Form & Fitness Q & A
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The Cyclingnews form & fitness panel
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.
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
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.
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
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.
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.
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.
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
a resource for cyclists, multisport athletes & endurance coaches around
the globe, specializing in helping cycling and multisport athletes find
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 February 12, 2003
Riding during pregnancy
Intensity vs Endurance
Reader responses: Patella-femoral syndrome
Riding during pregnancy
I am a 30 year-old female Cat II racer, and have been racing for 6 years.
I am two months pregnant, and have been researching the best training methods
for pregnant women. Most of the articles I've found recommend to continue exercise,
but at more moderate levels. But in the next line, it says that there is no
evidence to suggest that more intense exercise can cause harm to the fetus.
I would like to continue my intensity and duration of rides, until it becomes
impossible to do so. Is it ok to be getting my heart rate over 170? How about
180? How long of rides are safe to do? 2 hours? 3 hours?
I know it's probably not good to bonk, and I plan on taking lots of food
with me when I ride.
Kim Morrow replies:
Good question. As you have already discovered, there are various opinions
on this issue. Ultimately, you and your doctor will have to make these decisions,
keeping in mind your unique health condition and the gestation age of the
The American College of Obstetrics and Gynecologists (ACOG) offers some good
guidelines for exercise during pregnancy. These guidelines apply to healthy
women with normal pregnancies. They also offer a guide to exercise prescription
during pregnancy. These exercise prescriptions(which include the type, intensity,
duration and frequency of exercise), describe what is appropriate for 3 levels
of maternal fitness: sedentary women, recreational athletes & regular fitness
exercisers, and elite athletes. I encourage you to check them out and discuss
this with your own physician.
Please keep in mind though, that the issue of high-intensity endurance training
among elite athletes is still being debated. Ultimately, it is important to
minimize risk to the developing fetus. The longest duration of exercise that
I have seen recommended in any of my research is 60-90 minutes.
A few other thoughts to consider:
1) Be careful not to overheat, especially during the first trimester. Avoid
outdoor exercise during the heat of the day.
2) Stay well hydrated before, during and after exercise.
3) Stop exercising when you are experience pain, fatigue or shortness of
4) Non-weight-bearing exercises, such as cycling and swimming, are often
recommended and allow for the continuation of exercise during pregnancy.
5) Avoid exercise in the supine position, due to the decreased cardiac output
associated with this position.
6) There are greater energy demands during pregnancy. Make sure to eat an
I wish you the best during your pregnancy.
I am a 30year old male of medium fitness with a condition known as tennis
elbow what can I do to rid myself of this injury short of letting the doctor
jab me with a needle or cut open my elbow.
Kim Morrow replies
I'm not sure if you got the problem that you are referring to as "tennis
elbow" (lateral humeral epicondylitis) actually from playing tennis? Many
people use this term broadly, but can get it from playing any racket sport
actually, even from playing golf. It is a repetitive stress injury in which
the pain is manifested in the outer knob of the elbow (the lateral epicondyle).
I would suggest that you see your physician about this injury, but let me
offer a few comments:
1) Deal with this issue early. Don't let the problem linger.
2) Determine the cause of this problem. For example, a racket with a small
grip or a racket that is too heavy may cause tennis elbow. An improper swing/form
may add stress to the elbow joint. Let your doctor diagnose this for you.
3) Stop any activity that aggravates this problem.
4) Ice massage is often an effective treatment. An anti-inflammatory may
be prescribed for the pain and inflammation.
5) After your physician gives the ok, begin a strength and flexibility program
to address this specific problem.
The clients that I work with who have had this problem (or who are trying
to prevent this problem) engage in a strength and flexibility program that
focuses on the muscles and ligaments surrounding the elbow joint. The extensor
and flexor muscles in the forearm muscles are developed through wrist curls,
for example. I also suggest exercises for the bicep, tricep and shoulder muscles.
