Call for Abstracts for 2015 MOCC

Posted on January 21, 2015 by Alynn Kakuk

Call for Abstracts for 2015 Medicine of Cycling Conference

Medicine of Cycling is pleased to announce the Call for Abstracts for our annual conference to be held August 14-16, 2015 in Colorado Springs, CO.  If you are a researcher and are interested in presenting at our conference, we invite you to submit your original research papers now through April 30th, 2015.

We encourage abstract proposals in a variety of areas, however, the abstract must be relevant to cycling medicine.  Both quantitative (including data) and qualitative (program descriptions, educational interventions, etc) are acceptable, but published data cannot be submitted.  Submitted abstracts will be reviewed for relevance and quality, and highly ranked abstracts will be invited to give an oral presentation (limited to 10-minute presentation followed by a 5-minute Q&A).  Some abstracts may be invited to provide a poster presentation.  Research presentations are likely to occur on August 15th.


The following prizes will be awarded:

2 Best Student/Resident/Fellow Abstract Award: 2015 waived conference fee

1 Best Professional Abstract: 2015 waived conference fee

The waived conference fee is contingent upon presenting at the conference.



Abstracts must be no longer than 300 words (excluding a single Table or Figure) and should address the following:

  • Objective
  • Methods
  • Results
  • Significance to Cycling Medicine

Please include full author names, degrees and institutional affiliation if applicable.  Authors of accepted abstracts will be asked to disclose potential conflicts of interests.



Abstract Submission Deadline:  April 30th, 2015

Abstract Acceptance/Non-acceptance email notifications: May 15th, 2015


Abstracts should be submitted via email to Alynn Kakuk, DPT at

Members of the Research Task Force will be involved in the selection process.


We look forward to your submissions!



Medicine of Cycling Research Task Force

Research Blog: Carbohydrates for Training and Competition

Posted on January 19, 2015 by Alynn Kakuk

Article Review #2:  Carbohydrates for Training and Competition

Burke LM, Hawley JA, Wong SH, Jeukendrup AE. Carbohydrates for training and competition. Journal of Sports Sciences, 2011;29(S1):S17-S27


Article Summary:

There is an enormous amount of interest and research in the subject of carbohydrates as fuel and the relationship to performance in sports. “Carbohydrate availability” is often discussed in regards to timing of ingestion relating to exercise, as well as the overall daily intake. This subject generates significant interest in athletes and those involved in their care.

This article reviews carbohydrates for daily refueling and recovery, acute refueling strategies, glycemic index as well as intake during and after prolonged exercise. The key findings are:

  • When training at high intensity, daily carbohydrate intakes should match fuel needs of training and restoration. This starts at 3-5 g/kg/day to as high as 8-12 g/kg/day.
  • If the period of refueling is less than 8 hours, time is of the essence – begin refueling as soon as practical; early refueling will be enhanced by higher rate of carbohydrate intake in small and frequent feedings.
  • Adding protein when carbohydrate intake is sub-optimal will enhance glycogen storage.
  • There remains debate on manipulating the glycemic index – this still needs to be individualized to the specific event and the athlete.
  • In events longer than 2-3 hours; higher intakes of carbohydrates, up to 90 g/hr., require products providing “multiple transportable carbohydrates” (glucose:fructose in 2:1 mixtures) which can help achieve higher rates of oxidation of carbohydrate.
  • During shorter events, 45-75 minutes, mouth rinsing of a carbohydrate mixture or intake of a very small amount of carbohydrate can improve performance through a “non-metabolic” role involving the central nervous system.

In addition, low carbohydrate intake, or “train low/compete high”, may present a new paradigm for training adaptations. Recent research examining the effect of exercising at low glycogen levels has shown that both a surplus and a lack of glycogen with exercise can trigger positive training adaptations. A low carbohydrate diet has also been shown to increase the ability to oxidize fat during exercise, but may impair carbohydrate utilization with high-intensity exercise.

Some athletes already periodize their carbohydrate availability for training sessions. By design or accident, many workout sessions are undertaken with reduced carbohydrate stores. Whether implementing additional ‘‘train-low’’ strategies to increase the training adaptation leads to enhanced performance in well-trained individuals remains unclear, and further research is warranted.


Questions for Discussion:

An important question is whether training with reduced glycogen stores should be exploited, and how can that be accomplished without having negative effects on the athlete’s performance?

