Back when I first started getting into the sport of triathlon and training for my first half ironman, I was noticing a numbing sensation in my right foot each time I was on the bike that worsened with longer distance. Being less informed as a triathlete, and only just starting my physio studies, I would think “well it doesn’t hurt, she’ll be right.”
Come race day in my first 70.3 and coming out of T2 things got to the point where I had no feeling in my right foot. It was completely numbed and the pins and needles got to a point of being painful. Thankfully, things started improving, but it took until the 10km mark when it slowly started to dissipate. It was a horrible feeling, not only from a performance stand point, but now also concern of what had happened. As I then realised, I never wanted this to happen again, which got me looking into exactly what was going on and what I could do to rectify it.
Burning feet and foot paralysis during or after cycling is a condition known as ‘Hot Foot’. In the early stages these symptoms may resolve after cycling, but It has the potential to be debilitating, particularly in long distance and ironman athletes. If not recognised and addressed early hot foot may progress into a more chronic condition known as metarsalgia making it increasingly difficult to rectify.
So, what should things should you consider if you getting foot pain and paralysis on the bike?
Hot foot most commonly presents from pressures involving the base of the big toe. Checking the position of your cleats and making sure that they are not contributing toward any further pressure around this area is important. Moving your cleats further back toward the heal (approximately 1-2cm behind the base of your big toe) can help reduce these pressures.
Ill-fitting footwear is a common cause of hot foot in cycling populations. Shoes with a narrow toe box are a common cause and looking for a wider fitting shoe, or loosening your foot strap may help.
Most cases of Hot foot will resolve by giving your foot more space. Using less thicker socks is a simple but often highly effective treatment.
Any known case of a Morton’s neuroma can cause nerve irritation which is often aggravated when cycling.
Although giving performance benefits, carbon fibre soled shoes produce plantar foot pressures 18% higher than that of plastic soled shoes (Jarboe & Quesada, 2003).
Therefore, athletes suffering from hot foot should be cautious when using shoes with carbon fibre soles.
It may be possible that pressures on the foot are cause by something further up in the hip, knee or truck. Having a comprehensive bike fit it is recommended, especially if all other attempts fail.