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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 October 23, 2006

Winter training methods
Cycling and DVT
Arch cleats
Broken leg recovery
How should a good saddle feel?
Coughing blood
Why false positives can be positively negative
Hip drop
Wearing crank
Beer intervals

Winter training methods

I'm curious of your thoughts regarding winter training methods. I've read a few papers (they're at home so I can't reference them at the moment) that essentially argue against the traditional winter training methods of low intensity/high volume riding. These papers speak in terms of 20-minute maximum power (20MP) as the variable studied.

Their research shows that, basically, continuing high intensity intervals/training will increase the 20MP versus standard long easy rides that riders generally do around this time of year. They also feel that this is far more effective for increasing performance in-season instead of starting from scratch as traditional methods seem to teach.

I'm just curious which method you tend to gravitate towards or believe. I'm a person of science and if there's evidence for it, I tend to lean towards that.

Anne Racioppi
Matawan, NJ, USA

Ric Stern replies:

Great question. While I'm not sure if there are any actual papers looking at 20-minute power, the available research and first principles shows that performance is better controlled with moderate to high intensity training, which will increase our power output.

Previously, people have suggested that off-season training should consist of low intensity, high volume work, because high intensity may either make you peak (in winter) or have an adverse physiological reaction (e.g., a few people have suggested "bursting capillaries"). However, there is no evidence to support this, and in fact the evidence would run counter to that (i.e., high intensity training at ~ zone 5/VO2max levels) actually helps increase capillary density.

There may be some need to do easy, long volume sessions (e.g., a change of pace and prevent burnout, help with weight management if you have lots of training time available, you like long rides, and it helps you get used to being in the saddle for long periods of time - which may be important if you're a pro cyclist).

Low intensity rides don't do much physiologically speaking to help improve performance.

Cycling and DVT

I'm a 53 year-old recreational rider who has ridden about 5,000 to 6,000 miles a year for the past several years. Recently I have developed a blood clot in my upper thigh, also known as a deep vein thrombosis. (I can't ride for six weeks). I am currently taking a blood thinner to prevent any further clots. Is there any relationship between riding and developing blood clots?

Greg Stone

Kelby Bethards replies:

I do not know of any studies or evidence that would suggest that clots are associated with cycling. I would actually think that it would be quite the opposite. Cycling promotes blood flow and, for the most part, blood that flows doesn't clot. Blood is a strange 'material.' I, as I would say, in my monkey-brained way of thinking, think of blood as not a solid and not a liquid. It's a flowing solid. If it sits still, it clots. If it flows, generally (the exception being clotting disorders - hypercoagulable states) it doesn't clot.

One caveat that I can think of would be cyclists with excessive varicose veins. These however should not cause DVT (deep vein thrombosis), but rather a superficial vein clot.

Arch cleats

With all of the talk of cleats being positioned over the arch of the foot, a few questions have arisen. If one moves their cleats from the ball of the foot to under the arch by, say, two inches, how does that affect fore-aft saddle positioning?

Would one want to keep the foot/knee/hip relationship the same (by moving the seat forward) or would the knee in-front-of or behind the pedal spindle remain constant? How would 'arch cleats' affect the knee as a joint? Would they put more or less pressure/strain on it? What other factors that I'm missing should be taken into consideration?

Matt A.
Minnesota, USA

Steve Hogg replies:

I am using your timely query to pass on some stuff to all who have shown some interest.

Re your specific queries, you are probably asking the wrong person as I have only limited experience with this. My own view would be to position the seat fore and aft as I have mentioned on this forum before; i.e., the minimum distance behind the bottom bracket where a reasonably functional person can support their torso with little or minimal upper body effort.

Re foot/knee/hip relationship, etc., you are straying into the 'reductionist' view of bike position that we have all been indoctrinated with. Better to look at the body as a whole and get the whole job done well rather than focus on some 'mythical' relationships between limb segments that can be applied to a large population.

