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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 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.

Cyclingnews also has the full directory of all Form & Fitness questions and answers to our expert panel in a separate archive.

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.

Fitness questions and answers for May 22, 2005

Cleat positioning
Leg length discrepancy and lower back pain
Persistent positioning issues
Surgery concerns
Positioning query
Extended leg muscle soreness
Femur question
Foot angle and calf cramping
Foot numbness
Hamstring attach pain
Knee pain
Knee replacement
Leg length correction methods
Persistent bike fit issues
Pain in ankle area
Recovery drink

Cleat positioning

I have been following the cleat and saddle positioning threads of the last few months with interest. I am a recreational rider who tends to get sore hands and a bit of shoulder pain on long rides, and I also have a non-cycling related injury to the musculotendinous junction of my achilles/gastrocnemius in my left calf. I am 5 foot 8, 150 lbs. I wear SIDI Genius 4 shoes, Speedplay pedals, and have a cycling inseam of 33.25 inches. I ride a steel frame with 56 cm seat and top tubes in order to have a tall enough head tube to allow me to bend my elbows and relax my my arms while I ride. I have a fairly flexible lower back and hamstrings-- I can touch my palms to the floor with some effort while in a straight-legged standing position. I'm 38 years old, do mostly recreational riding and some racing.

When I got more serious in cycling several years ago, I set my saddle fore-aft position according to KOPS (Knee Over Pedal Spindle), which I thought was standard cycling dogma at the time. In order for me to achieve KOPS on a frame with a 74 degree seat tube and a seatpost with a fairly standard amount of setback, I had to have the saddle shoved all the way forward on the rails. With this setup and a saddle-to-handlebar drop which I varied from 3-4 inches, I would frequently get hand and shoulder/trapezius pain on longer rides. I had begun moving the saddle to the rear and the bar up a little bit about a year ago to try and reduce the pressure on my hands. Your saddle setback balance test (which mirrors the philosophy of Peter White, see his ideas here: http://www.peterwhitecycles.com) advocates being able to take your hands off the bar while riding and still maintain your forward lean without falling over, or being at the point of teetering if done indoors on a trainer. My current position nearly meets this test, but places me at a position where a plumb line dropped from underneath my kneecap falls approximately 3 cm. behind the pedal spindle.

This seems unusually far outside the norm, so I wanted to ask you if there was a limit as to how far back you are willing to move the saddle in order to find the balanced position you advocate. I am considering moving the saddle even slightly further back, or raising the handlebar to achieve a 2 inch drop from saddle to handlebars.

Also, are there other issues other than fore/aft weight distribution and bar height to address a problem regarding sore hands/trapezius? Regarding cleat position, I recall that in one of your previous responses, you mentioned that you would be addressing ways to move the cleat rearward when using Speedplay cleats. Currently my cleats are as rearward as possible without modifications. I was considering either grinding off the rear corners of the cleat or enlarging the screw holes which mate the top plates (4-hole) to the intermediate plates (3-hole).

Which method have you used and what comments would you make about the process? I also have recently been using Sole moldable footbeds in my Genius 4's. Even with the Ultra model, which is thinner, they do add a bit of heel lift. For shoes my size (43), would you recommend trying to move the ball of the foot about 10mm ahead of the center of the pedal spindle, or even further? I am not sure can identify that spot (center of first metatarsal) that accurately through the shoe, but I note that experienced fitters such as Paul Levine have suggested measuring from the second metatarsal, from the base of it if I recall correctly. It seems that your philosophy of putting the ball of the first metatarsal a bit ahead of the pedal axle would put the base of your second metatarsal very close to the spindle of the pedal axle, which I believe is Paul Levine's starting point for cleat fore/aft placement.

Charles

Steve Hogg replies

Charles,

If you do not have enough foot over the pedal ( cleat not far enough back on the shoe) then the seat will probably need to end up too far back in an effort to pass the balance test. When I suggest that it is always meant to be in the context of what I would call correct cleat position which is not ball of the foot over the pedal axle. Before you experiment further, move your cleats back appropriately to where I have suggested in the posts on cleat positioning. Those posts are a guide and will be close to on the money for the great majority of road riders though there are a host of reasons that I mean that I might vary those recommendations for a given rider by a mm or two either way.

