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TRIA Orthopaedic Center Your Cycling Blog

Preventing nerve damage while riding long distances

May 31, 2012

The experts from TRIA Orthopaedic Center return today to discuss another common cycling issue–numbness. Marc Swiontkowski, MD discusses the common causes of numbness for cyclists and some easy steps to take to prevent it.

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Prolonged pressure on nerves produces ischemia (loss of small blood vessel blood flow) which in turn produces various symptoms. These are primarily numbness and later tingling and electric shock like symptoms. Rarely in the case of mixed nerves, prolonged pressure can produce weakness and lack of function.

For cyclists the areas of concern are the hands and the crotch. In the hands the median nerve supplies the feeling to the thumb, long, index and half of the ring finger while the ulnar nerve supplies the other half of the ring finger and small (pinky) finger. The ulnar nerve supplies the motor function (power) to a lot of the small muscles in the hand (intrinsic muscles) as well. The pudendal nerve supplies the feeling to the genitalia.

Prevention of the symptoms involved is the best strategy for avoiding these problems. In terms of pressure on the nerves in the hands, changing positions on the handle bars every few minutes is the key.

There are 5 different positions that one can place your hands on standard drop bars- even more postions are provided if you are using an aero bar extension. You should experiment which positions feel the best in terms of control of the steering and generation of power with the pedal stroke. Identify which are your 3-4 favorites and rotate through them every hour during a ride or race.

As far as the crotch goes changing positions is the key there as well. The recommendation is to stand for 100-150 pedal strokes every 5-10 minutes. This will get the pressure off the pudendal nerve and will prevent saddle soreness as well. Standing is particularly valuable when climbing hills and in this situation 50% of time standing as well as 50% sitting are reasonable goals. Standing also provides mandatory changes in hand position which will get the pressure off the median and ulnar nerves.

As with so many potential injury situations in cycling, understanding the principles of prevention is the key to success and comfort while riding for pleasure or competing in this great sport.

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Up, Up, and Away (Part 2): Conquering the Hills of the Gran Fondo and Elsewhere

May 24, 2012

One of the best things about the Menomonie Gran Fondo is the chance to ride the same course that the pros ride later that day, but this is also the biggest challenge as well.

Here is the second part of USA Cycling coach Fiona Lockhart’s tips to help you conquer the hills that will break up the race later in the day.

by Fiona Lockhart, USA Cycling Coach

www.FionaLockhart.com

If You’ve Got the Gears, Use Them

Once you do have an appropriate gear setup on your bike, make sure you use them!  One of things that makes me want to weep as a coach is when I see someone struggling up a hill, mashing a huge gear at a cadence of about 40, and I look at their gears and see that they have at least one, if not two or three, easier gear options to choose.  Sometimes people will tell me “I want to save them in case I need them.”  Sister or brother, I’m telling you:  you need them.

Once your cadence starts to drop below about 70 rpms, your leg muscles will start to fatigue pretty rapidly, and it’s the kind of fatigue that is hard to recover from.   So it’s in your interest to try to keep that cadence above 70 as much as we can (and 80 or 90 might even be better, depending on the grade of the hill).  This has the additional benefit of taking some pressure off your knee joints, because there’s an awful lot of torque that occurs at the knee when we’re applying a lot of force at a low cadence.  That means using all the gears you have, and practicing shifting in and out of different gears when you are working hard to increase your ability to do it smoothly and prevent the chain from jamming.  Of course, if you don’t have any easier gears to use, then you just have to work with what you have.  But if you find that you are always riding below 70 rpms on hills and you’re always out of gears, then by all means re-read the paragraphs above about cranksets and cassettes and think about making a change.

