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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. 
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  Fitness questions and answers for September 25, 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. |  Knee pain after a vasectomyChanges in max heart rate
 Leg concentration relative to seat position
 Seat tilt
 T-12 fusion back surgery
 Frame size
 Back to riding late in the season
 Knee injuries
 
 Knee pain after a vasectomySubject line may sound a bit funny but I am going through a torrid time!!! I had the snip two years ago and ever since have had testicular pain after 
  a ride (it never fully clears before my next ride), I just assumed that discomfort 
  was going to be something I had to learn to live with. I never play around with the position on my bike, and have had my current set 
  up, shoes, pedals for eighteen months and I have never crashed so my cranks 
  are not bent or anything like that. The reason I write is that in desperation to “fix my boys” I turned my stem 
  over, which raised my handle bars by approx 20mm, guess what it has stopped 
  totally the discomfort I was getting in the boys. However I have since started to get really bad pain behind my left knee, I 
  have not experienced knee pain for over 7 years on my bike and then it was in 
  the front of my left knee and required surgery to fix it (a lateral release 
  I seem to remember it was called). I am at a loss to explain why this change would have had such a dramatic and 
  immediate effect on me – can you help? KevinAustralia
 Steve Hogg replies: 
  I too have had the snip and don't suffer any testicular pain on a bike. Nor 
    do any of the post vasectomy riders that I know so it is unlikely that this 
    is "something I had to learn to live with". I note too, that the position you have on your bike dates from 6 months after 
    the vasectomy "I never play around with the position on my bike, and have 
    had my current set up, shoes, pedals for eighteen months." All of which makes me think that your problems are caused more by the position 
    you have on your bike than your having had a vasectomy. By far the most likely 
    cause of your left knee pain is that you are overextending the left leg. Why 
    has this happened since you raised your bars? I don't know for certain but all of us protect or favour one side of the 
    body when riding a bike. Approximately 95% of riders favour and protect the 
    right side and sacrifice the left side to varying degrees in the process. 
    When you raised your bars, something or other changed in the way your pelvis 
    functions on the bike and now you are favouring your right side, probably 
    by dropping the right hip and asking the left leg to reach further as a consequence. Drop your seat 5mm for starters and see whether that is an improvement. If 
    it is but doesn't totally relieve the problem, drop your seat another few 
    mm. You say too that raising the bars has relieved the incidence of testicular 
    pain. Raising your bars means that your torso and pelvis will be more upright. 
    That means that your problem before was caused by bars that were too low, 
    a seat that was too high or a combination of both. Changes in max heart rateI am 21 year old female who has been riding for 8 years now, my max heart rate 
  over the last 4 years decreased from 196 to 193bpm (last November), however 
  over last few months I’m lucky if I see my heart rate reach 180 bpm. I have 
  experienced varying levels of fatigue over this time. Prior to when this started 
  I spent 3 months (November to January) training more seriously reaching up to 
  500km per week and doing some hard racing at which point my period also stopped 
  (due to a low calorie intake at the time) for six months. I have now been menstruating 
  regularly for 4 months however my energy levels have not returned to normal, 
  my concentration at times is poor and I am usually unable to ride more then 
  250km per week without a struggle, normally riding 150-200km/wk, apart from 
  the occasional week where I can ride up to 300 km no problem (still with max 
  heart rate of 180). At the end of January I took two weeks completely off my 
  bike and I have just started riding again after another two week break. My iron 
  levels are on the lower side of normal for me but not serious, my calorie intake 
  is now sufficient also, having increased from 56kg when my period stopped to 
  62kg (at 174cm tall). What I’m asking is, is it possible that my decrease in 
  energy levels and decreased max heart rate are due to my body still recovering 
  from when my calorie intake was low? Olivia W. Scott Safier replies: 
  Your initial decrease of maximum heart rate by three beats as you began to 
    train seriously was 100% normal. The further decrease by 13 more beats was 
    unusually large (typical total decrease is more like 6-10 beats). Yes, it 
    is possible that you are still suffering the after effects of your time spent 
    with inadequate calorie intake. However it would not be a case of you did 
    something bad so you are now being punished by God. It would be more like 
    you didn't eat enough and now the physiological effects are with you. You 
    probably lost muscle mass and you may well still have hormone levels quite 
    different than before you starved. If you simply eat normally and exercise 
    the amount that your body can currently handle without fatigue, you'll probably 
    recover over six more months or so. If you are concerned though, I'd suggest 
    a visit to an athlete-friendly doctor to get sent to the laboratory for an 
    extensive panel of blood tests for the hormones that might affect energy levels. Leg concentration relative to seat positionI wanted to find out the correlation of seat position, to muscles being worked 
  in the legs. Assume that the seat is dead center, and this is the "proper" set 
  up (knees over pedals etc..). If the seat is moved forward, does this begin 
  to emphasize the quadriceps and diminish the effect of the hamstring? Or is 
  it the opposite? If the seat were moved backward, would the effects reverse? 
