You can’t coast through an indoor cycling workout

Indoor cycling programs were originally designed to prepare participants for the outdoor season. Over the past 25 years, group indoor cycling classes have risen in popularity and in many cases are the only exposure to the sport of cycling.

Indoor cycling has become synonymous with the trademarked term “spinning.” The stationary bicycles used are fully adjustable and have a weighted flywheel that provides increasing momentum with each rotation. A key element to each workout is the ability to rapidly change the resistance necessary to drive the flywheel.

Different muscles are exercised based on whether the rider is sitting or standing and the position of the hands. Varying the pedaling cadence will also alter the work out.

Classes generally last one hour and the person leading the group will design a workout that is accompanied by high-energy music. A grimacing facial expression is typical of participants, based on the grueling nature of these workouts.

“Indoor cycling workouts are more difficult because the rider must use different muscles to control the momentum of the flywheel. As opposed to traditional cycling, there is no way to coast,” said Marc Nee, a personal trainer and owner of “Training with Heart.”

Lisa Weir, a spinning instructor at World Gym in Norwich, has been teaching spinning for two years. She previously taught aerobics and step classes. “The biggest advantage to spinning is the outstanding cardiovascular workout along with strengthening core muscles,” said Weir.

After researching this column, the temptation of personally experiencing one of these sessions was too great. I invited my friend, former professional baseball player and talk show host, Lee Elci, to join me in this challenge. We decided to attend a class at the Fitness Club in Old Saybrook.

At the end of the one-hour session both Lee and I, who work out regularly, clearly understood why these classes are so challenging. “I was most impressed by the rapid pace, allowing my heart rate to remain elevated throughout the class,” said Elci.

Overall, indoor cycling classes are a great way to get in shape for summer cycling or simply to improve aerobic fitness. The camaraderie of a class lead by a good instructor makes the experience worthwhile and enjoyable.

Red Sox prospect faces long road to recovery

When a patient presents with neurologic complaints of headaches and numbness, it is always cause for concern. If the patient is a healthy young professional athlete, it is alarming.

Last week, a cavernous angioma was discovered to be the reason for similar symptoms in Red Sox prospect Ryan Westmoreland.

A cavernous angioma is an abnormal mass of blood vessels. Although often inherited, the condition can be seen sporadically. The shape is similar to a raspberry with dilated areas where blood pools. Small hemorrhage is often the first symptom as opposed to an aneurysm where bleeding is explosive.

Location of this mass of blood vessels dictates the surgical difficulty. In the case of Westmoreland, it was located in the brain stem, making the situation more challenging.

The brain stem is the lower part of the brain where vital reflex functions like breathing and heart rate are regulated. Coordinated eye movements are also controlled in this delicate network of nerves and blood vessels.

Dr. Gregory Criscuolo, a neurosurgeon on the Backus Hospital Medical Staff who practices at Eastern Connecticut Neurosurgery, has operated on a similar lesion in another patient. “Surgery is potentially curable but there is a high likelihood of some permanent deficit,” said Criscuolo.

Hitting a baseball demands extremely precise eye-hand coordination to visualize the spin and direction of a high velocity pitch and to react appropriately. Any neurologic deficits like disequilibrium or double vision are career-ending in baseball.

Even in the best clinical situation, where there is no neurologic deficit, it is unlikely that Westmoreland will return to full activity this season.

The potentially life-threatening nature of this condition will make Westmoreland’s recovery and hopeful return to professional baseball exciting to watch.

Echocardiograms can save athletes’ lives

Chicago Bears’ defensive end Gaines Adams died in January of this year. Despite being in excellent physical condition, he was the victim of a potentially deadly heart condition known as Hypertrophic Cardiomyopathy (HCM).

HCM refers to abnormal enlargement of the heart muscle. It is an inherited disorder affecting one in every 500 people. Typical symptoms are brought on during exercise and include:

• Shortness of breath
• Chest pain
• Loss of consciousness
• Dizziness
• Fatigue
• Heart palpitations

Unfortunately, the first sign of HCM may be sudden death, as in the case of Adams. HCM accounts for 26 percent of all cases of sudden death in athletes.

