL would prevent) with even minor activities like walking, and this can cause
irritation of the meniscus, cartilage, and joint surface. Both physicians
are trying to resolve the translation at your knee, albeit through very different
methods. While one is trying to improve stability indirectly through strengthening,
the second is doing it directly through repair. My advice (through my non-surgical
lenses) would be to perform aggressive, appropriate strengthening first, and
if problems appear unresolved, have the joint imaged (x-ray, MRI) to see if
there is a meniscal tear or arthritic change. Given the number of asymptomatic
ACL-deficient patients and the fact that your ACL is somewhat intact, I would
proceed cautiously with a reconstruction. While I have discussed ACL repair
vs. deficiency in the past in this
post. I would look at the non-cycling activities that you perform (ie;
are you a skier or runner), the general condition of the knee, and multiple
opinions to develop an intelligent decision.
While I am sure that your surgeons have examined this, I feel obliged to
mention one additional concern for our readers. In your case, with the amount
of laxity you describe and injury mechanism, I would also be very curious
as to the integrity of your PCL. While not as frequently injured, I would
definitely make sure that it has normal function.
Finally, you mentioned that your pro-strengthening physician stated that
quad strength was a primary focus for you. While this is true, it is the hamstrings
that most closely associate biomechanically with the ACL and I would definitely
incorporate that into your strength program. Best of luck!
Post-Tib pain and bike fit
My story is very similar to the story told by Shane Anderson in the March 7
edition of the Cyclingnews Fitness column.
I am a 39-year old Cat IV road and mountain bike racer. I ride a custom steel
frame, use Sidi Genius 4 shoes (size 48), and Speedplay pedals. I'm 6'3" and
weigh 185 lbs. (84 kg). In March, I started experiencing nagging pain in the
area of my left achilles. It wasn't severe, so I kept riding. In mid-March I
attended a team training camp and did two back-to-back days of long climbs in
cold weather. The climbs were between 20 and 45 minutes in length, and I was
definitely overgeared for both, resulting in cadences as low as 40 rpm on some
steep pitches. I had to cut the following week's training short due to severe
pain in the left achilles area. I saw an orthopaedic doctor in the next week
and took a MRI. The diagnosis was achilles tendonitis, and the prescribed treatment
was complete immobilisation for 1.5 weeks, physical therapy and anti-inflammatories,
and to stay off the bike.
While I was off the bike, I had a professional bike fit using the Wobblenaught
method. The changes to my existing setup were minimal - saddle moved back almost
one inch and down about 2 mm, cleats moved back to farthest possible point on
Sidis (using Speedplay adapter on 3-hole drilling of Sidi sole), and everything
else stayed the same. The fit results suggested that my cleats should be even
farther back (194mm from back of heel), but the shoe would not allow the Speedplay
cleat to move back that far. During the Wobblenaught fit, we measured the distance
from my heel to the sesamoid bone to be 195mm on the left and 198 on the right.
Fast forward to four weeks later…the pain in the achilles has disappeared completely,
and I have had nearly two weeks of pain-free walking, stair climbing, and some
limited running.
Given that success, I thought I would try riding again. Unfortunately, after
two short rides with NO hard efforts (kept wattage below 150 watts), the pain
in my left ankle returned. It was bad enough that I had to unclip the leg and
pedal home on the other leg. Now, however, the pain is localised to a small
area on the inside of the ankle - my physical therapist believes it is on the
posterior tibialis tendon, not the achilles. There is noticeable bogginess in
the area of the post-tib, and there is NO pain in the achilles area. Walking
continues to be pain free. My physical therapist has found obvious flat-footedness
on the left leg, and has recommended orthotics. She believes the problem is
related to excessive pronation. I am continuing with physical therapy, including
eccentric calf exercises and stretching. I also have scheduled another appointment
with the orthopeadic doctor to examine the post-tib issue.
Now, at last, I come to my questions! Because the pain seems to be clearly
related to cycling, and specifically to the interaction of the foot and the
pedal, I am wondering what can be done to prevent the problem from reoccurring.
1. Do I need a medical grade bike fit? Where can I go to get a medical grade
bike fit in the United States?
2. Would orthotics help? Are there differences in cycling and running orthotics?
Are there specialists in making cycling-specific orthotics? 3. Would cleat shims
help? Should I attempt them on my own, or are there fit specialists who have
experience in dealing with post-tib issues? Any advice you could provide would
be greatly appreciated!
