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Hot Foot, Numbness, Morton's Neuroma....

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Hot Foot, Numbness, Morton's Neuroma....

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Old 07-15-08, 09:30 AM
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Campag4life
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Hot Foot, Numbness, Morton's Neuroma....

I am posting the following as a public service to the cycling community. In particular it is to give back for the help I have received from an unnamed member of the BF community who has provided tremendous insight if not moral support for this frustrating malady. I have Morton’s Neuroma in my right foot and am trying to cope with it. I have been blessed in my life with great health and this has been a daunting setback to say the least. Most of us are very focused on being healthy and why we choose the cycling lifestyle. Sometimes there is an elusive balance between breaking down our bodies and becoming stronger. It is analogous to carpal tunnel of the foot brought on by repetition and improper mechanics. I accept responsibility for it…mostly due to my fault of subjecting my feet to poor mechanics which I have learned about through my injury. I am somewhat of a careful guy by nature and don’t ride excessive miles and it is almost ironic that me of all people would be stricken by a mechanical issue because I am pretty focused on cycling biomechanics but none the less the case. There are warning signs that you should be made aware of. If you deny these, you will likely develop a chronic condition like I have if you subject your feet to the high repetition of fitness cycling which can affect not only your cycling but ordinary life as well. I touch upon some of this below.

Numbness: Don’t deny it. If you have it…make a change…now. It is a precursor to nerve damage which is what a neuroma is.

Shoe Toe Box: Wide and unfettered is what you want. You do not want the metatarsal heads…the landing pads for the front of your foot…smashing together. This promotes a neuroma.

Foot Pressure: Your arch has to bear some of the load for two reasons:
1. Takes some of the pressure off the metatarsal heads.
2. The foot is a suspension bridge. If the bridge sinks in the middle the metatarsal heads converge and cause damage. The nerve responds by growing sheathing around which increases its size setting you up for further pain.

Pedal mechanics: If you pronate, the metatarsal heads will crash into one another. Pronating is mostly caused by an unsupported arch. Support the arch with a proper orthotic or shoe floor shape and you will not tend to rotate your foot inward inside the shoe which causes the forefoot to be concave and smashes the metatarsal heads together. Perhaps you see a trend emerging 

What are the options?
I am going through this right now. Conservative treatment at first of course. Many I believe don’t solve a foot neuroma because they don’t address the root cause. You have to change your habits in your daily life and in your cycling. If you don’t, I don’t believe a neuroma will ever go away and in fact will grow much worse and you will be debilitated by it including your daily life of walking and standing.

Foot wear:
If you own a lot of shoes, get rid of all shoes that scrunch your toes together or have them stretched by your local shoe repair. Add an orthotic or metatarsal pad to all you shoes to separate the metatarsals.

Cycling:
I am loath to return to cycling shoes. I love cycling dearly and rode last night 35 miles with my friends averaging over 20 mph for a few miles. I am a decent but not a top cyclist. You not only have to change your footwear but how your foot is loaded. Not sure if you have heard about this trend but some believe and I am coming to this school of thought through trial and error and necessity that arch cleat or pedal positioning versus spindle over the ball of the foot is the way to ride a bicycle if you choose to clip in or not. One thing for sure, if your forefoot is injured as mine is, this is the "only way" to ride a bicycle. I have not lost any power as a result. In my case I have sidelined my Look KEO pedals and am riding large platform pedals and Nike Tennis shoes with generous arch support that are wide in front. I position the arch of my foot right over the middle of the pedal.
Here is some convincing reading about arch positioning of pedals.

http://www.serotta.com/forum/showthread.php?t=31187

http://forums.roadbikereview.com/showthread.php?t=95068

http://bartmangbikestowork.blogspot..../mid-foot.html

I am also coming around to the Grant Peterson school when it comes to clipping in. Don’t get me wrong, given a choice, I would clip in but many report hot spots with cycling shoes that if not fit properly will damage your foot as they do not flex.
If your hard sole cycling shoes do not agree with the shape of the bottom of your foot…you are setting yourself up for injury…what happened to me.

