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  1. #1
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    Peripheral Neuropathy

    No medical forum, so this will have to do.

    As a long time gear masher, I am fairly certain that I have induced pericpheral neuropathy in my feet form the constant compression of the foot. I've had this for several yrs. For those who may not know, this is not a temporary condition. Numbness and ultra senstivity, etc, persist. Has anyone experienced this situation? Have you successfully combatted it either through meds, therapy, etc?

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    Quote Originally Posted by cyclingman1 View Post
    As a long time gear masher, I am fairly certain that I have induced pericpheral neuropathy in my feet form the constant compression of the foot.
    What? You never stop cycling? While it's possible that cycling can exacerbate a pre-existing condition (eg, a neuroma), it seems unlikely that would cycling cause it.

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    It can also be problems coming from your back. Have you had EMG to confirm this thought? Spinal MRI to rule out nerve root compression? could it be piriformis syndrome?

    seems unlikely for biking to cause PN... Likely some other comorbidity etc

    source: Licensed doctor of physical therapy

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    Definitely not spine related. Not sciatica.

    Not sure about cycling not being able to cause some sort of physical situation, especially if done to excess. Cycling does not get a free pass. PN can be caused by overuse, compression, etc.

    Haven't resolved any of this. I was simply hoping that someone who had actually experienced this syndrome would comment.

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    Quote Originally Posted by cyclingman1 View Post
    Not sure about cycling not being able to cause some sort of physical situation, especially if done to excess. Cycling does not get a free pass. PN can be caused by overuse, compression, etc.

    Haven't resolved any of this. I was simply hoping that someone who had actually experienced this syndrome would comment.
    How much cycling are you doing??

    Even if "excessive" (whatever that means!) cycling can cause some sort of "physical situation", I don't think your foot problem one of the likely ones!

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    cyclingman1,

    Usually Peripheral neuropathy is from diabetes or chemo treatments. My wife and I have from diabetes. I find biking helps with the circulation you need to have comfortable shoes and socks. Sometimes my feet feel very hot especially at night. We have had some success with alpha lipoic acid. It is not a cure but helps releave the symptoms.

    You can see a Neurologist who usually tries a number of pills to see if gets better. Nothing worked for us, a lot of side affects.

    Ron65

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    Faster than yesterday
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    How about trying a different cleat/cleat position/shoe?

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    What does "fairly certain" mean? Were you diagnosed? I wouldn't try medicating yourself until you know for sure.

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    Well peripheral neuropathy is often a consequence of diabetes. If you have not ruled that out, you might think of checking it.

    I would think there are some things you could do to diminish the pounding on your feet. You could wear shoes with the gel inserts in them. That should give you a bit more cushion.

    Another thing you could try is riding at a higher RPM (spin more). But it sounds as if you are a veteren and I would think that it would be hard to change an ingrained technique.

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    Quote Originally Posted by cyclingman1 View Post
    Cycling does not get a free pass. PN can be caused by overuse, compression, etc. ... I was simply hoping that someone who had actually experienced this syndrome would comment.
    No help here as far as a cure or definite cause goes, but anytime I go hard on the bike after a layoff (more common than I wish it were as I get older), I have similar symptoms. I've mentioned them to a couple of docs, who pretty much checked me for diabetes, then forgot about it. In my case, at least, it seems to be related to cycling or the shoes or the pedals--I've never had the problem except under those circumstances. My shoes fit, and changes from one cycling shoe and pedal system to another (road to MB or vice versa) don't help, at least in the short term (but I haven't tried that until I was pretty jammed up, so maybe an earlier switch would head things off). Lately I've been riding with BMX pedals and running shoes, just to see if that makes a difference, but it's only been a couple of days. Too early to tell if it's a fix, but it feels better during the ride.

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    Thanks for input. No diabetes, etc for me. I suppose excessive cycling is relative to the person. I have ridden an estimated 150,000 miles over the last 35 yrs, most of it ridden very hard. It's going to be hard to reverse most of the damage.

    Neurologist is on the horizon - just been putting it off. Family doc diagnosed many yrs ago - no doubt she is correct. I've read that relief is often difficult to obtain. Many meds are ineffective with unpleasant side effects, which is the kind of input I've been looking for. I use Look pedal system. Do not like SPD.