Once you have achieved the recommended cleat position, then re evaluate your seat fore and aft position. Cleat position plays a larger part on our abilities to distribute our weight on a bike than is commonly realised. I would not suggest that you modify your Speedplay baseplates as there is not a lot of 'meat' to play with and a lot of the mods that I have seen in the past have resulted in the fixing screws pulling through the baseplate, usually at inconvenient times. If you need to move your cleats back securely more than you currently have, I have had alternative baseplates made that allow up to 15mm more than the standard Speedplay baseplate. Have a look at this site and scroll down to Specialist Fittings and 'Speedplay Rearsets'.

For info regarding cleat positioning and how to determine where the centre of the ball of the foot is in the shoe have a look at this post and this post. If you need more specific info than that, please get back to me.

Leg length discrepancy and lower back pain

I'm a 35-year-old male cat 3 / 4. I'm 5' 7" and currently 132lbs. My inseam is 32.5 inches, so I'm more leg than torso. Max HR of approx 202. I'm suffering from lower back pain for the past two months. It appears as if this was done while I was moving. I relocated from the Northeast to the Southeast. I'm now in South Florida. The pain has been present ever since and would not subside. I visited a Chiropractor a week ago. After doing a few x-rays the results were as follows:

My right hip is significantly lower than the left by 11mm. The x-rays were done standing up. Another x-ray from the knees down shows that the right Tibia has most or all of the difference.

Brief histories of injuries are as follows:

02/1998 - Suffered a broken right Tibia Plateau, torn ligaments and Cartilages. 11/2004 - had an Arthroscopic surgery done to the right knee? Right leg when bent at the knee backwards, does not go all the way back to the buttocks. Hamstrings are extremely tight, more so on the left and I'm unable to touch my toes.

Last raced during the 2003 season. Since then I've been on and off the bike periodically. In November 2004 I had a Scope done to the right knee and didn't ride again until Summer of 2005 in which I did a little over 2000 mile, mostly small gears.

As of recent (1 month ago) I began riding on weekends, between 40-50 miles on both days. I try to keep up with the group ride. During riding I'm feeling as if I'm utilizing my left leg more than the right and doesn't feel smooth pedaling. My right knee is inwards to the top tube, but not touching. (the left is straight). I would get chafing and saddle sores on the right side.

On my working shoes the outer heel on the right is noticeably more worn than the left.

I'm currently riding a Custom made Compact Titanium Spectrum by Tom Kellog. Top tube is 54cm and Stem is 100mm. I'm using the Fizik Airone seat and Salsa Poco handlebars (my hands are small). Speed play zero pedals and Sidi G4 carbon shoes.

My question is how do I accommodate this discrepancy on the bike. Do I need Ortho's, and if I do can you recommend. My feet are narrow and I have high arches, I'm considering going to the specialized carbon pro, what are your thoughts? What exercises would you recommend and overall I would really welcome any suggestions and solutions that you may recommend.

My goal is to get back into racing condition and to begin racing when the time is right. I have no time limit, as I prefer to get everything correctly and to avoid any more injuries.

Currently the doctor has me using a heel lift under the right heel to compensate for the difference until the Ortho's arrives. However when walking I can feel the pain in my right hip as if it's jamming upwards. I indicated this to him and his response was it will take some time to get use to the lift and it's more of a muscular issue that's causing the pain. I'm having therapy 3 times a week.

Thank you and looking forward to your response.

Elvis Budhram

Steve Hogg replies

Elvis,

How much shorter is the right tibia? When pedalling, and assuming that you are sitting squarely on the seat (which probably isn't a safe assumption), the lower limb tends to be vertical or more nearly so much more than the upper limb. That means that any compensatory spacer or shim needs to more nearly approximate the discrepancy than if that discrepancy was in the upper leg.

Can you confirm that you sit squarely on the seat? The way to determine this is to set your bike up on an indoor trainer, make sure the bike is levelled and while riding under load with shirt off, have an observer stand above and behind you on a stool or similar. Do you drop one hip down on the pedal down stroke on that side? If so, which side? If you can get back to me with that info we will proceed further.

Elvis then replied

Steve,

The right tibia is approximately 11mm shorter. I had the owner of my local bike shop observe me on the bike. His findings were that I'm not square on the bike. My right hip is forward. He measured my arms from the elbows to middle finger and found the right to be 1 cm shorter than the left. He took the angle of my leg on the lowest point of the pedal stroke. The right leg was 32 degrees and left 34 degrees. He also said it doesn't appear as if my hip is dropping. Hope this is helpful. Looking forward to hearing from you.

