Photo @cyclebro
The most commonly reported lower limb symptom reported from our patients at The Pedaler is burning feet or 'hot foot'. There are numerous reasons why your feet burn when you ride, however, the solution is usually fairly straight forward.
Riding involves an enormous prolonged period of repitition. As a consequence, the potential for small issues to evolve into larger problems is common. The load on the foot when cycling is one such example of the extremes of the sport. As social rides now creep up into longer and longer distances, it is unsurprising that so many begin to experience discomfort.
Often when discussing burning feet, I'll typically advise the cyclist, that while cycling may be an extremely efficient form of transport, it is not a pursuit we have spent centuries adapting to. With firmer carbon soles paired to stiff bikes and extra miles, the peak pressures on the forefoot are likely to lead to a degree of pain. In these instances, the prime area of load when cycling is the ball of the foot under the big toe. Secondary to this is the base of the big toe followed by the remainder of the pad of the foot. Studies also indicate load through the lesser toes and into the heel. The location of the cleats and the stiff sole of most cycling shoes tends to promote some loading (around 10%) through these structures.
When hot foot is caused by 'overuse' and increased distances rather then other pathologies, we reduce peak load on those particular locations through deflection, padding or cleat movement. If the shoe size is inappropriate, then this will need to be changed as well. Shoes that are too long for the foot cause huge problems as the stiff sole bites into the foot in the incorrect locations.
If there is soft tissue or boney prominances in the forefoot then targeted deflection and proximal loading with a prescription cycling orthotic is typically effective. In some instances the addition of a spongey metatarsal dome is also warranted to reduce peak forefoot load.
There are a raft of other causes for hot foot that will not respond with deflection and padding. In these instances, further investigation, diagnostic imaging and a tailored solution to ensure a quality outcome is the only way forward. Simply treating all forms of 'hot foot' with a blanket solution will certainly lead to a high rate of poor outcomes.
If you have burning feet when you ride, or indeed, when you don't, make time to use our experience and skill set in this niche field.
Words
Nathan White B Hth Sc (Pod) Hons M A Pod A