Cycling and Feet

cycling-feetWe treat bicyclists every week and there are several foot and ankle problems that are quite specific to cyclists. For example, one of the most common conditions seen in bicyclists is numbness or tingling in the feet and toes. While we do see this condition in other athletes, it is most common in cyclists.

If you are in the Seattle area and having a foot or ankle problem while cycling, make an appointment to see us for an evaluation.  If you are not near us and you need a podiatrist to help you with a cycling issue, be sure to find a podiatrist who specializes in sports medicine and treats a lot of cyclists. If you are coming to see us, please be sure to bring your bicycle shoes and any orthotics or arch supports you are currently using.

Video: How to treat foot/toe numbness from cycling

Alignment of the Feet for Bicyclists

Proper foot alignment is critical to avoid injury and can be achieved with proper bike fit, well-fitting bike shoes and cycling orthotics. Proper alignment can help eliminate pain in the feet, knees and hips while improving efficiency and eliminating wasted energy. Several conditions can lead to improper foot positioning including:

Cycling Injuries and Treatment

Every day, we treat cyclists who have sustained overuse injuries of the feet by pushing themselves beyond their limitations. As with any injury, persistent pain indicates a need to seek treatment and this should be from a sports medicine specialist familiar with cycling injuries. Some of the most common foot cycling injuries and their causes are listed below.

  • Achilles Tendinitis – Irritation and inflammation of the tendon that attaches to the back of the heel bone can be caused by improper pedaling, seat height, lack of a proper warmup, or over-training. Click for more on Achilles Tendonitis.
  • Numbness – Numbness or burning of the ball-of-the-foot is common with cyclists and is usually caused by entrapment of nerves between the second and third or third and fourth toes that results in tingling, numbness, burning or sharp shooting pains into the toes. Loosening toe straps or shoe laces or using wider shoes can alleviate the problem. Prefabricated or custom orthotics can be used to transfer force off of the ball of the foot. Clipless pedal systems can also help alleviate this problem.
  • Sesamoiditis – The sesamoids are two small bones found beneath the first metatarsal bones. The sesamoids can inflame or rupture under the stress of cycling. Sesamoiditis can be relieved with proper shoe selection and cycling footbeds or cycling orthotics designed to decrease stress on the sesamoid bones.
  • Shin Splints – This is pain on either side of the leg bone caused by tendon or muscle inflammation and may be related to an imbalance between opposing muscle groups in the leg. It can be tied to excessive foot pronation (collapsing arch). Proper stretching and corrective orthotics for pronation can help prevent shin splints.

Importance of Cycling Shoes

Besides your bike itself, proper cycling shoes are your most important piece of cycling equipment. Cycling shoes must be very stable in order to efficiently transfer power from your feet to the pedals. Running and other athletic shoes are not good for cycling. The lack of support lets the foot collapse while pedaling leading to arch pain, tendonitis and burning/numbness under the bottom of the foot.

You need a cycling shoe with a rigid shank and should invest in cycling shoes for both outdoor and indoor cycling, even for spin classes. But you also need to go one step further. Cycling shoes are usually manufactured with very minimal arch support and have just soft sock liners. Replaced these with either high quality prefabricated or custom orthotics. Otherwise, lack of support can lead to unnecessary motion of the feet, ankles, and knees causing inefficient pedal stroke.

Custom Orthotics for Cycling

If your knees ache after a ride, the problem may be a biomechanical imbalance that can be alleviated by prescription orthotic shoe inserts. Custom foot orthotics should help re-align the foot on the pedal and prevent injury. Custom orthotics for cycling should have the following features:

  • Orthotics should, in most cases, conform very tightly to the arch of the foot to transfer the arch force directly to the pedal. These are called total contact orthotics.
  • Orthotics should be the full width of the foot while still fitting snugly inside the cycling shoe.
  • Orthotics should correct conditions such as numb toes, shin splints, toe pain or Achilles Tendonitis.
  • Orthotics should have a slender profile and be light-weight to accommodate the slim fit of most cycling shoes.
  • Orthotics should be made of materials that help regulate temperature and help with shock absorption.

If you make an appointment with us to be evaluated for custom cycling orthotics, be sure to bring your bicycling shoes with you.

Prefabricated Orthotics for Cycling

While not as effective as custom cycling orthotics, there are some good prefabricated orthotics on the market that we have found work very well in cycling shoes. We recommend the P3 ¾ length Medical Grade Orthotic because it has thorough arch support and does not take up room in the toebox of the cycling shoe which helps eliminate numb and tingling toes that are common in bicyclists. This prefabricated orthotic doesn’t provide as much support as a custom one, but is the best non-custom footbed we have found for bike shoes.

The use of custom orthotics/footbeds for your cycling shoes will help in positioning the feet and knees in the most efficient position so that your pedal stroke is most efficient and energy and power will not be wasted. This also decreases the likelihood of overuse injuries.

Biomechanics and Cycling

Biomechanics, the study of forces on the body, play a crucial role in efficient, satisfying and healthy cycling. For example, when seated on a bike with hands on the handlebars, the hands, shoulders, and front axle should all be in line. By enhancing the biomechanics of the foot, experienced podiatric physicians can improve your cycling experience.

The following can ensure your body is in biomechanical alignment with the mechanics of your bike:

  • Custom foot orthotics
  • Proper bike fit
  • Cleat alignment
  • Use of shims

Contact the Foot & Ankle Center to Discuss Your Cycling Foot Issues

Dr. Huppin and Dr. Hale treat cyclists nearly every day. If you are a cyclist, make an appointment to see us today in our Seattle foot clinic for an evaluation to find out if you are a good candidate for custom cycling orthotics for your bike shoes and to see how your feet might be affecting your cycling. Be sure to bring your bicycling shoes with you. Click here to schedule or call (206) 344-3808.