Similar to this article by Burke and colleagues, the recent article by Volek, Noakes and Phinney (2014), “Rethinking fat as a fuel for endurance exercise,” makes a strong argument for using our largest fuel source, fat. Utilizing fat would cause a shift to fatty acids and ketones as the primary fuel for endurance athletes, which is known as keto-adaptation. There is a need to better understand what level of carbohydrate restriction is appropriate and what the exact composition of the diet should consist of to fully benefit from keto-adapation.

The review presents what may be an entirely different model of fueling athletic performance, “dietary periodization”, which includes periods of training in a low carbohydrate environment. On one hand, the review gives key recommendations for our athletes in regards to training and restoration of glycogen and fuel for performance. On the other, it asks, what might be the best training programs using carbohydrate restriction and dietary periodization?


This will be a fascinating area of future research.


Written By: Michael Reeder, D.O.

Reviewed By: Felice Beitzel, Ph.D.


Additional Reference:

Volek JS, Noakes T, Phinney SD. Rethinking fat as fuel for endurance exercise. European Journal of Sport Science, 2014

2015 Medicine of Cycling Conference

Posted on January 8, 2015 by Courtney Barnes

We are happy to announce that the 2015 Medicine of Cycling Conference will take place Aug 14-16 in Colorado Springs. We hope you will make plans to be there! Keep an eye out for more details as the dates get closer and you can find out more on our conference page. Let us know if you have any thoughts, comments or questions.

Seeking Volunteers for Core Strengthening Research Study

Posted on January 7, 2015 by Alynn Kakuk

A group of researchers are currently in need of more volunteers for their study on the effects of core strengthening on VO2max in cyclists.  Currently, there are very few studies related to core strength/core training in cyclists, so please consider helping them out!  See below for more information about the study, as well as who to contact!


Purpose: The purpose of this study is to investigate the correlation between core strengthening exercise and VO2max in elite cyclists.

Methods: We have developed an 8-week training protocol that targets core strength and VO2max. Our protocol utilizes specific core strengthening exercises and power-based cycling intervals that progress in difficulty over the 8-week period. This protocol has shown promise in a preliminary pilot study.

Inclusion criteria: Cyclists must be 18 or older; posses a license through USA Cycling or a comparable local license and demonstrate appropriate baseline fitness. Additionally, individuals must not currently participate in a core-strengthening program.

Equipment/space needed: As we are utilizing power-based data, participants must own or have regular access to a bicycle or stationary trainer with a power meter. Other necessary equipment includes a heart rate monitor and a cycling computer to download and share their data. Depending on group assignments, participants may need a 36 inch-long round foam roller and a 65cm gym ball.

What is required of participants to complete: Cyclists will be randomly assigned to one of our study groups. Depending on group, participants will be prescribed a VO2max training protocol tailored to their fitness as demonstrated in a baseline power test and/or a standardized core-strengthening program. Test will be performed to establish baseline fitness prior to the study and at 4 and 8 weeks to record performance.


Contact info:

Craig Abrams, DC

Founder/Chiropractor at CADC


Josh Friedman

Owner/Coah at ATP Race Consulting


Neil Krulewitz

Medical Student at University of New England

New Research Blog

Posted on January 1, 2015 by Alynn Kakuk

To start off the 2015 new year, we are debuting a new feature of our blog!  Every 2 weeks, we will post a summary of a cycling related journal article.  The purpose is to bring awareness to new research, as well as spark discussion about cycling medicine.  We hope you enjoy this new addition to our blog.  Here is our first post:


The Club-Level Road Cyclist: Injury, Pain, and Performance

Dahlquist M, Leisz MC, Finkelstein M. The Club-Level Road Cyclist: Injury, Pain, and Performance. Clin J Sport Med. 2014 Jun 9. [Epub ahead of print]


Article Summary:

