Question for orthotics users (long)

[sgmidf]

I'm in the process of getting some orthotics made, and had some questions for forumites that might be currently using them. I've had numbness in my R>L foot around the 3rd and 4th toes for years (usually when I hit 20 miles or do a lot of climbing) with either road or MTB pedals. A sports medicine doc thought that there was nothing significantly wrong, only a pressure effect on the nerves in the ball of the foot. When my Carnacs started to give up the ghost, I bought some Sidi Mega shoes and went to a local pedorthist to get orthotics to see if it would help. He acknowledged that he did NOT have experience with cycling, but told me that he would work with me to make this work (and he has). He took a mold, made the orthotics and we've been working ever since.
We've tried met pads, met bars and additional padding. The pads and bars DID seem to help the numbness a bit, but I felt like I was riding with a lump under my foot. Also, the volume of the shoe was getting a little tight, although I could make it work. I've moved my cleats back a bit, although maybe I need to go back further. I have to admit that the change is disconcerting as I've ridden with them more forward for years.
I'm 54 and try to ride as much as I can so this really pisses me off.
I was wondering what others with this type of metatarsal pressure problem did to reduce it. Was it cleat placement, did you get used to the met pads/bars? I've even thought about trying R7 shoes, but that would be a big stop cost-wise and the Sidi mega really seen to fit well with plenty of toe room.

Thanks and have a great holiday.

[Bruce K]

I use Sidi "normal" shoes with orthotics made by Bill Petersen.

Bill is now in AZ so new ones are going to be problematic.

He made the soles fairly thin to mimic the original footbed so volume was not an issue.

They work great and I have had several years of riding comfort.

BK

[deechee]

Do you have wide feet?
I wear wide shoes in general and 4E asics for running.
I started road riding with sidi megas and had numb toes. Not between the 3rd/4th which I've heard is a common problem (Morton's neuroma?) but just an overall numbness on long or HARD rides (ie. 40km TT). Getting a proper fit bike was important but so were the shoes. The sidis felt ok in terms of width but I knew I should try something different. I tried dmts, shimano wides but I've had very few problems with my Shimano TR-01's (tri shoes). The leather is soft on the sides to give but NOT too soft that my foot doesn't have support. I put in a superthin superfeet insole with thin socks and I'm almost 90% perfect.

I also tried Rocket 7 shoes and all I can say is that get the cast/mold done by someone who knows what Rocket7 requires. My physio helped me make my mold, and we thought it was very good with a good shape around my achilles, yet when I got the shoes they were unbareably tight, and the ankle area was sloppy. (I have wide feet but thin ankles/achilles.) The overall quality of the shoe was poor in my opinion. The wrap around design of the DMTs around the ankle area make it my absolute favourite for heel support. I probably should have listened to my mom when she told me she had custom shoes (cobler?) made long ago and never really liked them.

Aside from Shimano (btw the road 151E wide shoe is so incredibly stiff that I found it impossible to wear) I've heard good things about the Specialized Body Geometry shoes -they come with metarsal support n' stuff.

ps. I do wear orthotics in my running shoes to prevent occasional plantar fasciitis flare ups and earlier this summer some achilles tendonitis.

[zap]

I spent some money on custom orthotics some years ago and well, they did not work at all for cycling. The orthotics just took too much room so that great Sidi fit vanished. I now transfer the orthotics between casual and dress shoes.

Next I tried Specialized BG insoles that have the met button. These fit great, are comfortable and I never had any foot pain.

But my feet are as flat as they get, so in hopes of improving my alignment even further, I have a set of the new Specialized BG insoles ready to be picked up. They now come in 3 versions (Blue, Green and Red) depending on your arch.

So it's possible that all you need is an insole with a metatarsal button. The new Specialized kit goes for $50 and includes varsus wedges.

[David Kirk]

My orthotics didn't help at all for cycling but my custom D2 shoes made my cycling life much nicer.