Pace Yourself

You’re always going to be breathing a little bit harder on the hills (or a lot harder), but that doesn’t mean you can’t try to control the effort somewhat.   I will sometimes see people accelerate at the bottom of the hill, which might be a useful strategy if the hill is very short and you’ll just be able to pop over it quickly, but for most hills that take more than 30 seconds to climb, you’re better off trying to settle into a steady pace and maintain it for the duration of the climb.  If you exert too much energy in the first half of the hill and blow up, you’ll suffer more over that last half than if you had held back a little bit early on.

Once again, use your gears appropriately.  Practice shifting smoothly into the gears you need at the base of the hill.  You will want to have an easy enough gear that you can climb with, but you also don’t want to shift into too easy of a gear too early and lose a bunch of momentum.  Remember, you can always shift during a climb.  It’s a little harder on a hill to make the shift with your front derailleur (as the jumps between gears are bigger), so you usually will want to make sure you are out of your biggest chainring in the front when you start the climb, but then you can use your gears in the back to fine-tune your shifting as you move up the hill.  And plan ahead – thinking in advance about what gear you’d like to be in as you start the climb will help you avoid the mistake of shifting into too big of a gear and using too much energy early, or shifting into too easy of a gear and losing all momentum.

Be Happy

I used to race against a girl who was always smiling when we were climbing big hills.  It would alternatively amaze and infuriate me – “Really, this is making you happy?  COME ON, THIS HURTS A LOT.”  But in retrospect, I think it was a great thing – either she was, indeed, just happy to be hammering up a hill, or it was a very effective psych-out strategy for her competition.  Either way, she wins, figuratively.

But honestly, attitude does matter.  As I mentioned at the beginning of this blog post, hills are hard for everyone, but the way you approach the climbing of that hill can make all the difference between having it be a good or a bad experience.  Try putting some positive spin on the next hill you climb:  “These hills are making me strong”.  “The view from the top is going to be awesome.”  “I bet the downhill will be fun!”  Usually, this will make not only the hill but the whole ride a lot more enjoyable than if you are cursing (inside or outside) the whole way up the climb.

Increase Your Fitness

Well, duh.  But it does need to be said.  I started out this blog post by saying that the laws of physics tell us that it takes more energy to move a mass up a hill.  The more fit we are, the more we can comfortably meet those energy demands.  Apart from the things I’ve mentioned above, there isn’t anything magical about training to become faster on hills – the stronger we are, the less energy we’ll need to get up the hills (or the same amount of energy but we’ll go faster).  And how to increase that fitness?  Well, first and foremost, ride as much as you can (within reason).  And get out and train on hills, because they’ll make you work hard, and that hard work will make you strong.  I’ll talk in a later blog post about how to structure that training so that you have a good balance of hard work and rest and recovery.

So yeah, gravity is a law.  But that doesn’t mean you can’t bend the rules a bit.

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What are signs an cycling injury is serious?

May 19, 2012

The experts from TRIA Orthopaedic Center will be checking in from time to time to share tips for cyclists on a wide range of topics. Today’s installment is from Anne Moore, MD, CAQ who focuses on Musculoskeletal Primary Care/Sports Medicine. She will be talking to us about signs an injury may be severe and may need medical assistance.

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Cycling injuries occur across a spectrum of severity.

Many bike injuries are caused by overuse or ramping up into activity too quickly. Falling off the bike can involve more serious injuries, such as abrasions, muscle/tendon strains, ligament  sprains (or tears), fractures, joint dislocations and concussions.  Typically,  pain or soreness which occurs after activity and resolves with rest is less worrisome.  Pain that occurs during biking may be a sign of an injury that could benefit from further medical evaluation.

Soreness is simply less intense than pain, and can certainly be expected with intense physical activity.  One of the most basic prevention strategies for these types of injuries is to undergo a formal bike fitting and make sure that you do not overload any body part simply due to malalignment.   Additionally, cross training with strength training, flexibility exercises, swimming, and core stabilization can help overall fitness and minimize overuse injuries.

