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Form & Fitness Q & A

Got a question about fitness, training, recovery from injury or a related subject? Drop us a line at 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.

The Cyclingnews form & fitness panel

Carrie Cheadle, MA ( 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 ( 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 ( 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 ( 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 ( 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 ( 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 ( 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 ( 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 ( 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 ( 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 ( 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 ( 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 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.

Fitness questions and answers for January 24, 2005

Side cramps & Knee pain
Bike fit
Riding like a "pro"
Follow up to the HR/Power question.
Patella Tendon Strength Exercises
Upper Body Aches

Side cramps & Knee pain

I am a male 16-year-old cat 5/junior road racer. I just joined a team and am going on their fast paced training rides. I have been riding since the beginning of last year and doing long but slow paced rides (60-100 miles 17 mph average). I have noticed that when I climb as fast as I can with a high cadence (90 to 100 rpm) and take turns taking a fast pull at the front, I get cramps in my side. Is there a certain position on the bike that I could take or a added workout to my schedule that may help?

I have a second problem too. Recently (past two months) on our long 80+ mile team rides I have been having knee pain in my left knee. And when I am on the trainer I notice that it feels that I should move my foot further up on the pedel. I got curious and so I looked at my legs and feet side by side relaxed and saw that not only did my left foot have a different angle but my left leg was longer than my right by about 1/8 of an inch. I've tried moving my cleat back on the shoe (nike shoes) but it won't move back far enough. I think, because I havent noticed the knee pain before, that the faster speeds of the group are pointing out problems with my bike fit or cleat placement for my longer left leg. Could you prescribe me a better bike fit or cleat position?


Steve Hogg Replies

G'day Adam,

I can only guess at the reason for the cramps you are experiencing. The likely culprit may be if, like a lot of juniors when under pressure on the bike, you flex your spine and roll up. That could do it but it is only a guess. Re the knee pain; are you certain that the left leg is longer. Measurable leg length discrepancies can be hard to nail down accurately without X-rays. If as you say, the left leg is longer, then there a number of possibilities for your pain.
1.Your seat height may be too low for your long leg. If you choose to raise it, you will have to compensate by packing up the other leg a few mm.
2.The different angle of your feet on the pedals suggests that you may have a rotated hip. This too could indirectly be the cause of your pain. It would be a good idea to find yourself a physiotherapist with a cycling background or experience and get them to have a look at the way you function structurally.
3. What brand and size shoes do you use and what pedal system?
4.Where in relation to the centre of the pedal axle is the centre of the ball of your foot?
Let me know and I will attempt to advise further.