I wanted to put this out to heighten awareness. Six months ago I had never heard of Morton’s neuroma and I am finding out is extremely prevalent in runners and cyclists and other athletes that disproportionately load their fore foot improperly. My neuroma is getting better mostly by changing my foot mechanics, anti-inflamatories…no cortisone yet….and repeated icing. I am trying to avoid surgery at all costs. If you have hot or numb feet, I strongly urge you to study your foot mechanics and/or have an expert help you to prevent serious debilitation. No doubt foot neuromas have a genetic pre-disposition component but I am in camp that we break down our bodies mostly due to our own fault….from tennis elbow due to throwing too many curve balls…to the dilemma of a secretary who develops carpal tunnel and yet must continue to type to make a living.
Safe and healthy riding.

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Old 07-15-08, 09:52 AM
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Thanks for the post. I am going thru the same issues. Although it is dangerous to seek medical help from BF, a couple of questions.

1. Are you seeing a podiatrist or your regular doc?
2. I read that this is rare in men and more often an issue with women?
3. It is odd that surgery is often suggested as a solution, so other than the ice, wider shoes, etc. are there any exercises that can reduce the impact of this affliction?

In my own case, I have a narrow foot and extra narrow heel. I have a terrible time getting a proper fit in a road shoe. The best fit I have found is the Sidi 6.6 carbon shoe with the heel system.

When you do a search on the internet about this you can become freaked out due to the fact that they also call this Morton's Tumor!
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Old 07-15-08, 09:56 AM
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Also read the links on placing the cleats more rearward. The Mt. biker with the cleats directly under the arch is a wild move. What do you think on this idea?
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Old 07-15-08, 09:57 AM
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I purchased the Northwave aerator 3 shoe as it has a slightly larger toebox and helped me with numbness. I also purchased a set of footbeds which have contributed to fixing the problem, of course along with a super pro fit for getting the right pedal stroke/position.
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Old 07-15-08, 10:00 AM
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Sorry to keep posting but here is a link which gives a description of Morton's Neuroma: http://www.podiatrychannel.com/morto...ma/index.shtml
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Old 07-15-08, 10:18 AM
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Originally Posted by oilman_15106 View Post
Thanks for the post. I am going thru the same issues. Although it is dangerous to seek medical help from BF, a couple of questions.

1. Are you seeing a podiatrist or your regular doc?
2. I read that this is rare in men and more often an issue with women?
3. It is odd that surgery is often suggested as a solution, so other than the ice, wider shoes, etc. are there any exercises that can reduce the impact of this affliction?

In my own case, I have a narrow foot and extra narrow heel. I have a terrible time getting a proper fit in a road shoe. The best fit I have found is the Sidi 6.6 carbon shoe with the heel system.

When you do a search on the internet about this you can become freaked out due to the fact that they also call this Morton's Tumor!
As to no. 1: If you have any doubt what is going on, go see a Pod. The issue is no two Pod's are the same in terms of recommended solutions. Being informed is your best opportunity for recovery. We have the same foot shape. This foot shape creates a pre-disposition to Morton's neuroma on many levels.
- Less surface area/volume to handle pronation/foot rotation within the shoe.
- Narrow flexible feet tend to have their arch break down easily.
- Lack of support from typical width cycling shoes.


Women have it more than men mostly due to wearing high heels and fashionable shoes that smash their toes together. They also have narrower feet with less structure to support their body mass.

As to surgery, it is many times the default of last resort after all other options are tested. Surgery for Morton's has a very spotty success rate so I strongly encourage you to exhaust every possible option. There are many therapies and surgery is irrevocable of course with sometimes negative consequences.

Also, I strongly encourage you to abandon your cycling shoes and either get custom shoes...I believe Sidis are very bad for neuromas in particular due to toe box shape including shoe forefoot floor shape. Meanwhile either have shoes made with custom orthotics or go to a Nike tennis shoe as I have which tend to run a bit narrow anyway. You need to get the middle of your foot up by way of arch support to separate the metatarsal heads and my strong advice is you change your load path to that of arch versus ball of the foot loading of the pedal. I can hammer with this technique without pain. You need to lower your saddle fractionally if you relocate your pedal loading to your arch because your foot length adds slightly to your overall leg length in terms of saddle height. Pain is a barometer. If you have any, you need to quickly change your shoes and habits or you set yourself up for further damage.
Hope that helps.