If a fall is sustained while biking,  open skin wounds should be cleaned thoroughly and may require antibiotics  and/or stitches.   If localized swelling, redness, or bruising  occurs at an injury site, this should be evaluated by a health care provider, especially if it persists for days (sooner if sharp pain or loss of function accompanies the injury).

Although helmets are necessary and can protect riders from skull fractures, serious head injuries can still occur with falls from a bike.  Concussions are the most common of these injuries, and  should undergo formal  medical evaluation. Some typical signs and symptoms of concussion can include headache, dizziness, memory loss, difficulty concentrating, feeling foggy, visual disturbances, feeling nauseated, or changes in sleep. The majority of concussions resolve within 1-2 weeks, but lingering symptoms are more concerning.

As  a recreational and competitive sport, biking  is especially beneficial for people with knee arthritis since it does not tend to overload the joints.  However for patients with low bone mineralization/osteoporosis, it is not very beneficial from a bone strengthening standpoint.  None the less, biking provides several other health benefits, and can be  enjoyed throughout one’s lifetime.

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Up, Up, and Away: Conquering the Hills of the Gran Fondo and Elsewhere

May 17, 2012

One of the best things about the Menomonie Gran Fondo is the chance to ride the same course that the pros ride later that day, but this is also the biggest challenge as well.

USA Cycling coach Fiona Lockhart provides a few tips to help you conquer the hills that will break up the race later in the day.

by Fiona Lockhart, USA Cycling Coach

www.FionaLockhart.com

One of the most common questions I get from cyclists is “Why is riding up hills so hard for me?”  My standard response, which I stole from my colleague and mentor Dean Golich is “Because gravity is a law.”  What I mean by this is that by virtue of the laws of physics, hills are hard for everyone.  Of course, we know that some people seem to scamper up hills pretty easily, while we are grinding away in our granny gear, breathing too hard while seemingly going nowhere fast.   I guarantee you that those mountain goat riders who make the hill climbing look simple are actually working pretty hard too, but they likely have some tricks and tools up their sleeves that help make their work just a little more manageable.   Adopting some of these yourself may help you manage those climbs just a little bit faster and more efficiently.

Lighten Your Load

It’s no secret that it takes less energy to move a smaller weight up a hill than a larger weight.  So, to make hill climbing easier, losing weight off your body or your bike can definitely be useful.  Even a pound or two can make a difference.  Of course, losing bodyweight is not always the easiest thing in the world (and is too big of a topic to cover here), but if you can finagle a way to lose even a few pounds of bodyweight, you’ll almost certainly notice that on a hill.

The other option is to lose weight from your bike.  If you’re riding an entry-level bike from years ago, it might be worthwhile to think about getting a new bike frame.  Frame technology has come a long way over the years, so you may be able to find a much lighter bike than what you currently have within a fairly decent price range.  Of course, you can spend many thousands of dollars on a tricked-out carbon fiber frame that you can hold up with one finger, but you don’t need to do that to get a light bike.  If you don’t want to change out your frame, investing in lighter wheels can make a huge difference as well.  It may be worth a trip into your local bike shop just to see what they have available and what your options are.

One of the easiest things you can do on a given bike ride to keep the weight down is to just mind what you are bringing with you.  Of course, you need to have the things you need to get you through the ride (water and food, tools to fix a flat or other mechanical, and weather-appropriate clothing options), but try to plan ahead so that you have everything you need and nothing more.  If you are loading up a backpack or saddle bag with a bunch of extra stuff that you probably don’t need, know that there will be a price to pay for those things on the hills.

Gears Matter

If you know that much of your riding will be done in the hills, or you have an important cycling event you want to complete that is very hilly, you’ll want to make sure that you have the appropriate gearing for that task.  There is a “standard” crankset, which consists of a 53-tooth and 39-tooth chainring for your front gears (the ones by your pedals).  However, for most people, having either a compact crankset or a triple crankset is enormously helpful in improving one’s ability to get up hills in the most efficient manner.   A compact crankset usually consists of a 50-tooth and 34-tooth chainring. These smaller gears give you the ability to keep a little bit higher cadence on the hills and are easier to pedal with on hills.  A triple crankset consists of 3 different gear options in the front, with something like a 53-tooth, a 39-tooth, and a 30-tooth chainring.   This will give you a lot of gear options for climbing different size hills.