I did my own molding for the shoes as per the D2 instructions but in retrospect I should have brought the mold kit to my foot guy just to be sure.

But in the end I have much happier feet.

Dave

[sgmidf]

Having worked at this now for a few months (the pedorthist has been great about trying to help) I may try some Specialized and/or E-sole footbeds and then consider custom shoes. It's a lot of money but cycling's too much fun to have this ruin it.

How far back do most people set their cleats?

[Alan]

The best advice I have seen is on Cyclingnews.com in the fitness section. You can search for cleat placement. I copied in the basic info below. I was having problems with joint pain in my foot where my big toe joins the foot. After moving the cleats back the pain is gone. Per my local Serotta fit expert there was a recent study concluing that this cleat position does not affect power.

From Cyclingnews.com
Make sure that the ball of your foot [centre of the first metatarsal joint] is in front of the pedal axle with the crank arm forward and horizontal. For a rough guide for shoe size metric 36 - 38, 7mm in front; 39 - 41, 8mm in front; 42 - 43, 9mm in front; 44 -45, 10mm in front. It is unlikely that your feet are bigger than that. Don't forget to move the right cleat further back again as outlined in point 3. I know that this is at variance with the commonly given advice but you will find as you try it that it works.

Alan

[zap]

You folks bring up another good point. Cleat position. I would need to measure again, but I think my cleats are positioned so that the foot (1st met.) is 7mm in front. I wear 45's so I'm probably going to move the cleat back by another 3 mm next week.

I'm an avid reader of cyclingnews.com fitness articles. These people get it.

[rpm]

Feet are extremely complex mechanisms, so there are all kinds of variables that could be interacting to cause your pain, including how much you pronate, the length of your instep, whether you have bunions, how wide your shoes are, and where your cleats are, etc.

You need to work with somebody who knows what they're doing, at a fairly deep level. That may be a local podiatrist who works with runners and understands that cyclists need thinner, front-posted orthotics.

But if you can't get satisfaction from a good local podiatrist and stock shoes, then I suggest that you go straight to the source, Andy Pruitt in Boulder. That's what I did when I had foot and ankle pain that kept me from riding more than 10 miles at a time. It was like going to Lourdes. He fits orthotics and Lust shoes, but he kept me in my current orthotics, but he put in me in Carnacs with one cleat all the way back and the other 3 mm forward to compensate for a length length discrepancy. He also added 3 LeMond wedges on one foot and 2 on the other.
Bingo, I rode a pain-free 60 miles right afterward, and I haven't had problems since.

The whole trip, including the fitting, cost me about $1200, and it was the best cycling investment I've ever made.

[Ginger]

I found out my numb toes were caused by a bulging disc in my back...so all the fiddling with orthotics was for naught.

Here's hoping that yours is just a foot problem!

[Dekonick]

My orthotics didn't help at all for cycling but my custom D2 shoes made my cycling life much nicer.

I did my own molding for the shoes as per the D2 instructions but in retrospect I should have brought the mold kit to my foot guy just to be sure.

But in the end I have much happier feet.

Dave
+1

[Madison]

Do not waste your money. MRI.

[Frustration]

Moving your cleats around is not a fix...

*****ing about how the insert doesn't fit your shoe is short sighted...


D2customfootwear.com THEY ROCK!

Also Esoles.com if they have a fitter in your area.


Bottom line is to use inserts you may need to change shoes. It's worth it. Going one better is to use D2, as they will build the last around your foot including the insert. hey also have a very good quality sole and upper that you can't poke holes through as easy as Rocket7. Also better than Rocket seven is the fact that if you need some adjustment, D2 can adjust the insert, while Rocket7 mould the whole shoe and can't easily adjust.


But don't screw up your fit to fix your feet.

Go get the right shoes or orthotics (with shoes that can accomodate both). And go see a fitter that is good enough to understand feet too...

[Dekonick]

After I got my D2 shoes, I went to see Smiley for a final fitting. It was worth doing it in that order.

I just wish I had been able to get a Hors Cat custom fit by Smiley before they stopped making them.

