A Guide to Foot and Ankle Pain On Multi Day Bike Rides

One of our Ride25 tour crew, Paul ‘Smudge’ Smith (who is an all-round cycling guru/professional bike fitter/bike mechanic/rock tape expert/biomechanics trainer) talks us through the common causes of foot and ankle pain on cycle rides and multi-day cycling holidays…

Foot and ankle pain can be the most debilitating and agonising pain whilst cycling. It can make every pedal stroke almost unbearable.  Check out the blog below so that you know how to avoid some common foot problems so that you make the most out of your multi-day cycling holiday – and have Happy Feet!

About the foot

The foot itself is a complex structure that is made up of 33 individual joints, 26 small bones, over a hundred tendons, ligaments and muscles that allow weight bearing, structure and movement. It is constantly under load be that walking standing and sitting.

Most common foot pain whilst cycling: Hot Foot

The most common pain within the foot whilst cycling is described as ‘Hot Foot’ as this condition produces a number of discomforts that produce the sensation of heat as well as pain. Symptoms more often than not include pain under the balls of the feet, numb toes and a burning sensation along the bottom of the foot.

These symptoms are generally caused by a squeezing of the nerves between the toes in the ball of the foot. We often find that during our cycling holidays, our riders’ feet swell as they are on the bike for multiple days… however, modern synthetic and carbon soled shoes don’t accommodate the change in size of the feet.  If shoes are tight fitting when bought then this will aggravate Hot Foot whilst on longer rides. Most modern cycling shoes are also flat bottomed (where as feet are not) so specific insoles can be fitted to allow for natural arch movement.

The anatomy of the foot can also be the problem as bony, narrow thin feet lack the padding therefore move more through the arch or have a high degree of fore foot tilt, (Varus). This is the natural angle between the first and last toe. Wide feet are at risk also as they can swell and become jammed into cycling shoes that become too narrow.

How can I avoid ‘Hot Foot’ when cycling on multi day cycling holidays?

To escape Hot Foot would be to avoid putting pressure on a concentrated area of nerves on the ball of the foot. This could be caused by pedals that are too small or cleats incorrectly fitted.

The cleat on most pedal systems allows for 5 ranges of movement and these are: Fore, Aft, Left, Right and Rotation. If the first 4 adjustments are slightly out then this magnifies Hot Foot.

On our multi day cycling holidays, we sometimes use small metatarsal domes as an intervention to alleviate the symptoms of hot foot. By placing these on the insole behind the ball of the foot it allows the toes to spread slightly when pressure is applied thus reducing the pressure on the nerves. Thinner socks can also help whilst on multi day cycling tours.

Ultimately if Hot Foot is an issue, then a proper bike fit (before coming on your cycling holiday) incorporating cleat fitting is the answer as the fitter can measure the foot varus and identify any other contributing issues such as a leg length inequality and (as in running) a pronation of the feet. Wedges and insoles can then be fitted to allow for natural movement and pedal stroke.

Other common causes of foot pain

Outside edge foot pain:

Outside edge foot pain is another common pain that we see on multi-day cycling holidays. This is generally caused by the cleat rotation not allowing the foot to fall into its natural position. This can be assessed quite quickly when cycling and adjusted accordingly. The general rule of thumb is “Walk like a duck….Pedal like a duck”

Achilles Tendonitis.

This in an inflammation of the tendon that joins the calf muscle and heel at the back of the foot.

The main symptom is a pain at the back of the ankle that is magnified when the foot is moved up and down accompanied by possible swelling.

This can be caused by simple overuse, soft soled shoes on flat pedals and a more flexible sole which makes the ankle stretch at the bottom ob the pedal stroke. Cleats too far forward causing a toe down pedalling also causes the tendon to inflame.

Again correct footwear, cleat and pedal system can go a long way to prevent this issue. During Ride25 cycling holidays, the use of rock tape and repositioning of cleats has been used to great success.

Post-ride procedures

Good post ride procedure also helps on multi day cycling tours.  This includes light subtle stretching, trigger point therapy, “Smudge’s Balls” (you’l have to come on a Ride25 cycling holiday to find out about that one!!) and cold compresses before relaxing the feet in the evening in appropriate footwear or bare footed.

As always, a good thorough bike fit is recommended.