Fixing Foot Pain with Bicycling Australia Magazine

By 21 September 20162016 News

Riding a bicycle should be an enjoyable experience, opening new doors to what you can explore and where you can take yourself. However, if you have experienced unbearable pain in your feet it’s time you pay close attention to what Steve Hogg has to say in the July/August issue of Bicycling Australia Magazine.

”¬†‘Hot Foot’ is the numb or burning sensation in the forefeet that some riders experience. Hot foot can occur for a variety of reasons but almost all involve compression of the interdigital nerves of the foot. This article will attempt to explain the causes and general solutions. There are also some related conditions that can be confused with hot foot and I’ll talk about those as well.

True hot foot is caused by compression of the interdigital nerves. See below.

foot-nervesThe nerves are highlighted in yellow above. As you can see, there is a nerve junction between the base knuckles of each pair of toes. That nerve junction can be irritated if the joints on either side are compressed. The compression can be caused by a variety of causes. I’ve listed the common causes below with the general solutions. Often more than one stressor plays a part in this but the only way to explain them is one at a time, so here goes. There are basically two categories of problem, Mechanical and Functional.

MECHANICAL

1.¬†Shoes that are too tight¬†across the MTP joints (base knuckles of toes). This is entirely avoidable. Many people have wide feet. If a wide foot is forced into a not so wide shoe then the MTP joints will be laterally compressed usually resulting in pain. This can manifest as a burning sensation on the outside of the 1st and 5th MPT joints or as true hot foot where all or most of the interdigital nerves are compressed. Too often wide footed riders purchase shoes that are a size or two too large in length in an effort to get width. Doing this will solve the nerve compression problem but only at the cost of poor cleat position. If a shoe is too long and the foot doesn’t fill the full length, then the cleat mounting holes are likely to be too far forward. If the cleats are positioned too far forward and the rider is susceptible, seemingly paradoxically, solving the problem of lateral compression of the MTP joints may even cause the same type of pain through another mechanism which is explained below.

The ideal solution is shoes that are the correct length and width. Several manufacturers make wide shoe fittings.

2. Cleats that are positioned too far forward is another common reason for foot pain. ¬†The foot is a lever with the ‘effective’ lever length determined by foot size and relative cleat position. If the cleat is a long way forward relative to foot in shoe then the plantar fascia, the tendon like layer that connects the heel to the MTP joints¬†is under constant, excessive tension leading to the same nerve compression related pain.

There is wide individual variation in how likely a too-far-forward cleat position is to cause pain or irritation, in the sense that a cleat position that is pain free for one, can be the cause of pain for another. If in doubt, follow the general recommendation which is to position your cleat so that the centre of the ball of the foot is slightly in front of the pedal axle when both crank arm and shoe are level. This will solve the problem for most.

3. Riding with your seat too high is an uncommon cause or exacerbating factor in foot pain. This can happen when a rider’s seat height is so high that they have to point their toes just to reach the pedals. Pedaling like this causes strain in the muscles of the lower limb, (calves in the main) Achilles tendon and plantar fascia which can (but not necessarily will) result in the same issue as point No. 2; compression or tension on the interdigital nerves because of excessive loading of the plantar fascia.

FUNCTIONAL

4. Metatarsophalangeal joints that are too close to the surface¬†isn’t a common issue but is far from rare. Usually the tell-tale is a layer of callous over one or more of the 2nd, 3rd and 4th MTP joints. The proximity to the surface can cause pain in the area below¬†when applying force to the pedal (or walking or running):

The best solution is to spread and / or elevate the appropriate MTP joints with a metatarsal dome.

5. Lack of arch support is not a common cause of hot foot, but neither is it rare. When we cycle the muscle firing sequence of the legs is overseen by, but not controlled by the cerebellum, the seat of unconscious motor control. Rather, the on and off switching of the muscle of the legs is conducted by the Central Pattern Generator (CPG), a bundle of neurons in the lumbar spine. It is the CPG which fires the basic ‘extensor on / flexor off’ – ‘flexor on / extensor off ‘pattern of the leg muscles.

6. Imperfect cant of one or both feet.

This is not true hot foot but can be painful nonetheless. Human central nervous systems are incredibly adept at compensating by shifting load from a vulnerable area to somewhere else less immediately vulnerable. However our CNS has no ability to predict the long term outcome of any compensatory response and this is an example of that.”

To read the full article get your hands on the July/August issue of Bicycling Australia Magazine in digital form at Zinio, right here!

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