Training & Nutrition - Top of foot/front of ankle pain??

So .... what fit adjustment would you make to the bicycle if you suffered from top of foot/front of ankle pain??

This is a new one for me. I've had Achilles problems before, but never any pain on the other side of the foot/ankle.

what kind of pain - can you describe it? When and how does it occur?

The pain starts in the middle of the top of the foot (roughly over the arch) and goes up to about 6 inches up the front of my leg, like up the shin. It is a narrow band of pain right up the middle of the foot, and up the leg ... sort of along that tendon in front, I guess. I feel it when I walk, when my foot flexes as I walk. It doesn't hurt when touched, and it isn't bruised or anything.

I rode a century yesterday, and it was fine all through the century. It was fine last night when I was relaxing ... but when I went to stand when I got out of bed this morning .... OUCH!! It has been sore all day, but does feel a bit better now than it did first thing this morning.

my guess is tendonitis. My first suggestion is to see a doctor. barring that, I would heat it, then exercise the foot by attaching a weight (even cans in a grocery bag) and doing toe raises, then icing the foot afterwards. Combine this with a thorough stretching program, and you may get rid of it in a couple weeks if you stay off the bike. Otherwise it could get worse and keep you off for longer and need cortisone shots.

Again just a guess. I'd see a doc.

Possibly ... although it is already feeling much better than it did this morning. But I'm more after what might have caused it. Saddle too high, too low ... something else ?????? It's the first time in 17 years of cycling I've ever had pain on the top of the foot.

I get something very,very, similar on the first long ride, when I have been off the bike for a while.
It goes away after a few shorter easy rides. It feels as if something needs to be stretched in my case.
Once I get going and keep on riding it never comes back. It will repeat if I stay off the bike again.

I get something very,very, similar on the first long ride, when I have been off the bike for a while.
It goes away after a few shorter easy rides. It feels as if something needs to be stretched in my case.
Once I get going and keep on riding it never comes back. It will repeat if I stay off the bike again.


That's the thing ... I've been rotating and stretching my ankle on-and-off all day, because it did feel like it needed stretching out or something ... and it does feel better. In fact, walking makes it feel better ... the first few steps hurt, and then it seems like it settles down.

One other suggestion I got was that I might have had too much pressure on the top of the foot, or that tendon there. I was wearing heavy wool socks, my ankle braces, my shoes, and my neoprene booties. I wear that combination quite often, but perhaps this time something wasn't sitting quite right.

That's the thing ... I've been rotating and stretching my ankle on-and-off all day, because it did feel like it needed stretching out or something ... and it does feel better. In fact, walking makes it feel better ... the first few steps hurt, and then it seems like it settles down.

One other suggestion I got was that I might have had too much pressure on the top of the foot, or that tendon there. I was wearing heavy wool socks, my ankle braces, my shoes, and my neoprene booties. I wear that combination quite often, but perhaps this time something wasn't sitting quite right.

It sounds more and more like what I get. It goes away in a day usually.
In my case it does not matter what I wear.
Maybe something is flexing that part of your leg or ankle joint, more than the trainer. Did you take much time off at all?
It could just be the increase in riding time if you went right from the trainer to a century. If I remember correctly, it's gone in about a week of riding.

Well, the century was the longest ride I've done outside. I rode 65 kms on Saturday, then the century on Sunday. Two weeks ago I rode a metric century ... half outside and half inside on the trainer, and then the next day I did another 50 kms outside. And I've been riding my trainer an hour or two a day for quite some time.

So it isn't as though I've been off the bicycle for an extended period of time or anything ... but it has been just over 2 months since I've done my last century ...... maybe that's too long between centuries for me!! :D

I've had another suggestion that it might be cleat positioning ... that I need to adjust my cleat to allow my toes to point outward just a tad more. Either that or that I need a little bit more float.

I'm betting the joint wasn't thoroughly stretched and warm prior to the activity, and it may have pinched a nerve, whichc caused a shift in muscle use.

Be careful about assuming it's healed and thinking you can go right back tot he activity. Last time I did that I was out for 5 months of physical therapy and missed most odf the season.

Well, the century was the longest ride I've done outside. I rode 65 kms on Saturday, then the century on Sunday. Two weeks ago I rode a metric century ... half outside and half inside on the trainer, and then the next day I did another 50 kms outside. And I've been riding my trainer an hour or two a day for quite some time.

