If you’ve ever dealt with cycling foot pain, numb toes, or tingling then you know what a huge pain in the butt it can be. There are many causes to this problem because many different tissues can be affected and many cyclists feel lost in trying to solve this.
The solutions to cycling foot pain can vary from the simple (shoes are too tight) to the complex (forefoot varus posturing). Let’s take a look at some of the causes:
Poor shoe fit & beyond
Improperly fitted shoes are the simple, low hanging fruit. Some clients do come in with shoes that are too tight because they’re just too small. Many cycling shoes have a very tapered toe box that can put the squeeze on some rider’s feet, but more attention is being given to the shape of the shoes to fit a wider variety of foot types.
Even a shoe that fits well can become problematic when the wrong sock is worn. Socks that are too thick, just take up more space in the shoes and can restrict blood flow and nerve conduction the same as a shoe that’s too small.
I’ve had a number of clients turn to orthotics or insoles to solve foot issues, and while supporting the foot can be helpful, many of the more available inserts aren’t built with cycling in mind, they’re built for walking and running. Besides the mechanics being different and the walking orthotics not really controlling the movememnt the way we need to in cycling, they also tend to be high volume and so they take up a lot of space in the shoe. This extra volume can lead to a tight shoe and create the very problems we were trying to solve.
Poor cleat position
Having the cleats too far forward is the most common cause of foot issues that I see on a daily basis. Putting the cleat more forward leads to more pressure on the forefoot because the intrinsic foot muscles need to do more work to stabilize the foot since the lever created between the center of the pedal (axle) and the pivot point of the ankle joint is now very long. With the cleat further back, these muscles can “turn off” because the center of pressure is closer to the pivot at the ankle and aren’t required to keep the foot and ankle rigid through the power phase of the pedal stroke.
Having the cleat too far forward can also facilitate a more “toe down” posture of the foot. This can increase the pressure on the forefoot because the foot is more likely to slide forward and get jammed into the front of the shoe. There is another result of toe-down posture that’s negative — the quadriceps will be preferentially activated over the glutes and hip extensors which can upset the balance between these muscle groups and also the balance in weight distribution between the hips and feet.
Pain on the outside of the feet
This is going to affect a smaller subset of cyclists with foot pain but it is one that I see with some regularity. Some cyclists experience pain on the outside of one or both feet — out at the pinky toe and just behind it — this is the 5th metatarsal. Sometimes this pain can originate from the natural positioning of the forefoot. In a weighted posture (standing) pretty much everyone’s forefoot will rest flat on the ground — all 5 metatarsal heads make contact with the ground. However, when we lift the foot off the ground into a non-weight bearing or even limited weight bearing position many of us have a forefoot that wants to have a little twist in in — one where the big toe wants to sit slightly higher than the rest. This posture is pretty normal and is called forefoot varus posturing.