I believe one of the reasons I enjoy triathlon so much is the variety it provides. There are so many different aspects of the sport that it is unlikely that anyone can master the skills or acquire the knowledge that encompasses them all.
One area in particular that I enjoy learning about is bike fitting. It seems that good fitters understand biomechanics, human anatomy, and engineering principles well and those who are deficient in any one area can really "miss the mark" when it comes to a more complex fit.
In any case, Endurance Corner hosted Dan Empfield a month ago for a seminar in Boulder. It was really enjoyable to spend time with Dan. He has that wise, open sense as a teacher which makes learning very easy. It is not often you meet someone that has the knowledge and experience he has that maintains a sense of humility. That openness seems characteristic of people that seem to continue to accrue knowledge and remain at the forefront in any field.
I'm waiting for the day that Herbert does a more in-depth interview of Dan. In the meantime, I learned that Dan was a talented high school runner who was sidelined by ITB syndrome prior to reaching college. He directed his athletic pursuits in college as a X-country skier at the University of Nevada-Reno. During college, he resumed running and shortly thereafter did his first triathlon. Peddling gear out of the back of his car at races funded his early efforts as a triathlete, and eventually led to the first triathlon specific wetsuit and tri bike. We will have to wait for the Slowtwitch editor to give more details.
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His method for fitting is well delineated on his website. It was extremely helpful to hear it in person, and as always, there are details you can only pick up in person. In general, if you want to go faster in long distance triathlon, it is worth a visit to a F.I.S.T. certified fitter to test out Dan's principle for a steeper fit. The conclusions I get from his fit are:
1. There are general principles, but ultimately a fitter's experience and rider's comfort trump any specified geometric guidelines.
2. The results of a steeper fit are increased pressure on your crotch and upper extremity/shoulder girdle.
3. The way your body accommodates a steeper fit is through increased cervical lordosis.
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So, what are the ramifications of increased cervical lordosis? Well, that depends. Cervical lordosis is the normal curvature of the spine. People who maintain 30-40 degrees of cervical lordosis have a much lower incidence of neck pain than that of the normal population, presumably by taking pressure off the anterior discs by the strength of the posterior extensor muscles. Cervical lordosis is believed to be maintained by the strong extensor muscles of the neck. In fact, an entire physical therapy regimen, the McKenzie Exercises, have been developed to help reduce or eliminate symptoms of those people with discogenic neck pain. So, a gradual increase in the strength of cervical extensors by "looking up the road" may be helpful to those people with these symptoms.
That all sounds good, right? It is, UNLESS you have facet joint symptoms or nerve root impingement. This is pain that is the result of arthritis of the facet joints located posteriorly in the neck. The pressure on these joints are increased by extending the neck. Generally, over time, these people may develop nerve root compression by arthritis created by the increased pressure in these joints.
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What does it all mean? As with any change in position, gradual moves are tolerated much better than abrupt changes. If you have discogenic neck pain, strengthening the cervical extensors may even help your neck pain. However, if you have posterior facet arthritis, then the increased lordosis will likely be uncomfortable and unhealthy.
Sunday, March 9, 2008
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2 comments:
Jeff
We had a discussion the otherday at our P&T subcomitee meeting re: FDA warning that made me think of you and I wanted to see if you have any experience in this area. We do not directly have any peds at my hospital but we do, from time to time, provide services for Shiners hosp. any thoughts or experience would be appriciated. you can email me direct brfoot@msn.com
2/6/2008 Update: Early communication about ongoing safety review regarding Botox and Botox cosmetic (Botulinum toxin Type A) and Myboloc (Botulinum toxin Type B)
The FDA has received reports of systemic adverse reactions including respiratory compromise and death following the use of botulinum toxins types A and B for both FDA-approved and unapproved uses. The reactions reported are suggestive of botulism, which occurs when botulinum toxin spreads in the body beyond the site where it was injected. The most serious cases had outcomes that included hospitalization and death, and occurred mostly in children treated for cerebral palsy-associated limb spasticity. Use of botulinum toxins for treatment of limb spasticity (severe arm and leg muscle spasms) in children or adults is not an approved use in the U.S.
Great thoughts on a complex topic. very good stuff on physiology. Thanks
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