Bike fit

I am a 43-year-old cyclist with 23 years experience as a serious cyclist. About nine years ago I was lifting a heavy object and felt a tear that I imagined to be a hernia. At the time I was not cycling and recovered quickly; I felt great until about four weeks later when I took a hard ride. Upon returning I began to feel pain just to the right of my pubis synthesis and radiating into my right testicle. This pain persisted for many months and ended up keeping me off the bike for several years.
When the injury is at it worst, sex also causes it to flair up. I had several exams for hernias but nobody was able to identify the problem. After some time and with the help of a practitioner of Astin Patterning (structural re-alignment work) I was able to go back to a very physical work routine, and after several years got back on the bike and rode extensively without problems for about three years. I was very fit and had been riding hard when after a ride the problem suddenly returned and kept me off the bike for four or five months. Same symptoms with lower right side back pain ( that I now believe may be the ilio-lumbar ligament).
Again, after several months I was able to ride again and return to a high level of fitness. I now seem to be in a pattern with the problem recurring annually. Last year I was riding my road bike 12-15 hours a week but could barely ride my mountain bike without stopping to stretch every 20 minutes. During this period I discovered that if I went to the Chiropractor every 10 days or so I would not have any pain. Seems that my right hip is rotated forward and that results in a functionally shorter right leg with upper body rotation slightly to the right. I also tend to have more tightness in my right hamstring and soreness in my inner thigh. I'm generally quite flexible and can easily place my palms flat on the ground with my legs locked. I had several specialists look at me over the years with no definitive diagnosis. I am now seeing a doctor who has confirmed my belief that the problem may be related to the ilio-lumbar ligament and he is treating it with prolotherapy.
I am well into the treatment and may be seeing some results but it's too early to tell. I also do yoga and incorporate techniques from Laughlin's book daily. I have begun to concentrate more on bike fit (far later than I should have ) as a part of the solution to my problem. I went to a bike fit specialist and brought my mountain bike. He moved my seat up over an inch and moved me forward significantly (I was riding a setback seatpost with the seat all the way back ). I think he was on the right track but didn't like the formulaic approach he took, which was to determine seat height by setting my leg at a 35° angle and place my knee directly over the pedal axle with a plumb bob. When I transferred his fitting to my road bike I found that the fore-aft position was already over the axle but my seat needed to go up about the same distance. So the main difference between the bike's fit was fore-aft position. The change in seat height was enough on my road bike that I actually had to buy a new frame. I started looking into bike fit issues and found cyclingnews and the information about dynamic fit.
I am currently trying to get back on the bike but have a bit of a catch-22 situation in regard to applying some of Steve Hogg's ideas. His seat height determination requires putting in multiple hard efforts on a 1 km hill to determine the proper setting. I am not sure I can do this without the injury flaring and don't want to start riding hard without getting the adjustment right for fear of re-injury. I felt that the seat height based on the 35° angle was a bit high because I think my hips were rocking a bit so I have lowered the seat a few mm. This places my legs at the point were my feet are about level with the ground when my crank is perpendicular to the ground and my knees are fully extended. I did ride on the road some and using the balance technique with my hands in the drop, arriving at a fore-aft position that resulted in my knees being about 1.5-2 cm behind the pedal axle. I'll try to dial that in more after I settle in on a final seat height. I have been doing 30 min to 1 hour on a trainer, trying to get back on the bike and have made these observations about my position.
1) I feel like my upper body rotates forward on the right side and I pull my right shoulder up and toward my neck.
2) I have always felt that I put more weight on the right buttocks and I can even see where the saddle has worn more on that side. There was more space between the horn of the saddle and my thigh on the left side. I have rotated the saddle slightly to the left and this seems to help.
3) It seems that I may not be pedalling symmetrically, and that the right side may be doing more of the work. My "feel" on the pedal also seems different with more weight on the right, and maybe my left leg feels like it may have to extend more. In general, the higher saddle position seems good but I know it needs fine-tuning. Is there a way to get it close without having to make a hard effort on the bike and risk re-injury? My cleat position is over the ball of my foot. Should I look into changing that, and also is there a chance that a shim would help with addressing any pedalling asymmetry? Once I get the position that I feel is right on my road bike I will need to transfer if to my mountain bike. Should I just duplicate my position there with regard to contact points. I ride a 17"steel hardtail (Independent Fabrications Deluxe) and a steel 54 cm Salsa La Raza road bike. I have given some thought to going to full suspension, thinking that a lessening of the pounding would help, but don't want to do that unless it is necessary. I do tend to do a lot of long, hard rides when I mountain bike so perhaps it would not be such a bad idea. Any help would be appreciated.


Steve Hogg Replies

G'day Jeff,

If you are sitting so that your tibial tubercule [bony bump below kneecap] is 15mm - 20 mm behind the pedal axle with the crank horizontal and forward, then you are likely to be somewhere in the vicinity regarding seat set back. A more immediate concern is the asymmetric functioning of your hips and pelvis. It is probably best to answer the three points you have made at the end of your query.

