I’ve unfortunately become pretty knowledgeable about this here in good old 2020.
While I’m not sure this is exactly what you are dealing with there are definitely some things in common and certainly some warning signs everyone can observe before it is too late.
Whether my issue is similar to yours it’s hard to say but since the topic is foot circulation, here is my story on that topic…
In March I did a 4.5 hour ride. Cool weather, plenty of hydration and about 3 hours in I got the worst hot foot I have ever felt.
I pulled my foot out of the cleat and moved it around, loosened the boa and eventually pulled over and took off my shoes to get some circulation back.
Being the super tough athlete I aspire to be (haha, but am not and definitely should not have tried to be), I wrote it off as another minor bump and bruise we get as athletes. So I rode through the pain and hoped it would go away eventually.
Some rides would have pain, other rides were pain free so I again presumed time would heal this wound and all would eventually be fine.
Then that pain started to get worse OFF the bike. It was hard to walk after riding, numbness in my foot and toes, tingling and pain for hours off the bike.
By July (March, April, May, June and finally July, yes, I’m an idiot), I decided something had to change so I went to the podiatrist who said I might have a Morton’s Neuroma. She shot the painful spot with cortisone and for about 48 hours it felt like my foot was going to explode. I didn’t want to even look at a bike.
At this point I knew this was not a minor issue and I had to get very serious about how to deal with this problem as I did not want another shot like that, ever, if possible.
I’m a size 44 and I had a lifetime collection of shoes including some super nice race day only shoes for all disciplines I race. The first thing I tried was an insole in all my shoes with a metatarsal bump. That plus the cortisone shot made riding tolerable but not great. So I bit the bullet and ordered some Sidi Mega shoes in 44 with the extra wide toe box. It was hard to take my featherlight Giros off and put on the Sidis that at first looked like clown shoes (soooo big) but wow, immediate improvement.
The next thing I did was sell my entire collection of regular 44’s in order to replace those with wide versions in the same size. Ouch to the wallet but not the foot.
After exchanging shoes, I created my own custom insoles. I ordered 7 different insoles from various companies and found the one I liked best. I then cut the insole to remove all pressure from the area that was generating the pain. So I went from a narrow toe box normal insole to a wide toe box with a cutout insole with a metatarsal bump. Bingo, no pain on the bike regardless of the ride duration. 100% hotfoot cure ever since making that switch.
Off the bike I still had pain though. That irritated never was protected by my wide shoes, stiff sole and cutout in the insole on the bike but I wear dress shoes to work. So I went for an MRI to confirm that I have a Morton’s Neuroma. Google it but basically when a nerve gets irritated it will begin to form a protective layer which unfortunately creates other issues.
With all of the adjustments I have made to my footwear, I am trying to avoid surgery. This means never walking without shoes and gutting my shoe collection while rebuilding it with custom insoles.
My on bike pain went from 8 to 0. My off bike pain went from 7 down to 2-3 which I can tolerate and I hope to get that down to a 1-2 if not 0 over time.
The TLDR version, deal with what you are feeling now, don’t wait. Go see a sports specific podiatrist. Maybe your issue is more nerve related based on your position on the bike. I don’t know. I thought about all the possibilities that were creating my pain and that lead to me trying to self-diagnose, put off getting it evaluated and simply trying to push through the pain. Bad choice for me in the end. I should have dealt with it early and made the changes I was forced to make on my own before they were necessary.
Best of luck and reach out with any questions you may have.