So it isn't as though I've been off the bicycle for an extended period of time or anything ... but it has been just over 2 months since I've done my last century ...... maybe that's too long between centuries for me!! :D

Your body can't take it unless your ride at least 100 miles. :D

Was this the cold century without enough clothing you described in another thread ? The cold can do the same thing for some people. I'm one of them.

Try Tiger Balm or BioFreeze…Assuming the injury is minor tendonitis both of the products may help relieve the pain and improve flexibility. The active ingredient in both is menthol. I use both on occasion and sometimes as a warm-up cream on cold days. The downside of Tiger Balm is the odor :eek: but less so for BioFreeze.:)

Your body can't take it unless your ride at least 100 miles. :D

Was this the cold century without enough clothing you described in another thread ? The cold can do the same thing for some people. I'm one of them.

Yeah, that's the century!! My ankles were well wrapped, which may have caused some problems ... perhaps too well wrapped?? But still my feet were pretty cold by about 3/4 of the way through the century. I was pedalling up and down all the hills just to try to keep warm.

Try Tiger Balm or BioFreeze…Assuming the injury is minor tendonitis both of the products may help relieve the pain and improve flexibility. The active ingredient in both is menthol. I use both on occasion and sometimes as a warm-up cream on cold days. The downside of Tiger Balm is the odor :eek: but less so for BioFreeze.:)

I have a cream where the active ingredient is menthol and I used it last night ... all over my entire right leg from just above the knee (I had a tiny bit of knee pain) down to my toes. This morning when I got up, my knee, ankle, and foot felt pretty good and they've been improving throughout the day.

I've got a spinning class that starts in about an hour, so I'll see how that goes before I make any further decisions about extra rest etc.

Also, just in case anyone wondered ... I've got a Dr's appointment coming up in the not too far distant future for a couple other things. If this foot is still bothering me then, I'll ask about it too.

I have a cream where the active ingredient is menthol and I used it last night ... all over my entire right leg from just above the knee (I had a tiny bit of knee pain) down to my toes. This morning when I got up, my knee, ankle, and foot felt pretty good and they've been improving throughout the day.

I've got a spinning class that starts in about an hour, so I'll see how that goes before I make any further decisions about extra rest etc.

Also, just in case anyone wondered ... I've got a Dr's appointment coming up in the not too far distant future for a couple other things. If this foot is still bothering me then, I'll ask about it too.

If you have a choice warm up slowly for spining.

If you have a choice warm up slowly for spining.

Yes ... I hope they let us warm up slowly. This is my first spinning class ever! I'm also planning to leave in a few minutes to get there early so I can walk around the walking track a few times to warm up a bit.

Yes ... I hope they let us warm up slowly. This is my first spinning class ever! I'm also planning to leave in a few minutes to get there early so I can walk around the walking track a few times to warm up a bit.

Now it's Wed. night, what happened?

Now it's Wed. night, what happened?

It was good!! :) I posted about the spinning experience (a little further down in this forum), but as for the foot/ankle situation ... I'm really wondering about my cleat position. I was as comfortable as can be on the spinning bike (using runners and rat traps instead of cleats), but when I got back on Machak today there were some twinges.

I had my chainring and crankset changed recently. The crank arms are shorter than my previous ones, but wider set. I've already been playing with seat adjustment ... I wouldn't be surprised if I had to do a bit more with my cleats.

It was good!! :) I posted about the spinning experience (a little further down in this forum), but as for the foot/ankle situation ... I'm really wondering about my cleat position. I was as comfortable as can be on the spinning bike (using runners and rat traps instead of cleats), but when I got back on Machak today there were some twinges.

I had my chainring and crankset changed recently. The crank arms are shorter than my previous ones, but wider set. I've already been playing with seat adjustment ... I wouldn't be surprised if I had to do a bit more with my cleats.

It could be that. Maybe more float would help. Your feet move around a little with clips and straps.
Since the new cranks, have you put on many miles without this pain? Depending on what you are wearing in the cold, a few layers will raise your effective seat height, compared to warm weather and just shorts. Sounds like you are getting close to a solution.

It could be that. Maybe more float would help. Your feet move around a little with clips and straps.
Since the new cranks, have you put on many miles without this pain? Depending on what you are wearing in the cold, a few layers will raise your effective seat height, compared to warm weather and just shorts. Sounds like you are getting close to a solution.

Since the new cranks, I've put on about 450 miles without pain.

I'm going to use my cycling shoes at tonight's class ... the pedals there have SPD cleats so I'll try my shoes with those pedals and see what happens.

