Since cycling is a non weight bearing sport most people don't think too much about the possibility of foot injury until they feel that nagging burning foot pain during their ride. The truth, is your feet are working very hard during your ride to translate all that muscle power being generated by your leg and glut muscles into the pedals. The most common foot complaint I have treated in cyclists (competitive, long-touring riders and casual) has been burning pain under the center, outside ball joints,and into the toes. The ball joints and the nerves between them are directly over the pedals and can be strained with the repetitive pushing motion on the pedal.
The medical terms for this condition is "metatarsalagia," "neuroma," or "neuritis".
Metatarsalagia is when there is strain and bruising to one of the ball joints (metatarsalphangeal joint) of the foot. With cycling, the center three joints are most typically involved.
Neuritis is inflammation to a nerve without any long term structural change to the nerve. With continued and repetitive nerve injury causing inflammation the nerve may develop scar tissue which is referred to as a neuroma.
Steps to relieve this type of pressure include the following:
(1) Check your shoe for correct fit. - To do this take the shoe liner out of your cycling shoe and hold it up to your foot. You are checking to make sure that your ball joints or toes don't hang over the edge. Then place this same liner on the ground so you can load your foot with partial weight-bearing, and again check for overhanging of your ball joints and toes. You should also easily be able to wiggle all of your toes comfortable in your shoes.
(2) Check your socks. - You want socks that will wick moisture away from your foot to avoid heat build up, which will cause foot swelling and a tighter fitting shoe on longer bike rides. It is also important to get good cushioning under your ball joints.
(3) Use a proper rigid sole biking shoe with cleats. - The rigidity of the sole helps you more efficiently transfer the muscle power of the leg and glut muscles to the pedal. It will also protect the ball joints from the hardness of the pedal.
(4) Check the shoe straps over the ball joints. - As the foot heats up with exercise from increased blood flow, the strap directly over the ball joints may need to be loosened.
(5) Have your local bike shop check your position on your bike.- At the very bottom of your stroke the knee should be in a slightly flexed position, heel level or slightly lower than the ball joints, knee straight ahead without any bucking side to side with stroke, and finally toes pointed straight ahead. If the seat position is too high this will promote pointing of the toes and increased loading under the ball joints. Cleats not pointed straight ahead may put pressures on the knees and outside part of the foot. Seat height too low leads to inefficient use of glut, hamstring muscles, over active calf muscles, and pointing of toes.
(6) Remember to use both your upstroke as well as your downstroke.–Absence of or lazy upstroke will lead to putting too much weight on the pedals during downstroke. Balancing on these hard small objects for longer rides will put too much pressure under the ball joints and causes bruising to the metatarsal heads.
(7) Replace the shoe liner with a quality over the counter arch support. - Cycling is tiring to the feet. When the smaller foot muscles become tired, your arch may fatten too much (pronate), causing inefficient and uneven loading to the ball joints.
(8) Go to a sports medicine podiatrist. - If the above suggestions do not completely correctly your foot pain with cycling, STOP messing around and make an appointment with a sports medicine podiatrist. A more corrective Custom orthotic may be needed to align your foot and prevent the uneven loading of the ball joints, or a more serious condition like a stress fracture to the metatarsal may be the reason for your pain.
Dr. Victoria Melhuish at Sierra Foot & Ankle specializes in Podiatric Sports Medicine and has helped many patients just like yourself get back to the activities you love. I will develop an individual treatment plan that’s right for you. Call our office today to make an appointment. You can trust my office to deliver not only exceptional foot and ankle services, but as importantly to show you deep concern and genuine care for your well being.