"Hot foot"

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"Hot foot"

Postby trailgumby » Thu Feb 14, 2013 9:54 am

This week I've started to develop "hot foot" - an irritation under the ball of my left foot in line the fourth toe, about an inch or so back from where the toes meet the rest of my foot.

Root cause I think is the way I think I've changed the weighting of my foot on the pedal over the last few weeks to keep my knee in line with my hip so obviously I need to correct how I do that, but in the meantime is there anything I can do that you are aware of to help limit the inflamation?

Will be making a booking with my physio and with GP ASAP, as this is going to seriously restrict my preparation for the Mont 24 otherwise.

The planned training ride this morning I had to skip in favour of the bus. Walking in leather street shoes yesterday was uncomfortable, and there's a dull ache/burning sensation going on in the background as I type this

Other relevant info:
* Shoes: Normally, Bontrager RXL carbon-soled mtb shoes. This last week or so due to wet weather have been spending time in plastic composite dhb shoes which, while as stiff as the carbons, have quite a poor heel cup that does nothing to grip my heel
* Insoles: Spesh BG with 2x varus forefoot wedges (both pairs). I'm thinking I may swap one shim from right shoe to left as a short term fix.
* Have been doing exercises tensing the arch on the left foot to try and strengthen muscles to reduce tendency to pronation, poor balance on left leg (am very right side dominant), and the tendency for the left knee to track inwards when pedalling

Sorry about the novel. Thanks for your help.
Last edited by trailgumby on Thu Feb 14, 2013 11:42 am, edited 1 time in total.
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by BNA » Thu Feb 14, 2013 10:01 am

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Re: Hot foot

Postby sogood » Thu Feb 14, 2013 10:01 am

Sounds like it'll be problem for a bike fitter or various trial and errors than GP/Physio. But given that the pain is persisting after you are off the bike, maybe you will need to see a GP. A neuroma or other local foot pathologies come to mind.
Last edited by sogood on Thu Feb 14, 2013 1:22 pm, edited 1 time in total.
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Re: Hot foot

Postby trailgumby » Thu Feb 14, 2013 11:42 am

Have booked a session with Blair Martin for tomorrow week, which will include a bike fit, and with my regular physio for later today.
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Re: "Hot foot"

Postby whitey » Thu Feb 14, 2013 12:49 pm

This
trailgumby wrote:This week I've started to develop "hot foot" - an irritation under the ball of my left foot in line the fourth toe, about an inch or so back from where the toes meet the rest of my foot.

and this
Walking in leather street shoes yesterday was uncomfortable, and there's a dull ache/burning sensation going on in the background as I type this

Sound a lot like the symptoms I had when I developed Mortons Neuroma. I'm sure it could be something else but its worth checking out. Does it ever feel like you have a pebble in the shoe or your sock is scrunched up?

Anyhow, worth checking out. A orthotic dome and some wider shoes have mine under control.
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Re: "Hot foot"

Postby outnabike » Thu Feb 14, 2013 1:56 pm

Hi trailgumby,
If you have a shoe big enough to for an insert, cut a hole were the pain is felt in the insert and fit it into the shoe. It may take away some pressure.
Some times an insert with a stiffer soul on the shoe may help. I know it can be a pain full condition.
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Re: "Hot foot"

Postby grantw » Thu Feb 14, 2013 2:57 pm

I think I've already bored most of you with my bursitis and morton's stories, but wider shoes have worked well for me (that and a neuroectomy). You may find that icing your foot post ride can help with pain. From the sound of it you may want to reassess your work shoes too.
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Re: "Hot foot"

Postby trailgumby » Thu Feb 14, 2013 7:53 pm

Thanks for the suggestions.

Session with physio today was fruitful. She said we'd caught it early and it was only a "surface" issue and should resolve with care in a couple of weeks. Key thing is to ice it regularly.

