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Old 03-09-04, 10:09 AM   #1
JenHen01
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Foot Pains - I need advice!

I've been living with pain in my feet for a long time, and I've been able to grin and bear it. Two years ago, when I really started biking a lot, this pain got a lot worse and finally this winter I've decided I need to put an end to it. So I went to my doctor and got a referral to a chiropractor (she thought a natural approach would be a good start). That was no help, so I went back to the doctor (for another $10 co-pay) and got a referral to a podiatrist. He diagnosed me with a neuroma, which means the nerves in between my foot bones get pinched, which makes them develop scar tissue, which makes them bigger and more likely to get pinched the next time. This leads to burning, aching, numbness, and usually results in my having to remove my shoes, rub my feet for several minutes, and then start up again, though usually still in considerable pain. Now comes the bigger problem. This podiatrist seems more concerned with proving that he's right than with helping my feet feel better. He gave me arch supports which were just too big and bruised my feet. My uncle who is a sports trainer helped me get fitted with some smaller supports. These didn't really "help" either, but at least they didn't hurt me. I went back to the podiatrist for a follow-up and he got all defensive that his treatment hadn't worked. He hasn't once looked to see if my feet are too flat, or crooked, or anything. He's certain it's a neuroma and he's following the procedure for getting rid of it. He gave me an anti-inflammatory shot in one foot. 4 days later it has had no results. If anything, my foot hurts more. I also brought in my biking shoes to see if the podiatrist could help me tailor an orthotic that would fit inside those and give me the right kind of support. He said he didn't think orthotics would be that useful and that I need a different biking shoe. Unfortunately for him, my father owns a bike shop and knows quite a bit about biking shoes. He completely disagrees with the podiatrist, and maybe I'm just prejudiced, but I'd agree with my father any day over the yokle I'm seeing. So, the long and the short of this message is has anyone out there experienced a similar problem? Can anyone recommend a GOOD podiatrist/sports medicine person in the southern Maine area?
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Old 03-09-04, 12:20 PM   #2
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Believe me, I feel your pain. In fact, I feel it right now! Do you get relief by walking in your house barefoot? If so, maybe conventionally designed or shaped shoes are not a good fit for your feet. Start canvassing podiatrists in your area until you find one that will work with you, and prescribe full custom shoes, if necessary. My custom cycling shoes are actually the most comfortable pair I own...but horrifically expensive.
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Old 03-09-04, 05:29 PM   #3
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It makes me wonder if you don't have tarsal tunnel syndrome. (sometimes a nerve conduction test can determine that). http://www.acfas.org/brtarsatunnel.html

I've seen this confused with morton's neuroma (also an entraptment neuropathy) in my athletes. Not all podiatrists are as adept in discerning the difference. You may have to see a orthopedist or sportsmedicine specialist just to be safe. If they say it's morton's still, then stick with a podiatrist since they work and deal with that more but if it is tarsal tunnel, an orthopedist usually has more dealings with this. (not all the time of course but in general)
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Old 03-09-04, 06:31 PM   #4
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I get the same symptoms when my cleats are to far forward. Took me a while to figure it out. An eigth of an inch makes a difference with my feet.

My wife and I don't trust podiatrists. She went to three with no relief. A friend told us to try an orthopedic surgeon in a neighboring town who had a very good reputation. We were in his office no more than 30 minutes when he diagnosed the problem. Pinched nurves due to shifting foot bones. It took two operations oover several years, but she's 80 to 90% better. Sometimes, there's no perfect solution.

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Old 03-09-04, 06:49 PM   #5
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Morton's neuroma, I had this after riding for a few months with a flexy pair of shoes and my cleats too far forward. Mine got much better after I threw the cheapo shoes away and put my cleats further back, I also use a metatarsal pad in my shoes and place it right behind the ball of my foot (between the ball of my foot and my arch). It's a little uncomfortable at first but at least there's no pain. This worked for me. Good luck...
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Old 03-09-04, 07:27 PM   #6
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Hi,
I live in Southern maine, and the one podiatrist I saw cured me.I am completely and permanently cured of podiatrists. No more. You could try surgery like Al's wife. First I'd try a wider shoe, might not pinch so much. I used a Sidi Mega, only way to get wider is to go custom. I also use a Superfeet Cycling innersole. I think these are pretty nifty.Back Bay Bike has them. And underneath that I have a 3/4 length thin sorbothane innersole. That prob wouldn't help you. And just in case anyone has any doubts as to my sanity....I put the Sidi innersole that came with shoe back in today, underneath the two innersoles already there on the left foot. My left leg is shorter, and I am trying to compensate a little. I try a lot of things. Most don't work out, some do. I really like Sidi shoes and Superfeet, you might want to give them a try.
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Old 03-15-04, 10:13 AM   #7
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Based on what you have said I would stay far, far away from that podiatrist.
I too have had problems with neuroma. I came across a podiatrist at the expo for the L.A. Marathon who talked me into orthotics after talking with him for over an hour. It seems as though my neuroma was caused/aggravated by shoes that were too narrow. This included running and riding shoes. I did buy orthodics from him for my running shoes and they really helped esp. on my long runs of over two hours. Apparently the higher arch along with a small pad located under the ball of the foot in the orthodic causes the bones in your foot to spread slightly so the nerve doesnít get as aggravated. Additionally, I increased the width of my shoes all the way out to 4E in all of my shoes. I ended up with Carnacs in both my road and mountain bike shoes and have been very happy.