Ken Woodrow
Steve Hogg Replies
Re question 1. I assume by a medical grade bike fit, you mean having your
structural and or functional shortcomings addressed. If that is the case,
the answer is an absolute 'yes'. I thought that was what bike fitting was
about anyway. As to where in the States you would go, as an Australian who
has never been to the States, I cannot help with a personal recommendation.
I hope some of the U.S based panellists can.
Re question 2. Orthotics?. Depending on what the basic stressor is, 'possibly'.
If I can give you my two bob's worth about the use of these in cycling shoes.
The prescription of an orthotic is predicated around a predictable heel strike
such as when walking. The contact area on a cycling shoe is the forefoot,
not the rear foot. Additionally, part of the prescription of an orthotic may
be based around asymmetries further up the body, like pelvic obliquities causing
a functionally long and short leg etc, etc. which alters footplant. When we
walk or run, we support ourselves on our legs and exert force with them too.
When we cycle we support our weight on the base of the pelvis [ideally] and
exert force with our legs. Any asymmetries of function that a given person
displays off a bike may be noticeably lessened or increased when they get
on a bike. This means that the prescription for a cycling orthotic often needs
to be different than what a given person would need for running/walking.
As rough figure, I have found that of the people that I see that use one
pair of orthoses for both cycling and walking/running, approximately 50% have
no problems and the orthoses are beneficial in their cycling shoes. Of the
other 50%, either a portion or a major part of whatever problem brought them
to me is their orthoses, even though the same ones have been beneficial off
the bike. Yesterday I had a gent with an on-bike knee issue who uses his orthoses
in his cycling shoes. I was able to solve the problem but part of the solution
was to remove the right one and leave the left one in place. This is not particularly
uncommon though it doesn't happen every week. If you plan to go down that
route, the best advice that I can give you is to find a podiatrist who is
a competitive cyclist and who has applied him or herself to the task of thinking
about the requirements of cycling as opposed to walking/running.
Re question 3. Cleat shims. Do you mean shims in the sense that the cleat
is packed up in the vertical plane or wedges meaning that the shoe is canted?
You mention a flat left foot and imply, but don't say, that the other is not.
Proceeding on that assumption, have yourself structurally assessed by a good
structural health professional with a cycling background or experience. You
need to know what measurable or functional asymmetries led to your feet developing
differently. Once you have that info, potential options for solution paths
become obvious. Assuming that you sit reasonably square on your bike, get
some Lemond wedges and have a play.
Approach the task with some care and thought, not bull-at-a-gate style, and
you may well come up with a positive result. There is not a lot to lose if
you are sensible. Additionally, once you have been assessed by someone, get
back to me with the results and I will try and advise further. One last word:
your less than ideal cleat position may be a contributing factor. Cleat position
is a big deal to my mind. The people who made a positive difference with your
positioning session should have been harder on you. If I can't get a clients
cleats where I want them because of the shoe/pedal combination they have,
I ask them to spend money to acquire a pedal/shoe combination that will allow
good cleat position. If the client won't do that for whatever reason, it all
stops there. There is no charge but I will not proceed further.
Anyone in the positioning business is going to be judged by the client on
the results they achieve. I want the best chance of that being the case. To
that end, where is the centre of the ball of the foot in relation to each
pedal axle centre? If you need to move your cleats further rearward there
is a solution available. If you have a good relationship with your bike shop
or another that stocks DMT shoes, that brand has the most rearward cleat mounting
holes that I am aware of. You would need to fit your cleats and measure where
your foot is in relation to the pedal axle before buying. If that is not possible
and at the risk of being seen to tout for business, have a look at http://www.cyclefitcentre.com/cyclefit%20services.htm
and scroll down to Specialist Fittings and look at Speedplay Rearsets. Lack
of rearward adjustment is common with Speedplays which otherwise are a very
good system. I hope this gives you something to go on.
Shoes and stress fractures
Ivan at Spin City gym suggested I contact you for any possible solutions to
my problem. I had a stress fracture on the navicular bone in the right foot
- diagnosed and treated August 2004. At the time my two forms of exercise were
walking and spinning. I had orthotics in my shoes but had removed them for about
three months before the break - but not in my spin shoes.
A sports doctor thought it was the walking and a specialist thought it could
be the spinning and the radiologist that checked my bone scan thought it could
have been stressing the foot when I took the orthotics out. The orthotics were
originally prescribed as I had shin splints but as I don't really run now I
have removed them from all my shoes to try and pinpoint what is bugging my feet.