I have an old hockey injury to my left ankle. I experience both pain and weakness on the anterior of my shin, and then down over my arch -- just as you describe Machka. My physio described it as 'ankle flop' and gave me some exercises. It actually didn't do anything for me. I have to 'strap' now for every ride. Eventually I came to the perfect combo which is an elastic sock, with an ankle support overtop. Slowly the ankle has grown stronger through riding to the point where I can occasionally ride without strapping.

Another thing I've done is to move my cleats (both sides) basically as far back as I can. This takes a lot of pressure off the lever point of the ankle. The drawback of course, is that you want to have the cleat situated right under the centre of the ball of the foot for maximum power. But as a time trialist, this isn't critical; and as a rando, I'm sure it's even less important.

It sounds like you have spasming in your Tibialis Anterior muscle. Were you able to palpate any kind of bump along the front of your leg to the right of the bone? This is the same muscle that gets irritated in "shin splints". It causes pain "down the shin to the ankle and into the toes".

The bump, or trigger point, is ischemic tissue caused by a lack of blood supply. For self treatment: rub the front of your leg on the right side along the bone and apply heat to bring fresh blood into the muscle. Stretch the muscle by extending your toes and pointhing them down while sitting (keeping the foot free from obtrussion).

For professional treatment: consult your local massage practitioner who is knowledgeable/competent in myofascial release/trigger point therapy. A therapist with experience in trigger point therapy would probably be more beneficial and could easily "release" the muscle.

If this is the reason for your pain, I wouldn't point the cause to any foot adjustment. It's most likely due to improper stretching or warming up.

I have an old hockey injury to my left ankle. I experience both pain and weakness on the anterior of my shin, and then down over my arch -- just as you describe Machka. My physio described it as 'ankle flop' and gave me some exercises. It actually didn't do anything for me. I have to 'strap' now for every ride. Eventually I came to the perfect combo which is an elastic sock, with an ankle support overtop. Slowly the ankle has grown stronger through riding to the point where I can occasionally ride without strapping.


Are you saying you're having difficulty lifing your toes up as you walk and they have a tendency to drag the floor if you don't lift your foot high enough? If so: Has your condition improved? Sounds like the same muscle: Tibialis Anterior. I don't know if you have permenant paralysis of the muscle or only temporary and need to be rehabilitated. Either way, it would cause the 'ankle flop' or 'foot drop'. What excercises did he prescribe you?

It sounds like you have spasming in your Tibialis Anterior muscle. Were you able to palpate any kind of bump along the front of your leg to the right of the bone? This is the same muscle that gets irritated in "shin splints". It causes pain "down the shin to the ankle and into the toes".

The bump, or trigger point, is ischemic tissue caused by a lack of blood supply. For self treatment: rub the front of your leg on the right side along the bone and apply heat to bring fresh blood into the muscle. Stretch the muscle by extending your toes and pointhing them down while sitting (keeping the foot free from obtrussion).

For professional treatment: consult your local massage practitioner who is knowledgeable/competent in myofascial release/trigger point therapy. A therapist with experience in trigger point therapy would probably be more beneficial and could easily "release" the muscle.

If this is the reason for your pain, I wouldn't point the cause to any foot adjustment. It's most likely due to improper stretching or warming up.

Yeah, could be the Tibialis Anterior muscle. If there is a bump it isn't really noticable ... but I do have mild "shin splints". And I've been doing pretty much what you've mentioned for three days now ... and it does seem to have helped.

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Now today I rode the spinning bikes with my usual cycling shoes and noticed a bit of strain again, so I think I might have to adjust something. My cleats are quite far back already because I discovered that was more comfortable quite a few years ago. I'm still thinking angle.

Sounds like you're on the right track. Let us know if you find out that it is actually caused by the cycling shoes.

You probably wouldn't notice a lump in that muscle. If anything that you could detect, it would be a tightness that your fingers run across. It's really difficult to palpate with that muscle. I found some "crunchies" near the bone this morning and stretched and massaged it a bit...now I can't find them. Just keep an active eye on that area for a while now.

Sounds like you're on the right track. Let us know if you find out that it is actually caused by the cycling shoes.

You probably wouldn't notice a lump in that muscle. If anything that you could detect, it would be a tightness that your fingers run across. It's really difficult to palpate with that muscle. I found some "crunchies" near the bone this morning and stretched and massaged it a bit...now I can't find them. Just keep an active eye on that area for a while now.

Where I discovered a really painful "knot" was quite a bit higher on the lateral side of my right knee. There's a small lump on the lateral side of my left knee so I think the fact that there is something there is normal, but on the right knee, this lump was about twice the size of the one on the left and about 10x more painful. When I massaged it, I could feel twinges all the way down my leg to my ankle.

