Plantar Fascitis and Biking

[etu]

Looked up previous threads on this but most were about running. I haven't been running for a year now, but I am pretty sure my plantar fascitis seems to be exacerbated by cycling. Anyone have this problem and have suggestions to avoid getting off the bike? I've seen a PT who has guided me toward supportive orthotics and shown me how inflexible my calves are. She was quite sympathetic about my wish to consider cycling and felt I could get better as long as I didn't run and did some stretching and strengthening, but now not so sure.

[mg2ride]

I suffered from it but do not believe cycling exacerbated it at all.

Any activity that cause you to point your toes away from your leg exacerbates it.

I don't think that is the case with cycling.

Of course the body is the most complicated machine in existence and every case could very well be different.

The thing that seemed to help me the most was doing almost constant calf and achilles stretches throughout the day. If I was not on the move I tried to force myself to point my toes up.

[johnniecakes]

I suffered for a long time when I was running more than biking. I never seem to have any trouble when I was only biking. In preparation for my 3rd marathon in 2007 I got a real bad case that brought me to tears every morning when it was time to stand up. I bought a Strassburg sock https://thesock.com/and used it every night. In about 2 weeks I did not have any pain in the morning and within a month was running pain free. Since then I have paid attention to stretching my feet several times a week.

[rustychisel]

Any activity that cause you to point your toes away from your leg exacerbates it.




Having a hard time getting my head around this? Is it as simple as I think it is?

[etu]

I seems to have pain when I plantar flex (heel down) on the pedals. The tight calves apparently makes this a traumatic process at the level of the ligamentous insertion on the heel.

[Ralph]

Some very supportive hard carbon fiber orthotics fixed my issue, and stopped the pain, along with some PT. The hard foam insole type did not....in regular shoes. I'm controlling the movement of the arch now.

I ride with the Specialized highest arch support insoles, with a bunch of two sided tape on underside of insole on that leg.....to hold the foot from rolling over and super pronating. Super pronating gives that foot a little wiggle at bottom of stroke, and cause a wear issue on my butt cheek.....same effect as if that leg was shorter (it's not....it just wants to pronate). I've mostly got the pain controlled.

[eddief]

never been much of a runner and never had this plantar issue...prior to installing new cleats on a new pair of shoes. Frog cleats on the exact same model of shoe as the previous pair. And for some reason have been having a heck of a time dialing in cleat position to feel the same as the old shoe with old cleats. Left foot only. Not in terrible pain, but just feel a pull on the bottom of foot toward the heal. Rode 35 miles yesterday with 4100 feet of climbing and did just fine, but sometimes during the day, the foot discomfort was noticeable and bothersome. Back to more adjusting today.

[Slow Eddie]

I bet it's your peroneus longus. Have your PT check that.


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[Mr. Pink]

I had it (hope it's "had" at this point. Haven't had many problems lately) after I used sneakers on a spin bike in the gym, especially after hanging on the thing for an hour and a half because a Yankee playoff game was on the big screen in front of me, so, what the hell, where else was I going to go? Very painful trying to hike afterwards. I switched to my pretty stiff mountain biking shoes on the spin bike, whenever I did use the thing, fand that seemed to work. Didn't bother me too much on the road bike, just a little. So, I guess I'm saying, stiffen up your road shoes as much as possible, eliminating most flex in the arch as you peddle.

[Ken Robb]

I remember exactly when I developed this. My good pal/tennis buddy from Aspen was in town for a couple of days. We were playing doubles on the "challenge court" at our club where winners stay on court to play next challengers. I felt like I got a stone bruise at the back of my arch but we were having too much fun for me to quit so we played 9 sets. The next morning walking was VERY PAINFUL. Ice, rest, play tennis and pain returns. I gets so it hurts even when I was just walking. Custom orthotics for athletic and street shoes, NSAIDs, etc. These things helped but did not cure. X-rays showed some impressive bone spurs. Then I got steroid shots. They were painful but a few days later the pain was gone and never came back. Over time the spurs went away too. There are some risks to steroid shots but I felt the on-going pain made the risks acceptable.

