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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 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. |
Collar bone: to plate or not to plate
Scaphoid fracture
Shingles
Handling inflammation
Motor pacing
Heart rate max
Improving flat speed ability
Epstein-Barr Virus
Collar bone: to plate or not to plate
I am an elite level road cyclist from the UK, racing full time in France, I am 23 years old and male. I am currently back at home because of a broken collarbone from a crash whilst racing. It has been 9 days and I have changed from being unable to move my arm at all to an almost full range of movement (albeit very slow cautious movement). 3 days after the crash I was on my turbo trainer (would have been sooner had I not been travelling home etc.), after 4 days I could ride on the drops/hoods/tops/standing up, supporting my weight normally and the other day I even rode on the road on my town bike for a few miles (quite painful, though). I have just returned from the fracture clinic this morning, I was told it would take 12 weeks to fully heal. Is this really true?
I was also told I could reduce my recovery time by having a plate attached to the collarbone. This would undo do all my recovery up until now but reduce the recovery time from 12 to 6-8 weeks. Previous broken collarbone questions to Q&A have been given the reply 6 weeks until riding again. What should I do? I need to be racing again as soon as possible. Is unnecessary surgery worth the risk? My instinct is to say no, it isn't. Also, we must bear in mind the fantastic, free National Health Service we have in the UK, lucky as we are to have it, it does get a little fully booked so there could be a waiting period eliminating any shortening of the recovery period anyway and I've already 'lost' 9 days.
Please find attached a picture of my x-ray taken immediately after the crash, its broken into 'two and a half pieces' as one bit of bone hasn't quite detached itself. They look fairly aligned but from the big lump I have I suspect one bone is quite a bit further in front of the other.
I need to be racing again as soon as possible; any advice to hasten my recovery from a cycling perspective would be much appreciated. As my team is based in Nice with lots of mountainous racing and not a lot of sprinting I figure I can still be competitive without having to do arm wrenching sprints. We also seem to do a lot of TTs from which I think I will be ready to do even sooner.
Also, should I still be wearing my figure of eight brace? I removed it after 4 days as it was uncomfortable (and impossible to breath with whilst on the turbo trainer) but initially reduced the pain as it reduced movement. I'm willing to go through some discomfort to decrease recovery time if necessary.
David Mclean
Kelby Bethards replies:
I've looked at your x-ray. In looking at it, it appears to be a fracture that should heal on its own. Now, that is not your question. Would surgery benefit you? Hard to say. A few reasons. First of all, as you have mentioned, it may not be a full 12 weeks for you to recover. I have seen these heal much quicker and some don't. However, it is not surgery that would be considered emergent.
If you had the facilities immediately available and could have had it repaired right away, then possibly, it could heal quicker. By the time you would have your surgery, it may be weeks, 3 or 4 after your accident, it sounds like. I don't think that would be beneficial, at that point, because you have to do all the post operative recovery and resume healing and essentially start over.
What I would recommend, as best I can, is to go see a Physician and get a repeat radiograph. The physician should be able to evaluated healing, bone callus and give you a better estimate of time for healing. As you have noticed, by pain response and range of motion, it is healing appropriately.
I know this is a bit vague, but every case is different, and another visit would help you evaluate your progress.
Scaphoid fracture
Two weeks ago I was involved in a crash which left me with slight swelling on my palm between the thumb and index finger, and a small amount of wrist pain. A back slab was immediately fitted and subsequent MRI revealed a non-displaced scaphoid fracture across the distal pole. The wrist was immobilised in a short thumb spica fibreglass cast within 3 days of the fracture occurrence. I am attempting to maintain aerobic fitness by using the trainer/spin bike and strength by core and leg training at the gym.
I understand scaphoid fractures are not uncommon in our sport and yet I hear of professional riders resuming training within 2 weeks of similar, or more severe, scaphoid fractures. Unfortunately it is difficult to find a specialist who can empathise with our desire to resume training (and in my case also work) as soon as possible. Given the present 6 week immobilisation prognosis, I would be grateful if you could suggest other treatment options that may be available which may accelerate the treatment of this type of fracture, or, at the very least allow training back on the road.
Pete Fleming
Kelby Bethards replies:
I have seen many of these fractures. From ski accidents and also bike crashes. This bone is a bugger to heal. It has, as has been mentioned, a poor blood supply. The fact it is on the distal pole should (read - we hope so) be easier to heal than the proximal version since the blood supply tends to enter the bone from the distal end. As far as quicker way to heal - there isn't any quick and easy way for these to heal.
