Form & Fitness Q & A

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Fitness questions and answers for February 5, 2003

Patella-femoral syndrome
Separating proteins
Intensity vs endurance
Power output and Calorie conversion
Up two grades in a year

Patella-femoral syndrome

I am a 41 year old male cyclist mainly involved in road racing. Over the last 5 months I have experienced a niggling pain emanating from the top front of my patella, usually whilst making out of the saddle efforts, but also when descending stairs and car driving. My physiotherapist diagnosed patella-femoral syndrome and advised a regime of patellar stretching and strapping before getting on the bike.

More recently the problem appears to have slightly worsened and I now feel a little pain even when pedaling medium gears in the saddle. The pain is not severe and there's no swelling, but it is limiting my training. The physio has suggested that I continue stretching and strapping but also that I should take a complete rest from the bike for a few weeks to speed up the recovery process. He also proposed that a slight increase in saddle height may help.

I believe that this is quite a common condition so any advice, thoughts or information you can provide would be gratefully appreciated. I'm hoping to make my annual trip (pilgrimage!) to the Tour of Flanders cyclosportive at the start of April so training time is getting a little short!

Liam
Ireland

Kim Morrow replies:

I'm sorry to hear about your knee pain and the down time that it is causing related to your training. Your physiotherapist offered some great advice to you. No advice I could give you should replace the advice of a health care professional who has addressed your problem in person.

However, I will offer a few comments:

1) I have found that knee pain rarely gets better for most cyclists by attempting to "train through the pain", even if the pain is mild pain. As tough as it is for all of us to hear, REST is a crucial component in the recovery process. You may consider rating your knee pain on a scale of #1-10 and chart your progress that way. I would suggest resting as long as needed until your pain has subsided. You may test your progress with light spins on the trainer periodically. By testing your knee indoors several times (before venturing outdoors),you may prevent the occurrence of being stuck out on the road 20 miles from home with an aching knee! Do your best to carefully protect your knees during this winter season if you are riding outside.

2) Try to address the root cause of your knee problem. Ask your physiotherapist if your pain may be attributed to any anatomical abnormalities or possibly a strength/flexibility deficit. For example, a strength deficit, or muscular imbalance, may be a strong vastus lateralis (outer quadricep muscle) and a weak vastus medialis (inner quadricep muscle). A flexibility deficit may be tight quadriceps and/or hamstrings.

3) In some cases, an athlete may be able to speed up the healing process by adding ice massage to the "rest" prescription.

4) Finally, if your particular knee pain is caused by a specific muscular imbalance or by a flexibility problem, I'd encourage you to ask your physiotherapist for a list of specific rehab exercises to help prevent this from becoming a chronic condition.

I've had my share of knee problems in the past so I can empathize with you. I hope you get well soon!

Erik Moen, Director, Health Services, Carmichael Training Systems replies

Anterior knee pain is a common bicycling injury. Many overuse injuries are a combination of training errors, improper bicycle fit, or musculo-skeletal "challenges".

My usual treatment of any overuse bicycling issue includes bicycle fit analysis relative to a person's flexibility and strength. Musculoskeletal influences of anterior knee pain could be poor lower extremity flexibility, asymmetrical muscle development (or lack there of), or apparent leg length differences. Bicycle fit irritants of anterior knee pain include saddle position anomalies (high, low, fore, aft), excessive reach to bars, and poor cleat alignment. Training errors will include lower pedaling revolutions per minute, asymmetrical pedaling style, and excessive quad emphasis in pedaling.

It has been said that elevating the saddle generally treats anterior knee pain. This is the general case for bilateral anterior knee pain. A case of asymmetrical knee pain may not always be remedied by this fix.

It sounds as if your knee pain is becoming more reactive, thus the advice from your physiotherapist for some relative rest is sound.

Usual treatment for patello-femoral pain related to bicycling includes relative rest, attention to bike-fit/posture, flexibility, strength-balance, pedaling skills and anti-inflammatory modalities (ice, electrical stimulation, etc.). Patellar strapping or taping is utilized if there is a true patellar-tracking issue. In general, patellar taping should lessen or alleviate your pain with its use. A gradual return to bicycling is made as the knee pain lessens. A good indicator for gradual return to bicycling is the ability to descend stairs without pain. While making a return to your normal pain free riding volumes, continue to stretch regularly, pay attention to proper pedaling, and ice immediately following your activity.