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Old 07-15-08, 10:40 AM
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I've had a couple of foot problems: Plantar fasciitis, and Morton's Neuroma. The former, I treated with physical therapy, ibuprofen, and five pounds of weight loss (that's all it took). I'm glad to say it's gone completely.

The latter I've learned how to control. Occasionally I'll do something simple that inflames it. Usually it's simply a matter of standing up from a sitting position the wrong way, or wearing a shoe that's too tight. Once inflamed, it takes a few days or even weeks to bring it back down again. The trick is to remove the source of inflamation first, treat the inflamation second (to break the cycle), and exercise heightened care until its symptoms subside.

For example, one day I tweaked it by rolling my foot as I stood up. At that point some swelling and inflamation made it more tender. In its more swollen and tender state, anything can make it worse. In my case, it was bike shoes that were too tight. I broke the cycle by controlling the inflamation with ibuprofen, and by removing the source of re-inflamation by switching to wider bike shoes. Within a couple weeks I stopped feeling it altogether. But I know it will bite me again and again throughout my life.

I think the first time I felt it was when I was backpacking in my teens. My boots were a little narrow for me. This was before I realized that I have a wider than average foot. Over the years it's come and gone again and again, but at least now I know how to minimize its impact.

The primary response is, the moment I feel it, stop what I'm doing. Take off my shoe, walk around for a couple minutes. Take ibuprofen. Usually that settles it before it has a chance to really swell and get inflamed.
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Old 07-15-08, 10:51 AM
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Originally Posted by daoswald View Post
I've had a couple of foot problems: Plantar fasciitis, and Morton's Neuroma. The former, I treated with physical therapy, ibuprofen, and five pounds of weight loss (that's all it took). I'm glad to say it's gone completely.

The latter I've learned how to control. Occasionally I'll do something simple that inflames it. Usually it's simply a matter of standing up from a sitting position the wrong way, or wearing a shoe that's too tight. Once inflamed, it takes a few days or even weeks to bring it back down again. The trick is to remove the source of inflamation first, treat the inflamation second (to break the cycle), and exercise heightened care until its symptoms subside.

For example, one day I tweaked it by rolling my foot as I stood up. At that point some swelling and inflamation made it more tender. In its more swollen and tender state, anything can make it worse. In my case, it was bike shoes that were too tight. I broke the cycle by controlling the inflamation with ibuprofen, and by removing the source of re-inflamation by switching to wider bike shoes. Within a couple weeks I stopped feeling it altogether. But I know it will bite me again and again throughout my life.

I think the first time I felt it was when I was backpacking in my teens. My boots were a little narrow for me. This was before I realized that I have a wider than average foot. Over the years it's come and gone again and again, but at least now I know how to minimize its impact.

The primary response is, the moment I feel it, stop what I'm doing. Take off my shoe, walk around for a couple minutes. Take ibuprofen. Usually that settles it before it has a chance to really swell and get inflamed.
Really well said. There is a clear path to pain and its repetition. I believe it is mostly mechanical cause and effect now that I understand it. The key is to break the cycle that you address by removing the cause. That doesn't necessarily eliminate cycling from the equation but does pretty radically change my foot connection to the pedals. Thanks for contributing your experience. One must remove the mechanical root cause for the inflamation and only then will the inflamation subside. Its more than rest but habits when active. It took a while to create a neuroma and reversing the chronic cycle can take equally as long.

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Old 07-15-08, 11:45 AM
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Good post. I just had surgery for my neuroma and all I can say is that it was the best thing I ever did other than my hip replacement. I am NOT a big fan of surgery, but I realized life is to short to live with the pain and the constant aggravation of having to deal with "band aid" remedies to fix the problem.

The surgery for the neuroma is fairly simple and not complicated, however, it still is a surgery and not to be taken lightly. That being said, I was back on the bike in 4 weeks. Apparently I heal very quickly but I waited 1 more week just to be sure. I could have ridden in 3 weeks. I wore the boot for 3 weeks. Its a nuisance but not that bad. I took it off while I sat and walked flatfooted around the house. I could drive in it as well.

