How to Solve
Painful 'Hot Foot'
By Fred Matheny for
www.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.
For more information on
hot foot, orthotics and other foot-related issues,
see "Andy Pruitt’s Medical Guide for Cyclists,"
available as an eBook in the online eBookstore at
RoadBikeRider.com.
Receive a FREE copy
of the eBook “29 Pro Cycling Secrets for Roadies” by
subscribing to the RoadBikeRider Newsletter at
www.RoadBikeRider.com. No cost or obligation! |