At my wit's end with toe pain regardless of shoe/cleat/pedal type

I can’t figure this out. After I’ve been riding for a while, I get a “line” of discomfort running down the center of my left foot to my middle toe (nerve issue?) My middle toe gets increasingly painful to the point it feels like it’s being crushed in a vice and I have to stop. The warmer it is, the sooner this starts. For example, I’ve done 4 hour rides this year at 50°F with no pain, 2.5 hrs is my limit around 70° and it was 80° today and I had to call for a ride after 2 hrs.

I’m a 49 medium width on a Brannock device (flippers basically). I’ve had the exact same pain in Fizik 48, Giro 49, Specialized 49, and Bont 50W! I don’t think it’s a sizing issue. I’ve tried custom orthotics and Specialized blue footbeds, each with the same outcome. I’ve also had the issue with SPD, SPD–SL, and Look X-Track cleats/pedals.

I had a bike fit this time last year and that’s when the fitter suggested blue Spec footbeds. I’ve seen 2 podiatrists…while neither had a sports background, both looked at my feet and said there’s nothing wrong (no xrays, etc…literally just looked).

Has anyone encountered something similar? I don’t know where to go from here and I so bummed since I gotta get in some long rides!!

No idea but find a podiatrist that will sort this out with you. I had my own strange problem which was a result of too flexible of a foot. Solution was a small hard piece inside my shoe on the ball of my foot to stop the flexion.

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What did you look for in a podiatrist? Sports specialty or something else?

Based on my experience with the 2 I saw, they were more used to seeing toenail fungus that cyclists!!

I also have no idea, but I’m interested! Only happens when cycling? Walking, running ok? Do you mountain bike? Wondering if the same thing would happen if you rode on flat pedals.

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No on running or mountain biking…just ride road/gravel. I can’t run :rofl: I’ve never had the issue walking even on big days on my feet.

My GP gave me a recommendation on who to see. He was younger but was working alongside an older podiatrist. Both of them indicated to me to come back if it wasnt working or created other issues. It really was a cheap solution what they did vs needing custom orthotactics’. It seemed to be a lot of what they were doing based on the other customers I saw.

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Could it be this?

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Yeah that could be it! I’ve tried wedging to gry proper knee position with my fitter and I think I’ve ruled out the shoes. Now I’m looking for a podiatrist that can squeeze me in.

Thanks for the help.

If you can’t find a podiatrist that specializes in cyclist (which would be rare, I think) try and find one that works with a dance company. That will get you sorted out.

My daughter is a competitive Irish Dancer and believe me when I tell you that, athletically speaking, no one is harder on their feet than a high-level dancer. Their practices look like a convention of walking-boots.

As an aside, I was having really hard to diagnose pain in my foot last year, and it turned out to be a planter’s wart. Kind of like what you describe … it came and went with irregularity. I never would have known it was there, it wasn’t visible at all. I went to see my daughter’s podiatrist and she fixed me up courtesy of beetle venom (yes … this is true)

Good luck!

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If you think it could be Morton’s Neuroma, try this treatment option using KT Tape…

This is not due to any magical properties of KT Tape….the tape just provides a physical restriction between your toes, helping prevent the impingement. You could use other tape, but the flexibility of kinesio tape helps in this application.

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Thanks all!!!

sounds like a neuroma. Id start by looking at your shoes. Pull out the insole and stand on it barefoot. See if your foot is noticeably wider than the insole. Imagine how much your foot is being cramped inside the shoe.
Look up “Mulders Test” and see if you can recreate this. If so, its probably a neuroma. Wider shoes can help, as can insoles with a metatarsal pad. Solestar makes some or you can check if your insurance will cover custom ones. Steroid injections can be helpful. Lots of easy things to try before surgery. I probably see 5 of these a week any operate on maybe 5-8 of these a year

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The Bont 50W insoles seem to be a good width compared to my foot when standing barefoot but they feel big when riding. Not so much they’re uncomfortable at least. The problem only showed up this time last year…I’d previously done long rides and some centuries with no issues in the Fizik 48’s.

Is this something most podiatrists should be familiar with, or should I really look for someone with sports/dance specialities?

One more question…does the increasing pain with higher temps make sense? I’m guessing that means my foot is swelling more and causing more pressure in the shoe?

Thanks so much!!!

Your pain seems almost identical to myself. I get the same middle toe pain/burning/crampish that you have. Both with shimano tri shoes and giro lace ups. For my gravel shoes I went with lake mx238 and specialized blue footbeds. I have zero foot issues with that combo. I’ve done up to 6 hours and never thought about my feet. YMMV but there are a lot of shoes out there. There is probably a magic combo for your foot.

Ron

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Yup any podiatrist or sports doc should be more than capable.

Swelling from the heat makes sense. Can also try loosening the toe area of your shoes to see if this takes off any pressure.

Long story short, your interdigital nerve is getting compressed (assuming this is a neuroma and not something else). You feel it in cycling shoes bc they’re tight and there’s no padding compared to running shoes. Nerve is getting compressed from every direction

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Thanks for the help!

The podiatrist thought it was a neuroma as well and gave me a cortisone injection. That seemed to help prevent pain in the main part of my foot, but the tips of my middle and adjacent toes still get painful after 90+ mins in the heat. Need to figure this out :grimacing::grimacing::grimacing:

If you’re adjacent toes are going numb, all signs point to neuroma. See how the injection goes. May need more than one. Sometimes the answer is surgery if the easy things don’t work

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Cheers thank you!!!