It is MY opinion that if the neuroma is bad enough, just do the surgery and be done with it. I now ride pain free and it is wonderful.

Feel free to contact me if you want some additional information.
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Old 07-15-08, 12:00 PM
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It's really not something to get too excited about. It's generally controllable. We all deal with something right? Honestly, though it's quite painful when it flares up, in my case at least, it's easy to control. Remove the source of inflamation, treat the inflamation, use caution for a few hours, days, or weeks (depending on how badly I've inflamed it), and go on with life.

Respond to flare-ups immediately with a single maximum dosage of ibuprofen (not an overdosage, just a maximum dosage). This does wonders for taking down the inflamation, which breaks the cycle. Make sure your shoes aren't making it worse. Switching from Specialized Tahoes, which were too narrow, to Sidi Dominator 5 Megas (which are wider) got me to a point where I'm not re-inflaming it. That's important.

It's never kept me off the bike for more than a day.

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Old 07-15-08, 12:18 PM
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I will throw out another wild card I am testing. I rode pretty aggressively last night including some decent climbs out of the saddle. I hope other neuroma suffers read this....as there are plenty of candidates to go around. The foot is not rigid by any means. In Nike's and with platform pedals after 35 miles, I am pain free today. This is the first time in weeks. I don't think I will be pain free in days to come but I believe with soft sole tennies, platform pedals with focus on arch and not ball over the pedal spindle...how most kids ride their bikes in other words....I believe it changes my foot shape toward alleviating pain. This technique stretches the tendons and ligaments toward a more natural arch which is counter to the foot flattening with age. One technique for addressing neuromas is to perform foot exercises. Yes the foot has not only 26 bones but many muscles that can be strengthened to hold up the arch. I believe pushing on the arch with both the ball and heel of the foot unsupported forges a more natural arch and in fact naturally separates the metatarsal heads thereby removing the pressure that induces the neuroma flare up. Just a theory but everyday I cycle with the above technique my foot is feeling better so I believe there to be some cause and effect. I hope others try this approach as well and report back. The biggest thing for anybody to take away from this that believe they have a foot neuroma is to right now stop loading the front of the foot or maintaining the old convention of ball of foot over the spindle which is also known to help achilles tendon sufferers as well.

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Old 07-15-08, 12:29 PM
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Here is a link to another article on the subject
http://www.roadbikerider.com/article...l%20Hot%20Foot
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Old 07-15-08, 12:34 PM
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Originally Posted by daoswald View Post
It's really not something to get too excited about. It's generally controllable. We all deal with something right? Honestly, though it's quite painful when it flares up, in my case at least, it's easy to control. Remove the source of inflamation, treat the inflamation, use caution for a few hours, days, or weeks (depending on how badly I've inflamed it), and go on with life.

Respond to flare-ups immediately with a single maximum dosage of ibuprofen (not an overdosage, just a maximum dosage). This does wonders for taking down the inflamation, which breaks the cycle. Make sure your shoes aren't making it worse. Switching from Specialized Tahoes, which were too narrow, to Sidi Dominator 5 Megas (which are wider) got me to a point where I'm not re-inflaming it. That's important.

It's never kept me off the bike for more than a day.
Daoswald...what is considered a maximum dosage of Ibuprofen and how much do you weigh if you don't mind me asking as I presume dosage is somewhat weight related.
Thanks.
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Old 07-15-08, 12:40 PM
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Morton's hurts like hell when it flares.

I've actually ditched the orthodics I used to use to separate the bones in my right foot. I make sure all my shoes are wide across the front of the foot and the neuroma doesn't flare much.

Riding long miles is not bad, as a properly placed cleat and wide shoes (thank you Sidi Megas!) can help to mitigate the pressure put on the nerves.

Pain only returns when I try on shoes too narrow.

YMMV, I'm not a doctor, Get a second opinion, etc.
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Old 07-15-08, 12:44 PM
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I also have Morton's. Have had it for 10 yrs.
Cycling and backpacking agitate it the most.
So does sleeping with socks on my feet, the socks actually squeezed the joints together, causing agitation.

