Ask the Doctor
Orthopaedic consultant Simon Mellor answers CW readers’ questions
As a 58-year-old very competitive
cyclist, I’m always concerned when my heart rate hits 190bpm-plus on really hard efforts. My average is 170-180bpm in a race. Fellow competitors my age maxout at 140-150 and average a lot less. Is this something I should be worried about? Paul Mann
I’ve checked with my cardiology colleague Dr Simon Kennon, who says that while a race average of 170-180 may just be normal for you, it is quite high. Even if you feel fine during and after your cycle, he recommends getting a cardiology appointment to discuss whether further investigations are needed. A family history of heart disease or other medical problems such as high cholesterol or high blood pressure might be a significant contributory factor. And if you feel unwell in any way when you really push hard, I would advise you to stop cycling until you have been investigated.
I’m 56 and have a number of ailments that may be interrelated:
Stiff/aching lower back; sore upper/ outer right hip; soreness at top of right leg; painful right heel. I’ve noticed that my right knee tracks away from the top tube as the pedal reaches top dead-centre. Kevin Taylor
What you describe suggests that your hip is externally rotated as it flexes when you pedal. If you can, prevent it by concentrating on your knee position as you cycle. It’s probably a response to the various stiff joints that you have. If you can’t prevent it, then it may be stiffness in the hip joint, and the most common cause of this is hip arthritis. That may also explain the soreness around the hip and top of the leg. Try raising your saddle a little to see if that helps.
Since adapting my cranks to
150mm from 170mm, my knee problems have gone away. Is there any science behind this, or just a coincidence?
Jim Cooper
Shortening your cranks has a direct effect on the amount of knee flexion during rotation of the pedals. Shorter cranks equals less knee flexion at the top of the stroke, and less stretch of the leg at the bottom of the stroke. If your knees, and especially your kneecaps, don’t like being loaded in deeper flexion, then by reducing the crank length you will have reduced the amount of knee flexion and thus solved your knee problem. In fact, since we all have different length legs, we probably all have an ideal crank length, individual to each one of us. Better still, adjusting your crank length won’t necessarily alter your peak power output or your exercise tolerance.
I’m an experienced, 56-year-old
veteran racer, but since resuming hard rides post-lockdown I have been suffering with unimaginable cramps, particularly in my left adductor and quad/hip flexor. My nutrition is good. I use Nuun tablets on rides as well as bars and food. Matt Walters
Restarting exercise after a prolonged layoff can be quite a shock to the system. The muscles, ligaments and joints will have become deconditioned. Since you are refuelling during the ride, it’s unlikely to be just electrolyte imbalances. I’d suggest increasing your pre-ride stretches and warm-ups. And try to reduce the intensity and duration of the rides for a few weeks. You should also give your body enough recovery time between rides – that includes warming-down after the ride. Seeing a good physiotherapist, osteopath or chiropractor may help too
As an OMIL (old man in Lycra) who cycles 100-150 miles per
week, the dreaded cycling leg veins are increasingly apparent. They’ve not yet reached Paweł Poljański extreme, but are unsightly. Are there any health issues associated with this?
Roger Davison
The good news is that prominent leg veins are not known to be associated with health issues. Most specialists agree that regular cyclists will tend to have more visible veins as a result of lower body fat levels making the veins look more prominent. And after cycling, especially in hot conditions, the veins will stand out even more.
As we get older, some of us are prone to getting varicose veins. These are bigger, and take a tortuous ‘wiggly’ route up the leg rather than running in a straight line. These extra-large veins occur due to damage to the valves within the veins. As a result, the pressure in the veins increases, causing swelling and the characteristic serpentine shape. If you have varicose veins that are painful or itch, you should talk to your doctor about them.
THANKS TO
Simon Mellor, orthopaedic consultant at London service Total Orthopaedics: www.totalorthopaedics.london