I will back Jon up on his response. LET THIS HEAL correctly. It doesn't always end in surgery, however, if the healing process is disrupted, especially since the blood supply is not the best, you will be out of commission much longer than you would like to be, albeit already longer than you'd wish.
Shingles
I'm a 41 year old cat 2 with no significant health problems. However, I developed shingles just a few days ago (following a minor crash and a stressful week at work). I'm being treated with prednisone, acyclovir and Lortab, and was told to get lots of rest. But I'm unsure of how much rest I should take. I am feeling reasonably good. Can I ride? How hard or long can I ride? How long before I could race or train with intensity? Do I put myself at risk for post-herpetic neuralgia or other complications by not resting adequately?
Hope you can answer this one - I've searched the internet but found almost nothing on this topic.
John Stadick
Kelby Bethards replies:
I would say, in an ambiguous tone, ride as much as you feel ok to ride. Shingles can zap the strength right out of people. There is not a steadfast rule "Get back on your bike 1 week after the rash heals", but you can use your overall feeling as a guide. Don't be surprised if you ride 10 miles and feel wiped out. If you start out feeling really tired, then you are. Rest.
Make your return to full effort gradual. You do NOT want post-herpetic neuralgia if it is avoidable just because the pain can linger for months. The current treatment is adequate, but you do want to heal completely. Clear as dirt mixed with water I'm sure.
Bottom line is that you can continue to ride. But be cautious and don't get over zealous. You don't want to prolong your healing.
I will caution you that, Prednisone, a steroid, while a potent anti inflammatory is also a bit of an activator. People feel good on the medicine. In your case, be careful not to over do your rides, because the Prednisone will make you seem better than you are.
Handling inflammation
I'm a 57 year old cyclist and am interested in your current thoughts on handling inflammation / micro trauma / post ride pain. I am 5'10", 180#, 13% body fat. I finished a 21 mile rolling hill time trail last weekend in 53 minutes [the top time was 39'50", I was 42nd out of about 128 riders]. My interests are relative fast centuries, an occasional MTB race, and multi-sport events [events that mix skiing, running, cycling, paddling, mountain biking]
I've found in the past two seasons that balancing training with post inflammation a struggle, with sleep being interrupted by comfort and rising to pop a couple of acetaminophen or ibuprofen. I am now struggling to alternate hard sessions with even more rest, my cardio recovery rate/basal temperature does not indicate overtraining but it appears my muscle and joint "fitness" does.
Larry
Scott Saifer replies:
Every once in a while I get a question like this: riders who have soreness or stiffness after hard rides, and I scratch my head. I really rarely get that question from my own clients and never had that experience myself. Maybe the other panellists will jump in with their own experiences and ideas, but my guess is that you don't have the endurance or possibly strength base to handle the hard efforts that you are making. You are right to ascribe the muscle pain to micro-trauma, but the question is why you would have that micro-trauma enough that you are aware of it while many other riders don't. It sounds like you are not adequately conditioned to the work you are trying to do, and the two forms of conditioning one can do for cycling are base riding, and high-force training (either on-bike, low cadence work or gym work).
If you've not done several months of lower intensity riding and strength training of some sort before trying to race or ride hard, take a short break and then get yourself on a nice annual periodised training plan. If you have been training with base and strength work, write back to describe it in a bit more detail so we can assess the adequacy of what you've done. If it's not deficient, then we'll have to further investigate to find out why the work you have done is not protecting you from the effects you have been feeling.
Motor pacing
Hi, just need some input about my current training. I am a 43 year old male, racing category 3. I moved down from the 2's because of training constraints.
This year due to another child born and the usual work, my time on the bike is limited. I have worked out with my wife that if she motor-paces me, then she gets all the massages she wants.
Twice a week we go with family and dog in the small car and she paces me for an hour on a flat 4 mile loop. This usually equates to five or six laps (20+ mph).
We go 25-35mph depending on the section. I stay just on the edge of the bumper right or left to get some wind and see ahead. I am so much faster because of this training and have a huge kick on the last laps in the crits(I do two or more races depending on time) but would like to have a bit more to stick an attack, two or three times during the crit / rr. Also I would like some bridging power as well. If you have some workout ideas that I could incorporate into my training I would appreciate it.
Dan W
Scott Saifer replies:
How about a few times during your hour, your wife honks the horn and you pass the car? That would be good practice for attacking or bridging.
Heart rate max
I am a 44 year old male, used to ride a lot and lately have no time. I have just started my (late) spring training with my new Polar Heart rate monitor (first time training with a monitor). I was doing some light spinning on the flat and noticed that my heart rate was relatively constant at around 174 but often exceeding 180 (max was 184 that I am aware of). I am not terribly fit at the moment and my resting heart rate is at 60 (it used to be 42 in the old days) and I hover around 100 when getting ready to leave (walking around the house figuring out where my wife put all my cycling gear).