Another option for you is to make sure you have some larger cogs on your rear cassette (that’s the gear system on your rear wheel).  For example, if your largest cog is a 23-tooth, you could get a cassette with a 27- or 29-tooth cog, which translates into easier gear options.

There’s this strange thing that I sometimes hear from riders, that it’s somehow “uncool” to ride anything less than a standard crankset.  To me, that’s just silly.  What seems more uncool is to ride gears that are inappropriate for a particular course or person – I mean, if there are tools available to us to help us ride more comfortably and efficiently (which then usually also transfers into “faster”), why wouldn’t we use them?  Options are cool.

To be continued as Fiona covers efficient use of gearing, pacing and the benefits of a fit attitude…

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Equal Opportunity for All

May 14, 2012

The Nature Valley Grand Prix has always been a strong supporter of women’s cycling, but we thought it might be nice to share an outsider’s perspective of our race and its impact on women’s cycling.

Since she has been involved with the Nature Valley Grand Prix almost from the beginning, we asked Giana Roberge–former director of Saturn Professional Cycling team, World Champion time trialist, inductee in the International Cycling Hall of Fame, and passionate voice for women’s cycling–to share her thoughts.
When I first heard about Nature Valley Grand Prix, I was the director for the Saturn Cycling Team. A very nice voice at the end of the phone line, introducing himself as Dave LaPorte, pleaded with me to send some of the Saturn women who were not participating in the HP Women’s Challenge to a new race in MN. He offered what a lot of promoters were not at the time: housing, help with travel, prize money, and equal promotion of the women’s teams to that of the men’s. I was intrigued.  I had three women I could send and in June they traveled in MN to participate in what was to become one of the top women’s races in the country.

That was 2001. Saturn won both the men’s race with Frank McCormack and the women’s race with Suzanne Sonye. The Saturn women returned with good reports of the race.  It was mostly criterium style racing but the crowds were enthusiastic and the community was very supportive of the idea of a big race in the community. Saturn received some very useful press from attending the event; all in all it was a homerun: my sponsors and athletes were happy with the event. In my mind it was an early success.

Two weeks later Dave called me for feedback.  I was taken aback.  A promoter taking the time to ask me what he could do better?  He wanted my commitment to send a full squad the following year.  At the time I asked him to move the race so it wouldn’t sit over the HP race.  I asked him to support the teams with free entries, travel, gas, meals, and housing.  With smaller team budgets, a race offering assistance to the teams rather than prize money would help to get riders to MN.  I wanted a competitive field for my team to race in.  What I wanted from Dave was the same treatment we received when we traveled to Europe for a UCI World Cup or Tour.  Make it as financially feasible as possible for as many teams as possible to travel to MN and the competition would be then be world class.  It would take time, and over time, it has.

Later that same fall, the cycling community received the sad news that HP would not renew their contract for the HP Women’s Challenge.  Again my phone rang with Dave asking me how he could make his race the new June destination for women bike racers. I wanted to work with this promoter, as I also wanted to grow women’s cycling. His eagerness to grow the women’s side of the race was new to me.  I sent him a wish list of what my sponsors would like from a race, what my riders would want and what I wanted as a Director.  Some of these ideas included a women’s summit, an outreach program to women in the community, travel assistance, an easy housing support system, lots of media support, challenging courses, and a venue which allowed our sponsors to interact with the crowds in the Midwest.  It was a lot to ask.