Custom shoes are worth it. It is a small price to pay compared to the cost of a custom F/F + 'ponents...

May as well get the total package! :banana:

[quattro]

Has anyone heard of or owned a pair of shoes made by Simmons ?

http://www.simmons-racing.com/shoes.html

These look look like they are very cutting edge custom cycling shoes. Having a Neuroma and club toes I have been thinking about going the full custom route for quite some time. I have had custom cycling orthotics made and still my feet hurt, these will probably be the custom route that I go. What do you think?

[jahah]

:beer: I feel your pain !!!

I lived with the same problem for some twenty years, progressively getting worse as time went on. It completely smells of a neuroma (between 3rd and 4th toes) ! I have so many pairs of orthodics that I could open my own podiatry store. Over the years it was MRI'd, X-Ray'd, shot with cortisone, all to minimal relief. The pain was never immediate. Dress shoes after about an hour, running more than two miles, cyling for more than 40 miles and so on. The worst activity was golfing, if you can believe that. The lateral rolling motion would cause more of a "pinch" on the nerve. None of the diagnostics every showed anything abnormal. However, the problem became so bad that I went for three years without wearing shoes. (sandals only - thank goodness for San Diego weather) I finally found some measures on my own that allowed me to do some things again. The most significant was using a gel "toe seperator" between the 3rd and 4th toe. I also found that the less cushion under the fore foot actually helped. A cushioned pad would allow the toes to roll together agrevating the nerve more. So, I would take the insoles of my shoes and grind them very thin and flat. This would actually help.

Finally, two years ago I was at a mall and a local podiatrist was at his othorpedic shoe kiost(spelling ?). I started talking to him about my problem and he felt he could help. The symtoms could never be replicated in a doctors office, yet he was certain it was a nerve problem. We decided to do a surgery to try to correct the problem. I was always nervous about removing the nerve for fear of loss of feeling and posible phantom pain from the cut nerve ending. Well, we decided to perform a procedure, and when he opened my foot he found the nerve badly swollen and inflamed from the years of pinching. What he did rather than remove the nerve was to re-route it from between the toes and attach it to the muscle tissue on the top of my foot. I am very pleased to say that it worked. While I will never be 100% (forget a marthon ), I can now do all the activities I enjoy with minimal discomfort. The doctor told me up front that I could never have complete relief due to the length of the problem. However, I am thrilled with the results. I don't have any loss of feeling or any other adverse affects.

The bottom line is, don't give up with one or two (or 3,4,5) opinions. Someone can figure out what is wrong. But, don't wait to long as I did and maybe you can have complete correction.

Hope this helps

Jim :beer:

[sw3759]

"Has anyone heard of or owned a pair of shoes made by Simmons ?"

qauttro,
I know a guy in Denison TX that has known this guy for years and has been wearing some prototype Simmons all carbon cycling shoes for about a year and loves them.he has used his custom all carbon racing skates for years and from what i gather,he kind of pioneered their use in skating and are used by lots of speed skating medal winners.apparently he knows his stuff and has years of experience.i can get you in touch with Charlie or you can thru his website ntsk8.com if you want more info on the shoes he been wearing.

Scott

[Frustration]

Off PezCyclingnews

simmons racing
http://www.pezcyclingnews.com/photos/tech/interbike06/intersimmons06.jpg


You can get em through groupedetete.com

They make several different kinds...

[A.L.Breguet]

Contact Solo Labs. Perhaps they can recommend a doctor in your area who can help with cycling related probs.
These guys make prescription orthotics, and are very knowledgeable(sic). I'm pretty sure they won't sell direct, but they've been in the biz quite a while, and should have some good advice.
I worked for them when I was in college.

[sgmidf]

There doesn't seem to be anyone listed in the middle TN area, but there is an eSoles fitter in Philly, Breakaway Bikes on 19th and Chestnut, that I can see for a fitting next month on a family visit. Does anyone know of this store?

Thanks