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Keep Your Feet in Shape When You Cycle

Based on a document produced in cooperation with the: American Podiatric Medical Association.

In the early 1900s, cycling was one of the more popular ways to get around town. Ironically, cyclists clamoring for improved roads helped set the stage for the automobile, which relegated the bicycle back to where it started: as a recreational mode of transportation. Today, cycling is more than just fun. It’s an extremely efficient way to keep in shape and improve cardiovascular fitness. More than 100 million Americans still ride for pleasure on occasion. In New York City alone, 100,000 people cycle to work each day. Lance Armstrong, with 5 straight Tour De France titles in a row has brought cycling awareness and respect in the United States.

The bicycle was not invented by one single person, but was gradually developed throughout Europe beginning in the late 1700s. Invention of steering, the wheel crank, and the chain-and-pedal system is attributed to various Europeans. An important American contribution came in 1889, when John Dunlop developed the first air-filled tires; in 1898, the first coaster brake brought the bicycle into the modern age.

The Feet’s Link to the Pedals
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 pedaling, 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 pedaling.

Investing in a cycling-specific shoe is a good idea if you have had preexisting problems with your feet or wear orthotic shoe inserts. Most orthoses control the arch and heel, and for cycling, usually require critical forefoot balancing. Riders with mild bunions or hammertoes should select a wider, deeper shoe that will accommodate the deformity.

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 recently become popular.

The use of toe clips, and their degree of sophistication, begin to separate the casual rider from the more serious devotee. Toe clips range from traditional clips to newer shoe-cleat ensembles — “clipless systems” — that resemble ski bindings. Many companies model their units on the French manufacturer Lookª. A Look-compatible unit will offer the most diverse combinations of shoes and clips from which to choose.

Proper shoes and clips or cleats working as a unit are important to achieve maximum efficiency in transferring power generated by the hips to the foot. For most efficient pedaling, shoes should extend fully under the ball of the foot.

Biomechanics and Cycling
Biomechanics, the study of external forces on the living body, plays a crucial role in efficient, satisfying cycling. For example, when seated on a bike with hands on the handlebars, the hands, shoulders, and front axle should all be in line.

By enhancing the biomechanics of the foot, podiatric physicians specializing in sports medicine can improve the mechanical functions of related body parts. If, for example, an experienced cyclist’s knees hurt after a 30-mile ride, the problem may be a biomechanical imbalance. A podiatric physician can alleviate the pain by correcting that imbalance through prescription orthotic shoe inserts. Training and conditioning methods should also be evaluated.

To preclude 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, or rate of pedaling. The seat is at the proper height when knees are slightly flexed and hips are over the knees.

Podiatrists recommend the use of a pulse monitor for a cycling-based training regimen. Some models strap around the chest, while smaller units wrap around the wrist or the thumb and display the pulse rate as you ride.

Ask your podiatrist about an appropriate pulse rate while you ride. Usually, the same criteria applies as with running: your pulse should be 60-70 percent of the maximum for efficient training.

Injuries and Treatment
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 sports medicine specialist familiar with cycling injuries.

Knee Pain: 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. Riding in too high a gear, too far uphill, or standing on the pedals all may aggravate the problem. Cleated shoes or touring shoes with ribbed soles that limit side-to-side motion can cause knee pain if the knees, feet, and pedals are misaligned.

Shin Splints: 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.

Achilles Tendinitis: Irritation and inflammation of the tendon that attaches to the back of the heel bone can be caused by improper pedaling, seat height, lack of a proper warmup, or overtraining. 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.

Sesamoiditis: 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.

Numbness: 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 system.
Numbness or tingling with leg pain may represent a serious problem known as “acute compartment syndrome,” which requires immediate medical attention.

Competitive Cycling
Undertaking a successful cycling regimen frequently results in the desire to match skills with others. There are four categories of competitive cycling. Category I denotes world-class competition — with conditions and strategies an average cyclist would not be able to navigate. Category II is also advanced, and employs such techniques as drafting, and involves certain “courtesies” of cycling etiquette.

Categories III and IV offer opportunities for fit cyclists to go out and test their mettle against other enthusiasts of the sport. No special equipment is required, only the desire to compete and an adequately trained, biomechanically tuned body. See your local bike shop for schedules of races in your area. As with all competition, start at a low level and work your way up the categories. Remember, put safety first, and enjoy yourself. Before beginning any exercise program, be sure to check with your physician.

