Foot Pain and Cycling

It’s August…have you ridden your bike for over 2,300 kilometers (or 1,400 miles for those of us in the United States) in the past 2 weeks? Don’t feel too bad if you haven’t quite reached that number on your bike’s odometer, only about 190 people in the entire world have.

cyclists dreamstime

The 103rd running of the Tour de France has just concluded with Chris Froome achieving a third Tour de France career victory.  As the temperatures continue to rise back here in the states, so too do the number of bicyclists out on the roads and trails throughout the entire Kansas City area. From the competitive cyclist to the infrequent weekend trail rider, no one is completely immune from biking injuries. But with the correct knowledge and proper equipment, cycling injury “immunity” becomes an achievable goal.

The most common cycling injury involves fractures, mainly of the upper body, as a result of the rider trying to catch themselves during a fall. These acute, traumatic injuries are inevitable when trying to balance yourself on 2 wheels only an inch wide through traffic, over loose gravel, or dodging potholes. However, pain to the foot and ankle while staying upright on the bike is never normal and should not be considered part of the cycling experience.

Due to the relationship of the foot to the bike’s pedal, whether using regular tennis shoes or a clipless pedal system, coupled with the narrow toe box design and stiffness of most cycling shoes, it is not shocking that forefoot pain and numbness are the typical foot complaints for most cyclists.

“Hot Foot” (as it is known in the cycling world) can be the result of common foot ailments including capsulitis and a Morton’s neuroma. Whether it is swelling at the joint level, as with capsulitis, or swelling around a nerve, as with a “Morton’s” neuroma, the simple connection between them all is foot instability.

These conditions affect everyone, not just cyclists. Just as with walking and running, the downward force exerted during a pedal stroke causes an outward rotation of the heel, flattening of the arch, and an over-pronation of the forefoot resulting in overall foot instability. It is this instability that strains the soft tissues of the foot past their normal force threshold leading to inflammation and pain.

Early recognition of these symptoms is key to not only continued enjoyment on the bike but also to avoiding the operating room. The most basic treatment includes purchasing shoes with a wider toe box and ensuring laces and straps are loosened appropriately as the foot swells during increasing levels of activity. Initial treatment for capsulitis and Morton’s neuroma starts with inflammatory control.

At Kansas City Foot and Ankle we offer several methods of eliminating this inflammation to get you feeling better, faster. Non-surgical treatments for these conditions include traditional oral non-steroidal anti-inflammatory medications, steroid injections, and Musculoskeletal laser. However, for long-term prevention of continued instability and pain, we strongly recommend custom molded orthotics. Custom orthotics are fitted specifically to your feet and therefore provide the exact support you specifically need. By utilizing custom orthotics during your ride and in your everyday shoes you are improving the foot’s stability and allowing pressure to be distributed evenly throughout the entire foot, essentially eliminating the excessive force to the forefoot.

If you find that your bike rides, runs, or even trips to the grocery store are being cut short because of pain in the ball of your foot, call Kansas City Foot and Ankle at (816) 943-1111 and schedule an appointment with one of our doctors to get you back on your feet.