I did have surgery, it came back worse because of scar tissue.

All of my footwear have homemade metatarsal arch supports constructed of molefoam and duct tape.
I have modified in this way...
4pr of ski boots.
2pr of cycling shoes.
Pack boots.
Hiking boots.

My molefoam solution has elimated Morton's pain from my activities.

I had a custom orthotic made (~$350) which was heavy, did not fit in all of my footwear, and was destroyed in 2 months.

My hiking boots are full shank and very stiff.
I prefer stiffer, more supportive soles in my footwear, less flexing of the joints.

Sorry, I know my post is a stream of consciousness about Morton's. If you have more direct questions, let me know.
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Old 07-15-08, 12:46 PM
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i had most of the foot problems here from dancing, and ended up having surgery for the neuroma...fixed!

all the other suggestions are great, but if worse comes to worse, the surgery gave me great results, and custom orthotics fixed the rest of the issues i had.

good luck!
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Old 07-15-08, 10:09 PM
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How do the custom footbeds fit into this as this is, as I read it, a pressing on the nerves between the toes from a fatty tissue deposit?

Not ready to ditch my $300 Sidi's just yet.
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Old 07-16-08, 06:34 AM
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Originally Posted by oilman_15106 View Post
How do the custom footbeds fit into this as this is, as I read it, a pressing on the nerves between the toes from a fatty tissue deposit?

Not ready to ditch my $300 Sidi's just yet.
Sidi's are generally acknowledged to have a pointy toe box. I developed Morton's by wearing Sidi Genius 5 Narrow shoes. I have a pretty average forefoot width and narrowish heel and my foot overall is low volume. You mentioned $300. If you have foot pain, you need to make a change. You may very well want to keep your Sidi's if wide enough which may well be if you have the standard width Sidi's with a narrowish foot that you mention. You will need to change the floor of the shoe. Your narrowish foot is likely pronating in the shoe. Again...a foot is a suspension bridge. If you load your foot and it is unsupported the toes smash together. Do a search for metatarsal pad. Remove the shoe inserts and tape a lift or pad right behind the balls of your feet which are called the metatarsal heads...which are crashing together because your foot is not properly supported. There are four arches to a foot. Cycling is repetition. If you repeatedly load your foot compressing your toes together you will cause further damage. I suggest you change your habit asap. Any hot foot or numbness is a precursor to damage if unaddressed.
Good Luck.
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Old 07-16-08, 02:45 PM
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Thanks OP for the info.. seriously. I haven't felt my 4th toe since I got back from Ride the Rockies. [A month ago LOL]

You have inspired me to stop hoping that it will fix itself and actually seek out a podiatrist and see what's up. Pretty sure it this Morton's thing, only the symptoms are slightly different.

Arch supports...Hmmmmm
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Old 07-16-08, 07:03 PM
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Originally Posted by MyPC8MyBrain View Post
Thanks OP for the info.. seriously. I haven't felt my 4th toe since I got back from Ride the Rockies. [A month ago LOL]

You have inspired me to stop hoping that it will fix itself and actually seek out a podiatrist and see what's up. Pretty sure it this Morton's thing, only the symptoms are slightly different.

Arch supports...Hmmmmm
Glad to help. A doctor on here gave me some good advice and I wanted to pass it along. Neuromas are all too common with distance cyclists and runners in particular because prolonged repetition magnifies any mechanical deficiency. Neuromas can be prevented and cured but the point made earlier by another poster that has lived through this painful issue is you have to break the cycle of repetition by making a change. Supporting the arch not only separates the metatarsal heads such that they don't implode on one another but also locates the foot in the shoe such that it can't rotate and pronate. I basically violated every major tenent of what a proper cycling shoe fit is and wanted to share what I learned to others in the hope that they can ward off this malady. A neuroma is nerve damage that is hard to reverse. The good news is I am on my bike and perhaps next year will seek harder soled cycling shoes but for right now I want to flex my arch and try to strengthen my feet using platform pedals.
Best of Luck.
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Old 07-16-08, 07:36 PM
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Another Sidi user who thinks he has Morton's Neuroma. My right foot and ankle have been bothered me for 8 months now. Everything started for me with a Plantar Wart on my right big toe. That sucker hurt big time and caused me to adjust my gait. I couldn't put any pressure on my big toe and I was walking on the outside of my foot. By the time I finally got the wart to go away my ankle was starting to cause me issues. I was, and still am, having pain on the outside edge of the ankle bone. Then later I started getting pains on the outside of my right foot, right where I had been putting pressure. At this point I don't believe I had Morton's, but my feet were bothering me so I thought changing my insoles would be good. I had been using the blue Specialized BG inserts in my Sidi's and I found that there seemed to be excessive arch support. I decided to try the red's which have less arch support.