[etu]

Yeah, my wife keep suggesting steroid injections, but not quite ready for that yet.

[alancw3]

are you sure you have planters fasciitis? i had a sore foot for about 2.5 months that just would not get better. several friends said i had planters fasciitis. anyway, finally went to the foot and ankle doctor and had X-rays. ends up i have a classic case of posterior tibial tendon dysfunction or pttd stage 1. i have to wear a boot (almost like a ski boot but super cushioned) for 8 weeks to see if there is any improvement. if not then an operation. bottom line only activity i can do is swimming as long as i do not have to walk to far from locker room to pool. at 67 years old the doctor told me that basically i have over worked my foot with all the exercise i do. first the bottom tendon failed and the top tendon did all the work for the foot but after awhile the top tendon could not do it all alone.

http://www.footankledc.com/patient-education/posterior-tibial-tendon-dysfunction/


as to planters fasciitis a good friend had it who was a runner. his doctor told him no running but that it was alright to bike ride as long as he wore a shoe with a rigid sole.

i guess i have always taken my feet for granted. have now learned that the foot is a pretty complicated system of tendons, bones and cartledge.

[PFSLABD]

Looked up previous threads on this but most were about running. I haven't been running for a year now, but I am pretty sure my plantar fascitis seems to be exacerbated by cycling. Anyone have this problem and have suggestions to avoid getting off the bike? I've seen a PT who has guided me toward supportive orthotics and shown me how inflexible my calves are. She was quite sympathetic about my wish to consider cycling and felt I could get better as long as I didn't run and did some stretching and strengthening, but now not so sure.

Running created my Plantar Fasciitis problems and became the reason I took up cycling. I had heal spurs that were created by me striking the pavement too hard when I ran. I don't know why you would have Plantar problems from cycling. It is usually the other way around.

[downtube]

I added specialized insoles to my shoes and it really helped the issue.

[etu]

Running created my Plantar Fasciitis problems and became the reason I took up cycling. I had heal spurs that were created by me striking the pavement too hard when I ran. I don't know why you would have Plantar problems from cycling. It is usually the other way around.

Yeah, it's a bummer, but unfortunately it is what it is. I'd be OK not running (for fitness), but now that it seems to be interfering with biking, I have to be more serious about addressing it.
My atypical presentation does raise some questions. My understanding is that my very tight calves are a big part of the problem, but I am also learning that tight arch structure also contributes to the problem. I had foot surgery a while back to remove a tumor on my big toe which left that toe with very little flexibility for a long time. I suspect this created an area of weakness or tightness that may be driving my problem. So for my case, stretching, deep massages and strengthing of the arch (which I haven't emphasized) may prove more effective than other remedies. For now, I'll plan on avoiding gear mashing and raising my saddle 1-2cm.
Superfeet seems to help. Specialized BG seemed to make it worse.
I don't think I'll take my feet for granted again.
Peroneus longus - will have to look that up. My PT's initial evaluation was very tight calves, hip flexors (more on the effected size) and slightly weaker glutes also.
Posterior Tibial Tendon Dysfunction - thanks for the link, but on reading the description, it doesn't sound like what I am experiencing.

[Slow Eddie]

...Peroneus longus - will have to look that up. My PT's initial evaluation was very tight calves, hip flexors (more on the effected size) and slightly weaker glutes also.
Posterior Tibial Tendon Dysfunction - thanks for the link, but on reading the description, it doesn't sound like what I am experiencing.

All the stuff your PT found may very well be true, and could be contributing to your issues. Partuicularly, If gastroc/soleus is ridiculously tight (like, you can't get to neutral in passive dorsiflexion), then if you are ankling during the pedal stroke, that is putting a lot of stress on the achilles tendon insertion, which can irritate the origin of the plantar fascia on the anterior surface of the calcaneus, but in a properly fitting shoe, there should be not be enough repetitive flattening of the arch to cause plantar fasciitis, especially in a rigid road shoe. If you're in relatively flexible MTB shoes and doing a lot of CX-type run-ups, maybe. But road shoes are designed for minimal flex. My guess is that your tight calves aren't qute that tight, but still aren't putting the power to the pedals very well because they aren't in the sweet spot of the length-tension curve, and your body is recruiting peroneus longus to help out because one of its actions is to plantarflex the foot, but since it's not meant to do that job to the extent you want it to, it's getting overworked, pissed off, and letting you know.

