Foot pain cause -- shoes, orthotics, cleat, other?

[wwtsui]

Have been struggling with hot foot/pain underneath the metatarsals for the last season or so, and am trying to figure out what to do. From what I've read so far, I can't quite tell whether this is plantar fascitis or Morton's neuroma -- it doesn't seem localized to between the 3d and 4th toes; it seems more like it's between the 2d and 3d toes. The current setup is Sidi Dominators & SPDs; I've tried both ShockDoctor and Superfeet insoles, which helped some but not enough; I've had cleat positioning checked by the fitters at LBS, but have had better results moving them all the way back as suggested in some book or other.

In searching this and other boards, the following possibilities have been mentioned:
1. Get a shoe with a stiffer sole
2. Switch to pedal system with a wider platform (probably need to switch to a road pedal at some point anyway...)
3. Get custom orthotics
4. Find a sports podiatrist (may be the same as #3)

Any suggestions on which of these to try next (or maybe something else entirely)? If #3 or #4, any recommendations for doctors with bicycling expertise in the Boston area?

Thanks very much!

[eddief]

I ride Dominators on good old old SPD's. I also have custom orthotics and in the last 6 months or so my feet ache too. I'm old and think the ache could just be a relatively mild case of arthritis. On the other hand (foot), sometimes I think my Dominators might be too narrow. So I am now experimenting with dialing cleats on new pair of relatively high end Shimano mountain shoes. They seem a tad more roomy and maybe, just maybe the combination of more room, custom orthotics, and excellent cleat positioning will all add up to foot nirvana.

[Louis]

I have no clue if your problem is even remotely related to my experience, but my "hot foot" was caused by shoes that were too narrow. Going from my old Specialized to plain Sidi's fixed that.


Louis

[Ken Robb]

in my experience, plantar fasciitis occurs at the front of your heel not near the toes.

[Kane]

The only time that I have met Lance is when he came to our office in S.F. to see Dr. Ehrenberg (Podiatrist). Lance was apparently having pain in the front of his foot and Dr. Ehrenberg made some orthotics for Lance. Doug Ehrenberg D.P.M., is the finest podiatrist that I know. I worked with him for ten years. He is technically excellent in his production of orthotics, an absolutely astute diagnostician and he is honest.

His website is (footdoc@wellfeet.com). Go to his website and educate yourself with his information. Than send him an email. Ken, your an east coast guy as I recall, but he has a long distance product that may be suitable for your needs. He'll probably tell you to try a 'cookie' first as a clinical trial. His website explains a little bit about what it is and how to place it in your shoe.

You may also benefit from switching to Sidi Dominator "Mega's", to allow more room in your shoes. Order "NOW" brand or "Nordic Natural" Omega 3 liquid fatty acids and start at one a day for a few days. Ramp up your intake to 4 grams for a month. These brands are distilled to eliminate Mercury. Also try glucosamine at 1500mg/day. Both of these supplements have an anti-inflammatory effect. Consider the possibility of getting your foot adjusted a few times by a Sports Chiropractor or Physical Therapist who works on feet.I'm very good with feet and I have seen excellent results on occaisions. But, remember every intervention is a clinical trial.

Good Luck,

Kane

[wheelworks]

3. Get custom orthotics
4. Find a sports podiatrist (may be the same as #3)

Any suggestions on which of these to try next (or maybe something else entirely)? If #3 or #4, any recommendations for doctors with bicycling expertise in the Boston area?

Thanks very much![/QUOTE]


go see Gordon Hay

If this set up is for road riding, then look into a road pedal shoe combo..ie, the new time pedals with a large platfrom

[Needs Help]

Kane,

I've had a chronic pain in my forefoot for many years now. From the base of my 4th toe, the pain is located about an inch towards my heel. Is that the(a?) metatarsal? It feels like a bruise you might get if you jumped up and landed on a small pebble. I went to wellfeet.com and read the description of a neuroma, but I don't have a pins and needles feeling. I've seen several podiatrists, and the last one put me on a steroid dose pack, and the pain went away for the 2-3 weeks I was on the dose pack, but then it returned. Sometimes I don't notice the pain at all, and other times it can get sensitive enough where I have to limp around. I never feel pain while cycling, running, or most exercising, but afterwards my foot can get sore. If I do something like calf raises while lifting weights or classic cross country skiing where I bend my toes backwards and really weight that spot, then I notice it while exercising.

I've tried weeks of daily ice massages, and someone recommended massaging it with a golf ball first, then ice massage, but I found that made my foot swell up, although it served to pinpoint exactly where the trouble spot was. I've also tried stretching before exercise by pulling up on my last two toes, but that doesn't seem to help either. If it really starts to bother me, I've found massaging the spot by aggressively digging both thumbs into my forefoot helps.

I've sort of resigned myself to living with it. Any suggestions?