First time I tried them on the shoes felt great. My foot finally felt like it was getting consistent support and not putting so much pressure on the arch. Well as time went on I started to notice that I was getting pain in the area you described. I just assumed it was all related to all the other little pains I was having in my foot.

After reading your thread I thought 'bang! that's what my problem is'. Your comments about arch support make total sense to me. With the red insert the shoe feels nice and seems to fit my foot, but I do notice that when riding that there is a lot of pressure across the ball of the foot. The arch is taking very little of the pressure and I'm sure the ball of the foot area is getting the pinpoint pressure.

My feet are also narrow and I'm certain that the Sidi's aren't to narrow for me, but the floor shape is wrong! It's too curvy and creates excessive pressure on my big toe. One thing I have done with my Specialized inserts is to place one of their shims in the bottom of the shoe. I've cut an area of the shim out to allow more room for my big toe. This modification flattens out the floor of the shoe and gives the toe more room, but it also takes away from the arch support of the shoe. So I think this modification and the red insert have brought the arch support down to zilch.

My next step is to put the blue insert back in the shoe and see how my foot feels. I'm sure the additional arch support is something I need.

My foot wasn't too bad until this past weekend when I hastily carried the laundry up from the basement to the second floor in bare feet. The next morning the Morton's area was really sore and in coincidence was when I read your thread.

Hopefully these changes help. The next step is finding a local podiatrist who has experience dealing with cyclists.

I just wish I could find shoes that fit like the Sidi's, but with a more flat floor across the forefoot....

I hate shopping for new shoes!

BTW at this point I don't have a lot of pain or numbness and it doesn't come close to stopping me from riding, but I know there is a problem.
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Old 07-16-08, 07:41 PM
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I have had massive foot pain for a while and attribute a lot of it to a small pedal surface and narrow q factor bike for my wide q factor body. I found some relief by using SPD's and pedal extenders, but I still end up getting numb spots while riding. I have been looking at getting some Time Atac Z pedals as they seem to have a fairly good sized surface, much like a platform that I can still click into. They are heavy as hell on the downside at 512 grams, but then again so am I. My shoes have plenty of space in the toe box, but I find I am riding on the outside edge of my foot a lot. Has anybody tried the Specialized Body Geometry shoes and the semi-custom beds?
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Old 07-16-08, 07:48 PM
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Originally Posted by rbart4506 View Post
Another Sidi user who thinks he has Morton's Neuroma. My right foot and ankle have been bothered me for 8 months now. Everything started for me with a Plantar Wart on my right big toe. That sucker hurt big time and caused me to adjust my gait. I couldn't put any pressure on my big toe and I was walking on the outside of my foot. By the time I finally got the wart to go away my ankle was starting to cause me issues. I was, and still am, having pain on the outside edge of the ankle bone. Then later I started getting pains on the outside of my right foot, right where I had been putting pressure. At this point I don't believe I had Morton's, but my feet were bothering me so I thought changing my insoles would be good. I had been using the blue Specialized BG inserts in my Sidi's and I found that there seemed to be excessive arch support. I decided to try the red's which have less arch support.

First time I tried them on the shoes felt great. My foot finally felt like it was getting consistent support and not putting so much pressure on the arch. Well as time went on I started to notice that I was getting pain in the area you described. I just assumed it was all related to all the other little pains I was having in my foot.

After reading your thread I thought 'bang! that's what my problem is'. Your comments about arch support make total sense to me. With the red insert the shoe feels nice and seems to fit my foot, but I do notice that when riding that there is a lot of pressure across the ball of the foot. The arch is taking very little of the pressure and I'm sure the ball of the foot area is getting the pinpoint pressure.