1) The upper body rotation is likely to be a consequence of the rotated right hip that you mention. With a rotated right hip on a bike, it is likely that you are dropping the right hip down and forward with each pedal downstroke on that side. Commonly a rotated hip is caused by the ilium [ half of the pelvis] on that side being tipped forward at the top. This will jam or restrict the sacro iliac joint on the same side to a greater or lesser degree. When this happens the glute on that side tends to 'switch off' and the hamstrings, quads and hip flexors fire up more. The effects of this in a practical sense is that the hip and pelvis on the affected side tend to function as a unit rather than independently. This is why you drop your hip forward and down. For every 5 mm that the iliac crest [top of pelvis on that side] is tipped forward, you hip joint will move up and back approximately 3mm resulting in a functionally shorter leg. Don' t forget too, that your right sit bone will have moved rearwards and for you too feel that you are bearing your weight evenly on your butt bones, you will twist to the right. Unconsciously we will do whatever it takes to stabilise our pelvis on a bicycle. It is a very common reaction to thrust the shoulder further forward on the affected side to brace against the forward and down movement of the hip. One potential trap is to twist the seat. By twisting the seat nose to the left as you have, you are reducing the distance that the right leg has to reach to the pedal but increasing the distance that the left leg has to reach to the pedal. This sounds okay but has the unfortunate consequence of perpetuating the misaligned way of functioning on the bike. In your shoes I would try twisting the seat nose to the right a bit to try and square up your hips, at least on the bike. Experiment with degree of twist. A starting point would be to point the nose of the seat at the right side of the handlebar clamp of the stem. This is about as much as most people can cope with. This will bring the right hip rearward and the left hip forward. If the seat nose rubs the inside of your right leg with any force, then reduce the degree of twist, but to the right is the way to go almost certainly. You will now be in a position where the right leg is reaching further towards the pedal than it has been.
It may cope with this, it may not. If so, fine. If not then you will need to pack up the cleat on the right side a small amount. Try 3mm as a starter but be prepared to go to 5 mm if necessary. Have someone you trust observe you from behind while pedalling. Are you still dropping the right hip [which is likely]? If so, put a build up on the right rear of the seat where you bear your weight on the top only, don't extend the build up down the side of the seat as that will increase the tendency to creep over to the right. The stuff I use here is strips of adhesive backed felt that I get from a printing shop. Get some if you can. If you can't I will leave it up to your ingenuity. Once this is done you will still be dropping the right hip but the lower limit of the hip drop will have been raised somewhat. Probably about 3 mm. You may then find that you need a further build up under the right shoe to accommodate the extra reach. Equally you may not, but it is worth trying to see which feels better.

2) The extra weight you feel on your right sit bone is a consequence of the hip drop and the off centre twist to the seat nose, allowing you to exacerbate that hip drop. It feels better than straight ahead because it allows you to function as your body wishes, given that you are a bit twisted. My experience though, is that long term you are just encouraging the perpetuation of the under lying asymmetry.

3) You probably ARE doing more work with your right leg. Are you right handed? We all favour one side over the other, but the degree varies enormously. Generally but not always, right-handers favour their right legs and left-handers favour their left legs. One problem we all have is that we assume we are symmetrical. We never are. Even if our limb length is equal, we are functionally asymmetrical. One hand is bigger than the other, one foot is larger than the other, one side is more muscular than the other, one side is more facile than the other because one side of the nervous system is more developed than the other and so on. The underlying issue that all of us have to varying degrees is that a bike is a functionally symmetrical apparatus. The seat is on the centreline as are the bars and the pedals are equidistant from the centreline. When we place a functionally [and maybe measurably] asymmetric body on a symmetrical bike there will always be mal-adaptation at some level, great or small.
Your twist to the right technique is why your left leg feels like it has to extend more and so on. Change your cleat position too. This is important. Where you have the cleat places a premium on stability. Everything further up the pedalling chain has to work harder than necessary with ball of the foot over pedal axle cleat positioning. See ( in the archive and adjust your cleats accordingly. If the adjustment is a large one as I suspect, you may have to lower your seat another few mm to allow for the greater extension of the leg that will force upon you.
Regarding transferring position to your Mtb - assuming you work through the above and get a result it would be a good idea. Ideally you need to eliminate as many variables as possible. Use the same shape and model of seat on both bikes if possible. When you measure your position on both bikes there is one common trap. On an Mtb hardtail such as yours, the act of sitting on the bike will compress the front suspension to some degree, which in turn moves the seat forward. Depending on your forks and settings, this will be somewhere between 6 and 12 mm typically. What you are trying to achieve is the same effective seating position. You can only measure this off the bike. As a starting point your hardtail seat should be that 6 - 12 mm further back with you off the bike to be in the same position with you on the bike. Also account for any differences in cleat/ pedal height if you are using different systems on the two bikes when setting seat height. For the moment, forget setting seat height by the method I usually recommend. Be careful, feel what you are doing and make small changes based on what you feel. Lastly, all of the above is fine, but no substitute for doing whatever you have to do and seeing whoever you have to see in an effort to resolve the asymmetry issues. Working around them is fine but not needing to work around them is better.