[zap]

Of late, I'm wondering if bike shop fitters can cause more harm than good for those with aches and pain. Many seem to stick with basic fit parameters that anyone can find on the web.

wwtsui, as you've found, moving the cleat back was the first step to take. Depending on the size of your feet, up to 10 mm back from metatarsals is what some recommend. I moved my cleats back some late last year to help take some stress off my patelar tendon, and found additional foot comfort as well. It's hard to describe, but it feels like my feet just float on the pedals compared to being "stressed".

Getting road pedals like Looks or SPD-sl will also help. I tried those original spd's when they first came out but gave up after some months of foot pain that I never had before.

Kane's advice is always appreciated. His post as well as posts from others helped me last year when trying to resolve my patellar tendon problem.

[BarryG]

FWIW, I've had both a nasty neuroma (aka "metatarsalgia") and nasty plantar fasciitis. Both were overuse injuries from running and about 7 years apart. Cortisone injections were tried in both instances and didn't ultimately do much of anything. The cure was the same - stop running for an extended period of time (1 year +), and wear high quality insoles.

Needs Help, I would stop the running if I were you.

[Kurt]

and are any of your shoes too small? Hallux Limitus is my guess as to what you have - go see a foot doctor, one that knows sports - don't fool around with trying to fix this one yourself

[OldDog]

I've chimed in here in the past on Mortons Neuroma. Do a search on it on this forum and the old one. Also try cyclingnews.com and seach the letters.

Go see a podiatrist. The last thing you need is a bunch of bike junkies diagnosing your injuries on their lunch hour. Our advice may be helpful but you need to see a doc before any permenent damage occurs.

Good luck.

[Brian]

I, too, had a problem with hot foot/pain - especially on long climbs. It wasn’t debilitating, but it sure was annoying. The owner of my LBS made me some custom orthotics and the foot pain went away – immediately.

Find someone who knows what he is doing and who is willing to guarantee his work. Then you’ll have nothing to lose.

[William]

Try rubbing a mixture of witch hazel, gingko biloba, cinnamon, crushed red peppers, and ground Twizzlers between your toes and.....

Go see a podiatrist. The last thing you need is a bunch of bike junkies diagnosing your injuries on their lunch hour. Our advice may be helpful but you need to see a doc before any permenent damage occurs.

Good luck.

Actually that is the best piece of advice you're gonna get here. :)

William ;)

[Kevan]

I tried on both the Sidi's and Carnac shoes. Neither shoe had the form to my foot and I could sense trouble brewing if I left with anything less than profection in their fit. Fortunately, the Shimano shoe seems to have its bumps and curves just at the right places for me. Regardless of padding, if that shoe isn't spot on from the first try, there's a world of hurt coming and no pretending it'll get better, will solve it.

I know nothing of feet, but maybe other brands or custom fits are your solution.

[Sandy]

Lesson one- Three feet = 1 yard

Lesson two- 1 yard = a lot of mowing and weeding :) :)


Scholar Student Serotta Sandy

[eddief]

As mentioned earlier, was riding on Sidi Doms, 43.5, with SPD pedals. Feet felt generally comfy on bike and while walking in these shoes. But, in general, feet seemed achy in regular life.

Just got finished dialing in a pair of Shimano mt shoes in size 44, with another set of SPD cleats. The Shimanos seem to be more roomy in the toe box and are even more glove-like feeling than the Sidis.

I'm not sure what a pair of 44 Sidis or even Sidi Mega might do, but since I had the Shimanos in the closet, this size in that shoe seems to allow my forefoot to spread out a bit more and less after ride pain as a result.

[quattro]

wwtsui, I have now had Moton's Neuroma for about three years in my left foot. I had been riding Mega Dominators with Speedplay Frog pedals. This winter I changed to Genius Mega with the new Time RXS pedals. I have only ridden outdoors once, rode my wind trainer all winter on them, oh I have custom orthodics made by a chiropractor named Dr. Michard located in Newton on Rt. 16. He is very good with feet and treats many high caliber runners, anyway, the cleats on the Time pedals are wonderful, they have almost a cantilever effect as compared to the Frog that pressed on the area where my pain is. I still have some discomfort when riding, it's a work in progress, think I need to adjust the cleat angel a bit. Just wanted to pass on the name of Dr. Michard, he is worth calling and he makes very good orthodics. Good luck.

[mdeeds71]

I had a similar problem when I used to do long movement in military boots...Distances of 40k plus with about 80-110lbs on back...I started to develope a tenderness underneath my big toe and the one next to it only on one foot...After several deployments finally had time to get it looked at...Soft tissue, deep, bruising that I just kept from healing by my continual use...seems the only thing was to take anti-inflamitories as needed...It eventually went away but also that was in conjunction of my redeployment back to the states and subsequent time down...

See the boots have NO, I said NO, padding since that would breakdown quickly, so just a small insoal on solid rubber soles...made for a little pain that given the circumstances I had to deal with...My Northwaves are not much different in the insoal...but custom orthodics with a high/low density absorbing material under the ball of the foot is what I use...but after I saw the military podiatrists...

The light/airborne infantry and SF move on feet thus we get really good care for them.