It took a few months but Dave was relentless in his pursuit of growing the race.  His sponsors rose to the challenge and the following year Nature Valley Grand Prix became the destination for women bike racers in the month of June.  Over the years Dave and his amazing staff have worked tirelessly to ensure women bike racers have extraordinary courses to test themselves, sponsors have tangible returns to utilize, and team management has a tremendous support system to make the race accessible to every team and every rider – not just the ones with the big budgets.

Over the years, some of the greatest women athletes in world have tested themselves at Nature Valley Grand Prix. Some of the “greats” include Kristin Armstrong, Ina Teutenberg, Petra Rossner, Georgina Bronzini, Lyne Bessette, Christin Thornburn, Katie Mactier and Amber Neben.

But the bigger story is that of the women who are not household cycling names but those who are the foot soldiers of women’s cycling.  It is the story of these women that needs to be told when talking about the Nature Valley Grand Prix.  These are-the women who work 40 hours a week in “normal jobs” who carve out time from their families and their jobs to train and race, and who hold women like Kristin Armstrong in awe.  These women have stood at the line with Olympians, World Champions, World Cup and Tour winners, they have tested themselves on the same courses, side by side with the women who have worked to create our cycling history. Nature Valley Grand Prix is also about these women, who have had the opportunity to race with the best of the best for several days; an opportunity not to be had here in the US without Dave LaPorte and Nature Valley.  To hear the crowds in the Twin Cities screaming for the winners, to see your team’s jersey on a baseball card, to be able to be on the radio, TV or the newspaper is available to ALL women who participate at the Nature Valley Grand Prix – not just the “Queens” of the sport.  It is truly an equal opportunity for all.

Nature Valley Grand Prix has supported all facets of women’s cycling: athletes, sponsors, and management.  I will look to the 2012 edition of Nature Valley Grand Prix to indicate who some of the next great women in cycling will be, as well as a point in history when women and men racers are treated equally.  At the 2012 Nature Valley Grand Prix every woman will have an opportunity to experience what is like to be treated as the Champion bike racer she is.

Giana Roberge
http://TeamSpeedQueen.com

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Training Tips for the Menomonie Gran Fondo: Part 2

May 10, 2012

By Jonas Carney, Performance Director
Optum Pro Cycling Team

Nutrition

There is nothing more difficult than running out of energy halfway through a long ride, or even worse, cramping up due to dehydration! As the Menomonie Gran Fondo and Spectator Rides approach, your nutrition becomes the critical component for a successful and enjoyable day. A few days prior to the ride you should start hydrating. Drink water frequently, cut back or eliminate caffeine and alcohol, and add carbohydrates to your diet. Practice proper nutrition habits for each training ride leading up to the event to be sure you are eating and hydrating properly.

On the day of the Gran Fondo, eat a light breakfast of high-carbohydrate foods and drink lots of water. During the ride drink before you’re thirsty. The rule of thumb should be one water bottle (20 ounces) per hour on the bike especially if it is warm weather. Water or a sports drink should be your first choice. Carry two bottles and alternate your consumption throughout the ride. Eat easily digestible, carbohydrate rich-food such as energy bars, bagels, fruit or granola bars. Don’t try something new on the ride; eat things you know agree with you. Remember, practice makes perfect so do several test rides before the Gran Fondo.

Attitude

In a large group ride, it’s only natural to feel a sense of competitiveness in our veins. Don’t let the adrenaline take over your ride! Ease into the ride pace. The Menomonie Gran Fondo isn’t a race and if it’s your first long ride, the goal is to finish comfortably and enjoy the experience. Stay positive and attentive to others around you. Safety should be at the front of your mind during the day. Here are some more tips for an enjoyable ride:

• Change your position on the bike frequently. Move your hand position, get off the saddle, stretch your arms, shoulders, neck, and calves, and arch your back. Avoid staying in one position too long.

• Take short rest breaks off the bike. The Menomonie Gran Fondo includes both water and food stops. Take advantage of this time to get off the bike, refill your water bottles, stretch, and use the restroom. Keep these stops to 10 minutes or less or you may risk getting stiff from lactate build up in your muscles.