I was straight back on bike when the plaster came off but foot was still too
swollen to wear my Carnac bike shoes, so just used my runners. Foot settled
down but then as soon as I started to wear my Carnacs again both feet stressed
across the top of the foot. When that happened Ivan made me take a month off
the bike - that was what made me realise that it was the bike shoes stressing
my feet. I am back in runners and my feet almost completely settled now. My
problem is - is there a reason that after four years my Carnacs would stress
my feet? I realise a stress fracture for whatever reason is caused over time,
etc - not easy when no-one is really sure of why it happened. Any info or suggestions
would be greatly appreciated.
Cheers,
Anne Hood
Steve Hogg Replies
Interesting story. I am not familiar in any depth with the latest Carnac
shoe models, but from what you have said yours are 4+ years old. I am quite
familiar with their shoes from that period and before. Carnac cycling shoes
for many years stood alone in design terms in a negative sense, in that they
did not [and possible still don't, I am not sure of the current stuff because
I don't see much] have the same proportional placement of the cleat mounting
holes in every size. Essentially the smaller the shoe, the further forward
in a proportional sense the cleats had to be because of where the holes were
placed. At the time Carnac used an insert system in the sole so that their
shoes could be configured for any pedal system by changing the sole insert
to the appropriate one for a given pedal type. A great idea in practice but
when combined with the Carnac style high arch, heel lift last shape, it was
a problem.
The inserts from memory were 90mm or thereabouts long. That meant that the
shoe needed 90 plus mm of more or less flat or slightly curved space forward
of the high arch and kicked up heel. To get that 90mm the only solution was
to move the insert further forward as the shoe size decreased. In practice
my experience is that with a size 42 or below it is nigh on impossible to
position a 3 or 4 bolt pattern cleat where I would put it unless the subject
had freakishly proportioned feet. Sizes 43,44 and 45 shoes had a rough proportion
of achieving successful cleat position of probably 50%, and with size 46 or
above there was rarely a problem because the shoe was big enough to position
the cleat mounting holes in pretty much the same place as the better shoe
manufacturers do on their products.
As a woman it is likely that you have small feet and a contributing factor
to your problem has been less than ideal cleat placement - the smaller the
shoe size, the greater the potential for and severity of any problems. Why
your navicular bone and why four years? The simple answer is that I don't
know; but if I saw you in your shoes on your spinning bike I could probably
make a good guess. I strongly advise you to change your shoes to one of the
following brands: Nike, DMT, Sidi, Specialized, Shimano, Gaerne or Diadora.
Once you have done that have a look at this
cleat positioning post, and this
posting and position your cleats as per that. Once that has been done
and if there are any ongoing issues, look me up. If you know Ivan then we
are in the same part of town. Say g'day for me to him when next you see him.
AHR
I am a 48 year old woman of Mexican Basque descent who is 5'3" and weighs 115
lbs. My resting heart rate is in the low to mid 40s. Since childhood I have
enjoyed running, swimming, and biking.
I ride five to seven days per week in the hills of San Francisco and like to
keep my average heart rate for the 50 to 60 minute ride between 160 and 165.
Is this a problem?
A friend thought my heart rate was too high and suggested I see a cardiologist
to avoid having an "enlarged" heart. I enjoy my workouts and thought my heart
rate was fine. Thank you for your prompt consideration.
Eli Aramburo
San Francisco, California
Scott Saifer Replies
Hi Eli,
There is nothing wrong with maintaining a heart rate of 160-165 for an hour.
Being able to do so certainly does not suggest that you have any heart problem.
If you have any other symptoms of heart disease you should see a doctor of
course, but not simply because you can ride at 160-165. Many of my clients
can do that.
Kelby Bethards Replies
Eli,
Without knowing too much more about you, I do not think you need to worry
about an enlarged heart. Using the simple formula of having a maximum HR of
220 - AGE, that would give you a maximum of around 172. So, you are exercising
at a fairly high percentage of your "maximum heart rate". HOWEVER, this is
a highly individualised parameter and you may have a max HR that is higher
than what the formula states.
I feel as long as you are tolerating the exercise without difficulty and
aren't "passing out" or having an extremely hard time with recovery and not
having chest pains, then you are probably fine. The hills of the San Fran
area are challenging and you will have quite a few ups and downs of your heart
rate, which correspond to the terrain.
Enlarged hearts happen for a multitude of reasons, but I would suspect that
most of the pathologic reasons for heart enlargement (bad reasons) would cause
you to have a decreased exercise tolerance and you would fatigue too easily
and not recover well amongst other symptoms. Exercise tends to thicken the
heart wall muscle, but not to a point of inefficiency.