Thinking back, this issue started a couple of weeks ago during a spin class when I had a "bike" with a worn clipless pedal on which my left foot was quite unstable in the roll axis. Ended up putting a lot of pressure on the outside side of the ball of my foot. I suspect that was the trigger.
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Re: "Hot foot"

Postby Baalzamon » Fri Feb 15, 2013 12:28 am

I just hope you have caught it. As I type this I'm feeling the tip of my 2nd toe on my left foot tingling with a dull pain sensation. In other words I need another cortisone injection in my left foot. I've got bursitis in both my feet and it isn't nice.
The numbness I can put up with, but when it starts shooting pain then that's a different story entirely.
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Re: "Hot foot"

Postby Dr_Mutley » Fri Feb 15, 2013 1:13 am

Maybe a good podiatrist mite be more useful than a physio?

But must agree with sogood, this is a fit issue, so physio will be just symptomatic. Address the biomechanics is obviously the key (as ur doing). If your running 2 ITS varus wedges with BG insoles, u might be better off trialling cleat wedges to replace the ITS and seeing if that fits. U will need 3, 1mm wedges to replace 2 ITS's.

You may also be over wedging? At some point there needs to be a trade off between knee tracking and the amount of supination of the forefoot. Your much better to track a little medial (inwards) with your knee, than over supinating your forefoot, as this will result in loading up your lateral foot (especially if ur running a wide pedal separation distance). This only holds true however if the medial tracking of your knee causes no stress or pain in the knee joint. If it does try running your existing amount of varus wedging but narrowing your pedal separation distance little.

If all that fails then some custom orthoses would be worth considering.
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Re: "Hot foot"

Postby trailgumby » Sat Feb 16, 2013 10:37 pm

Ah, yes, a "good" podiatrist. The guy steve Hogg sent me to see was helpful with my walking action, but no help at all with my cycling shoes unfortunately. :(

However, I've learned from that experience, so will feed that into whatever analysis we do next week.

My shoes are mtb shoes so external wedges are a little challenging.

Thanks for your thoughts. Will update you with findings from the fit session.
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Re: "Hot foot"

Postby Dr_Mutley » Sun Feb 17, 2013 2:21 pm

trailgumby wrote:Ah, yes, a "good" podiatrist. The guy steve Hogg sent me to see was helpful with my walking action, but no help at all with my cycling shoes unfortunately. :(


Ahhh Uhuh... I hear yr pain..... Seems there is often a big difference between "good" and good... The elusive search...

I'm not convinced it is useful, but I often wonder when consulting "good" sports physicians or health practitioners whether u should ask the question "how far do u ride per week?". Less than 200km/week means do not bother with the consultation. Cynical much? (yep :-))

I've had friends consult one of the pro teams head sports/cycling physicians with straight forward cycling problems, only to get very unspecific and borderline useless advice. Not sure if such gurus have no clues or just can't be bothered with the time and effort it take to sort out most cycling issues... It sometimes gives punters a pretty cynical view of being able to source appropriate help & advice... Good luck with your consultation...
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Re: "Hot foot"

Postby trailgumby » Sun Feb 17, 2013 2:37 pm

Spin session this morning was interesting. Got there a little late, fortunately the one bike that was left had good pedals. No ventilation, though, I was dripping wet all over by class end. Did another 20 minutes afterwards, including some single leg drills.

Foot was a little sore during, but now seems pretty good. background ache still there, but much reduced.
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Re: "Hot foot"

Postby trailgumby » Sat Feb 23, 2013 11:57 am

Spent a few hours with Blair Martin yesterday. Changed cleat offset and angle, lifted saddle, changed from flat to low riser bar on one bike and low to hi rise on the other.

Was concerned about rolling the hips on the higher seatpost position, but he videoed me and the results exceeded my expectations significantly - the core strength work I've been doing (now in maintenance phase) has really worked. :D

Took the dually for a short spin around the streets yesterday including a few down-the-stairs tests to see whether my concerns about having the seat up so much affecting bike control on techy descents were going to materialise, and it felt great.
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