The dilemma is that an enlarged heart is not uncommon in athletes. One of the benefits of intense training is that the heart muscle increases in size, allowing it to pump more blood with less effort. That is why most athletes have lower heart rates than the average person.

The definitive way of resolving this dilemma is by performing an echocardiogram. This test uses ultrasound technology to image the heart’s chambers and valves while measuring the volume of blood being pumped.

While cost is not an issue at the professional and collegiate levels, it is a tremendous obstacle for the millions of high school and youth sports athletes.

Norwich cardiologist Dr. John Foley, a member of the Backus Hospital Medical Staff, recommends a thorough pre-participation physical evaluation for every child partaking in a sports activity.

“Physicians performing these examinations should have a low threshold for ordering an ECG or echocardiogram when they suspect a problem,” said Foley.

Cost should not be an issue when dealing with a life-threatening problem like HCM.

Cardiac screening is crucial for athletes

Sudden cardiac death is always tragic. When it strikes highly trained athletes at the peak of their careers, further investigation must be carried out.

Locally, the 2007 death of Norwich Free Academy athlete Larry Pontbriant has resulted in legislation requiring the availability of automated external defibrillators (AEDs) at all high school athletic events in Connecticut. AEDs provide an electrical shock to the heart in order to correct a potentially fatal condition called arrhythmia.

Designing an effective cardiac screening program presents a challenge.

Ways to perform non-invasive assessments of the heart range from simply listening with a stethescope to highly technical imaging procedures. Some of those are:

• Auscultation — listening to heart sounds with a stethoscope. This is performed routinely as part of a pre-participation physical that should be required for all athletic activities at every level. Detection of a murmur or abnormal sound indicates the need for further evaluation.
• Electrocardiogram (ECG) — this examination provides an electrical map of cardiac function. It can detect a potentially fatal arrhythmia but provides only a snapshot while the athlete is relaxed.
• Cardiac Stress Test — evaluates the heart while the athlete is active, typically running on a treadmill.
• Echocardiography — allows visual examination of the heart’s chambers and valves through ultrasound.

The principle issue regarding the use of these examinations centers on cost.

At a recent American Heart Association meeting, one presentation addressed the ECG as a cost-effective way to screen student-athletes. The recent decline in the cost of laptop ECG machines allowed the authors to study every competitive sports athlete in a suburban high school for less than $3 each after an initial investment of $500 per school.

As technology progresses, sports medicine professionals must constantly re-evaluate the most efficient ways of screening athletes properly.

Olympian breaks down barriers for diabetics

Twelve kilometers into the Olympic 30-kilometer cross-country ski event, Kris Freeman literally ran out of gas and collapsed. Freeman, an American hoping to medal in the event, shocked everyone when he was found lying in the snow asking for sugar. He is the first Olympic distance athlete who has type 1 diabetes.

Insulin is a hormone produced by the pancreas. People with type 1 diabetes produce little or no insulin. Insulin allows glucose to move into cells and produce energy.

Distance athletes must be meticulous about balancing energy requirements and extreme physical demands. This challenge is infinitely more difficult for athletes with diabetes.

Technology has made a huge difference in preparing diabetic distance athletes for their quest. The insulin pump is a computerized apparatus that provides a constant infusion of insulin. It is programmed according the expected level of activity.

Dr. Leslie Domalik, Medical Director of The William W. Backus Hospital Diabetes, Endocrinology and Metabolism Center, recalls her experiences at Duke University. She enjoyed the challenge of managing athletes with diabetes.

“In the past, patients would have to regulate their activities based on a fixed insulin dose. We can now alter the insulin based on the patient’s activity level,” she said.

In the case of Freeman, he anticipated a slower pace in the cross-country event and programmed the insulin pump to release more insulin. Unfortunately, the pace was faster and there wasn’t sufficient time to re-program the pump, resulting in a drop in blood sugar and loss of consciousness. A nearby German coach was able to give him some sugar and he eventually completed the race.

Although he didn’t do as well as he would have liked, Kris Freeman’s efforts in long distance sports have successfully broken a previous barrier, and isn’t that what the Olympics are really about?