Re knee strain, properly done, it should result in less knee strain as the lower limb would be doing less work. I have been having a dialogue with Gotz Heine, a German resident in Switzerland who is the gent behind the shoes used by Susan Ljungskog and others. Basically, he is saying that arch-over-pedal-axle cleat positioning, correctly applied, results in a lower metabolic cost for a given power output than ball of the foot over pedal axle; that each pedal stroke has a LOWER torque peak and a HIGHER torque trough meaning in turn that a given output can be sustained for longer. He candidly states that this is best applied to events with steady pace and effort like TTs, hour record attempts and so on. He has some high-profile 'converts,' too.

He has offered a test on a pair of his shoes which I will take him up on and report via the forum on what happens. For anyone wanting more information regarding this, have a look at

Broken leg recovery

I am 23 and a third-year expert MTB racer. I'm 6'4" with a 36 inch inseam. Recently, I slipped in the rain and broke my left fibula just above the foot. It required surgery to fix and I had a plate screwed into my leg. I'm told I'll be on crutches for at least two months. Luckily, racing just ended for the year and won't start again until next May.

Now, assuming recovery goes well the next couple months, what should I expect when I start training again? Will I have many problems with a dominant right leg? Are there ever complications in cycling with this type of leg fracture? How long will it be before I might expect to see the fitness I had this season?

Karl Nelson

Kelby Bethards replies:

Your orthopedist is more likely to be able to give you a better feel for these questions. To attempt an answer for some of your questions:

Can it cause problems with the dominant leg? Sometimes. This, I find, is usually from increased wear and tear and stresses on the non-injured leg, due to favoring the injured leg. Your ambulation and so forth is altered for a while due to hobbling around. Without knowing exactly how extensive your fracture and surgery was, it is not unlikely that you will have some pain in that fracture area and ankle.

The fitness question is completely dependant on how well you rehab your injury. The operation was the fix of the structural problem. The rebuild of strength, etc., happens now. Make sure you follow through adequately with your rehab. I have seen quite a few people have orthopedic surgeries and fail to rehab seriously and never get back to their prior state.

Most cyclists are motivated athletes, so I imagine you'll rehab well. After my ACL construction, the physical therapist told me to not do the exercises so injured leg is now stronger.

How should a good saddle feel?

I'm a 24 year-old female cyclist, 5'6", 125lbs. I have a 51cm Cannondale R5000. I've been cycling for a little over a year now and I have some questions regarding where your pressure is while in the saddle. I'm a very calculated person in everything I do and I love to know the details. Everything that I've read and researched excludes the major detail about 'how' to do things, in other words, how they should 'feel'. They just tell you what to do.

While seated, where should your weight be? You can either rotate your hips back to sit more on your ischium or you can lean forward and place most of the pressure on your pubis. Being a female that has tried a few saddles, with and without cutouts because of a bad discomfort factor, I don't know whether I just don't know how to 'sit' or if my Terry CrMo cutout saddle is another one to throw to the trash. I have the nose of my saddle tilted down a little for comfort reasons. But I've found that anything other than flat terrain causes me to roll more forward (sitting on my pubis) and occasionally keep sliding back in the saddle - which gets annoying and turns into discomfort by the end of a two-hour ride.

Would chamois cream help this? It just seems like every time I'm done riding, I want to put caution tape around the area because it's so sore. Could this just be a misfitted saddle issue? I'm not sure whether I have 'wide hips' or what. The saddle I'm using now is by far the most comfortable out of the ones I've tried and why I've stuck with it. Only problem is, I feel like a might still have a problem. Any super light-weight racing saddle I've gotten on, I want to scream after about a minute. I definitely need a cutout, but aside from that, I don't know which direction to go.

Anne Racioppi
Matawan, NJ, USA

Steve Hogg replies:

See this document and this one as a background to sensitivity issues. Then, have a look at this post on balance and anything else in the archive on women's issues and seat choices.

