Hot spots while cycling
I tried to find my previous post about this, but don't quite have Nemo's search-fu...any way...
Last year, while I was beginning the long training slog thru to IMAZ in November, I all-of-a-sudden started to get hot spots on the bottom of my feet, while cycling. I don't remember what the timeframe was for it, but anything over 45 miles, it starts to get hot on the balls of my feet (yes, both of them).
Granted, it was Texas' hottest summer on record, with 100+ days of 100+ temps, but I've never had problems before, with the same shoes (Specialized Tri-vents) and pedals (Speedplays). Earlier this year, I got some new Specialized roadie shoes (white, very Euro!), and am having the same problem.
I have tried getting new footbeds/inserts (also from Specialized, with the "metatarsal 'button'), tried Brevet Bill's Tums trick, tried moving the cleats all the way forward and also as far back as they can go. I've tried different powders, socks, sockless, etc.
Just about the only thing I haven't tried is new pedals themselves - which very well might be next!!
Different brand shoes, is also an option - if I can try them out first and not have to buy $300 shoes just to TEST!
Any other ideas? This is quite frustrating. Downright hurts at times! I cannot see any lasting damage on the ball of my feet.
Comments
I find that taking a break, or excessively pulling up on the pedal stroke to alleviate the pressure (which tires me out faster, as the hip flexors aren't intended to be pulling muscles!), are the only things that do the trick.
My PT today said it could be some neuroma, which he's seen on some cyclists. And I've always had issue with hot spots on the run, just not as pronounced as the last few years on the bike. I'll work with a local podiatrist, well recommended, to see if that's the problem.
Just frustrating, just like every other sort of injury around!
I used to have this exact problem. Or at least it sounds like it. Mine used to flare up at the end of long rides, but would go away within 5-10 minutes of running. I could be in agony on the bike, but as soon as I quit the bike, it got better quickly (even if I went running...even mid-race!)
For me, it's volume related too, and I haven't been doing quite as much volume since I had the problem a lot. I switched shoes, and I don't know if that was causal, but I've had the problem a lot less, too.
In any case, for me, the answer was to ride on top of my shoes for a few minutes. Just slip the feet out and pedal on top like you do at the end of a race.
But I defer to Bill on anything related to volume or long rides! :-)
I learned this one toward the end of my first 600k brevet. I pulled in to a control and complained to the volunteer about my burning feet; I had been riding long stretches with my feet out of my shoes, finding relief if not power! He told me that he'd heard that Tums helped. I actually had a roll of them so I doubtfully ate one, thinking the guy was full of it. But it worked! I need to re-Tum every 45 minutes or so.
I've told this story/trick to many athletes and they've all thought I was full of it until they try it out, then I always recieve messages of gratitude.
Active Ingredients: Calcium Carbonate USP (500 mg) (Antacid)
Inactive Ingredients: Sucrose, Calcium Carbonate, Corn Starch, Talc, Mineral Oil, Natural & Artificial Flavors, Adipic Acid, Sodium Polyphosphate, Red 40 Lake, Yellow 6 Lake, FD&C Yellow 5 Lake (Tartrazine), Blue 1 Lake
I understand that calcium is needed for your body to promote the formation of healthy bone tissue, as well as muscle, heart and nervous system function. Do you think that if someone is low on calcium in their diet they might be prone to the issue above?
The normal clinical effect of Tums is also just that it's a way of neutralizing stomach acid.
As many people are aware you CAN take enough bicarbonate orally to briefly change your blood pH (with positive effects on fast/sprinting events), but there's a major problem with - shall we say - very common "explosive" results afterwards. But that's a lot more bicarbonate than the amount of carbonate in Tums. :-)
That's what I use. Have always used them, never had any sort of problems!
Honestly, sounds like a nerve issue.
A number of years ago I was experiencing the same problem and came across the following article. Although it did not seem to work for you, the Specialized footbeds with the metatarsal buttons fixed my problem. Good luck.
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 activitySpokane Al's repost of Metheny's comments above reminds me that in 1997, on a 3400 mile cross country bike trip, I developed numb toes - the Great ones. I read something he had written in the mid 90s, and moved my cleats all the way back, problem was solved. They've been there ever since, no recurrence. No Tums required, alhtough they *are* good for us OF's calcium needs.