Intensity vs Endurance
With respect to the reply
to Andrew Gannon, I am sure I have read of studies which indicate intense
interval training brings benefits in terms of endurance. My own training over
the past 5 months (off season) has involved a lot of track work, typically 1.5
- 2 hours total ride time with flat out efforts interspersed with steady tempo,
usually twice weekly and one night of Track racing which again is roughly two
hours total ride time consisting of four efforts at or very near my limit for
10-20 minutes. I have done very little road work over this winter period with
the exception of a few 3 hour rides and a couple of 5 hour rides at a fairly
high tempo. I will be competing in road races of 2-4 hours duration and haven't
in the past had any problems with endurance. I would say that my weaknesses
would be recovery from over the limit efforts, but this tends to disappear after
3-5 races in the early season, and making sprint efforts after riding near my
limit for long periods. Is this a result of my off season or would you suspect
these are just weaknesses anyway. Could I expect to see better results by following
a more traditional build up of steady tempo riding for longer distances. With
the season a couple of weeks away is there little chance to remedy any weaknesses.
Dave Palese replies
First we should make some clarifications. Endurance, in my vocabulary, can
be defined as an athletes stamina (how long can the machine run before it
starts to breakdown). Endurance was not the subject of my response to Andrew.
What I refer to in my response to Andrew, and suggest that he focus more attention
on in his training, is the development of the Aerobic energy system. My intention
was to illustrate that for an athlete to develop his or her abilities with
a certain amount of depth he or she must focus on all of the energy systems
in the body, there being three major systems: ATP-CP, Lactic Acid and Aerobic,
the Aerobic being the system in question. I am not saying that you should
only perform workouts focused on the Aerobic system, but rather there should
be a balance to your training, and that that balance will be weighted in different
areas at different times of the year.
Development of the Aerobic system, usually characterized by long steady rides
at about 65-70% of your max working heart rate, carries many benefits that
will increase efficiency at higher intensities when engaging the other energy
systems. Some of those benefits include: increase capillary density, and increase
in mitochondria in the muscles and increased stroke volume resulting in increase
cardiac output. It's when training this system that your body can concentrate
on putting in place all the things that will help it to run more efficiently
when the pressure is on - bridging the gap to that break, attacking on a that
hill and so on. When a particular energy system runs more efficiently, the
results is often higher output at a given intensity, and quicker recovery
after and between hard efforts.
What I see very often is that riders want to feel like they are getting a
workout, and may not feel that riding at such a low intensity carries any
benefit. It takes a lot of self-control to perform a solid block of training
focused on developing the Aerobic system.
You mention having a difficult time recovering after hard efforts during
your races. I believe that a solid, structured block of training focused on
the Aerobic energy system will go a long way to helping you recover after
such efforts. Your track events will also benefit. Your recovery after sprints
in the points race will increase. Your ability to retain control over your
situation while holding a good position in the miss-and-out will increase.
You will likely see faster times in your endurance events like pursuits and
the kilo. It's a win-win situation.
Reader responses: Patella-femoral syndrome
Editor's note: we're not intending to turn this section into a discussion forum,
but we received the following excellent letters from readers about
knee pain and patella-femoral syndrome. The advice and anecdotes that follow
are not necessarily supported by our fitness panel, but are presented on the
basis that shared experience may be useful to anyone suffering this not-uncommon
As a cyclist myself, I sympathise with Liam's inability to train due to your
patellar-femoral joint problem. I have had a personal experience of my own with
this problem and have found a strict regime of glucosamine and chondroitin sulphate
daily very beneficial. These compounds are the building blocks of cartilage
and are readily available from sports nutrition or health supplement shops.
They usually have a loading phase and in my opinion, must be taken diligently
and for a while before their benfits become apparent.
The logic goes as such. When I suffered from the problem, I experimented with
most things eg reduction of training, raising of saddle, stretching etc. However,
cartilage wear is a factor of synthesis and wearing down/degradation. You haven't
mentioned in your letter an abrupt increase in the amount of training so the
latter probably hasn't changed. Furthermore, the remedies mentioned so far target
only the latter and thus may not actually solve the root of the problem. Therefore,
I think the fault may lie with your intrinsic biochemical synthesis of cartilage.
Research has shown that aging and glucosamine-6-phosphate dehydrogenase (G6PD)
enzyme deficiency results in a reduction in glucosamine synthesis and so this
limits your synthesis of cartilage. Thus, an extrinsic dose may help you get
around the problem.