Coughing blood

I am a Cat 4 roadie, X-pert MTB, and train pretty hard. I have been hit with a few bad chest colds this year. After recovering from the colds, I coughed a little blood during a race. The first time was last February during a cross race, again in June then it happened a few weeks ago, and after a 10-day rest I did a hard ride today and had a small fleck or two come up. I had a chest X-Ray last week that was clear. Do you have any thoughts? I know that it could be many things, and I am pursuing further testing.

Geoff Luttrell

Kelby Bethards replies:

Without more information, it'd be hard to completely tell what the problem is. For example, I have seen cyclists have this problem if they have cold, especially sinus, symptoms. There can be a little bit of bloody drainage that, at night or whenever, dribbles down the back of the throat, and subsequently gets coughed up later on. However, you need to see your physician and work this up further.


I'm a physical therapist and recently had a 50 year-old male cyclist referred to me who had been diagnosed with fairly severe osteoporosis of both femurs and of his lumbar spine. I had a former teammate who was refused back surgery by an orthopedic surgeon based on poor bone density, and I remember reading that Chris Boardman was also diagnosed with osteoporosis.

Assuming there is no hormonal/regulatory problem and diet is adequate, do you have any specifics on how to maintain (or promote) bone density? I know weight-bearing exercise is necessary but most research focuses on post-menopausal females, and a quick search did not turn up anything specific to male athletes.

George Poscover
Towson, Maryland, USA

Kelby Bethards replies:

I would tend to think that the exercises and methods for osteoporosis would be similar for men and women. As you have mentioned, it is less likely in men, but it is probably under-diagnosed in men, also.

Why false positives can be positively negative

I was interested to read Kelby Bethards' musings on the potential for false positives in dope testing as I have been considering the same subject myself. As a biomedical scientist with a master's degree and over twenty year's experience, I have some experience of laboratory analysis of patient samples. I do not know of any current methodology that can claim 100% sensitivity and specificity - sensitivity being the ability to detect positives and specificity the ability not to return false positives.

In the case of patient samples, a few false positives are acceptable as long as the treatment instigated is not harmful, the main issue being not to incur unnecessary expense through pointless therapy. False negatives are considerably more undesirable as they may lead to essential therapy not being offered.

The situation is quite different for athletes, however, in that false negatives may allow a small number to 'get away with it', while false positives can deprive an athlete of their livelihood and good name. For this reason I find the aggressive posturing of Dick Pound and certain sections of the media unacceptable where there is an undeniable margin for doubt. In some cases this is tantamount to a witch-hunt and I feel considerable sympathy for any athlete who has been unlucky in this respect.

I would like to add that I have studied the paper on which the test for exogenous blood transfusions which snared Tyler Hamilton and Santiago Perez [who was disqualified from second place in the 2004 Vuelta - Ed.] was based, and I consider the complaint that there was no false-positive study well founded. The requirement for athletes to prove their innocence (contrary to the burden of proof required in federal law) leads to the ridiculed 'vanishing twin' and chimera theories being propounded in desperation, whereas the onus should be on the researchers to investigate false positives before validating their methodology.

Finally, I suspect (though I lack information on this) that medical-based analyses for some doping products rely on parameters obtained from patient samples or from the general population, whereas athletes constitute a subset with altered parameters resulting from unique stresses and conditions. To illustrate this point, if cyclists were to be confined to a limit on thigh size, then a size range established by measuring the general population would lead to the exclusion of half the peloton.

I hope this has been of some use.

Michael Freeman

Kelby Bethards replies:

Very well put. I can't remember if I busted out the sensitivity and specificity terms, for fear of an inadequate description. Thanks for your contribution; it describes the terms and helps explain my concerns with the testing of athletes.

Guilty until proven otherwise can ruin a career.