Maybe you could try going to a running specialty store and asking if they know of a good foot doc.
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Old 03-15-04, 11:04 AM   #8
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Hi,
I have seen innersoles with that small pad in medical supply stores. Might be worth a try. Sidi Mega shoes are about 3E.

Last edited by late; 03-15-04 at 11:23 AM.
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Old 04-08-04, 02:13 PM   #9
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Quote:
Originally Posted by JenHen01
I've been living with pain in my feet for a long time, and I've been able to grin and bear it. Two years ago, when I really started biking a lot, this pain got a lot worse and finally this winter I've decided I need to put an end to it. So I went to my doctor and got a referral to a chiropractor (she thought a natural approach would be a good start). That was no help, so I went back to the doctor (for another $10 co-pay) and got a referral to a podiatrist. He diagnosed me with a neuroma, which means the nerves in between my foot bones get pinched, which makes them develop scar tissue, which makes them bigger and more likely to get pinched the next time. This leads to burning, aching, numbness, and usually results in my having to remove my shoes, rub my feet for several minutes, and then start up again, though usually still in considerable pain. Now comes the bigger problem. This podiatrist seems more concerned with proving that he's right than with helping my feet feel better. He gave me arch supports which were just too big and bruised my feet. My uncle who is a sports trainer helped me get fitted with some smaller supports. These didn't really "help" either, but at least they didn't hurt me. I went back to the podiatrist for a follow-up and he got all defensive that his treatment hadn't worked. He hasn't once looked to see if my feet are too flat, or crooked, or anything. He's certain it's a neuroma and he's following the procedure for getting rid of it. He gave me an anti-inflammatory shot in one foot. 4 days later it has had no results. If anything, my foot hurts more. I also brought in my biking shoes to see if the podiatrist could help me tailor an orthotic that would fit inside those and give me the right kind of support. He said he didn't think orthotics would be that useful and that I need a different biking shoe. Unfortunately for him, my father owns a bike shop and knows quite a bit about biking shoes. He completely disagrees with the podiatrist, and maybe I'm just prejudiced, but I'd agree with my father any day over the yokle I'm seeing. So, the long and the short of this message is has anyone out there experienced a similar problem? Can anyone recommend a GOOD podiatrist/sports medicine person in the southern Maine area?

Here are a few things you might consider:

1. A metatarsal pad/insert that is placed just behind the balls of your feet may work wonders for you. I just tried these this past weekend on a century ride and I had no hot spots whatsoever -- it worked! They cost about $4-$5 (mine were called "ball of the foot pad" and you can get them at most drug stores. You can also get a 3/4 insole with a similar metatarsal "pad." It will feel a little strange at first (you feel the pressure behind the balls of your feet instead of on the balls of your feet).

2. The Specialized Body Geometry shoes are designed with this metatarsal pad in the shoes as well as several other features designed to provide comfort and proper alignment -- almost all reviews or descriptions I've read have been very positive.

3. Cleat position -- if you can move your cleats rearward as far as possible, that may take pressure off the balls of your feet (where the hot spots usually occur).

4. Stiff soled shoes -- if your shoes are too flexible, the pressure from pushing down on the pedals may be causing the soles of the shoes to flex and the cleats to push up into the balls of your feet.

5. Walkable shoes -- if you're using road shoes (and the cleats are not recessed), walking on the cleats may be putting pressure on the balls of your feet. If you have walkable shoes, there is no pressure point from the cleats while walking.

6. Pedals -- typically, a wider platform will disperse the pressure of the cleats over a larger area and thus reduce or eliminate the hot spots. Most Look pedals and the new Shimanos are examples of the wider platforms.

6. Orthotics.

Good luck -- I've felt your pain!!
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