Why do my feet burn when I ride?

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.

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Nathan White  B Hth Sc (Pod) Hons  M A Pod A

Getting the most from your Health Insurance

Most people who pay for the benefits of Private Health Insurance, wish to get the most out of our coverage.  We pay for the privilege so why not make it count.

One of our niche differences at The Pedaler is the provision of Podiatry alongside our cycling retail passion.  We have a collective 20 years of experience within the field.  If you need help finding comfortable shoes, or understanding the basis for your aches and pains, we are there to help.  Having HICAPS onsite means you can claim while in store.  Neat and tidy.

Make a time to sit down with us and ask us the tricky questions.  

Benefits of being a 'Pedaler' Patient.

If you're lucky enough to be one of our special podiatry/orthotic clients and your feet reside at our 'macabre' storage facility, then you're set for life.  All of our orthotic customers are able to organise a second set of orthotics for no out of pocket expense if they have applicable health insurance.  

Simply make a time to see us and we can ensure that we have your prescription and needs met, then we can fabricate and get your new orthotics out to you within a few days.  This may be a set of walking, running or cycling orthotics.  

This may be a set of walking, running or cycling orthotics

If you're unsure regarding your entitlements, contact your Private Health Fund today and make sure you are getting the most from your coverage.

Call us for more details.  If you aren't an existing client of ours, then rest assured, once you are part of The Pedaler family, you too will be entitled to the same generous treatment.

The Pedaler Cares.  Your LBS and LPP (Local Podiatry Practice).

Cycling Orthotics. What do they do?

I've covered this topic previously in fairly scientific terms and unfortunately, the jargon contained therein makes for pretty heavy reading.  To simplify, let's approach the topic in a more example driven context and explain what we can achieve when using orthotic therapy in cycling.  But first, let's run through a couple of the frequently presented pathologies to us at The Pedaler and across our sister brand Cobra9 Cycling Orthotics.

1. Hot foot - Either focal regions or the whole forefoot.  Very common.

2. Numb foot - Again, either focal regions or the whole foot.  Very common.

3. Painful boney 'lumps' - These can be over bunions or soft tissue swellings.

4. Lower limb overuse injuries - Knee pain, hip pain or ankle impingement.  Very common.

5. Arch strain / pain - Typically in the arch or on the outside of the foot.  Less common.

The use of cycling orthotics to treat these conditions depends on the circumstances behind their emergence and no broad generalisation of treatment options is possible.  However the method by which a cycling orthotic may effect these conditions is set out below.

1.  Increasing the surface are for reduction is pressure.  Simply, Pressure = Force / Area of distribution.  

By providing an increase in the surface area, you can reduce the peak pressure (as long as the force remains constant).  We shouldn't over estimate our influence here as the orthotic in the shoe is an inert object.  It doesn't 'push' back.  However, a stable and well designed shell can alter the pressure.

2. Reducing overuse injuries by altering the direction of force of the pedal stroke.  By shifting the angle of the orthotic we can adjust the direction that the load passes through the foot and ankle.  Again, we shouldn't over estimate the impact here and imagine meteoric shifts in visual outcomes, but given the repetition involved in cycling, small changes can make a huge difference.  

3.  Altering focal areas of pressure via prescribed additions.  We can modify an orthotic and add a range of options to alter pressure points.  Domes, deflection cut outs, dual density materials, memory foam and camber shifts are a few examples whereby you can improve pain by moving load to a tolerable location on the foot.  

When treating a cyclist or any patient for that matter, providing generalised treatment prescriptions is impossible.  There are far too many other variables to simplify the process down to a pure formula.  However, you can begin to see where the relationships emerge.

Someone who complains of focal forefoot burning may benefit from an increase in area of pressure distribution along with selected topical orthotic modifications to shift the load away from boney, swollen or painful regions.  

A cyclist with a sore knee due to repetitious knee movement may benefit from altering the direction of load from the 'foot up'.  

A cyclist suffering from 'numb foot' may benefit from a reduction in insole thickness paired with changing shoes and/or the alteration of the forefoot load by modifying the shape of the forefoot of an orthotic with a dome / cut out or a combination of both.

As you may have noticed, the concept of power has not been discussed.  That is simply because there is no scientific study to back it up and what current studies that do exist within this field are either statistically imperfect or not relevant to the use of prescription orthotics.  It is unlikely this will change as placebo double blinded trials with prescription orthotic therapy are incredibly difficult given no two prescribed orthotics are the same and a placebo prescription cycling orthotic is virtually impossible to create.  There is however, a great deal of good research into other cycling orthotic based outcomes from a variety of institutions including some very good examples from Brisbane's own University of Queensland.

As a consequence, most studies end with similar conclusions supporting the notion of a case by case approach to orthotic therapy whilst using as much evidence based practise as practically possible. This is our approach at The Pedaler and Cobra9.  Our 16 years of experience treating cyclists certainly helps as well.

So when you are considering whether a cycling orthotic is what you need, remember that they aren't magic wands.  They are one treatment option among many others and may require fine tuning.  Make sure your condition is explained to you first, then the basis behind why orthotic therapy may help your pathology needs to be clearly outlined.  Be informed......then get something cool from your Private Health Insurance for a change!!

Nathan White B Hth Sc (Hons) Podiatry, M A Pod A, AAPSM, SMA