Persistent positioning issues

Greetings,

A short profile is that I'm 59, weigh 205lbs and have a height of 6'3". I was out of cycling for 15 years but stuck my toe back in the water a couple years ago. About 25 years ago I was a mediocre racer at best. The highlight of my career was winning two "B" category (versus A where the cat 1 & 2 guys were) training series crits on a flat closed circuit (by being shrewd rather than good). At that time I weighed about 180.

While I obviously don't have serious competitive goals at this point I'd like to be able to build up to sticking with the fitter, younger riders on the two hours club rides that average 20 mph on rolling terrain. If that were to work I'd consider losing the weight I'd need to lose to do age group racing (Can you imagine looking forward to turning 60?).

When I decided to get back into cycling I went to a respected bike shop (that advertises with Cyclingnews) and was carefully fitted to a new Colnago Dream B stay with good components. I was fitted using a Serotta fitting cycle. While I was totally satisfied with the buying experience I later found it was very difficult to get comfortable on the bike. Not to sound like a total cycle hypochondriac but we're talking lower back pain, numb hands, saddle making male areas tingle,... I couldn't get comfortable enough to ride more than half an hour without issues.

I then made an appointment with a shop that specializes in fitting issues and training for triathletes and racers. One that came very highly recommended. I spent more than half a day with them. I was measured every which way, video taped, power output measured, put on another Serotta machine, interviewed and whatnot. New saddle, new stem, adjusted geometry, footbeds, and encouragement. The changes helped noticeably with comfort, and my speed went up a little, too.

A year later I find myself with the discomfort symptoms back. After an hour of pedalling it becomes less fun. After more I need to get off the bike to stretch to continue. I'm more than a little frustrated. Now that I have time to put into cycling comfort has become a limiting factor. Rather than having a specific question I'm wondering who you might suggest I speak with about a plan for how to get back on track in general. Did I buy the wrong frame? If so what do I do now? How do I get it fitted perfectly? Are my comfort issues solvable or am I so brittle, inflexible and "experienced" that the lack of comfort is unavoidable? Do I go back to the fitting service I've used for more work, or do I find a cycle guru with experience dealing with someone with my specific 'resume'? Thanks in advance for your advice.

Scott McCandless
Germantown TN

Steve Hogg replies

Scott,

I'd best preface this by saying that I know little or nothing about the state of bike positioning expertise in the U.S. but have you contacted the 2nd shop that positioned you?. All of the symptoms that you relate suggest that you don't bear your weight comfortably on the bike. Do you stretch much?

If not and you are tight in the lower back and hips, and in the year since the second ( successful?) fitting session, it may be that you have trained your body but not maintained or improved your structural fitness and your discomfort relates to you being a year older and incrementally less functional. Give the shop a call and have them cast an eye over you would be my advice. Let me know how you get on.

Surgery concerns

Hi Guys,
I am a 25-year-old male and have been cycling since I was 14. I race both track and crits here in Adelaide. I have a serious back problem and looking for some advice on what do. November last year I hurt my back, not sure if it was from training/racing or in the gym. CT and MRI scans revealed a protruding disc in my L5-S1 causing major pain with the sciatic nerve in my right leg. I have had two Foraminal Injections in my L5-S1 neither giving me any relief, constant physio and neither giving me any relief and looks like an operation (discectomy) is the only way im going to get relief.

Is this a common problem with cyclists and if so would I be able to train and race again if I get the operation as I am getting varied responses from docs and physios or are the other alternatives I should try before going under the knife. It's killing me not being able to race.

Dylan Kerslake

Steve Hogg replies

Dylan,

I don't know much about what happens in Adelaide but explore all your non surgical options first. Surgery may end up being necessary but once you have had an operation it is forever. There is an exceptional physio in the Adelaide area named Aileen Jefferis. I know a number of people who have seen her with problems that they were told required surgery and after treatment by her were able to avoid an operation and get back on the bike. If you contact me privately I will give you her contact details.

Positioning query

I am having problems with my ankles. My biking buddy doesn't think it has much to with my pedalling style. Last year I had problems at the beginning of the season with my knees hurting. I had trouble extending them at times too.

After several weeks off the bike the problem went away. This year starting in January I noticed my heels were dry and peeling. It hurt to walk on them barefoot. The area around my tendons would always be a mild red. Towards the end of February I had mild pain and could produce no power. One of my other biking buddies said Achilles tendonitis. The doctor concurred. He couldn't understand how I could do it biking. I didn't bike for three weeks. I still had pain.

