Saturday, May 23, 2015

Anterior knee pain in cycling

While anterior knee pain can be caused by more than one issue, most cyclists ignore some common muscular imbalances brought on by a repetitive single plane motion sport. Many of these issues can be corrected by strengthening and stretching especially in the off season. A common weakness in a cyclist’s knee or runner for that matter is the VMO (Vastus Medialis oblique) which is located on the inside of the patella (kneecap). In cycling we seldom complete the last 35 degrees of knee extension which is controlled by the VMO. Over a long period of time the muscles along the lateral side of the leg or knee become stronger and sometimes tighter than the under engaged (VMO) medial muscles. This causes the patella to track improperly and cause irritation to the tissue under it. Sitting at a desk all day can just aggravate the issue as the knee is rarely extended engaging the VMO. Bike specific issues to be aware of that can contribute to this is a saddle that's too low or too far forward, pushing big gears or cranks that are too long.

Treating this issue involves stretching and rolling the lateral side structures (outside of the leg) and strengthen the VMO muscles. A few VMO exercises would be short arc single leg press and wall squats while compressing a ball between your knees. The process of correcting this issue is sometimes slow so patience is a must. Taping the knee properly by a PT can help relieve some pain and shorten the rehab period.

Friday, May 8, 2015

Altitude training and nutrition

The basic theory regarding altitude training is simple: when exposing an athlete to an environment that is low in oxygen the body will slowly adapt to the stress by getting more efficient at transporting and utilizing oxygen (Higher red blood cell count, and a stronger respiratory system). Lots have been written regarding this but what about nutrition and hydration when training at higher elevations?

Extra fluid intake is essential. Training at altitude means that breathing is shallower and more frequent meaning fluid loss through increased ventilation is higher. Additionally, sweat evaporates quickly due to dryer air so you are less inclined to drink adequately.

Your appetite can become suppressed by hypoxia so make certain you keep up with your calorie intake. There also seems to be a shift in calorie utilization with the reliance on carbs as opposed to fat stores. Carbs also attract water so increase your carb intake slightly over what you would do at sea level.

Iron is required to build hemoglobin so make sure you have sufficient ferritin levels prior to altitude training (ferritin is a protein used to store iron, it's concentration level gives a baseline of the bodies iron stores). Increasing your protein intake is essential in getting the iron that's required to manufacture hemoglobin as well as preventing illness and infections. Any Iron deficiency will negatively affect any altitude training.

It's important to be patient when beginning altitude training, pay attention to your body and don’t expect to feel great in the first few days and possibly up to two weeks.