How cycling impacts on the foot
Cycling requires the entire lower body to function as a harmonious unit and bring sufficient force down on the bicycle pedal to move forward. This tremendous force begins in the hip joint and thigh muscles, and passes through the ball of the foot to the pedal. As long as the bones, muscles, and joints of the lower extremity are properly aligned with each other, there is an efficient and pain-free excursion of the pedal. Deviations from this alignment may eventually cause foot, ankle, lower leg, knee, thigh or hip pain.
Potential problems and when to seek the help of a podiatrists
Every day, podiatrists treat cyclists who have sustained overuse injuries by pushing themselves beyond their limitations. Here are some of the most common cycling injuries and their causes. As with all athletic injuries, pain that is persistent indicates a need to seek treatment from a podiatrist familiar with cycling injuries.
Irritation and inflammation of the tendon that attaches to the back of the heel bone can be caused by improper pedalling, seat height, lack of a proper warm-up or over training. This condition is usually seen in more experienced riders and can be treated with ice, rest, aspirin or other anti-inflammatory medications. Chronic pain or any swelling should be professionally evaluated.
Some intrinsic knee problems like swelling, clicking or popping should be immediately evaluated by a sports medicine specialist. Cartilage irritation or deterioration, usually under the kneecap, can be caused by a biomechanical imbalance, improper saddle height or faulty foot positioning on the pedals.
Impingement of small nerve branches between the second and third or third and fourth toes can cause swelling that results in numbness, tingling, or burning, or sharp shooting pains into the toes. Wider shoes, or loosening toe straps or shoe laces can alleviate the problem. If the problem persists, try a clipless shoe system. Numbness or tingling with leg pain may represent a serious problem known as “acute compartment syndrome”, which requires immediate medical attention.
Sometimes known as the “ball bearings of the foot”, the sesamoids are two small bones found beneath the first metatarsal bones; the sesamoids can inflame or rupture under the stress of cycling. Sesamoiditis can be relieved with proper shoe selection and orthoses.
Pain to either side of the leg bone, caused by muscle or tendon inflammation. This may be related to a muscle imbalance between opposing muscle groups in the leg. It is commonly related to excessive foot pronation (collapsing arch). Proper stretching and corrective orthoses for pronation can help prevent shin splints.
Besides selecting a bicycle that meets your specific needs, proper shoes are the most important piece of cycling equipment. Cycling shoes must have a stable shank to efficiently transfer power from your feet to the pedals. The lack of shank support in sneakers allows the foot to collapse through the arch while pedalling, which may cause arch pain, tendon problems, or burning under the bottom of the foot. A rigid shank protects your feet from the stress of pedalling. Select a shoe that’s right for you among models designed for racing and mountain biking. For the casual rider without known foot problems, cross-
training shoes provide the necessary support across the arch and instep in a shoe that can be used for other purposes. They also provide the heel lift that cycling shoes give. Combination cycling-hiking shoes meet the needs of the casual rider well and have become popular recently.
- Carefully choose the shoes you will wear in cycling.
- Make sure your bike fits you properly.
- Warm up properly. Condition yourself safely in the off season.
- To stop pain before it starts, podiatrists advise stretching the major muscle groups used in cycling - the gluteals, the quadriceps, calves and hamstrings - before and after getting on the bike. Riders should start slowly and work up to normal cadence (rate of pedalling).
- Ensure the seat is at the proper height when knees are slightly flexed.