Posts tagged efficiency
Strength Training Improves Cycling Performance
boulder-cycling-strength-training

As we move towards the end of winter many Boulder cyclists are growing tired of the indoor hours on their bicycles.  One of the benefits of the winter months for cyclists is the opportunity to introduce strength training into their work out programs.  A 2 to 3 day a week, total body strengthening program not only reduces a cyclist's risk for injury, but has recently been shown to improve cycling performance.

As noted in a previous post on running economy, cycling economy is one of three factors shown to influence endurance sports performance.  Essentially how much of a cyclist's energy resources are used to produce a given speed and distance.  At a given speed or power intensity, a less economical or efficient cyclist will ride at a higher intensity of their max, burning more valuable fuel and oxygen, than a more economical or efficient cyclist.  These variations in efficiency are most visible during a cycling competition.

Sunde and colleagues recently examined the impact of an 8 week strengthening program on cycling performance and economy (J Strength Cond Res. 2016).  The cyclists continued their cycling training but also performed high intensity squat training (4 sets x 4 reps) 3 days per week to maximize their positive nervous and muscle system adaptations.  As expected the athletes demonstrated improved strength and power after the 8 weeks, but they also improved their efficiency and aerobic output.  These athletes extended their time to exhaustion at their maximum power output by close to 20%.  

Cyclists are advised to work with a local Physical Therapist to implement an individualized lower body strength training program to improve aerobic performance and reduce injury risk.

Do One Thing and Do It Well
shoulder-pain-strengthening-exercise

The majority of patients undergoing treatment by a Physical Therapist will receive a home exercise program (HEP) based on their specific symptoms.  This individualized program is essential for the reduction of symptoms and restoration of function.  In my opinion, not providing an exercise program to patients with musculoskeletal conditions leads to patient dependence on the clinician and is detrimental to a patient's recovery, leading to persistent symptoms and a higher risk of recurrence. 

The greatest limiting factor of an effective HEP is patient adherence.  If a patient cannot or will not complete an exercise program then its’ effectiveness is null.  In my practice, the most common reasons for lack of compliance includes a lack of understanding on the importance of exercise or a lack of time.  Boring, non specific exercises are destined to be stopped and greater than 4 time consuming exercises will likely be dropped for family and work responsibilities (see sheet below).  Thus, a Physical Therapist has to prescribe efficient and effective exercises for each patient. 

generic physical therapy exercises

A recent article in Clinical Rehabilitation highlights this point.   Littlewood et al. randomized 86 patients with rotator cuff tendinopathy to either a single exercise or or multiple interventions commonly used in the treatment of these patients (2015).  The single exercise was designed to load the tendon based on the patient’s pain and activity tolerance.  This exercise was modified or changed as the patient’s status improved.  Although both groups improved the authors did not note significant improvements in function in the short or long term between the single or multiple exercise groups. 

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The key takeaway from this article is time is a finite resource and we should not waste a patient’s time with ineffective or inappropriate exercises.  Instead, we must continually design and refine each HEP to stimulate healing and restore function in every patient.  A written, generic handout for every patient with shoulder pain will not suffice.  In Physical Therapy, one size does not fit all. 

Choosing one thing, performing it frequently and performing it to the best of their ability may be the best option for our patients.