Riding like a "pro"

Whether we like to admit it or not, most of us not only want to ride like a pro, but we want to look like a pro on the bike. This drives us to lower our stems, etc. to achieve that "look". Often this is vanity and a fool's errand.

But I have noticed something about the professionals that I want to ask about as it applies to bike fit and me. When I watch professionals, even though it appears that there are a wide variety of positions, if I slow the footage down, it seems that they all end up in a very similar place at the bottom of the stroke. Legs nearly extended, very powerful, very natural...etc. When I do my "form check" I notice that I appear to be in a position that puts me too far back as compared to them when I go through the downstroke. Is this something I should be concerned about as I begin to increase my miles and intensity?
Is it possible that I have become comfortable in a position that is at a genuine disadvantage? I seem to remember guys like Sean Kelly riding in positions which I though put them at a disadvantage. Bottom line: should us non-champions try to look like the pros? Should we be alarmed if we don't? At least when it comes to leg/knee position from as we go from the 3 o'clock to the 9 o'clock position?

Steve Hogg Replies

G'day Dean,

I think I know what you are getting at, but can't agree with a bit of what you say. Firstly, your first paragraph is spot on. A lot of riders want to look like their conception of what they think a pro looks like, BUT, the bottom line is if somebody wants to imitate an aesthetic ideal, then the necessary starting point is to meet the functional ideal that allows that. A majority of riders fail this test.

Bear in mind too that to some degree pros are self-selecting. If you can't ride 30 - 50 thousand kilometres a year without injury, then you won't be there. If proportionally or functionally they are far enough from the norm, they won't make it, as during their junior years they will never have a position that is close to optimal. What I am saying, is that some of the more unusual ones are weeded out at a young age because they cannot get a good position on a stock frame and hence can't perform well enough to excel. They are also young and don't work behind a desk, which is not the case with a lot of their would be imitators.

Now to the guts of your query - I can't agree that there is a uniformity of ' look' or technique amongst pro riders. I don't see thousands, but I see enough to know that there is variety of techniques and 'looks'. Probably a lesser variety than exists in the wider population, because to be a professional cyclist, a rider needs to be fairly functional in a structural sense. To be a club or recreational rider does not require this to the same degree.

As to your belief that you are sitting further back than the pros you have observed; well you may be right and they may be wrong, or vice versa. We look at the pro scene as something to imitate because they are the pinnacles of cycling achievement to many people. The stories relayed to me by various pros that I have dealt with suggest that beyond a basic level, knowledge of bike position is undeveloped and of little interest to most teams. It is a ruthless business. If a rider doesn't perform or tends to get injured, the message is simple. Perform, or there are 50 other riders of similar ability who can replace you.

Human beings are wondrously adaptable, and so it is possible to comfortably adapt to a position that is not the optimal one for injury free performance. Your description of Kelly I would have to agree with, but he still won a lot of races. You have to decide whether you are happy with the positional choices you have made, whether or not that allows you to look like an elite rider or not. The only test is the empirical one. Does a given position allow you to perform better?

If so, it is better than what you had, no matter how you 'look'. If not, back to the drawing board. If it is any consolation, I am a 48-year-old of average [probably less] talent. I look like a pro in the flat back sense, which is the product of stretching five hours weekly for many years. However, I sit a lot further back than many pros. If I don't my performance drops and niggles occur that lead to injury. Not everyone needs to sit as far back as I do and I am not advocating that. What I am saying is that ideally, there are only individual solutions to the positioning puzzle.

Follow up to the HR/Power question.