I sold my Motobecane 59cm and bought a Specialized Allez Elite 62cm with a sloping top tube. My biking buddy always though that I looked funny on the old bike. I had decent leg extension but I laid down pretty low and straight with a drop of 4". I'm 6'2", 200lbs and my true inseam is somewhere about 34-35"

I tried to resume riding on the Allez. I incurred pain in the tendon and hot spots under the ball of my right foot and other toes. I had retained the same keo cleats and pedals. I have been using Lake CX100 shoes.

I decided to move the cleats in a sort of desperation. I moved the cleats all the way backwards. I had them previously in20 middle. This puts my ball of the foot very close to the center of pedal axis. I did not experience any pain in my ankle after riding some short trips. I noticed a slight sensation after the group ride on Sunday of 50 miles. I rode in the small chainring with various gears and I went a little nutty once in the 14.

My ankle on the left side is now hurting. I went to shoe and discovered that cleat had slid forward towards its original position. I am wondering where my cleats should be and my seat. I currently have the top of the seat at 32" from the BB. The bottom part of the rails are 3 1/2" and the seat clamp is in approximately the center of these rails.

I do not think that I get maximum power from my current seat position in the drops, but I haven't really tried to judge it. I also want to have a good position to avoid pain and damage. I've attached my training log for the past three years. I did not have any goals other than riding around for the past few years. I was considering of trying a local criterium or two, but I don't know if I can do it at my current state.

Thank you for your advice.

Bill O'Hara

Steve Hogg replies

Bill,

If moving the cleats all the way back resolved your problem, which doesn't surprise me, have a look at this post and this post for cleat positioning. As to seat height and set back, there is a search function in the archives and a lot of posts which touch on those subjects.

Extended leg muscle soreness

I just recently stumbled onto your website, and needless to say, very pleased, especially with the Q&A Forum!

Here is my situation: I recently was able to pick up the amount of riding (time and distance), and my legs (quads mostly) have felt like they never recover (i.e. always feel sore). I have also noticed that my heart doesn't seem to rise to the level it used to before I feel the effort. I was riding previously in North Carolina (flat to slight rolling), riding about 2-3 times per week (about 20 miles, no long rides). Upon moving to South Korea, I began riding 3-4 times per week, and lengthening my weekend ride. Terrain changed significantly with flat terrain spotted with 8%-12% grade hills. I began an aggressive effort to be able to tackle the hills, and while I can tackle them (and at a quicker pace), my legs always feel tight, especially the next day. Previously in riding, I only experienced that for a short bit, and then my body felt like it caught up. The tightness does not seem to go away.

Background:

Age: 38
Height: 5'6"
Weight: 155#
Fitness: Recreational rider
HR: Previously began feeling the effort in the 154-156 range (old Max
HR was 178). Now, same "feeling" comes on at 144-148 range. I was never a racer, just a hobby road cyclist.

I'm suspecting too much hill climbing, and never letting my body recover (age thing too). I recently decided to stop cycling for 3-4 days to see how the legs feel. Any suggestions would be appreciated!

Kirk Hebert

Steve Hogg replies

Kirk,

The quad deadness probably indicates that your seat isn't far enough back or your cleat position is poor or perhaps both. Have a look at this post and this post for cleat positioning. There is a lot of stuff in the archives about seat position. Go through that and if you have any further queries, let me know.

Femur question

I am a Cat. 3 road and cylocross racer, mostly mid-pack, 43 years old. I am 5'10", 150 lbs. This past March I developed pain in the knee, probably "jumpers knee" or tendonitis perhaps. This has happened to me in the past as well. Anyway, I have been noticing that my left femur is not symmetrical with the right. For example, when I lift my legs in the air and bend the legs at a 90 degree angle to do crunches, the left knee is about 1-2 cm longer. I also notice this when I do squats - in the lower position the left knee is 1-2 cm longer than the right.

So I'm wondering a) what I can do about it, b) if it may be related to the knee problem described above, and c) anything else you can think of.

Mark Featherman

Steve Hogg replies

Mark,

Have an x-ray or CT scan and determine femur lengths. You may as well have a look at the lower limb as well. If you do indeed have a longer left femur the simple solution is to pack up the cleat on that side. Get back to me with what you find out.

Foot angle and calf cramping

I am a 23 year old category 2 racer, and in the past two years or so I have often had problems with twitching muscles in my right calf. At the end of hard rides/races, this twitching can lead to a cramp if I happen to point my toes down too much at the wrong time. It's something I've pretty much learned to deal with, and I can still finish well at the end of a race even when my calf is twitching like mad. I've tried the traditional cramp remedies: staying hydrated, using sports drinks, electrolyte pills, etc. and nothing seems to stop it. I am pretty much convinced that I have some sort of positioning/biomechanical issue since the twitching only happens in my right calf and also because it shows up regardless of the weather conditions or type of ride I'm doing. I sometimes even have twitching after something as easy as a one hour recovery ride.