Hip drop

I'm a 34 year-old Cat 5 rider just getting into racing after 15 years away. I've spent the better part of the year getting my position dialed in, but am finding that my pelvis drops to the right, making it uncomfortable to ride as I'd like. This has been verified by someone riding behind me, as well as someone standing above me on a trainer. I also have scary digital pictures to confirm my awkward position.

I ride with Speedplay Zeros and have had my fit checked by both my LBS and the sports medicine group nearby. I've had a LLD measured and not been found to have any discrepancy, though my right foot is about a half-size smaller than my left. I did suffer a back injury eight years ago that resulted in severely tight lower-back muscles. That, paired with tight hamstrings, isn't doing me any favors.

I've tried shimming my right foot up to nearly 1cm, and while my body adapts to the shims, it doesn't seem to alleviate the asymmetry. I have to concentrate constantly when I ride to remind myself the square up on the saddle, but quickly revert to dropping my right hip. I've seen suggestions that using a modified FSA seatpost will help align the rider to the bike, but I have yet to try this.

Before I purchase one, I'd like to learn more. Specifically, if I don't have a LLD and tightness is to blame, might I be able to correct this imbalance by a routine of stretching? If so, what should I concentrate on, hamstrings, hip flexors? I've found it difficult to understand the underlying causes of the imbalance. Secondly, if I shim my cleats and use an off-center seat post, will this be counter productive to my stretching?

Thirdly, I'm confused about which way to adjust the seatpost or point the saddle based on a right hip drop. When working with my sports medicine group, I was first shimmed on the left side. This did no good, though at the office it felt good, but I think it was simply different. The next appointment, I was shimmed up on the right side with the left shims removed, and that felt good.

To me, this feels like a guessing game, and although I can adapt to these changes, I'm not finding the results I'm looking for. Rather than pouring money into parts and appointments, should I just accept that I'm off-center now and move on? Mind you, I don't want to be uncomfortable, but I'm starting to feel like there isn't a magic bullet out there and maybe I'd be better served if I stopped obsessing over it.

Thanks a bunch for your service to the cycling community and taking time to answer questions - you guys are brilliant.

Patrick Turner

Steve Hogg replies:

By far the best solution is to become more functionally symmetrical off the bike, i.e., to even up and straighten up. How to do this? I cannot advise on specifics as I haven't seen you, but you must be able find a health professional who can do a global structural assessment and advise you on your underlying problems and what to do about them.

Next, do you know whether you have a measurable LLD? If you don't know or if the results you were given were deduced by external measurements, it is a good idea to have a scan or x-ray to establish that one way or the other. That way you are not dealing with guesswork.

You mention that you have your right cleat shimmed up 10mm but it doesn't stop the right side hip drop. That indicates that the problem is with the hip/lower back/pelvis and that is the area you should be focusing your attention on freeing up/fixing/stretching by whatever method. If you want to try the self-help method, you could do worse than to buy a copy of Overcome Neck and Back Pain by Kit Laughlin as it has a lot of stuff about asymmetries, self assessment etc.

Now, assuming that what you have been told is correct, that you don't have a short right leg, perhaps it is time to try a laterally-offset seat post. In your case, move the seat off centre to the left as far as possible (about 12mm) and probably point the seat back towards the centre line of the bike. That won't stop you dropping the right hip, but will make it harder to drop it as far, as well as giving the left leg some relief. With a dropping right hip, the left leg has to reach further. If you can use a mechanical method like a laterally offset seat to gain a greater degree of functional symmetry on the bike, it can only be a positive.

However this doesn't mean that you should neglect your efforts to diagnose and correct the root causes.

Wearing cranks

I am a 29 year-old rider and I have just started cycling this year. I have found that the inside of my shoes is rubbing very slightly on the crank and causing it to wear. The wear is occurring on both the right and left side. The wear is worse on the right side. I have attempted to adjust the cleat position to reduce the wear but this hasn't helped.

Is it possible to get pedals with longer axles or is there something else that I need to adjust? BTW, I'm 188cm; my bike is a 58cm Specialized with 172.5mm Ultegra Cranks, and Look Keo pedals.