 Michel van MBuford USA
 Steve Hogg replies: 
  Generally, as the seat moves forward the quadriceps do more work and as the 
    seat moves backwards the hamstrings are more heavily loaded. I say, generally, 
    because pelvic angle and seat height play a part in just where effects are 
    felt as the seat is moved forward and backward. Seat tiltI have recently sustained a back injury and am wondering about seat position; 
  specifically should the tip of the seat be; horizontal, slightly raised or slightly 
  lowered? Many older books say slightly raised but I believe this is so the rider 
  can adopt a time trial position if needed, what is the generally accepted rule 
  now or is there none? Robert Farquharson Steve Hogg replies: 
  SMP and Concor seats aside, (as both have a kicked up 'back rest') most people 
    will be happiest with their seat noses somewhere between 2 degrees above or 
    below vertical. Most riders who feel comfortable outside that range have problems 
    with other positional parameters of their bike whether they realise it or 
    not. T-12 fusion back surgeryI am a 43 year old CAT 3 racer from Virginia Beach Virginia who was recently 
  hit from behind by a drunk driver while on an early 6:30 AM training ride. It 
  was found that I had a fractured t-12 vertebrae with torn ligament damage which 
  required fusion surgery. I now have 6 screws and 2 rods in my back. I am a little 
  bit worried about getting back on my bike and returning to my original aggressive 
  bike position that I am used to. I begin Physical therapy this week and am a 
  little worried about a full recovery. Any suggestions or testimonials that could 
  help my optimistic outlook on the recovery process. Rick Steve Hogg replies: 
  I have had several clients who have had similar surgery. The best general 
    advice is work on your posture and core strength like it is the most important 
    thing in your life, because it is. When you get back on the bike, raise your bars initially and experiment sensibly 
    to find out what you can and can't cope with. If you are sensible, you will 
    be fine. What you need to avoid is unnecessary flexion in the damaged area. Scott Safier replies: 
  I don't have specific experience with the particular injury or fix that you've 
    experienced, but I have seen riders race successfully after a wide variety 
    of hip, knee, back and shoulder surgeries. The keys are to do your rehab therapy 
    and to keep after the doctors and yourself to continue the process until you 
    have the mobility you need. The danger is that discouragement early on makes 
    you less aggressive about demanding support for adequate recovery and pushing 
    yourself to follow through on your part. Frame sizeI am a 24 year-old male cyclist who recently got back into cycling. I put on 
  about 2,500 miles a year with the occasional race and hill climb events. My 
  question is about frame size... what frame size should I ride?  I am 5' 8" with a 76.5cm inseam, and have a 10.5 shoe size. My local bike shop 
  fitted me for a 52cm frame and said it was because I have a larger than average 
  shoe size for my height. I was just wondering if I should be on the 52cm or 
  a 50cm frame because I read an article that said your frame size should be equal 
  to 65% of your inseam, which would be the 50cm. I was just wondering what your 
  take on it was and if there are any physical implications to riding the wrong 
  frame size in regards to this? Chase Steve Hogg replies: 
  Chase, it is not possible to answer your question regarding frame size because: 1. Manufacturers have different methods of measuring the seat tube length 
    of frames meaning that the same nominal size across several brands may be 
    substantially different. Additionally frame size is determined by seat tube 
    length which is not that important except for reasons of stand over clearance. 