As far as plantar fasciitis in general, it is my opinion that PF is a way-overused diagnosis, and medical professionals who are not familiar with foot and ankle injuries tend to hear "pain on the bottom of the foot" and just go to plantar fasciitis. When they end up in front of a foot specialist, however, it ususally ends up being something else that is causing their pain and dysfunction.

/rant

[alancw3]

what needs to happen is that the original posteur needs to see a foot specialist and get X-rays to see what is really happening with his foot and then decide on a plan to cure the problem.

[Slow Eddie]

what needs to happen is that the original posteur needs to see a foot specialist and get X-rays to see what is really happening with his foot and then decide on a plan to cure the problem.

Well, yeah. I wasn't assuming that the OP was coming here to the exclusion of actually seeing a medical provider, but I would hope that he takes the information that he finds in his reasearch here and elsewhere, and together with the provider, arrive at a sensible plan of care. Sometimes providers get stuck in a rut, and just need a reminder that other possibilities may be out there to explain the patient's symptoms. The good ones will accept input and start a dialog with the patient. The ones who get all butthurt, dig in their heels, and stick their heads in the sand? Well, if they're not getting you any better, then there needs to be some reassessment if that's a patient/provider relationship that needs to continue.

[rugbysecondrow]

what needs to happen is that the original posteur needs to see a foot specialist and get X-rays to see what is really happening with his foot and then decide on a plan to cure the problem.



If my pain is manageable, I tend to follow the simplest path, then work my way to the Dr. Order The Sock or another tool for $40 bucks from Amazon, have it at the house tomorrow and by tomorrow night be working towards a solution.

To be honest, I have gone the Dr. route first, and after weeks to get an appointment, then x ray, then another wait for a follow up to discuss the x rays, then the equipment/treatment we are 3-4 weeks into the process and how many hundreds of dollars. And to be very honest, sometimes the Dr. seems to be taking informed guesses which, after long duration and cost, were less effective then cheaper, more easily sought solutions. The Dr. is never as invested in your own care as you are.

This is all a long way of saying, I just ordered the sock for my manageable, but irritating foot/heal pain. Thanks for suggesting it.

Well, yeah. I wasn't assuming that the OP was coming here to the exclusion of actually seeing a medical provider, but I would hope that he takes the information that he finds in his reasearch here and elsewhere, and together with the provider, arrive at a sensible plan of care. Sometimes providers get stuck in a rut, and just need a reminder that other possibilities may be out there to explain the patient's symptoms. The good ones will accept input and start a dialog with the patient. The ones who get all butthurt, dig in their heels, and stick their heads in the sand? Well, if they're not getting you any better, then there needs to be some reassessment if that's a patient/provider relationship that needs to continue.

I would also add, many Dr. don't exercise or are not as active as us. They just don't understand why it is hard to take 4-8 weeks off. Find a person who is just as active as you and gets it.

[benb]

Coming in late.. I've had this too (from running) and it's lingered as this odd/occasional thing that can sometimes come back at a lower level after lots of biking or even walking. Of course I ran for 10 weeks this summer with no issues too, so shoe selection seems to be super important there.

The thing with it is the stretches are pretty easy to do.. even without a real diagnosis (I never got one) it's pretty easy to learn and try.

There aren't many excuses for cyclists to have stiff calves.. if you're on clipless pedals you can stretch your calves & hamstrings very easily while you're riding as the pedal gives you a fixed thing to hold tension against. I stretch my calves while seated and typically stretch my hamstrings while standing. I do so on almost every ride. I stretch my quads while riding too.. which is a lot harder and maybe stupid but you can do it if you're riding alone.

[Ken Robb]

In my case bone spurs were obvious in x-rays and the ends of the spurs where the ligaments attached were very sensitive to moderate finger pressure.