Separating proteins

I have read articles that claim the human body uptakes free form amino acids better and uses them more efficiently than those found in concentrated animal proteins. Furthermore, the fact that humans combine protein and starches/sugars "carbs" in the same meal makes it difficult for the body to absorb most of the protein sources in animal proteins because the body is busy trying to digest the carbs first.

It has been suggested by Daniel Reid to separate protein meals from "carb" meals, as they do not combine well to get through the digestive system efficiently and if eaten together, the protein uptake is sacrificed and most of it is sent to the intestines where it sits and most of does not get absorbed into the body for fuel. What is your opinion?

What is your opinion about getting supplemental protein in the form of whey powder/beans/soy as opposed to eating chicken and beef which is ridden with steroids or who knows what?

David Reed
Team Apache, Elmhurst, IL

Ric Stern replies:

Endurance athletes are advised to increase protein intake compared to others (e.g., sedentary people). For moderate to heavy endurance training (up to ~ 3 hours training per day) the recommendations are to eat ~1.2 to 1.8 grams of protein per kg of body mass, i.e., a 70kg rider would need 84 - 126 grams of protein per day. For extreme training/racing (e.g., Grand Tour) the recommendation would be to consume ~2.0 g per kg body mass or 140 grams per day for the 70 kg rider.

Although there is little data available, it's possibly thought that intakes >2.0 g/kg per day may have an adverse impact on health, e.g., increased calcium excretion, and possible kidney damage.

In most countries (e.g., USA, UK, Australia, etc.) people typically eat a surfeit of protein, even vegetarians shouldn't have a problem meeting the increased needs of the endurance athlete. Certain people might not consume enough protein, e.g., those on a severely restricted energy controlled diet, those on extreme faddy diets, etc.

Assuming that you are getting enough energy from your food and haven't restricted protein from your diet, you will almost certainly be consuming sufficient protein to meet your energy demands.

Considerable amounts of protein can be had from a variety of sources, not just animal sources, e.g., bread, pasta, rice, beans, etc.

There is no evidence to support us "separating" our foods, and very little evidence to suggest that we need to supplement our diet with protein.

Intensity vs endurance

I am a male vet racing cyclist, 40 . All my events are under 3 hours -mainly 1-2 hours.

My training time has become limited due to various commitments. I have between 7-9 hours a week to train mainly in my commuting. I am familiar with periodisation - effectively gradually increasing volume, duration and intensity with sufficent rest.

My question; why is high intensity ie HR over 6min TT average discouraged in base training? Surely small amounts of intense intervals are as easily recovered from and far more beneficial then less intense workouts. I find long rides quite tiring and not specific to my racing.

Andrew Gannon
Melbourne, Australia

Dave Palese replies:

I'll agree with you that the average rider has the ability throughout the year to recover from small amounts of intensity. I will however have to strongly disagree that higher intensity work carries greater benefits than less intense work.

Our sport is an aerobic one, regardless of how the effort might feel or heart rates you may see during competition. Thus, the majority of your training time during the base period should be aerobic training (endurance, tempo...). During this period you may also want to put some time into strength work, either on or off the bike, as well as efficiency training for your pedaling mechanics.

To me it is less an issue of any harm that can be done by doing higher intensity work, but rather what gets excluded for the sake of that higher intensity work. I believe that if you were to complete an 8 week block of training focused on training your aerobic system, dedicating 5-6 of that 7-9 hours of total training time for the week to endurance and tempo training, you would see that the quality of your higher intensity intervals would increase (i.e., go longer and recover faster between hard efforts, both key abilities in the short circuit and criterium type races).

Power output and Calorie conversion

Having read the Jan 29th fitness questions I have a question about power output. I recently purchased a PowerTap. My power output for the few rides I have done with it this winter have averaged about 250-270 Watts for hard rides of 20-30 miles. I am a 44 year old who is 6' 3" and weighs 88 Kilos. I started riding about 2 years ago. I do well at time trials because of my size and body type. Is this kind of output normal for a cat 4 rider of my size?. Also, I rode very hard through December with simulated races but on only 2, or at most 3, days per week. In the last month and a half I have ridden an average of 1, or at most 2, days per week.

My question is: should I still be riding hard or building base miles now? I feel like the couple of days a week that I do get to ride should be as hard as possible. I want to be at a high level early in the season then build for another peak in mid summer.

Also, in the Jan 29th letters it was stated that 278 Watts translated to a 1000 calorie output. Am I doing the math wrong? The example said to use 4.19 as the conversion factor. Using that I come up with 238 x 4.19 = 1000 watts. Did I miss something?