I did not feel that I was pushing very hard and was certainly not fatigued at the end of the ride and had no muscle pain the next day. My theoretical maximum should be 210-44/2=188 so I was approaching this without any real effort. Should I be worried? Is there a problem training near the theoretical maximal rate? I guess my body will let me know rather quickly if I am exceeding the aerobic threshold especially in its current condition... Am I risking a coronary?
Scott Saifer replies:
I've answered this question several times, so you can dig through the archives for a more detailed answer, but here's the short one. The 210-age/2 formula predicts the population average for a given age, and about 96% of riders are within 15 beats higher or lower than the average, so don't waste your time with that calculation or worry about training close to that level.
A resting heart rate of 60 is still pretty healthy though not super-fit. A walking around heart rate of 100 is quite high unless you are very anxious about getting ready to ride. Chances are very good that your heart is healthy and you are just out of shape, but I still suggest you follow the advice found everywhere these days, "check with your physician before starting this or any program of vigorous exercise." Assuming you get physicians clearance, do a few weeks of riding below your ventilatory threshold and then do your own maximum heart rate test to determine your own training zones.
Improving flat speed ability
I wonder if you can help me with this. I seem to have a weakness riding on flat terrain. I find another rider who is 28lbs lighter than me can give me a hard time on the flat especially into the wind whereas I can give him a hard time up the hills even though I am 2st's heavier.
Of course this does not make sense as, if you can ride faster than another rider up the hills whatever the length then it makes sense you should have a greater advantage on the flat if you are heavier. What do you think I am doing wrong - is it possibly biomechanics at higher cadences?
How can I improve my riding speed on the flat say within a group breakaway or for e.g. a 10-25m ITT?
I am 12st 7lbs, 5ft 11" tall and very slim build. I have a best 10 of 22:30 and best 25 of 58:14 and have never been on the podium in a RR and desperately wish to improve my abilities on the flat and undulating terrain. I was thinking of doing short hard power intervals on flat terrain into the wind @ around 90-95% of max HR or around 4km pursuit pace and around 90-100rpm what do you think?
Alan Bullock
Scott Saifer replies:
Since you are pretty good on the hills but not on the flat, my suspicions would be that either your flat-riding position has lousy aerodynamics or that it is somehow keeping you from making the same power you can make in the hills. Do either of those seem possible?
Epstein-Barr Virus
Still looking for your section on EBV.
The Type 1 pro team rider, Glen Chadwick, has joined the list of EBV victims which includes Michael Rogers, and at least one Aussie women too.
What was his 'cure' and when will he be fit enough to return to the peloton?
EBV Bob
Kelby Bethards replies:
So, you are requesting an explanation of EBV.....I wish I had a good one. EBV is a bugger. So, let's start with EBV. Epstein-Barr Virus. This is a virus in the Herpes Virus clan (I know I know, viruses aren't classified in "clans" but I like it that way.) It is the virus which causes Mono (i.e. Infectious Mononucleosis - the kissing disease). Infectious Mononucleosis can be EBV negative but that is another story.
Now, although adults can get EBV mono, it is more common in kids and teens. It is relatively hard to spread, thus the close contact reference, the "kissing disease". The condition starts off as pharyngitis, swollen glands and a fever. This can progress to a swollen spleen (splenomegaly) and a swollen liver (hepatomegaly). This was, in the olden days, referred to as glandular fever. A key problem with the illness is also fatigue. It makes people very, very tired, as you know.
The most common age to develop symptoms is 15-24. Kids, for whatever reason, don't develop symptoms as frequently. And adults, usually, have been exposed and made antibodies to the virus and thus don't get the illness to frequently either.
What's the deal with it you say? That is the 43 dollar question. MOST people resolve the symptoms of illness in 1 month. That being said, 13% of patients in one study had fatigue for more than 6 months. But, that is in the general population.....not the elite athlete population. Right now, it's all the rage to try to connect EBV to Chronic Fatigue Syndrome.....that is yet to be completely linked.
Now, like I wrote, if you have a "normal" person, which in America, is a couch potato not using there body to 100% efforts frequently, he/she may not notice the degradation in conditioning or performance, or they may just feel a little tired. AN ELITE athlete, however, needs every percentage of physiologic reserve to perform. You can't race a car with the timing on the engine a fraction of a millisecond off. So, if there are any sequelae (ongoing consequences) of the illness in a cyclist, it makes it very difficult to perform at an extreme level.