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    Quote Originally Posted by cyclingman1 View Post
    Thanks for input. No diabetes, etc for me. I suppose excessive cycling is relative to the person. I have ridden an estimated 150,000 miles over the last 35 yrs, most of it ridden very hard.
    4286 mile per year (or about 286 hours per year assuming an average of 15mph).

    That's a fair amount of riding but I don't think it's anywhere near what professional racers do. Of course, they don't necessarily do it for 35 years.

    I have no idea, given this amount of experience, why you would have chosen to be a "masher" for so long (it's not like cadence is a new concept).

    Quote Originally Posted by cyclingman1 View Post
    It's going to be hard to reverse most of the damage.
    If your problem was caused by 35 years of cycling, it's likely going to be impossible.

    Quote Originally Posted by cyclingman1 View Post
    Neurologist is on the horizon - just been putting it off. Family doc diagnosed many yrs ago - no doubt she is correct.
    Why put it off?
    Last edited by njkayaker; 06-28-10 at 10:39 AM.

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    All relevant observations.
    By gear masher, I mean brisk to fast pace(up until ten yrs ago, I seldom averaged less than 20 mph on a solo ride). Not an unsmooth rider, I just use bigger gears that I go fast on. Like a Jan Urich as opposed to a Lance. I don't think that made Urich a non-sensible rider compared to Lance. It is quite true that many, especially professionals, have and do ride more miles than me. But then again, they may not be predisposed to this problem. For all I know, some of them may have it. In my case, my feet are very thin and long. Whether that is a factor I do not know. Most TDF riders are smaller type guys. I'm 6'4" and around 195 lbs.

    Why put off going to doctors? So many reasons. Expense. And getting jerked around. I've known so many people with stranger type injuries who have been shuttled around among specialists with all kinds of tests and meds who come out on the other side maybe worse off and a whole lot poorer. My conidition is a nuisance and a concern, but is not exactly life threatening. I really do not believe any doctor is going to solve my problem. At best they may provide some relief. I intend to go in the next couple of months. I need a referral from primary doc.

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    Then I am not quite understanding why you posted this thread if you aren't willing to attempt to solve the issue, think that it is something minor, and believe that your condition is too weird to be cured (when in fact neuropathy is not that rare). If you want to wait until you can't feel your feet anymore, then that's your choice, but I'd choose to address it sooner rather than later.

    Mashing vs spinning refers to cadence, not speed. A higher cadence is generally easier on the knees.

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    Quote Originally Posted by cyclingman1 View Post
    Most TDF riders are smaller type guys. I'm 6'4" and around 195 lbs.
    There are a lot of people like this who ride a lot.

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    You are ready for custom orthotics with metatarsal arch pads. bk

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    Reason for posting:

    Has anyone experienced this situation? Have you successfully combatted it either through meds, therapy, etc?

    I seem to be getting a lot of pot shots, but not a lot of helpful responses except for a few, which I do appreciate.

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    Sorry that you are dealing with this. My wife had a weird thing happen last year after a botched bunyon surgery (quack doctor, I know exactly what you're talking about above) wherein her right foot up to her shin went numb and tingly, discolored (white from reduced blood flow) and painful. She was diagnosed (by a new, QUALIFIED doctor) with a condition alternately called RSD or CRPS (complex regional pain syndrome) -- neither of which are that hopeful to shake.

    Not saying by any stretch this is what you have, just relating her successful outcome: we made the decision together that this was NOT going to take her down. She was sent to a pain management specialist who gave her a patch to increase circulation at her foot and what amounted to an epidural...basically put her leg to sleep with a shot in her back, and "rebooted" the nerves as we were told they were firing on each other instead of back up to her brain and back down to her foot. It took about a week, but her condition steadily improved.

    Over the following months, she/we did lots of PT, lots of prayer and positive thought (read and put into practice a book called Creative Visualization by Shakti Gawain -- hey you've nothing to lose except the pain and research shows that mental state can greatly affect pain and pain management). She did this DAILY, for several months and we continue with the prayer and visualization. Today, a year later, she is running again and that condition is GONE. I feel like we dodged a bullet.

    I can tell you to COMPLETELY avoid internet forums discussing the worst aspects of whatever you're diagnosed with. A lot of them are commiseration corners that can scare the hell out of you and make your situation seem hopeless. Focus on the positive and damn the odds. I repeat: damn the odds.