Of course if you feel better seeing a cardiologist for the piece of mind,
please do so and see what he/she thinks.
Cycling for fitness and pleasure
I am a 61-year-old female, quite fit, and until very recently a regular gym
user. I used weight machines and aerobic machines. I am coming to resent the
boredom and lack of return from going to the gym - I just don't feel the gain
is equal to the effort. I used to love cycling when I was young and have decided
to start again.
My only health problem has been wear and tear in my knees - which started early
in life; when I was about 35 years old, and has now become chronic. I control
the pain with codeine when necessary as I can't tolerate any form of aspirin.
I find that when I have been exercising the pain lessens for the most part,
except for the odd time when it flares up. Am I right in thinking that cycling
will replace the aerobic activity and also build up the muscle in my legs? I
am thinking of a mountain bike.
Jackie Ryan
Kim Morrow Replies
Hi Jackie,
The cardiorespiratory benefits from cycling will be very similar to other
aerobic activity that you may have done in the gym. I'd suggest checking with
your physician regarding your knee problems and to answer all questions you
may have regarding beginning a cycling program. Also, you would want to make
sure that you have a proper bike fit for your new bike, so that your knee
problems are not aggravated. You may also consider taking a few bike skills
sessions if you have been off the bike for a while. This will help you feel
more comfortable with riding in traffic, in groups, etc. In general, cycling
is a great activity and certainly beats the boredom of working out solely
in the gym!
Hammertoe and cycling
Hello,
I was recently diagnosed with a minor case of Hammertoe on my pinky toe. I
inquired what possible treatment there might be for a competitive cyclist and
the doctor could only tell me "padding". Surgery is an option but since it is
such a small case it would probably cause more long-term harm than short-term
relief.
Are there any other remedies that I could try to help relieve my foot pain?
I'm already using orthodics and I'd prefer not to buy new shoes since the price
point is so high. How have others handled this?
Nathan
Steve Hogg Replies
For similarly afflicted riders use I corn pads. These are like a padded sleeve
that fits over the toe and have found them to be quite effective in many cases.
How effective comes down to two things; the basic suitability in a fit sense
of the shoe they were using, and how severe the problem was to start with.
Another handy trick is to take the insole out of the shoe, place your foot
on it and using a pen, mark around the toe from webbing on the inside to just
before the metatarsal joint on the outside. Once this is done, cutaway the
insole in that area, using you pen line as a guide. If that and or corn pads
doesn't work the bottom line is that if you are in enough pain, the price
of new shoes becomes secondary. If you have to look at new shoes, look for
ones with a wide toe box. DMT and Shimano stand out in road shoes but they
are not alone, so try a few others as well. If you get to that point and can't
find anything you are happy with, consider custom made shoes. On the better
ones, a cast is taken of your foot, a foot mould is made from that and then
a shoe is made around the cast.
Cycling with a fever
Reading a number of articles about the pro riders it seems that they still
race even when they have a fever. I would have thought that this was quite a
dangerous thing to do as I know of one person locally who died while running
and I personally know someone who was taken to hospital with a heart rate of
300; it was fibrillating at the time, doing an orienteering event. Both people
thought that they had a flu-type disease but tried to run through this.
Is this just a bad idea or is there something about cycling that is safer than
running?
Cheers
Brett Rallings
Scott Saifer Replies
Hi Brett,
No, cycling is not safer than running on this measure. How many runners have
run with fevers and not died though? Probably quite a few.
High heart rate
I'm a 20 year old male and I've been riding for a couple of years. But my main
focus has been running for about five years now. I'm thinking of changing that
and getting into cycling for my college team.
I'm 5'10 and I weigh 150lbs. I recently bought an HRM and have been wearing
it for the past three weeks. My question relates to my heart rate. My resting
heart rate averages out to about 85 and the max I've been able to hit is 197
(only a couple of times).
I was expecting my resting heart rate to be much lower. Is this range normal
or could there be some underlying problem, if these values are unusual? Your
help would be very much appreciated.
Vikram Singh
Scott Saifer Replies
Hi Vikram,
A resting heart rate of 85 is very unusual for a trained athlete, even an
overtrained one. When you say resting, do you mean lying on your back, relaxed
resting or sitting on your bike between hard efforts resting? If you are seeing
a resting heart rate of 85 while lying down for 20 minutes or more and not
thinking about anything exciting, make an appointment to see you physician.
There are several possible explanations that are not horrible but should definitely
be attended to.
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