Thought while I was held up waiting for my collar bone repair surgery tomorrow, I'd update on my feet issue (it seems I'm falling apart! haha).
I went to a podiatrist that I was told had lots of experience with this issue. He took xrays to confirm there were no fractures or visible damage. So, pretty much like Dr. Penny said, he confirmed it sounded like a nerve issue.
The doc gave me cortisone shots between my 2nd and 3rd toes on each foot, to see how that helped. First ride that night, my toes were still numb, so it didn't help. The next long Saturday ride, it was already happening - although not as severe at first, but was happening at a shorter distance than before. But still happening nonetheless.
So, the next step is a "nerve ablasion", where they go in and kill the nerve that is causing the pain/"heat". I originally had that scheduled for 6/18, but with my recent collar bone issues, I decided to put it off a few more weeks so I can deal with one thing at a time.
I'll let you know whhat happens when I get it done. Hopefully it's just what I need to finally fix this pain in the arse problem once and for all!!
Scott this is a weird question, but do you eat meat? I ask because I am vitamin b 12 deficient and hot spots on the feet is one symptom due to nerve damage. Also, how do your shoes fall over the top of your foot meaning where are the pressure points. I changed how I tie my sneakers and how. I strap my bike shoes and it made a huge difference FWIW. Good luck with your surgery. You will be so glad you did it!
I've also tried every velcro and buckle adjustment I can think of, including not strapping my foot in at all (not a good idea on a roadie ride).
Hm. I'm fascinated by this Tums story. (files in race execution toolbox).
Maybe try out a different pair of pedals? I had hotspots all the time when I was a newbie long course athlete, going on long rides with eggbeater pedals. Keywins solved everything.
Only other thought -- are your shoes the correct size? Maybe there is pressure somewhere it doesn't need to be and that's causing problems?
P.S. Hijack: great success on this brevet: a new PR for the distance: 27:33, and first finisher to boot! The culmination of three years of study, training, and experience.
Hang in there...I think I've shared some common injuries as you(I've broken my collar bone and have had issues with hotspots twice since the early 90's)
Just to share my experiences with hotspots:
1) occurence #1: carnac triathlon shoes (old school Paula Newbie Frazier style) - moderately stiff carbon composite shoes mated with speedplays --- I switched to Shimano Dura Ace look-style pedals and the next day the hotspots were gone. My theory about (at least the early models of speedplays) is that they work great for lighter athletes but may not be enough surface area for larger athletes.
2) On my road bike with Ultegra pedals, I started with a pair of Shimano Crazy, Crazy stiff carbon soled shoes. Hot spots like crazy. Switched to Specialized high end road shoe and the problem was gone.
I ride specialized tri-vents for tri's and I've been very happy with this mated with Dura-Ace.
Anyway... for me equipment came to the rescue... it was just a matter of finding what worked for me.
Good luck and speedy recovery on the cb surgery.
That's amazing, Bill! I'm amazed and with these brevets it seems like you have found your race.
I'm only riding the trainer until I get clearance to go outside again (can't wait), the hot spots were showing up indoor about the 40 minute mark, so I decided to go ahead and get them done. Interesting procedure, with combination of cold, hot, tingling and pressure. Not painful at all, just weird sensations.
I'm sincerely hoping this fixes the problems, after years of agonizing workouts!
Sorry if you receive this twice. There are a couple of foot threads up right now.
As you can read in the thread, in October, I had my nerves "ablated". It worked great, with low volume, low intensity and low temperatures!
I had a bg bike weekend last weekend in Fredericksburg TX (what we here in TX call "hill country"). Well, the "killed" nerves didn't end up dying after all. By mile 60 of both Sat and Sun rides, my right foot was ON FIRE, and my left wasn't far behind it.
Last week, I went and got a 2nd/3rd opinion from an actual foot-specializing ortho instead of a podiatrist. The ortho said that their compatriots wouldn't do the ablation, they'd rather go in and cut the whole nerve out. So that's what I'm doing this friday - outpatient surgery to completely remove the nerve in both my feet, between my 2nd and 3rd toes. I sure hope this is a good investment of time, once and for all!
I'll be completely forbidden from s/b/r workouts for two weeks, even in stiff-soled shoes (ex cycling shoes). I'm going to start another thread to see if y'all have suggestions on what to do in that timeframe, but wanted to let you know the progress on my feets.