Ben Dore

Steve Hogg replies:

If you have moved your cleats as far to the inside of the shoe sole (meaning shoe as far from the crank as possible) and still cannot gain clearance, you have two basic options open to you.

1. Fit a 3mm-thick washer onto the pedal axle and then securely tighten (and recheck periodically for tightness) the pedals back onto the cranks. That will give you better clearance and use brass washers if you can find them as they are not as hard on your cranks as steel ones can be.

2. Try other pedals. The Look CX 6 model has pedal bodies that can be moved laterally on the pedal axle and are similar in basic concept to the Keos that you are using. If you do go with the CX 6s, you will need to raise your seat and bars about 6mm as they are a higher profile of cleat and pedal to your Keos.

Beer intervals

Dear Dr Kelby,

Earlier this summer, you provided sage advice for me, an aging racer seeking to "hold his own" on a cross-state ride held in late July. I carefully followed your plan and, modesty aside, I think I did alright vis-à-vis my younger companions. So valid were your suggestions that my success spilled onto my late-season race venues, culminating [sound of my own trumpet] in a solo victory in my state's criterium championship.

Unfortunately, you've opened Pandora's Box for me, and the pressure is building for next season. I've just completed an end-of-season wind down, and am preparing my winter and early spring schedule of weights, riding, and cyclo-cross, all of which have potential 'rehydration' components. Do you have any tips for me? [Please note: I do suffer, from time to time, temporary vision issues and wobbly knees. What am I doing wrong? Was I over-training, or not working hard enough?]

Grandpa Kim

Kelby Bethards replies:

You pose a question valid to all cyclists: maintenance of fitness through the winter. It is a problem for those of us that live in areas that have seasons…..

However, beer fitness poses a new challenge. It is entirely possibly to become too beer fit in the winter. Yes, I know, this seems impossible. But, just as extreme, cycling fitness brings a trim, lean and powerful physique. Beer fitness tends to have its own physiologic attributes. Those are somewhat opposite of a racing physique.

Strong drinkers will grow larger abdominal regions. Sometimes the courage center of the brain becomes hyper-developed. And, if the beerclist isn't coordinated enough, he/she may end up with an enlarged bicep muscle on the favored side. A beercep, of sorts.

"So what", you beer affectionados may say. Well, the big beer belly muscle may impede pedaling and cause you to ride bow legged. I know you can use the belly to 'bounce' your legs off of, but this will only work a while before it causes you to puke on your shoes. The overdeveloped courage may make you attempt things that you cannot do, such as wheelies (as I attempted to get Lance Armstrong to do on the said "tour", which he was not brave enough to attempt - not enough beer I guess). And, if you have an enlarged beercep muscle, you may find yourself sprinting in circles next spring. That'd be a bummer in a final sprint.

Thusly, a cyclist must keep a balance. Yin and yang or whatever the hell it is. You must keep your lean, mean physique, yet enjoy beer season. After all, that's what winter if for. A few simple tips may help:

First of all, avoid the urge to do beer intervals in the winter. That isn't necessary. Just keep your fitness, keep your base beer miles and enjoy it. You don't want to overtrain.

B) Drink with both hands. At the same time if you wish… This will keep you from sprinting in circles and looking ridiculous.

3) Ride your bike to the bar or to the beer. Even in the winter. This allows you to 'earn' the beer. Even in the snow and so on. It also keeps the urge to do beer intervals, and beer sprints to a minimum, since you need to be sober enough to get home safely.

7) You mentioned opening Pandora's Box. Open that baby up, fill it with beer and hop in. I have a Mr T. rubber ducky you can borrow. I pity the fool.

Kelby Bethards, MD (Ft Collins orphan)

P.S. Yes Kim, you did very well on the said "tour" and held your own. Wobbly knees, eh? Low beer to blood ratio, I reckon.


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