I have seen a professional fitter to try to figure this problem out, and although he did move my position around a bit it hasn't gone away. I also tried moving my cleats back as suggested by Steve Hogg on this site, and again that didn't solve the problem. I recently read a book which suggested angling your cleats so that your feet can take on their natural angle while you're pedaling. By natural angle, I mean the angle that your feet assume when you sit on the edge of a table and let your legs dangle with your feet parallel to the floor. I tried this test and noticed that my right foot assumes a very large angle, with my toes pointing outward and my heed pointing in towards the other foot. The angle is large enough that if it would be impossible to duplicate it on the bike because my heel would rub the crank. What I did try, however, was to angle the cleat as much as possible to try and get my foot closer to its natural position (FWIW I am using Time Impact pedals, and I have them set on maximum float). I did an interval ride like this today, and unfortuantely the problem still showed up.

In any case, do you think that my calf problem could somehow be related to having such a large natural angle for my right foot? Or do you think it's caused by something else? Any suggestions on how to remedy the problem? Thanks for the help.

Greg Cristian

Steve Hogg replies

Greg,

From what you have told me, this is my best guess. The (un)natural angle of your right foot suggests that you may have an externally rotated right hip or a twisted ilium on the right side. Either of those conditions can lead to muscular changes that mean either that: a. your soleus ( part of the calf) may be working to hard to stabilise the lower limb to allow foot in a position that it doesn't really want to be in ( you mention that you can't attain the foot angle that you want on the pedal) or b. that because of asymmetric patterns of tightness in and around the hips and reciprocal inhibitions caused by that, your right calve may be overworking to take up load properly distributed over other musculature.

The best bet is to see a structural health professional like a good physio or chiro and find out just what the state of play is in a structural sense with your body. Your foot with normal function further up the limb should not need to be at the angle you describe. Let me know what you find.

Foot numbness

I'm a 23 year-old Cat 4 racer and triathlete, 5'11" and 155 lbs, who has been having some foot numbness issues. This winter I changed bikes, shoes and saddles - Cannondale CAAD 8, Shimano 215's, and Fizik Arione, respectively - and began training normally. I noticed that my toes were getting colder than usual, but chalked it up to cheap booties. But as the weather has gotten warmer, I've noticed that my toes aren't getting cold so much as they are getting a little numb. It's mostly in my toes and ball of my foot. I have tried going back to my old shoes and saddle, but it hasn't seemed to help. I also notice the numbness on my fixed-gear commuter. It usually comes on after about an hour in the saddle (on either bike), and lasts until I get off the bike.

I'm interested in getting the numbness to go away, but also in knowing if I should be worried about it. It is not painful, mostly just annoying. It also is not so bad that I have to get off the bike, I just ride through it. I'm training for an Ironman triathlon, so I do a good number of 4 and 5-hour rides. Should I be concerned? Am I hurting my legs? For a while I thought it might be a bike fit issue, but I've been fit at the shop I work at, and it was right on. I'm also pretty good about stretching both after the ride and on days I'm not on the bike. Any ideas?

Bryan

Steve Hogg replies

Brian,

There are a number of causes for toe numbness but the most common one is poor cleat position so it is worthwhile ticking that box before we progress further. Have a look at this post and this one. If this means a substantial cleat movement, you may have to adjust your seat height slightly. Up if the cleats move forward substantially and down if the cleats move backwards substantially. Once you have done this, if the problem is still present, let me know and we'll tackle the other potential reasons.

Hamstring attach pain

I'm a 30-year-old female who does long course triathlon (main length half ironman). I train 20 hours a week, with 250-350kms a week on the bike using a Selle Italia Lady Gel seat

I have a new bike (same old seat- approx 1 year old), which has been set up apparently correctly.... the string from the knee test and leg length onto pedal tests done and i completed an ironman on it and 6.5 hour traing sessions without this much pain.

Yet since I have had this bike my hamstrings have at times been irritated. Last week I raced in a half ironman and was in complete agony, all I wanted to do was cry and get off the bike and I have never felt like that before. Where the hamstrings attach to the bones on my bottom felt like there was nails driven in. On the second lap (30km loop) I was sitting un aero (straight up), rolling right forward, any position that was not on the spots.

