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Mont Ventoux
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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.

The Cyclingnews form & fitness panel

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.

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.

Fitness questions and answers for September 25, 2007

Knee pain after a vasectomy
Changes 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 vasectomy

Subject 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?

Kevin
Australia

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 rate

I 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 position

I 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 M
Buford 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 tilt

I 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 surgery

I 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 size

I 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 season

For 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 injuries

Hi, 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

Jenny
Melbourne, 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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