Training

Foot pain

Keep feet sweet

Most foot pain that occurs during cycling is temporary. Things like hot spots and numbness are usually related to problems with your shoes, but if symptoms persist off the bike, plantar fasciitis might be to blame. This presents as pain around 4cm in front of the heel, which is generally worse in the morning. It’s caused by repeated small injuries to the ligament that runs along the sole of the foot.

Pain around the ball of the foot (metatarsalgia) can be caused by bunions, foot deformities or Morton’s neuroma (a problem with one of the nerves of the foot).

Assessment

Persistent numbness, heat or cold can be caused by illnesses such as diabetes or circulatory problems and should be checked by a doctor. Plantar fasciitis can be confirmed by examining the foot, while bunions and foot deformities are more visually obvious.

A Mortin’s neuroma is diagnosed by squeezing the foot while pressing between the affected bones, causing a click that may be felt or heard.

Treatment

Check your bike fit – a saddle that is too high puts strain on the Achilles’ tendon, which can cause plantar fasciitis and metatarsalgia. Poor fitting shoes don’t help so check your cleat position and tension. A good arch support can ease plantar fasciitis; a bike fitter or podiatrist can provide customised insoles or wedges. Off the bike, ice packs, elevating the feet and painkillers can ease symptoms and plantar fasciitis can be improved by stretches (see http://bit.ly/plantarstretch). If problems persist, a steroid injection may be required.

Andy Ward, GP and cyclist @awkwardcyclist

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