Once I started running the pain eased to bearable. After completing the race I found it difficult to sit on hard surfaces and hard use of the hamstrings caused extreme pain in the area. Do you have any ideas that I can try? I have always used this type of seat. I am also still using the same shoes and pedals.

Kerry Augustson

Steve Hogg replies

Kerry,

I have seen this a couple of times, both times for the same reason though I can't guarantee that you are the same you could do worse than give it a try. The first thing to do would be to drop your seat say 5mm as your hammies are certainly being loaded up more than they would like.

Are you tight in the hip flexors? If so, read on. If not get back to me. Both the sufferers I had seen had been positioned the same way as you had and had their cleat position placed so that the centre of the ball of the foot was over the centre of pedal axle. Both had tight hip flexors and combined with their poor positions on their bikes caused their hip flexors to tighten more over the time taken to complete an Ironman bike leg. Those tight hip flexors caused reciprocal inhibition in their glutes (glutes switching off in a neurological sense) and the hamstrings were forced to assume a greater load causing pain at the origin point as you describe.

Have a look at this post and this one for cleat position. Once that is done ( and if you have problems achieving that cleat position get back to me) have a look at this post and this one as well. Once you have read those, you will probably have further queries. Let me know what they are.

Knee pain

Hi,

I just found the forum and am still baffled as to where and why my knee pain is presenting. I am 25 year old male, cat 3 road racer, who also races cross and mountain bike. I average roughly 8 hours/week of training. Earlier this winter I sold my road bike and rode my cross bike at the beginning of my base training then switched to a friends road bike for more intense racing and the first few road races of the season. I was pain free on both these bikes.

At this point I got a new pair of pedals, Crank Bros. Quattro SL's and they felt off. Within two days my new road bike showed up and I put the new pedals on and began to ride. Within a few days I was getting some good irritation in my knee (the pain seem to alternate from the inside of the knee, to the top of the knee, to just above my tibia). I then went back to my old pedals, Looks, and kept riding and racing but still was getting pain.

I then took a few days off, went and got an official bike fit. They raised my seat, moved it back and put me on a shorter stem...at the fit I felt better but was still irritated in the knee. We ended up going to a Speedplay pedal with 3 shims for the bad leg. We also noticed that my IT band was extremely tight. At this point we agreed upon a combination of the new setup and some aggressive stretching and massage. I also took a week away from the bike. But since then I have started riding again and the knee pain is back. I have measured the geometry of my new bike vs. my friends and they are very close, the main difference I notice is that my new bike has 175 mm cranks and my friend's road bike and my cross bike both have 172.5 mm cranks. Can this difference in crank length be causing the agony?

Todd Otanicar
Cincinnati, OH

Steve Hogg replies

Todd,

Crank Bros pedals are good but have a couple of shortcomings that affect some people but not others. Firstly there is no ability to adjust the cleat laterally across the shoe. Secondly they have very limited ability to angle the cleat on the sole of the shoe. There is a limited range of rotational movement but as this can't be adjusted to any real degree it is not enough for some riders. What I am saying is that these features may have been enough when you changed your pedals to cause the injury.

Did you lower your seat when you switched from Looks to Quattro's? If not, the Quattros need a lower seat height by approximately 5mm compared to a standard Look cleat. If you used the 3 hole adaptor it would be less. That assumes that you didn't change your shoes at the same time. Did you try and maintain the same relative cleat position on the Quattro's as on the Looks?

If not, another variable is introduced. Lastly, the frame geometry may be similar on your new bike and your friends bike but the question you should be asking is whether the position is similar. They may not be. A change in crank length of 2.5mm ( 1.4% difference approx) should of itself not be enough to cause injury unless you were either on or over the limit of what you could cope with from other factors, or went too hard too soon. From what you have said, both of these are likely.

Any of these factors could have been enough to set you up for injury. Knees are full of fibrous tissue; ligaments, tendons and the like and have limited blood flow. Because of that they are hard to injure. Equally because of that they are hard to recover from once injured. The best advice would be to see a sports doc or physio with an interest in cycling or with cycling injury experience, have them assess you and plan a recovery regime which will probably involve low intensity cycling. The lesson to be learnt, and I hope I'm not doing you a disservice, is that when you change equipment and "they felt off" to use your expression, take a bit of care and use a bit of method.

Knee replacement

I am in the early stages of planning for a complete left knee replacement and wonder how an artificial knee will affect my riding. I ride about 100 miles per week in the Los Angeles- San Gabriel Valley area, with a good mix of hills and flat trails.

