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 Form & Fitness Q & AGot a question about fitness, training, recovery from injury or a related subject? 
  Drop us a line at fitness@cyclingnews.com. 
  Please include as much information about yourself as possible, including your 
  age, sex, and type of racing or riding. Due to the volume of questions we receive, 
  we regret that we are unable to answer them all. 
  Fitness questions and answers for August 15, 2007 
    | The Cyclingnews form & fitness panelSince 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. 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.  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. 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. 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. 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. |  Bike SizeInsulin pump therapy
 Leg Length
 Bike fit and cleat placement
 
 Bike sizeI live in East London. Is it possible to send you the appropriate measurements 
  for you to assess what size bike I require? Recently I bought a Cannondale Synapse, 
  frame size 47 compact and it is too small for me. I just cannot get comfortable 
  on it. I have consulted several people who are respected in the cycling fraternity 
  who have confirmed the wrong size, but would like your opinion as well before 
  embarking on buying another frame. Which measurements would you require? CarolEast London, UK
 Scott Safier replies: 
  The short answer is "no", it is not possible to prescribe a frame size strictly 
    based on any body measurements with total confidence that the result will 
    be a bike that is comfortable to ride. I could give you a bunch of questions 
    to answer that might get you close, but I have another suggestion that is 
    almost guaranteed to get you the right size bike. Go to a shop and try bikes. 
    Have the shop employee adjust the bike for you and really test it by riding 
    hard, taking some corners, riding it up a hill and down. Keep trying different 
    bikes until you find one you love. This method guarantees you'll end up with 
    a bike you love. Insulin pump therapyI am a 60-year-old cyclist, having been so for 46 years. I raced up to the 
  age of 40, with a little success – a handful of wins and completion of an 8-day 
  stage race as the highlights. At 40 I was diagnosed with type 1 diabetes, and 
  by 50 was suffering from atrial fibrillation, a form of arrhythmia. This curtailed 
  my cycling to 20-mile rides, generally about 90 minutes exercise. In 2002 I 
  started to use an insulin pump to improve my blood sugar control, and removed 
  the pump whilst cycling. In 2006, I had an ablation procedure which cured my 
  fibrillation, and since then with the absence of beta blockers and warfarin, 
  I have improved my ability on the bike, moving up to 3-hour + rides – approx 
  50 miles. The downside of my increased endurance is that I finish these rides with high 
  blood sugars, in excess of 15mml/l. I am currently combating this by keeping 
  the pump running on a reduced basal dose (50% of normal, though I can adjust 
  it to any fraction of the standard dose) and stopping every 30 minutes to take 
  a sugar-level reading. I react to each reading by applying more insulin, more 
  carbohydrate, or nothing, as the case may be. Although each stop is brief, I 
  don’t really like stopping at all, and would like some advice from people who 
  have already solved this problem, either for themselves or for others, to help 
  me establish the most effective pump regime for my longer rides.  John RichardsLouth, UK
 Carrie Cheadle replies: 
  You need to come to camp! Check out the Stroke-Spin-Stride camp. It was designed 
    just for you! The director has pulled together some of the top coaches, nutritionists, 
    and med staff in the country to come together and produce an integrated camp 
    to address how to manage diabetes and exercise for optimal performance. The camp was also featured in Newsweek this 
    week. If you contact them through the website 
    they may be able to answer your questions more in depth regarding how to regulate 
    blood sugars during a ride. Leg lengthMy left leg has been measured by an experienced bike fitter at 3mm shorter 
  than my right leg. My saddle is set up for full extension of my left leg (short 
  leg). However, my saddle feels low. If I raise my saddle 2mm more that puts 
  too much of a strain on my left hamstring. What would be your recommendation 
  for a shim thickness if any and corresponding saddle height change. Frank DePasquale David Fleckenstein replies: 
  Before recommending any shim changes, I have two issues of concern. I would 
    very seriously question the ability of anyone to consistently measure a 3 
    mm difference in leg length - research shows us that these measurements have 
    poor validity and the only true way to measure leg length is with long leg 