• Find a companion or two who ride at a pace similar to yours. The ride will go faster and feel easier with a friend or two who you can chat with and provide mutual support. Also, skilled riders can take advantage of drafting and save some energy in the wind. On windy days, take turns leading into the wind with your fellow riders to conserve energy.

Attitude is everything. If you have prepared yourself well, you can sit back and enjoy the beautiful scenery around Menomonie and Dunn County (and maybe plan your next big ride). In my next entry, I’ll cover Gran Fondo day-of-ride preparation.

Get out and ride!

Jonas Carney
Performance Director

Optum Pro Cycling Team

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Training Tips for the Menomonie Gran Fondo & Spectator Rides

May 3, 2012

By Jonas Carney, Performance Director
Optum Pro Cycling Team

A milestone in the life of any avid cyclist is riding in a major event like the Nature Valley Bicycle Festival’s Gran Fondo rides in Menomonie, WI, June 16. While riding 65 or 85 miles in a day may sound extreme to a non-cyclist, you can do it too! Almost any novice cyclist can complete a Gran Fondo ride if they follow a consistent training routine. The key is to start your program early to give your body a chance to respond to the training plan and not wait until the last minute to train. If you are not up to the challenge of a “Big Ride” this year, give yourself a chance to succeed on your own terms by participating in the shorter distance Menomonie Spectator Rides, which are 32 or 15 miles in length!

There are 4 key success factors to have a fun and rewarding Gran Fondo experience:

• The right equipment
• The right training
• The right food
• The right attitude

Equipment
The right equipment means comfort and functionality. Your bike should fit you well and you should be familiar with it. If you aren’t sure about fit, have your local bike professional provide a fit-assessment. A visit to the local bike shop will also identify any mechanical issues with your bike. Don’t plan to ride a new or a borrowed bike on your first Gran Fondo ride. Consider having a tune-up before the ride, and carry a spare tube and patch kit, tools, a pump and knowledge of how to use them. Other essential equipment includes:

• A helmet that fits appropriately (must be worn to be effective)
• Water bottles and cages
• Energy drink and snacks for the ride
• Cycling clothing, including shoes, shorts, gloves and rain gear
• Sunglasses and sunscreen

Training
The core of your training should be endurance training. If you start your training at least 12 weeks before the ride, you will have ample time to prepare for the Gran Fondo. If you already ride more than five hours a week, you will need far less time to prepare. While most of your rides will be at about 65% of your maximum heart rate (MHR), add two days of interval training, where you push hard for several minutes – up to 85% MHR. Hills are a great way to add interval training to your ride. And don’t forget to allow one day per week for recovery. If you can only ride four to five days a week, don’t do your rest days consecutively. A sample training schedule may look like this:

• Saturday: 1-2 hour ride with 30 minutes of hard effort
• Sunday: 1-2 hour ride at steady pace (65% MHR)
• Monday: Rest
• Tuesday: 1-1.5 hour ride with hills
• Wednesday: Rest or 1-hour easy recovery ride
• Thursday: 1-1.5 hours with interval training
• Friday: Rest or 30-minute easy recovery ride

More Training Tips
• Maintain a cadence of 80 to 100 revolutions per minute
• Increase your mileage as you get closer to the Gran Fondo, no more than 10% at a time.
• Ride with friends, family or your local club to increase your level of comfort riding in larger group.
• Plan a 50- or 60-mile ride at least two weeks before the century to gauge your fitness
• Taper your mileage a week before the century. During that week you may even reduce your riding to one or two days of an easy five to 10-mile spin. Also, try to get plenty of sleep.

In the next blog, I’ll cover Nutrition and Attitude as you approach the day of the Gran Fondo rides. So, stay tuned!

Get out and ride!
Jonas Carney
Performance Director

Optum Pro Cycling Team

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