Jeff Lawson
Virginia

Eddie Monnier replies:

Welcome to the world of power-based training. I admire your wanting to make the most out of your very limited time.

Is 250-270W "normal" for you?

It's your height, not weight, that you're spending most of your energy to overcome on the flats. I estimate if you maintained 260W for a 40km flat TT, you would complete it in about 63 minutes. Given your age and the fact that you've only been riding for two years -- and not training all that frequently -- I'd say that's pretty good. I think you could improve on that quite a bit with focused and more consistent training.

Should you still be riding hard or building base miles now?

Candidly, I think it's difficult to *build* any real fitness riding only one or two days per week. You didn't indicate how many days a week you can train from this point forward so I presume you'll have 2 days. As for what types of rides might be best, that depends on what type of races you're targeting and what your limiters are. So I'll provide some general advice, assuming you are doing all types of events.

Initially, I would have you complete an all-out 30-minute TT (which you would repeat every 3-4 weeks). Your average power for that effort is a reasonably good proxy for your power at lactate threshold (LTP). Your average HR for the last 20-minutes is a reasonable proxy for your heart rate at lactate threshold (LTHR).

For one of your workouts each week, I would have you do intervals to maintain/build your LTP. These need to be sufficiently long, at least 10 minutes each. Personally, I like 2 x 20 minutes at your LTP with about 5 minutes rest in between. The idea here is to "build a bigger motor." As for how many watts you can expect to add to your LTP, that's too difficult to answer. For somebody training regularly who is as new to cycling as you are, 10-20% would be a good target (less for a more experienced cyclist). The more power you can generate at LT, the less often you will be dipping into the red zone during races. These are fairly difficult but should not leave you totally wiped out. I would probably keep this workout as a regularly scheduled day.

For the other day, I would initially have you do an endurance ride (2-3 hours) trying to get at least half the time at about 80-90% of LTHR (HR Zone-2 in Joe Friel's zones). HR is a perfectly good metric for intensity at endurance training levels, and much easier to govern then power.

After sufficient endurance is built, I would switch that other day to either a repeat of your LTP workout if you're next race is farther away then about six weeks, or if your next race is within six weeks, to anaerobic intervals. For anaerobic intervals I would have you complete a 6-minute all-out TT (this would be repeated every 3-4 weeks as well) -- a decent field test to estimate your velocity at VO2max (vVO2max). Say you averaged 375W. I would then have you do intervals at this power level. There are many different forms of intervals here, but as one example you could do descending intervals (Efforts of 3, 2 and 1 mins at 375W with a rest interval equal to the preceding work interval. Repeat three times).

Conversion factors

The 4.19 conversion factor was to convert kJ into kCalories. What you're asking is how to convert average watts to kJoules. An easy way to convert watts to kilojoules for any ride duration is as follows:

kJ = Average Wattage x Ride Duration in Seconds / 1,000

So, in this example 278W x 3,600 / 1,000 = 1,000 kJ. As Ric noted, there is some variation in individuals' actual efficiency. However, for most people you can take this number and translate it directly to calories. In other words, if you generated 1,000 kJ, you probably burned about 1,000 calories.

Best of luck and I hope your schedule soon affords you another few days of riding enjoyment.

Up two grades in a year

I'm 19 years old and have been riding for about 4-5 years now with a bunch of centuries during that time. I've been racing for the past 2-3 years, but not very seriously and have only done a handful of races - junior and collegiate. This year I have finally realized that a training program is what I need in order to become successful and have studied the basics of "periodization". So after reading Joe Friel's "Training Bible", I have decided that with my time available between school, work, and still having a social life I want to devote 550-600 hours of training this season w/ my main goal being an upgrade from a Cat 5 to Cat 3 by the end of September. Is this too much too soon for my age? I know its a pretty general question, but hope to get a reply.

Anthony

Eddie Monnier replies:

Glad you've found Joe's book helpful. The next edition is coming out this Spring. An annual training program of 550-600 hours is plenty for your level and with all the other things going in your life, you'll be busy.

As for whether or not moving from a Category 5 to Category 3 this season is reasonable, it's not uncommon but it's certainly not the norm. Assuming you have the physical capacity, you've taken an important step by deciding to adopt a structured a program and setting an overall objective. The next step is to identify race priorities (see my e-tip: www.ultrafit.com/newsletter/december02.html#eddie), limiters and then design your training program to minimize these limiters and accent your strengths.

There will be a lot of learning this season. Savor it!

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