How
to Solve Painful 'Hot Foot'
By
Fred Matheny for roadbikerider.com
In
cycling, it’s known as “hot foot” -- a burning
pain in the ball of the foot, perhaps radiating
toward the toes. Severe cases feel like some
sadistic demon is applying a blowtorch.
Hot
foot occurs most often on long rides. It may develop
sooner or more intensely on hilly courses because
climbs cause greater pedaling pressure. The pain
results when nerves are squeezed between the heads
of each foot’s five long metatarsal bones. These
heads are in the wide part of the foot (the
“ball”) just behind the toes.
My
worst case of hot foot occurred on a 3,400-mile,
24-day transcontinental ride. With an average
distance of 140 miles per day, no rest days and more
than 100,000 feet of vertical gain, my dogs were
smoking by the third week.
My
RBR partner, Ed Pavelka, remembers being in agony
near the end of one 225-mile ride early in his
long-distance career. It was his first experience
with hot foot, and the problem plagued him that
season until he changed to larger shoes. Feet always
swell on long rides (more so in hot weather),
causing pressure inside shoes that normally fit
fine.
“Hot
foot” is actually a misnomer. It’s not heat but
rather pressure on nerves that causes the burning
sensation. You’ll sometimes see riders squirting
water on their pups in a vain attempt to put out the
fire.
Besides
tight shoes, another risk factor is small pedals,
especially if you have large feet. Small pedal
surfaces concentrate pressure on the ball of the
foot instead of spreading it the way a larger pedal
will. If your cycling shoes have flexible soles like
most mountain bike shoes, they’ll be less able to
diffuse pressure.
Before
Ed figured out his shoe-size problem, he tried to
solve the pain with cortisone injections. That’s
an unnecessary extreme in most cases -- and it’s
not fun to have a doctor stick a needle between your
toes. Here are several better solutions.
- Adjust
shoe straps:
It’s the top strap nearest your ankle that
stops your feet from slopping around in your
shoes. Tighten it as much as necessary, but keep
the strap nearest your toes loose for maximum
room.
- Use
thinner insoles and/or socks:
This will give your feet more room to swell
without restriction, especially helpful if your
shoes are borderline snug.
- Re-focus
the pressure:
Many riders solve hot foot by moving their
cleats to the rear by as much as 8 mm.
Long-distance enthusiast may go back as far as
the cleat slots allow. They might even drill new
rearward holes. After using this remedy, lower
your saddle by the same amount if you moved your
cleats backward 2-4 mm. If more than 4 mm, lower
the saddle about half the amount. So, if your
cleats go back 1 cm, put the saddle down 5 mm.
- Add
metatarsal buttons:
These foam domes are placed on insoles (or are
built into them) just behind the ball of the
foot. They spread the metatarsal bones so the
nerves running between them aren’t pinched by
pressure or swelling. You can find these
products in the foot-care section of drug
stores.
- Switch
to larger pedals:
for the reason mentioned above.
- Buy
new shoes:
Look for a model with a wider-and-higher toe
box, a stiffer sole and an anatomical footbed
with a metatarsal button. One model that meets
these specs is the Specialized BG, with versions
for road and off-road.
- Purchase
custom orthotics:
These plastic footbeds are supplied by
podiatrists or sports medicine clinics. Among
their biomechanical benefits are built-in
metatarsal buttons. Be certain the practitioner
understands you're a cyclist, because orthotics
for runners are not what you need. Cycling is a
forefoot activity, not a heel-strike
activity.
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