    Trying to get her onto the bike is a challenge as running is really her gig, but I'd like to save her knees so she can run 'til she's 80! Anyway, I hope this is of some help/hope to you. Do not give up. There is hope.

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    Constant compression of the foot on its load-bearing areas (ball of the foot, heel) should not lead to peripheral neuropathy. There are plenty of heavyset people who are otherwise healthy who spend all day on their feet at work, and they rarely develop peripheral neuropathy. I myself used to weigh 280 pounds and I stand on my feet all day at work. If anyone has constant compression of the foot, it's me.

    I would venture that your clipless pedals might not be set up correctly, perhaps causing you to put load on areas of your feet other than those designed to bear weight, or constricting places where the major nerves pass.

    In addition to a neurologist, you might want to consider seeing a sports medicine specialist as well.

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    All the second-guessers may be right--it may not be cycling-related. FWIW, though, I've had what sounds like the same problem for several years, and nobody's found another cause. It started when I started training hard after a long layoff in shoes that were a little narrow. I figured that was the problem and ignored it for a few months until I got new shoes and pedals. The numbness (sensitivity is rare for me) has gotten steadily, very slowly worse for maybe five years. I've mentioned it to several doctors, who poke my feet with various implements and say, "Yep, it's numb, all right.") At this point I have almost no feeling in the soles of my feet (I feel pressure, but not, say, a needle stick). The usual causes, diabetes and a range of common neuro conditions, have pretty much been ruled out. To be honest, I've gotten so used to it that I don't think about it, but I'm curious about what it is. I took almost 10 months off the bike with another medical problem recently, though, and it didn't improve, so who knows? Might be permanent damage, or might not have anything to do with the bike at all.

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    Insane Bicycle Mechanic Jeff Wills's Avatar
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    Quote Originally Posted by Velo Dog View Post
    All the second-guessers may be right--it may not be cycling-related. FWIW, though, I've had what sounds like the same problem for several years, and nobody's found another cause. It started when I started training hard after a long layoff in shoes that were a little narrow.
    I'm diabetic, and when I started getting numb toes I thought it was peripheral neuropathy. I was run through several tests to verify this, and my doc (who's a runner, cyclist, and experienced with diabetes) told me it was a Morton's neuroma. He refered me to a podiatrist, who reconfirmed the diagnosis. I had a surgery to remove it last spring and feeling has returned to my toes.

    Bottom line: don't guess. Get a proper diagnosis.
    Jeff Wills

    All my bikes.

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    Quote Originally Posted by cyclingman1 View Post
    No medical forum, so this will have to do.

    As a long time gear masher, I am fairly certain that I have induced pericpheral neuropathy in my feet form the constant compression of the foot. I've had this for several yrs. For those who may not know, this is not a temporary condition. Numbness and ultra senstivity, etc, persist. Has anyone experienced this situation? Have you successfully combatted it either through meds, therapy, etc?

    What the hell! Don't tell us tell your doctor for crying out loud!
    My preferred bicycle brand is.......WORKSMAN CYCLES
    I dislike clipless pedals on any city bike since I feel they are unsafe.

    Originally Posted by krazygluon
    Steel: nearly a thousand years of metallurgical development
    Aluminum: barely a hundred, which one would you rather have under your butt at 30mph?

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    Thanks both GipsyKing and Velo Dog for the input. Things seem easy and straightforward from the outside, looking in. See doc, get a med or a procedure, everything hunk-dory. Those who have non mainstream problems can attest to just how puzzled and unceretain docs can be. They pass you around among their fellow specialists with no end in sight. But I'm still working on my problem. I am ignoring all the "what the hey" and the "I cycle, I don't have a problem, therefore you cannot either" comments.

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    Quote Originally Posted by GipsyKing View Post
    Over the following months, she/we did lots of PT, lots of prayer and positive thought (read and put into practice a book called Creative Visualization by Shakti Gawain -- hey you've nothing to lose except the pain and research shows that mental state can greatly affect pain and pain management). She did this DAILY, for several months and we continue with the prayer and visualization. Today, a year later, she is running again and that condition is GONE. I feel like we dodged a bullet.

    Helps to wear a tin foil hat when doing this

    I'll agree with the sensible ones. See a Dr. I deal with foot issues as a diabetic, they have a lot of info at their disposal.

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