I am in good over-all condition but have had to drastically cut back my riding over the last several months due to extreme knee-soreness after riding, especially on prolonged hill climbs where I stand up in the pedals like a stair climber exercise. How have other riders handled a knee replacement?

John LaGrandeur

Steve Hogg replies

John,

I will preface this by saying that I don't know a lot about artificial knee joints but some of the people that I have seen are doing a lot more than 100kms weekly. Once they recovered fully of course.

John then responded:

Steve

Thanks for your reply

What kind of mileage do these replacees do? My doctor said 50 per week was it. I want to do 100.

Steve Hogg replies

John,

I am not a health professional but have set up a number of riders post knee replacement. Assuming that the surgeons do their job well and that you take a bit of care with post op bike positioning and return to cycling at a rate that your recovery dictates, the artificial knee should be no hindrance to continued cycling.

Leg length correction methods

Hi Steve,

I have been suffering on and off the Bike for many years with a sorish lower back (on the LH side), it has got worse over the last year or so. I have followed many of your postings and bike set up procedures plus had medical checkups done by various Doctors, including physio and related core exercises, all of which made very little difference. The only thing the Docs could find was that my left leg is about 1 cm shorter than the right. This was not measured by x ray but by a visual assessment of my left and right hip bone height, how I walk and adding thin plates under my feet until the hip bone heights were equal. As a result I am now wearing a 5 cm heel raiser in my RH shoe, in a few weeks I will progress to a 7.5 cm raiser. So far I must say that my sore back feels better, albeit only 1 week since I started wearing the raiser.

The Doc said I should also add the heel raiser to my shoe, my question is - Would a heel raiser be effective in a cycling shoe for correcting leg length discrepancies? I have been trying to find ready made shims locally (Switzerland) without success, can you recommend anyone on line who makes and sells shims? If I decide to manufacture my own what easily available material would you recommend using?

Jack Hyde

Steve Hogg replies

Jack,

A heel raiser is a waste of time in a cycling shoe because the contact point is the forefoot and the heel raise only serves to make the foot less secure in the shoe. When walking the first point of contact is the heel and so a heel lift can work well for that. Just as a caution, have a look at yourself in the mirror bare legged. Do you tend to lock one knee more than the other?

If so and it is the right knee that you lock, be wary of believing that you necessarily have a short leg. Hip height discrepancies are very common and can be caused by other factors as well as a measurably shorter leg. If your have tighter hip flexors on the right for instance, that can be enough to pull up that side of the pelvis. It is probably worth having a scan or X ray to determine bone length difference accurately. If more than 5mm or so, my experience is that there is likely to be functional asymmetries arising from a life time of functioning with a short leg. Depending on how you have compensated for this, these compensations may add to or reduce the amount of shimming you need.

How many millimetres do you want to build up?

I have shims to suit 3 bolt pattern (Look, Look Keo, SPD - SL, Keywin etc) in 2 and 3mm. With those two thicknesses a cleat can be packed up 2-6 or whatever mm is required. If you can't find anything suitable locally, contact me directly. If you are using Look ( not Keo) and need a shim of 9 - 10mm, the easiest way to achieve that is to get another Look cleat and grind the front tab ( the part that engages with the pedal) off and use that as a shim. If you do this, remove the black rubber plug in the centre of the modified cleat and with a sharp blade be prepared to pare down the black rubber plug in the centre of the cleat that engages in the pedal. Otherwise this will protrude more and noticeably stiffen the quality of the rotational movement. As a general rule, for every 5mm that you need to pack up, move the cleat back another millimetre relative to foot in shoe compared to the other side. This will largely negate any extra rocking torque and consequent need to work harder to stabilise the foot on the pedal. Let me know if you have any problems.

Persistent bike fit issues

I'm a Cat 2 with seemingly similar issues as described in Micheal's post. I seem to be constantly making small adjustments to both by bike setup and cleat setup with no profound benefit. My HT/WT: 73 inches/168lbs Pedals/Cleats: Dura-Ace 2005/Full float Cleats Size 45 Diadoras Crank: 172.5mm.

I've measured forefoot varus, noting slightly more on the right side with one wedge as the recommended range. My physio has noted the same with a temporary orthodic mold to see if that is a direction I want to go. I've tried varus wedges with some success, but using more on the right side doesn't seem to feel natural. And the temporary orthodics hurt my reasonably high arches as they are not padded. I have not decided to throw down $300 for these yet, as I am not convinced this is the solution.

I take yoga in the off season twice a week and always feel a bit more fluid from it. But time gets tighter with numerous races throughout the spring and summer, and the stretching always seems to hit the backburner.