    x-rays. Secondly, I would question whether you have a true leg length difference 
    or a functional difference due to pelvic rotation/shear and would recommend 
    having this evaluated by a PT or chiro. The concern with shimming to make 
    up the functional difference is that rather than addressing the root cause, 
    you are potentially making the original problem worse. I have found frequently 
    that by normalizing length of the hamstrings, hip flexors and hip external 
    rotation musculature rather pronounced leg length differences suddenly are 
    minimal or eliminated. Bike fit & cleat placementThank you for the detailed response 
  last week. I just bought a set of Specialized Body Geometry shims and plan to 
  start experimenting, given your suggestions. However, before I do I wanted to 
  provide some additional information that occurred to me that might help you 
  in your diagnosis. First off, I mentioned previously that I currently wear a Specialized BG Pro 
  Carbon shoe, which has built in to the sole 1.5mm of varus angulation. Might 
  I need more? Secondly, in years past when I used to run (before an ACL tear and reconstruction 
  ended that—on my good side by the way) I noticed that on my left foot, the one 
  in question, I was an inside “heel striker,” whereas on my right foot I was 
  a more typical outside heel striker. Is this an indication of valgus angulation 
  on the left and varus on the right—or is the running motion unrelated to cycling? Before getting my Specialized shoes last year, I wore Shimano. I still wrestled 
  with the same issue back then, but as mentioned earlier it seems more pronounced 
  now. Maybe it is just mental, but then I thought, “what if the varus angulation 
  of the shoe is exacerbating the condition because my foot is really valgus”? One last thing: I am very flexible now. I stretch aggressively almost daily. Further, I have 
  been a serious weight trainer for 25 years. I have very good core strength; 
  however, I do know that my dominant right side stabilizers are notably stronger. Before I start experimenting, can you offer any more insight in light of the 
  additional information above? Jim MartinTroy,MI, USA
 Steve Hogg replies:  
  I can give you a general picture but I can't diagnose what I can't see. I 
    can make educated guesses as I do all the time but that isn't the same thing.Regarding 
    whether you need further varus compensation - I don't know. Perhaps, perhaps 
    not. That's why I suggested you visit a podiatrist or someone knowledgeable 
    regarding feet and gait and find out what the situation is with regard to 
    forefoot varus or valgus. Once you have done that you will have information, 
    fact rather than guess work, that will allow me to advise you further based 
    on hard information. Interesting what you say about the difference in heel strike for each side. 
    Typically, this means that there is either a leg length discrepancy (another 
    box to tick) or a functional leg length difference caused by a lateral pelvic 
    tilt. It can mean other things too, but they are the most likely. What it 
    means too is that your gait isn't symmetrical. Gait plays a part in determining 
    how we function neurally. If you gait is noticeably asymmetric, this will 
    lead to functional asymmetries and in the end the motor control functions 
    of your brain will be asymmetric as well. Re the Specialized shoes seeming to make the condition worse. Yes, it may 
    be that you have a valgus right forefoot. If that is the case, any shoe with 
    varus compensation would make it worse. I can't stress enough that in an effort 
    to solve your problem quickly, you need to be armed with information. It would 
    be better to see a podiatrist or physiotherapist interested in feet so that 
    you can find out what the story is with regard to your feet. This is infinitely 
    better than trial and error until you eventually eliminate possibilities and 
    stumble over the correct solution. If you don't want to do that, try building up the outside edge of your shoe 
    insole on your right side. If that improves things on left side, then it is 
    likely that you have a right side valgus forefoot. If it makes the situation 
    worse, or you get pain in the right hip or right knee after doing this, it 
    is likely that you don't have a valgus right forefoot. The only thing that 
    I can be nearly 100% certain of is that you function asymetrically with a 
    tendency to favour the right side. This is the underlying general picture 
    of the problem you have. What you need is more detailed information so that 
    you know your own state of play and can make decisions based on what you find. It is good that you are flexible and have good core strength. Both qualities 
    will help minimise the effects of the asymmetric way you function in terms 
    of pain or discomfort. Other Cyclingnews Form & Fitness articles |  |