I'm learning the parts of the leg (got to know them by next Thursday for an exam) but I'm not quite sure what this lump part is, or why it seems to be affecting the whole lower leg. But it, and the rest of my leg, have been feeling some better today.

The lump...how close is it to the patella? Is it immediately lateral to the patella or how many inches superior or inferior? Does it send pain down the anterior or posterior side of the leg?

What class are you taking? :)

The lump...how close is it to the patella? Is it immediately lateral to the patella or how many inches superior or inferior? Does it send pain down the anterior or posterior side of the leg?

What class are you taking? :)

The lump not immediately lateral to the patella, it is about 2 inches inferior. It sends pain down the lateral (?) side of the leg but perhaps a bit more anterior than posterior. The pain seems to sort of curve toward the top of the foot by the time it reaches the ankle.

And I'm taking my Alberta Fitness Leadership training - Fitness Theory and Resistance Training.

http://www.provincialfitnessunit.ca/aflca.php?p=certification

My exams are tomorrow so I've been up to my eyeballs studying.

Good luck on the exams...or have you already taken them?

It's the same muscle...Tibialis Anterior. Check http://en.wikipedia.org/wiki/Tibialis_anterior...or your textbook...notice how the muscle wraps towards the large toe when at the top of the foot.

Otherwise, if you're able to take a picture pointing where the spot is. I still suggest stretching and heat while massaging.

Good luck on the exams...or have you already taken them?

It's the same muscle...Tibialis Anterior. Check http://en.wikipedia.org/wiki/Tibialis_anterior...or your textbook...notice how the muscle wraps towards the large toe when at the top of the foot.

Otherwise, if you're able to take a picture pointing where the spot is. I still suggest stretching and heat while massaging.

I just finished the exams tonight. Fingers crossed they went all right ... a pass is 80%!

Here are a couple photos, I'm pointing at the most painful spot on the leg (it is actually a bit of a lump). As for the ankle/foot, the pain down there has gone down to one spot, right in the middle of the top of the foot ... right above the arch.

Hmmm...the pictures add a new "fun" element. lol

In second thought, now, I'd say it most likely is the Extensor Digitorum Longus...which runs along the Tibialis Anterior just laterally. Check http://www.gla.ac.uk/ibls/fab/glossary/extensordigitorumlongus.html for some great pictures.

Both the Tibialis Anterior and the Extensor Digitorum Longus cause pain at the top of the foot. The Tibialis Anterior, however, also causes pain "down the shin to the ankle and into the toes". The trigger point for the Extensor Digitorum Longus appears to be right near where you are pointing, as well.

What book are you using to do your muscular research? A good muscle book is very important.

As my basic muscle bible, I currently am using An Illustrated Atlas of the Skeletal Muscles (http://www.amazon.com/Illustrated-Atlas-Skeletal-Muscles/dp/0895826704/ref=pd_bbs_sr_1/102-9730874-2224104?ie=UTF8&s=books&qid=1174073052&sr=8-1). This is an excellent book and gives a great understanding of the muscles location as well as specifying the referred pain patterns. The information on palpation and the trigger points are taken from Travell and Simons' Trigger Point Manual.

That's my coming out of a very long winter look there ... I'll blind the motorists first time those come out on a ride!! :lol:

Thanks for the book suggestions. Right now I don't have anything specifically in the way of an anatomy book ... all my books are more fitness-related and just refer to anatomy in passing. I would like to pick up a good anatomy book!


OK, I've been paying attention to my footwear and what I'm doing when I feel the pain, and here are the results of my research:

1) Cycling does not seem to make it any worse. Most of the time when I ride, I don't feel anything, and when I get off and start walking around it is no worse than it was.

2) One of my jobs requires me to stand and step for 6 hours straight ... in other words, I take a step to the right, pick something up, step to the left and put it down, over and over and over and over and over .......... For variety, I might step another direction after a while. I have a pair of black running shoes which I have been using on that job for the past 1.5 years. The last month or so, I've noticed that those shoes seem to bother my achilles tendon. I switched to another pair of running shoes for a couple weeks, and my foot felt fine, then went back to the black pair last week ... and when I came home, the top of that foot was in agony!!

3) Today I went to my spinning class, which was fine, and then I got onto the treadmill. It is the first time in about 10 days since I've been on the treadmill. I had to get off after only 20 minutes, and of that time, I only ran for 5 minutes. My foot hurt!! In fact, it hurt all the way up the front of my shin.