My feet are also narrow and I'm certain that the Sidi's aren't to narrow for me, but the floor shape is wrong! It's too curvy and creates excessive pressure on my big toe. One thing I have done with my Specialized inserts is to place one of their shims in the bottom of the shoe. I've cut an area of the shim out to allow more room for my big toe. This modification flattens out the floor of the shoe and gives the toe more room, but it also takes away from the arch support of the shoe. So I think this modification and the red insert have brought the arch support down to zilch.

My next step is to put the blue insert back in the shoe and see how my foot feels. I'm sure the additional arch support is something I need.

My foot wasn't too bad until this past weekend when I hastily carried the laundry up from the basement to the second floor in bare feet. The next morning the Morton's area was really sore and in coincidence was when I read your thread.

Hopefully these changes help. The next step is finding a local podiatrist who has experience dealing with cyclists.

I just wish I could find shoes that fit like the Sidi's, but with a more flat floor across the forefoot....

I hate shopping for new shoes!

BTW at this point I don't have a lot of pain or numbness and it doesn't come close to stopping me from riding, but I know there is a problem.
All good points. I have read exhaustively about this and the whole thing makes a lot of sense to me now. So much can be written about foot mechanics. If you have a narrow foot you have greater psi's throughout the bottom surface of the foot anyway. If one doesn't support the arch, then the pressure goes to the pads or metatarsal heads as they are called as you correctly call point loading. If a foot is narrow and unsupported it is like a hotdog rotating in a bun and this torque distorts the foot and pinches the nerve between the 3rd and 4th interspace...known as Morton's neuroma. This all happened to me. The key is understanding how to address it. The other thing I will mention is Sidi's have a fair amount of arch built into the floor of the shoe. When you introduce an arch support...say a Specialized foot bed or insert, it is the confluence of the shape of the insert in combination with the floor of the shoe shape that dictates the interface with your foot. They are not independent.
This is why you want to seriously consider custom shoes at some point if you are going to ride big miles. The other important thing is cleat placement. Read all the links on mid arch cleat placement. I believe it is critical for those that have damaged their forefoot like we have to pressurize the pedal more toward the middle of the foot. If you want to recover and continue your cycling you have to move your cleats back.
All the best and please update this thread with what you learn.

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Old 07-16-08, 08:07 PM
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Originally Posted by jaxgtr View Post
I have had massive foot pain for a while and attribute a lot of it to a small pedal surface and narrow q factor bike for my wide q factor body. I found some relief by using SPD's and pedal extenders, but I still end up getting numb spots while riding. I have been looking at getting some Time Atac Z pedals as they seem to have a fairly good sized surface, much like a platform that I can still click into. They are heavy as hell on the downside at 512 grams, but then again so am I. My shoes have plenty of space in the toe box, but I find I am riding on the outside edge of my foot a lot. Has anybody tried the Specialized Body Geometry shoes and the semi-custom beds?
Many schools on this as well. One school is...if you have a carbon soled shoe, point loading of the cleat is less critical...in other words, shape of pedal matters less. Likely the truth is even carbon soled shoes flex a bit. Another school says that neuroma suffers should not ride carbon soled shoes because they are too unrelenting in terms of pressure. The bottom of the foot isn't rigid and if the sole of a rigid carbon soled shoe does not precisely agree with the anatomy of one's foot, you will have point loading and hot spots. Nylon floored shoes have a bit more forgiveness. Bottom Line...if you can find one is....if you have hot spots you have to change what you are doing. The best method of changing hot spots is to move your cleat location. People damage the pads of their feet if they are right over the spindle and the floor of the shoe shape does not precisely agree with the shape of the bottom of the foot which is many times the case without custom footbeds. This lack of agreement is what causes hot spots and injury.
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Old 07-16-08, 08:32 PM
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This is a lot of great info though. Thanks for posting. My shoes are somewhat old and a little more flexy than when they were new, so that might has something else to do with it as well. I guess I will go by the Specialized shop on Saturday to check them out.
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