Selecting Cycling Shoes
– by Paul Langer, DPM

Selecting the appropriate cycling shoe isn’t as easy as it used to be. Like a lot of athletic shoes, cycling shoes have become increasingly specialized. There are multiple pedal systems, and different types of cycling from spinning, to cyclocross, to road, mountain and triathlon biking. Casual cyclists do not need to worry about purchasing cycling shoes but for those who ride 3 or more times per week, a cycling shoe and pedal system can improve your performance.

Much like the bindings attach the ski boot to the skis, performance cycling pedals attach the shoe to the bike via a clip-in system. These types of pedal systems are designed to improve the efficiency of the pedal stroke by allowing the biker to pull up as well as push down during a 360 degree pedal stroke. Most pedal systems snap the shoe cleat into the pedal as pressure is applied and the shoe is released from the pedal by twisting the foot outward.

As a word of warning, clip in cycling systems can be intimidating and it is almost a guarantee that you will fall once or twice while learning to use them. If not completely comfortable with the idea of being attached to your bike then hold off on a shoe/pedal system. For casual riders the increased pedal efficiency is negligible at best anyway.

Mountain and recreational biking shoes have a recessed cleat and a flexible sole. The recessed cleat and flexibility of the shoe make it easier to walk which is great for mountain bikers who may need to carry their bike over an obstacle or a recreational biker who wants to bike across town to check out the art fair.

For more competitive or performance-oriented road bikers, the shoes are much stiffer and the cleats are not recessed but instead are attached to the outsole of the shoe. These types of shoes are definitely not made for walking. In theory, the stiffer outsole of the shoe allows more efficient energy transfer to the pedal. The most expensive and stiffest shoes use carbon fiber outsoles while low to mid-range models use nylon or plastic outsoles.

Some models of cycling shoes are designed to combine the performance features of a competitive shoe and the comfort and flexibility of a recreational shoe. For example, a newer category of cycling shoe was born out of the popularity of stationary biking classes that are offered at many athletic clubs. These shoes fall somewhere between the casual riding shoes and competitive models. They tend to have more breathable uppers to compensate for the lack of airflow during stationary riding. Triathlon cycling shoes usually have one to three velcro straps to allow for easy entry and exit during transitions.

Fit and Comfort
The upper of a cycling shoe is, of course, the most important part of the fit. Casual cycling shoes have laces or Velcro. Performance shoes have ratchet-style buckles and/or Velcro. Most uppers are made from leather or synthetic materials. Tighter shoes translate to more efficient energy transfer but tight shoes can also restrict blood flow to the feet. For wide or difficult to fit feet some manufacturers are starting to make wide sizes. For example, Sidi offers some of their models in “mega” sizing. Also, a company called Rocket7 makes custom-made cycling shoes.

As mentioned above, performance shoes will be very rigid under the foot. A significant drawback to stiffer shoes is decreased comfort. Stiffer shoes have been shown to significantly increase pressure on the forefoot. For bikers who are vulnerable to forefoot pain, they may want to consider the stiffness of their shoe or modify the insole to decrease pressure on areas of pain. Those with sesmoiditis, neuroma, or metatarsalgia may either need to purchase a plastic soled model or have the forefoot modified either with a custom-made orthotic or changes to the insole. These changes inside the shoe can help distribute pressure over a broader area of the forefoot.

Once you know which category of cycling shoe you need, it is extremely important to evaluate a number of different models before making a purchase. Unfortunately, standing in a bike shop is not the truest way to test the performance or comfort of a cycling shoe and buying a shoe via the internet without ever trying it on or comparing it to another model is NEVER a good idea. While in the shop though, focus on fit and comfort. Be especially aware of the fit in the forefoot because most cycling-related foot discomfort is going to occur there. The small surface area of the pedal and the stiffness of the shoe combine to create high forces under the ball of the foot. Selecting a shoe that has a removable insole will offer greater opportunity to modify the shoe or add an orthotic if necessary down the road.

Finally, friends and bike shop employees are great sources of information but your foot is almost as unique as your fingerprint so do not buy a shoe merely on someone else’s recommendation. Trust your instincts on which shoe has the best fit and feel for you.

Come Visit One Of Our Two Convenient Podiatry Offices

Podiatry Office In Sugar Land, TX
15200 Southwest Freeway Suite 130
Sugar Land, TX 77478

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7737 Southwest Fwy., Suite 500
Houston, TX 77074
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