When I read: "What many athletes (and even some coaches) fail to realize is that heart rate does not trigger training adaptations. A quick way to make this point is to compare similar intensities (same % of VO2max) in swimming and running. The HR associated with this intensity will be higher while running than while swimming for a number of reasons (ie - smaller muscles used in swimming versus running, cooling effect of water, etc), yet the training adaptations will be similar. " - it lead me to ask the following:

If HR doesn't trigger training adaptations, then is HR merely a second-hand way to get a measure of the training effect you are having, with Power being a more direct way? Then wouldn't endurance rides ideally also be governed by power? I know HR on endurance rides is a better indicator compared to HR on intervals, but if I have an SRM, should my long rides be governed by watts ranges? Or to be blunt, if you have an SRM, should you EVER base a ride on HR? It sounds like you should just use HR as a way to see how much you are improving, in the same way you would use time, speed, or distance covered.

Also, what does the above quote mean for the infamous LT? I assume the more important LT number would be Watts? Are we looking at future where HR becomes obsolete?


Ric Stern Replies


You're correct - HR is just an indirect measure of intensity - it's a dependent variable. Power output itself is the independent variable, which causes training adaptations. Personally, I find power a great way of prescribing training for all sessions, including endurance and recovery workouts. Sure, power might be variable when doing endurance rides, and you may well find yourself out of a prescribed zone when e.g., accelerating out of corner. However, this would also occur should you be training solely by HR (you just wouldn't necessarily realise it). As a coach i find no reason to stay specifically at all times within a zone -- it's fine to come out of the prescribed zone. In general you should be aiming to average a range of powers or generally stay in a prescribed zone (but to come out, as and when required). Likewise it maybe impossible for lower category racing cyclists to stay in an endurance zone when going uphill -- consequently, i would prescribe a higher zone to aim for when going uphill (i'd do similar with HR to!).

While there are several definitions available of LT (none of which matter for this point), LT is an invasive measure (i.e., blood is taken, usually from either a fingertip or ear lobe) that has little or nothing to do with HR. Measures of LT are the workload that elicits certain changes in blood lactate (for e.g., the workload that elicits a 1mmol/L increase over exercise baseline levels). The work that increases the lactate would be measured in power (W) for cycling or velocity (km/hr or m/s) for running. HR has nothing to do with it.

On the other hand, I find prescribing HR zones quite useful (which are used in conjunction with PE) for those people I coach who don't have a power meter.

Eddie Monnier Replies

Good questions, Dean.

Yes, HR is a proxy for intensity, and intensity dictates the training effect. There are coaches who prescribe Endurance workouts by power, but it's very difficult for an athlete to follow a wattage prescription over the course of an endurance ride, especially if s/he lives in anything other than a pancake flat, windless region. And HR works pretty well at lower intensities, so I prescribe HR for Endurance rides (but sometimes include wattage prescriptions as well, for example: "Ride 3-3.5 hours at HR 125-150. Include a 20- to 30-min climb at 280-300 watts").

No, HR is not a very useful way to see how you're improving. It's subject to many influences, both internal and external. The best way to judge the efficacy of your training is to see an increase in the wattage you can maintain at certain durations pertinent to your training focus.

There are a host of issues associated with the concept of LT (several of the panelists and I have written on this many times; so see prior editions for lots of useful information), but suffice it to say that what's really important is the power level you can sustain at this intensity, regardless of which definition you use (because they are all highly correlated). In an LT test (a ramp test), blood lactate levels are plotted against power. The administrator's note on the athlete's ventilatory threshold and the athlete's rating of perceived exertion provide additional useful information in case the deflection point where the lactate level rises significantly is not easily discernable (as is often the case). Notice that while HR is usually recorded at each step, it is not a determining factor.

While some would definitely like to see HR become obsolete, I'm of the opinion that it is useful for endurance training and will continue to use it until we have a more suitable approach for governing intensity for Endurance rides. Hope that helps

Patella Tendon Strength Exercises

I have consistently battled patella tendon problems with my left knee. I have been fit to my bike twice over the past year to make sure all is well.
Presuming all is well with my bike fit and pedal locations, what are some non-weight exercises that I could do to help strengthen my tendon. Also, I typically cycle at higher cadences, not using the big gears.

Gene McLean


Steve Hogg Replies

G'day Gene,

I won't attempt to advise re strengthening exercises because I don't consider myself an expert in those matters but couple of things do occur to me. True knee problems that are intrinsically a knee problem are comparitively rare on a bike. The knee is a hinge joint that needs to work in a single plane. The things that prevent this are common malformations of the foot and restrictions in the hips and/or lower back. Either or a combination of these things can place lateral or rotational loads on the knee. Have you had anyone structurally assess you?