If you take a cyclist in the middle of training or competing and knock them out for a minimum of weeks if not months, then that is a big deal. It is not only lost training time and competing it is a negative factor, in terms of lost fitness. It's not as though they are just not training or riding. They are ill. It's frustrating for cyclists, because they only feel tired after the acute phase. But the fatique is part of the illness and can persist.
Treatment: None. Well, ok, rest. I have a feeling most cyclist are compulsive, as are most athletes, about training and don't rest completely. Which causes frustration, possibly delay to form and so on. They have tried a course of steroids (Prednisone) with an antiviral medicine for Herpes (Acyclovir). While this helps the acute pharyngitis and the shedding of the virus, it did not show any difference in terms of return to work or feeling less tired. In some cases, the consequences of the steroid use was negative and so it's not generally recommended.
The prognosis, generally, after resolution of the symptoms is good. It just takes a while. Which, when you make a living riding, is not good.
Kendra Wenzel replies:
I've been waiting for one of the doctors to chime in first to give information about EBV and Mono and then I'd like to add from a coach's perspective as someone who has coached and consulted with a number of athletes who have suffered through the experience as well as gone through it in the worst way myself. My own experience is a prime example of how NOT treat EBV.
When I first started to have a downturn in my performance while I trained for the track nationals and the Pan Am Games, my coach at the time figured I just needed a few hard days on the track, so I trained as hard as usual even though I felt wasted. Meanwhile, my appetite was down, I tossed and turned at night, and yet I felt like napping all day. Flu-like symptoms came and went and low iron was deemed the culprit for my woes at the time. It was selections time and an important time of year for me and I couldn't "afford" to take time off.
Besides, I didn't seem truly sick any longer with sore throat, congestion, or other symptoms, so I kept on training. I trained consistently through the winter after a short end-of-season break, but I knew deep down that that damper was still there. Anyone who's ever had EBV knows the feeling: it's like your competitors are sports cars going over the top of the hill and you are stuck in a U-haul truck. I attempted to train for more than a year from my initial downturn and flu-like symptoms. After dropping out of the Tour d'Toona completely demoralized, I was finally diagnosed with chronic EBV. By this time I had ridden myself into a monumental hole.
I read every book I could find on EBV, Chronic Fatigue and Mono and was unable to relate to a lot of it because just walking around, I felt just fine. Kelby Bethards nailed the situation just right: had I not been an elite athlete, I would have probably never even known I was still sick because I only felt the drag at the very top end of my game. In competition, you hit a glass ceiling whenever the pace kicks into overdrive. You rest a few days, and still you don't feel better in the weekend's race or group ride. In desperation, I read up on every suggested "cure" - everything from vitamins and herbs to drinking one's own urine (I didn't try it, but I was desperate enough that I considered it)!
When it comes to recovering from EBV or any Mono-like illness, total rest is key. Nothing that raises your heart rate above a walking pace should be permitted. It's this simple: the athletes who take the full time off the bike and really rest, eventually recover and are able to train at full levels within a couple of months. The ones that rush the process end up struggling sometimes for several months to several years. If you've contracted EBV, fully expect to take at least a month off from training and exercise. Expect the whole return to normal training to take nearly three months. Coming back can be deceiving because you'll feel fine on endurance rides and feel ready to rush the step up to intervals and racing again and then find out that you aren't really ready. Depending on how long you struggle with comebacks, you may find that from then on you aren't able to train in the same way as before, requiring more rest days than you did pre-illness. It's not that you aren't able to train hard once you are recovered; it's just that you need more recovery in order to do so.
Coming back could mean walks at first, then cruises on the bike path, then an hour, two hours and eventually building to intensity again - not just jumping back into 3 hours rides a month after first diagnosis. If I sound alarmist, it's because I've seen so many athletes go through it the hard way. In my own case, it took a full six months off the bike before I was ready to begin training again. While it may seem at the time like you can't afford to take the time off, the real situation could be that you can't afford to keep training through the illness.
Patience in returning to training after an extended break also tends to put training and competing into better perspective. All performance contributions don't have to end just because time is spent off the bike. In fact, time off is a good time to focus on optimizing nutrition, working on the mental game, and focusing on relationships and financial security. The good news is that if you treat EBV correctly, you will recover. Keep a positive attitude, because even though it may seem like all is lost while you're it, great days on the bike are still to come. In my case, the best years of my career came after my EBV, and that has been the same for many of my athletes. In fact, I'd say that having EBV helped me and some of the athletes I've coaches prioritize and focus their training more effectively for the future.