Over the past few years, I've developed a very hard muscle knot about 3 inches about the patella just to the lateral side of the quad betweem the rectus femoris and vastus lateralis. The knot, surrounding muscles, and IT band have been worked on thoroughly by both a massage therapist and physical therapist. I suspect it has to do with using excessive force pulling over the top and early stages of the downstroke on the left side, all whilst moving around for some compensation happening on the right side.

In terms of stability and cleat position, I can't seem to find what stance width and toe in/ toe out arrangement is appropriate. I seem to want to have the left cleat slightly more toe in then the right, and I would assume this is due to reaching a bit more from hanging to the right. When the left cleat is positioned a fractioned toed in too much, and my seat is a bit too far forward, my IT band/vastus lateralis is a war zone for more than 24 hours post ride.

Any help would be much appreciated, as this seems to be such a limiting factor in my future development. Thanks for all the responses and help you generously give out to so many of us.

Josh Lewis

Steve Hogg replies

Josh,

The problem of trying to minimise the effects of riders hanging to one side (usually the right) has exercised me for some years. I have recently come across what I would describe as the best solution so far. Have a look at this document online. There are a few typos including the title ( should be Asymmetry) as a draft version was uploaded by mistake but the info is fine. If you apply this, get back to me with any subsequent queries.

Pain in ankle area

I have heard of cyclists having problems with knee pain if they ride hills before sufficient base miles, but, I have to admit never hearing of ankle pain.

The last time I had really ridden with any sort of intensity was about 10 years ago. About 5 weeks ago I determined to get back on the bike and lose some weight/get in shape. It's difficult where I live to avoid hills, so about 5 days in, I rode a couple of small hills. My ankle troubled me after that a little: stiffness, lack of strength through range of motion, soreness causing me to limp while walking...etc, but it was manageable. I started taking 500mg of Ibuprofen 3-4 times a day, and re-doubled me efforts to stay away from the hills. The pain slowly went away over the next week.

After two weeks, I felt comfortable riding for 90 minutes, so I went for a group ride. Put in about 2-1/2 hours over flat to slightly rolling terrain. Felt fine (if not a little tired/sore in the crotch). A day or so later, the soreness was back. I rode a little bit (15mins) the next day to try and stay loose. It got worse the day after that, to the point where I couldn't walk on it. I started on the Ibuprofen regimen again, but it had no effect.

Any sort of rotational movement or movement of the foot structure away from the tibia/fibula put me in agony. After 2 more days, I saw my doctor and had x-rays in case of any avulsive fractures: negative.

I am currently not riding at all, continuing the Ibuprofen, immobilizing the ankle with an ace-wrap, and icing it once/twice a day. It has gotten much better within three days, but...

Any recommendations for when it's back to "normal" and I want to ride again? How can I avoid this in the future? Any ideas on what caused it in the first place? Thanks in advance.

Mark Loftus

Steve Hogg replies

Mark,

A relatively uncommon problem that you have. A few questions: Was this one side only and if so, which side? In the meantime, mount your bike on a trainer, level it, warm up until you are pedalling under reasonable load with your shirt off and have an observer standing above and behind you. Do you drop or rotate one hip forward and down? If so, which side? What brand, model and size of shoe do you use? What brand and model of pedal do you use? Get back to me with the answers to that and I will attempt to advise.

Mark then responded:

I'm sorry for getting back to you so late. I tried riding my bike on my rollers (with no resistance) and couldn't due to pain - I had three revolutions of the crank-arms before giving up. The pain seems to be in the deltoid ligaments (medial) of my right ankle although I have also had pain in the lateral side and Achilles' tendon too. It is getting better and I can walk on it now.

Steve Hogg replies

Mark,

I can only speculate as to the reasons for what you have experienced. 10 years off the bike and then this injury. I would think that the health professionals on the site would be able to give you more to go on than I can.

Recovery drink

Have you ever heard of Muscle Milk? I was told by some friends to try it. I ride a lot of road and mtn bikes to train for Motocross racing. I'm 38 yrs old and male. Will this hinder my health at all. Or will it make me fat? I'm at 189 pounds now, but I'm trying to get down to 175 or less. Right now all I've been drinking for recovery is Endurox 4.

Dan Kochanek

Scott Saifer replies

Dan,

I've never heard of Muscle Milk, but if you'll list the ingredients for us, I'll express an opinion as to whether it might help or hurt you in some way. Please attach your earlier note so that I can answer your specific questions about this product.

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