Douealing It Out! Liz Doueal and Her Time Spent on the Bike

Athlete Interview #2
Name: Elizabeth Doueal
Sport: Cycling – currently racing the National Road Series
Team: Specialized Securitor
FN: Hi Liz, great to see again!
It’s been a few years since we have caught up; let me know what have you been doing with yourself?
Last time we had a really good chat you were just coming off an injury and still involved in some national level middle distance running.

LD: It has been definitely far too long! I am currently working as a registered nurse at St Vincents Hospital, and juggling my new sporting adventure racing the NRS (National Road Series) domestically for the women’s team Specialized Securitor.

FN: About 3  years ago you had finally had enough of the constant injuries you were having while running, can you talk us through those injuries you had, why you believed you had them and what enticed you to take up cycling?

LD:  I fractured my right navicular in 2008 and had a non invasive rehab, I returned to racing at a national level and then fractured it again at the end of 2009, and I had surgery fixating the bone. I’m no podiatrist like you, but I feel this recurring injury was related to the poor blood supply of the bone in healing from the first fracture, I also have since discovered that I have limited flexion within my ankle, and also have extremely tight achilles and calve muscles that affect the natural shock absorption through my foot. When returning from surgery I tore my plantar fascia racing, that progressed into plantar fasciitis and ended up having a plantar fascia release resulting in further time rehabbing. I this injury was related to offloading from the right foot.

FN: Have you had any major injuries or concerns since taking up cycling as your sport of choice?Leading the Pack

LD: I have recently discovered since beginning strength and conditioning training, that my previous injuries are still causing some problem, so I am currently working to strengthen through the arch of the left foot, and also trying to improve the flexion within my right ankle and to stop subconsciously guarding my right foot from putting weight through the arch as I tend to pronate outwards. I have since discovered that these pre-existing injuries have altered certain parts of my pedal stroke and positioning.

FN: What does a typical day in the life of an aspiring professional female cyclist look like? Do you have time for work and play these days?

LD: Unfortunately there isn’t as much funding within the female scene of cycling, so riders don’t get a salary as such meaning that we need to balance working, training and racing. I am very lucky that my team is so supportive with fantastic sponsors that provide us with the best equipment, clothing, vehicles, travel and race supports having a team DS and mechanic provided by Specialized Securitor.  I am very lucky that I have a supportive fiancé that supports my hours training, need for sleep, travel, and need to work.  We both enjoy when I have a break from cycling and live it up, but focus during racing/training periods.

FN: What kind of bike set up do you have? Can you walk us through the specifics and how many bikes currently occupy the garage at home?

LD: My team bike is an S-Works Amira, which is a female specific bike. It is a carbon frame, has dura-ace electronic gearing. I race on carbon roval wheels. The total set-up weighs in just on 7kg. Ummm… we have too many bikes at home!  Between us we have 10 bikes, all for different purposes… Not all mine! I promise.

FN: Do you currently use any insoles, wedging or off-loading devices in your shoes?

LD: I currently wear “high arch” supports that are made by ‘Specialized’. But I am researching into personalised orthotics due to my injury history, as I feel this could make a different to my pedal stroke and efficiency.

FN: What, if any, cross training activities do you take part in?

LD: As previously mentioned I’ve just started strength and conditioning training to try and get on top of weaknesses. You don’t realise what you need to work on until you look!

FN: Do you have any major racing events coming up?

LD: I have two NRS races coming up soon, firstly the “Tour of Adelaide” on the weekend after Easter, and then I have “Mersey Valley Tour” which is in Tasmania early May. Otherwise I’m just following the local criterium circuit, and will be looking at cyclocross races over winter for something different.

FN: Cycling in Melbourne has come under the spot light in the last couple of months with Australian cities being declared as one of the worst places to ride a bike. What is your general experience with motorists? Do you believe there is a misunderstanding of the law from both sides, impatience or a structural issue which is presenting these issues?

LD: I had personally been hoping that the 1m passing law would be carried through. As I feel that it is important for motorists to provide cyclists with adequate space for safety.  I do feel that both parties have responsibility in managing the current situation, and there needs to be mutual respect. Places like New Zealand have a law for a passing distance for cyclists and it is amazing to ride there, you feel very safe. I do feel that impatience is an issue from both parties.

FN: What comes next in the life of Elizabeth Doueal? What are your goals? Where do you see yourself in the next couple of years?
LD: Long term I am pursuing the opportunity to race in Europe, I would love to race for the national team in the green and gold, and to achieve the best from myself that I can. I will continue to race the NRS, learn from my team and teammates, aim to win some races and enjoy the cycling adventure. Otherwise I am recently engaged so have a wedding to plan, and am furthering my nursing education and experience to find a specialist area to focus on.

Thanks heaps for talking with me!

We may catch up with later on in the year to see how she’s going. Next month coincides with the Good Friday Foundations Royal Children’s Hospital Appeal, a charity which I am in my 23rd year of collecting for. As a result we will be looking at an overview of clinical presentations of young athletes including Sever’s and Verruca.