4) Then I got to thinking ... I rode that century which seemed to trigger the problem on March 4th. The first time I ran on the treadmill in almost a year was on February 28th ... and I ran quite a bit that day.


Perhaps it's not the cycling ... perhaps it is my feeble attempts to run. I knew running was a bad thing!!

I've been to the Dr, and she thinks it is most likely a pulled muscle, but there is a possibility it is a stress fracture, so I headed off for X-Rays. Now I'm waiting to hear back.

I've been to the Dr, and she thinks it is most likely a pulled muscle, but there is a possibility it is a stress fracture, so I headed off for X-Rays. Now I'm waiting to hear back.

Just some johnny-come-lately thoughts after readin the thread - it does sound a lot like 'shin splints' which really are tiny (or not so tiny) stress fractures. Could be complicated with some muscle issues.
You are a high mileage rider, which over time could be causing a depletion of minerals. Causing both bone density issues as well as muscle physio issues.
Have you had Bone Density tests? To what result?
Its not uncommon to have structural issues be evident in the feet at 1st. Especially since you spend large blocks of time in fairly static upright fashion (your job). The small amount of movement is not enough to relieve the stress down there.
Riding, of course is a relief, since the weight bearing is greatly reduced, but still, pedaling does put regular leverage forces on the upper foot, arch and shin.
Baring some real definitive - "Bone Density is OK!" statement, I might adopt a real 'loading' process of calcium and the other minerals that would have little or no adverse affects in high doses. And find a way to reduce the standing stress. Maybe back off on the high mile rides (I know, heresy !!!) for a 3 week period. That would be enough to really see'changes' and hopefully improvement.
Even though we may not seem to be 'sweating' during the colder months, we are depleting the body just the same. And the depletion process can be long term; not evident until we start feeling evidence of it in 'strange' issues.
Hope you get it pinned down soon...

The thing is ... cycling doesn't seem to really bother it. Running does. So I've quit running for now.

And I can't get a Bone Density test. My Dr won't authorize it. I tried to convince her, but she kept saying that at my age I don't need one and it would be a waste of time. :(

And I can't get a Bone Density test. My Dr won't authorize it. I tried to convince her, but she kept saying that at my age I don't need one and it would be a waste of time. :(

Same Doc who said you might have stress fracture? she seems to show little understanding of sport related stress nor of how taxing your kind of riding has on the body. There are plenty of young people who have bone density issues, not just us old pharts.
No recourse on another way/diff. doctor, to get tested?
If your xrays do show the possibility of stress fracture, I'd be demanding a bone density test.
BTW, here's hopin its not and that its just one of those low cycles we all go thru

I have my X-ray results .....

I do not have a stress fracture. That's the good news.


The bad news is ........ I've got arthritis!! It's in the first metatarsophalangeal joint and I suppose it may be affecting that tendon that runs from the big toe up to the ankle. :( :(


BTW - yes, I'm going to pursue a second opinion on the bone density test.

I have had a similar problem for some time, it is not good!! I have taken a lot of time off from biking the mountains of Utah and running due to school and the extreme pain exhibited with what it seems like is the exact same injury. The only real difference is the location of the pain. My pain seems to be located a little lower on the tibialis anterior, and not so close to the knee like your picture indicates.

What have you done for this injury? I have taken time off, but it still hurts. I tried to stretch it in easy yoga classes and various other ways, but it hasnt helped. I did see a doc, but he didnt help much. I think I am going to head back and get a second opinion soon, but I am wondering what you finally did to alleviate this issue?

What have you done for this injury? I have taken time off, but it still hurts. I tried to stretch it in easy yoga classes and various other ways, but it hasnt helped. I did see a doc, but he didnt help much. I think I am going to head back and get a second opinion soon, but I am wondering what you finally did to alleviate this issue?

Two things:

1) I stopped running on the treadmills. Within quite a short period of time, the pain was gone.
I haven't run on a treadmill since.

2) Just a few days after my last post there, I crashed badly, and other areas hurt a whole lot worse and had my attention. :D Plus I rested a few weeks because of the crash before returning to heavy duty cycling.


You might have a look at these articles to see if there's anything in there which might help:
http://www.cptips.com/knee.htm
http://www.cptips.com/footsyn.htm

I wasnt running on treadmills. Im not sure what prompted it. I rolled my ankle a few times playing basketball and may not have taken enough time off to let them heal. I have just strained it and kept it going. But its the exact same pain as you describe, these postings were helpful. Thanks for being vocal :D

BVA