    Top tube length, head tube length and seat tube angle have more importance 
    than seat tube length. 2. You are making the assumption that seat tube length is a function of inseam 
    length plus foot length. Their is only a vague relationship in my view. 3. The frame size equals 65% of inseam 'rule' is not particulary accurate. What are the implications between the 2 sizes, 50cm and 52cm? I don't know what frame you are referring to but typically, there will be 
    approximately 20mm difference in head tube length and probably 10mm difference 
    in top tube length between the two sizes with the larger frame being longer 
    and having a higher front end. There may be negligible difference in seat 
    tube angle. Assuming that you pedal with an 'average' technique, your larger than average 
    foot length will allow you to sit higher than you would be able to with a 
    shorter foot. This may mean a longer head tube is necessary to lift your bars 
    because of the higher seat; or perhaps just more head set spacers are necessary 
    on the smaller frame. Whether you are able to reach further (longer top tube 
    on larger frame), only you can decide. Test ride both and make a decision 
    based on which feels best. Back to riding late in the seasonFor unexpected reasons I had to get off the bike for 3 months. I'm a Cat 4 
  and intend to get back to racing next year. I see there is no point in really 
  doing any kind of training since I have nothing to train for. Should I just 
  get the miles in till winter training starts? Should I just go ahead and start 
  Winter training? Thanks for any insite you can give.  Scott Safier replies: Assuming you are completely over or past whatever forced you off the bike, 
  this would be an ideal time to start your build up of training towards the 2008 
  season. A longer, more gradual buildup makes for an increased chance of getting 
  through the winter healthy and uninjured and means that if you miss a day here 
  or there you'll still be getting plenty or riding in all. 
 Knee injuriesHi, I have a question about a knee injury. Every time I ride my bike I get 
  a large swelling of fluid behind my left knee. It makes it very difficult to 
  squat and the fluid causes pain by pushing on the hamstring, calf muscle and 
  sometimes the vein through the knee. The fluid does not go away on its own. 
  I have tried having the fluid sucked out but it came back the next time I rode 
  (about 6-8 weeks later). Unfortunately they didn't bother to analyse the fluid. 
  I'd tried standard physio with no benefit previously. This time I've had low 
  level laser treatment and the swelling disappeared within two weeks but I'm 
  scared to get back on the bike! It is worse from riding on the flat than when climbing/descending, I think 
  because I spend more time standing up when climbing. The other thing is it doesn't 
  swell when I do anything else - I ran a half marathon last weekend without an 
  issue - no pain, no swelling. I'm short (165cm) and ride a road bike, used to race but haven't since I first 
  did the knee about 24 months ago. I've had my position on the bike looked at 
  and been told that if anything my seat could be a fraction too high (but they 
  thought this would be more help than problem for the knee). Is it possible that when cycling I am pinching something causing the fluid 
  to build up? It was suggested the fluid is lymph fluid and I've pinched a duct 
  somewhere. Is this possible, and how do I find it and fix it? I would like to 
  ride my bike again! Any ideas welcome as the surgeon is telling me to have a knee operation. I 
  don't see the point when he doesn't know what's wrong and there are no structural 
  problems - both knees look the same by MRI, and it's not really a knee problem 
  - the fluid just accumulates there! Thanks JennyMelbourne, Australia
 David Fleckenstein replies: The fluid in the back of your leg is the end result of an inflammatory process. 
  Simply having the fluid removed or having a laser treatment (which is a questionable 
  therapy at best) does not address the actual source of inflammation. I would 
  be very suspicious of a meniscal or joint surface injury to generate the frequent 
  and consistent posterior swelling that you describe. Rarely, we also see rheumatologic 
  conditions that will generate similar symptoms.  My advice would be to seek out a sports based orthopedic physician and have 
    a diagnostic study (x-ray/MRI) to determine the cause of the swelling so that 
    you are treating the source of the pain rather than placing a band-aid on 
    the symptoms. I see that you already have had the MRI, when was that study 
    performed? Not all joint lesions are apparent on an MRI, and I remain very 
    suspicious that something is being overlooked. 
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