Until next time

Jackson McCosker
Director /Chief Editor

Cycling and the Foot

Cycling and the Foot

The activity of bike riding has been present for centuries, a skill once taught and never forgotten. With all activities, there is the prospect of being able to complete said task; and then there is being able to do it well. As mentioned in the previous blog, the foot is a very unstable structure of 26 bones and 33 joints, in the sport of cycling – whether for elite sportspeople or the average weekend punter, the body, and in particular the lower limb is asked to move more like a machine than the multi-directional and dynamic creature it is.
In true road cycling, where the foot is latched to the pedal via cleats or a strap and both a push and pulling motion is created in conflict to the opposing limb, the legs are asked to act as levers or pistons to generate optimal force upon the small area of contact. With the foot being a highly maneuverable item, the ability to act as a stiff lever is difficult while cycling. Certain cycling shoes do have a carbon fiber sole which is in place to stiffen the shoe itself, however, this does not account for the movement inside the shoe which can then affect the angles of the knees, hips and body as a whole.
In any case of injury, irritation or performance altering ailment a full assessment should be complete to identify areas of weakness, equipment failure or technique problems associated with that particular activity. In the case of cycling this happens to be the bike and the cyclist themselves.

Road bike set-up is broken down into a number of parts:
The seat height has the ability to change power output by disrupting the length-tension relationship of the lower limb. If the seat is too high it can cause increased stretch from muscles of the posterior chain and decrease core stability as the hip drops to compensate for the extra length required to pedal. Alternatively, having the seat too low can increase knee flexion placing the muscles of the posterior chain into a position of shortening which not optimal either. When seated the cyclist should have stable hip alignment, while one leg is extended with only slight knee flexion and the pedals sit close to 0 and 180deg . The best way to measure this is to place a thick book between the legs of the cyclist while in a standing position and measuring from in-seam of their bike shorts to the ground, then multiply this number by 0.88 – the measurement found is then transferred to the bike measuring from the base of the crank to the top of the seat. Using a book between the legs aims to separate the legs to just inside hip width and provide a base to measure from.
The seat height can be adjusted from this position depending on a number of different factors including; flexibility, crank length, comfort, cleat position and shoe thickness.

The fore/aft or saddle position contributes to how much load is place through the knee joint as well as glute-hamstring length and the amount of hip flexion available. Increased patella-femoral compression forces occur if the saddle sits too far forward. Additionally, the more upright a cyclist becomes the less aerodynamic they become, this also results in the increased flexion of the knee and further extension of the hip creating a less than optimal length-tension relationship.  If the saddle is in a position too far back then the glute-hamstring length will be in excess and reduce force, similar to that if the seat post was too high.  To find the best saddle position the Plumb bolt method is used, where the bolt is dropped from the tibial tuberosity of the cyclist while the cranks are leveled at 90 and 270deg respectively. The aim is to have the bolt sit behind the pedal or in line with it to decrease the chances of patella-femoral load. Once again this method can be altered depending on a number of factors affecting the rider including; personal preference, hip flexibility and race type.

Deciding on cyclist’s reach ability (bar position) is a completely subjective task based on how the rider feels in a particular position and what appears to be safest from developing a structural injury.
Bar reach and drop is focused on the cyclist’s available flexibility and past experience. The overall desired look of the cyclist should include relaxed upper limbs which sit with unlocked elbows, retracted scapula and an anterior pelvic tilt.

Cycling technique seems easy enough to write about but mastering it is a whole other story. The pedaling motion of a cyclist needs to do exactly that…CYCLE. A smooth and continuous repetition which does not have an upstroke, which would destabilize the pelvis and decrease the available power generated. The combination of drive from the descending leg and carried on flow from the ascending limb should create a moment which pulls the ascending limb through the top stroke moment.

Cycling and Orthotics
As mentioned earlier the foot is a very unstable structure. Despite the carbon fiber sole of the shoe attempting to stiffen it to act as a lever, the millimeters of room available in the shoe still allow for the natural movements of the foot which are trying to be prevented for best transfer of energy. There are a number of items available out there for cyclists but the better quality devices are those which are rigid, supportive and able to advance the locking mechanism of the subtalar joint by pronating the rearfoot and supinating the Midfoot to created a stiff ever and reduce movement of the foot. Creating a stiff lever in theory will help increase power output during cycling, however a recent systematic review completed by Yeo and Bonanno in 2014, found that the current available evidence provided no justifiable conclusions about how cycling orthotics and wedging effect the lower limb.

Despite these findings it is important to understand that just because current evidence is not supportive of custom orthotics for power output; it should not be extrapolated to the effectiveness of the device for issues which can reduce the performance or enjoyment of cycling in a person. Complaints such as “hot foot”, knee pain, ankle pain and metatarsal head discomfort can all be addressed with the use of an insole off-loading device or adjustment to bicycle set-up.
When trying to design a custom orthotic for a cyclist which is not affiliated with a particular specialist brand, it should be recognized that the foot adjustments will have the greatest effect where the foot makes contact with a surface. In the case of road cyclists this is limited to a 20-50mm point of contact, unlike traditional orthotics which operates in a way which facilitates natural motion and reduces pathological movements at the foot through the full range of gait.

Jackson McCosker
Director /Chief Editor


Brukner, P., & Khan, K. (2007). Clinical Sports Medicine. McGraw- Hill Education Pty Ltd

Yeo, B. K., & Bonanno, D. R. (2014). The Effect of Foot Orthoses and In-Shoe Wedges During Cycling: A Systematic Review. Joural of Foot and Ankle Research , 1-11.