With the increase in popularity in cycling in the United States, there is more information about types of injuries in cyclists. The authors of this study looked to examine the differences in activity levels of injured and non-injured cyclists, identify factors that influence when a cyclist seeks medical treatment, and examine biomechanical measures and their relationship to injury in an observational and prospective study of 63 experienced road cyclists. Participants reported demographic information, training information, and 8-week injury incident questionnaire. Researchers collected anthropometrics, bike fit measurements, hamstring flexibility, isometric strength, dynamic strength, and plyometric strength. The researchers found that 68.7% of participants experienced pain while cycling due to injuries with 65.1% reporting the injury duration >1 year. Of those reporting pain at enrollment, the average visual analog score (VAS) was 4.8 at the worst. The most common injuries at enrollment involved neck, shoulder, lumbar spine, and knees, which were reported due to muscle, tendon, and stress/overuse. During the 8-week prospective injury-reporting period, 39.7% of participants reported 34 injury events. Those who reported pain at initial enrollment were 48.8% likely to have an injury during this period compared to 20% of those uninjured at time of enrollment. Those that had a professional bike fit performed were more likely to have prospectively reported an injury. Flexibility, strength, and bike fit had no relation to injury. The authors concluded that greater than 2/3 of participants experienced pain >4 on a VAS, cyclists train intensely even with pain, if pain intensity >5.6 a cyclist is more likely to seek medical treatment, and factors that contribute to seeking medical care included pain levels and age.


Questions for Discussion:

  • With one of the most common injuries at enrollment being related to the lumbar spine, are cyclists performing enough core training and stabilization activities to prevent this issue?
  • Cyclists train even with pain. Are we encouraging athletes to take adequate rest and recover to improve performance?
  • What are the common attitudes and/or mental aspects of cyclists that might lead to not seeking treatment?


Written By: Alexandra Flis, MD

Reviewed by Louis Yu, MD


Cycling Safety

Posted on September 26, 2014 by Courtney Barnes

Cycling is a beautiful and fun sport.  We have to figure out a better system for safety.  Our friends are getting hit (disabled and killed) by vehicles AND our friends are hitting (disabling and killing) pedestrians.  Cyclists are doctors, lawyers, engineers, entrepreneurs, artists, researchers, executives.  This is our problem to solve.  Please blog, email, FB, tweet, and talk about it.

CME Course Materials for 2014 Medicine of Cycling Bike Fit, Emergenices & Main Conference

Posted on August 22, 2014 by mabramson

Each course has its own special landing page for handouts and links to online evaluation surveys.  They are:

Updated Medicine of Cycling Research Library

Posted on July 30, 2014 by Alynn Kakuk

The Medicine of Cycling Research Library has been updated to include articles that have been published up to 7/30/14.  We will continue to update the library on a bi-monthly basis.  Check out the new additions here!

Curtis Cramblett discusses Bike Fit and MOCC in Performance Conditioning’s Cycling Newsletter

Posted on July 30, 2014 by Courtney Barnes

You can read Curtis Cramblett's interview about Bike Fit in Performance Conditioning's Cycling Newsletter, with a mention about MOCC 2014 as well, here: Performance Conditioning Cycling Newsletter

Registering for Medicine of Cycling Conference, MECC and/or Bike Fit University

Posted on July 16, 2014 by mabramson

Registration for the MOC conference, Medicine Emergencies in Cycling Course (MECC) and the Bike Fit University hands-on workshop and seminar is handled via the University of California San Francisco (UCSF) Office of Continuing Medicine Education (CME). Here are some handy instructions on how to navigate the registration system and register for the portions of the conference you want:

1. Click or copy and paste this link into your web browser:

2. Create an account, if you do not already have one (unfortunately you must create an account first).

3. Choose the type of registration you would like:

If you would like to register for the Medicine of Cycling Conference ONLY (Saturday and Sunday)

  • Please choose the correct type of registration (Physician, Allied Health Professional or Trainee) from the “Registration Type” drop down menu and then click “continue”.

If you would like to register for the MOC Conference AND the MECC course (Friday, Saturday and Sunday)

  • Please choose the type of registration from the “Registration Type” drop down menu AND select the registration box for “Medical Emergencies in Cycling” and then click “continue”.

If you would like to register for ONLY the MECC course (Friday)

  • Please choose “Only Medical Emergencies in Cycling” from the drop down menu AND select the registration box for MECC and click continue.

If you would like to register for ONLY the Bike Fit University and Workshop (Friday and Saturday)

  • Please choose “Only Bike Fit University and Hands-On Workshop” from the drop down menu AND select the registration box for Bike Fit and click continue.

If you would like to attend Bike Fit University and Workshop AND the Medicine of Cycling Conference (Friday, Saturday and Sunday)

  • Please only register for Bike Fit, using the above instructions, and then send us an email to let us know that you registered for Bike Fit and you’d like to attend portions of both Bike Fit and MOC: medofcycling (at) Please note, MOC and Bike Fit overlap on Saturday, Aug 23rd. You will be able to attend Bike Fit and step away to hear lectures that may be of interest to you at the conference. Sunday MOC lectures are included in this registration option.