This is only my 2 cents worth but I guess there is no harm in trying.
Deep tissue massage
I was diagnosed with a very similar condition about 5 years ago. I was told
to quit riding and start developing my inner quad to create the balance required
to pull my knee cap back in alignment. I tried this - diligently - for an entire
off season (which in Milwaukee is a long time) - but w/ no luck.
I also tried new pedals (back to Looks with bigger platforms) and superfeet
inserts - both helped some, but did not completely fix the problem.
I got lucky and had a friend diagnosed with the same problem and had deep tissue
massage recommended on the IT band - and IT band stretches done in conjunction.
He had relief in a week, though his girlfriend is a PT so he gets massage daily.
I found a professional who has worked mild miracles for me in only a few sessions.
I know everyone is different - but it seems there are a lot of IT band / knee
pain issues out there, and a lot of physicians saying "build up that inner quad..."
One vote for deep tissue work - combined with stretching to loosen the IT band.
I am a 29 year old cyclist who competes primarily in road races with the occasional
mtb race. Typical training volume is approx 400km/week.
I was diagnosed with patella-femoral syndrome after suffering from re-occurring
right knee soreness after hard or long rides. Rest, anti-inflammatories and
stretching exercises were prescribed by a sports doctor however the effect of
these actions was minimal and I was becoming concerned my cycling days might
Eventually, via a process of trial and error, I figured out I was twisting
my right knee slightly (primarily given away by slight scuff marks on the crank
arm). Repositioning my cleat by approximately 2mm and concentrating on keeping
my pedaling action central and smooth eliminated the pain within a couple of
I present my story more to give encouragement to other cyclists to keep trying
when sometimes an injury may seem insurmountable. I am not advocating "DIY"
type diagnosis although I seem to have been lucky in that regard.
Not just the knee
As a physiotherapist with a great deal of interest and work performed on patellofemoral
patients and good knowledge of the existing body of research, I would like to
add a comment to your experts' opinion. Patellofemoral dysfunction is truly
multifactorial and each portion of the kinetic chain must be examined. Very
often the patella is simply the 'victim' for rotational/torsion 'culprits' located
above and below the knee. These can include excessive pronation, excessive tibial
varus/valgus, increased Q-angle, and hip mobility dysfunctions. There are numerous
research articles that both support and question the effectiveness of patellar
taping - I seriously question the effectiveness of the tape maintaining an altered
position of the patella through thousands of pedal strokes when there are research
articles that show it does not result in an altered position even at rest.
My personal treatment plans include possible orthotic use, fit evaluation,
careful pedal selection (I think that Speedplay-type 'endless float' pedals
actually exacerbate this problem by allowing unlimited LE torsion), ice massage
and mobilization of the medial and lateral structures that surround the patella,
and aggressive iliotibial band/ hip external rotator stretching.
Prevention by stretching
I'm 28 and I have been cycling for 15 years and am currently a professional
with Sierra Nevada/Clif Bar. Twice in my career I have been sidelined up to
2 1/2 months without any riding at all due to chronic knee pain, very similar
to what you have described. Experience and trial and error have taught me how
to overcome chronic knee ailments. Prevention is what you (k)need to work on.
With a proper stretching routine and a consistent riding regimen you can learn
how to work through this.
While resting, massage with your fingers around the patella to stimulate blood
flow, if you get a lot of swelling, use some ice and anti-imflammatories to
reduce the swelling and pain. STRETCH!! This is the single most important thing
you can do to reduce the pressure under the patella. The key is balance the
stretching between the quad and the hamstring, as well as the IT band and the
muscles on the inside of the thigh. The hip-flexor and the glut are also in
the equation as well. Stretch often, before the ride, during the ride, after
the ride, before bed. And learn to listen to your body. In my opinion it is
not an overuse issue (as my doctor's advised me) rather, it is a lack of the
...and use the small ring
Bottom Line: what you have will go away.
You need to:
1) stretch your quads
2) pick an anti-inflammatory medicine and take the proper dose
3) ice twice a day for two weeks
4) back off on hills, stay in the small ring for at least 3 weeks
Again, this is treatable and it will abate.
J. McGillicuddy, M.D.
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