If not, that would be a good starting point.

Upper Body Aches

I"m wondering if you can help me out here. I've been experiencing persistent aches in various parts of the upper body for almost a year now. They include:

1) Shoulder blades aches (the protruding bones in the upper back)
2) Neck aches (especially when I tilt my head to the left and/or right)
3) Lower back aches

In addition, I also constantly struggle with an uncomfortable feeling with my left leg/knee. My left leg just does not "feel right" and does not seem to give me the same kind of pedalling feeling I get from my right leg...due to that, I constantly have to consciously apply more power to my left leg (my master leg is my right leg). It also feels like I'm not "on-top" of my pedals.

I am 1.7m tall, 29 yrs...I also have a non-proportionate upper-lower body...thus I have a long upper torso but a short lower body. Thus I use a 125mm handlebar stem. I clock about 300km a week and am quite competitive.

Please advise on the possible causes to the persistent aches that I've been getting.


Steve Hogg Replies

G'day Edmund,

Yours is a bit of an open ended question, but here goes. The most likely reason for the shoulder and neck aches is that you are bearing too much weight on your arms and/or are using your upper body to stabilise yourself with on the bike.
The lower back pain could be anything from sitting too far forward to having your handlebars too low and/or too far away. Or perhaps a combination of both. Do you have access to anyone with reasonable knowledge of bike positioning?
If so try them. Find someone that uses a structural approach rather than a measurement based method.
Additionally, I see that your job is largely sedentary. How much time do you spend stretching or on other structural maintenance and improvement?
Potentially poor bike position aside, no one has a problem with their legs being strong and their lungs being large. But everyone is limited by the constraints their structure and degree of function impose on them.
I strongly suggest that you take up a stretching regime and have someone position you properly. In a general sense I suspect that would resolve your issues.


I'm a 22-year-old road cyclist who has been riding for one and a half years. I am currently doing my second base training. I have read a little about the hematocrit in cyclists and how it looks to be considered a fitness indication. I'd like to know:

1) What levels a strong rider would have

2) How may a cyclist raise their hematocrit just by training

3) What's the relation of between hematocrit and VO2 Max (if there is one)? Thanks very much for the assistance.


Curitiba - Brazil

Eddie Monnier Replies

Christian -

I've never seen anything that specifies Hematocrit (HCT; percent of red blood cells to total blood volume) as an indicator of fitness. Are you thinking about cyclists who when tested at above 50% HCT are forced to take a break? This is because a high HCT can be dangerous because of the resulting increase in blood viscosity. However, not everyone agrees that 50% is the "right" cut-off.

All athletes have a natural HCT level when "detrained." Some are higher and some are lower. And there are even isolated cases when an athlete gets a medical certificate that their natural level is above 50% (which sets their cut-off level, at say, 52%).

But as an athlete becomes more fit, their plasma volume increases more than their red blood cell count, which makes their HCT decrease. To give you an example, say Joe is a pro cyclist and after his 3-4 week transition phase at the end of the season, he has blood work done and finds out his HCT is 45%. He then resumes training and has blood drawn again 20 weeks later just before his big stage race of the year. His HCT is likely to be a few percent lower (e.g., 42%) because his plasma volume will increase more than his red blood cell count.

Regarding your question about how to increase one's HCT, there is some evidence that *some* people respond favorably to altitude exposure of 2,000 meters or more (some studies have reported benefits at lower levels). Note that I wrote *some* because not all people are "responders." There are several schools of thought on altitude exposure, but a popular one here in North America is "live high, train low." For those who don't live at altitude, altitude tents are gaining in popularity (to the chagrin of some athlete's significant others). See the recent feature on this topic:

Of course, there are illegal ways to increase one's HCT level as well. Thankfully, these are becoming increasingly difficult to get away with due to improvements in testing methods.

There is no relation between VO2max and HCT. In fact, some very successful mountain climbers who have rather high HCT levels have been shown to have rather pedestrian aerobic fitness levels.

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