What’s so difficult to diagnose about pain is that the place that you feel the pain and the root cause of the pain can be very different. Everything is connected so extensively not just physically (nerves, fascia, tendons) but also systematically (central nervous system, hormones, nutrition). Foot pain can be caused by a problem almost anywhere else in your body.
I would really focus on this timing. I don’t necessarily think it’s the saddle, but could be anything in your life that changed around then: sleeping in a different position, adding/changing weight training / other exercise, getting a new chair at work, etc. Think of anything else in your life that changed or any non-bike symptoms you are experiencing around that time.
As a diagnostic step (and a great experience regardless), I recommend getting a full body massage from a highly recommended professional. I get one whenever I’ve managed to knot myself up and the pain just doesn’t want to go away. It’s amazing how I’m struggling with for example hip pain and the masseuse finds that I’m actually really tense in my neck and once that’s worked over my hip relaxes.
As far as bike-related changes, I don’t think anyone mentioned your cockpit. Did that change at all, even just moving your levers for example (regardless if they got moved back to the “same” position)?
Is it possible that your seat wasn’t straight before (or isn’t now if you’re swapping the seat without loosening the post)?
The bike needs to be set up extremely straight and perpendicular or it’s going to cause uneven stress on your body. I use 4’ levels, measure both sides from centerline and even use an app that mirrors the cockpit outline to make sure everything is as aligned as possible.
The app for checking the symmetry of your setup is Ceramic Speed. There’s a “toolbox” tab in the app that helps with that. It’s all free, but I think I had to create an account.
That’s what I’m thinking, also. What would you recommend is the best way of diagnosing the possible cause of this? I have booked EMG in few weeks but not sure if this will solve anything.
No other changes were made at the time when the issue started, and I just reverted back to old saddle after. I would say by my eye that the saddle was always aligned.
No offense, but some people are much worse at seeing something is out of alignment than others. The fact that swapping back the saddle didn’t fix things means something: 1) maybe you didn’t truly get back to where it was before, 2) maybe the same thing was pure coincidence, 3) maybe your body got inflamed by the saddle switch and hasn’t recovered because it needs a longer break / other areas of life are also affecting it
And it’s not necessary that the root cause was directly / solely the saddle. Try to think of other changes with a few weeks of the issue occurring. Our bodies are good at compensating with stress, for a while. But it can eventually get past the tipping point. And once that happens, significant change / healing may be needed to get back to baseline
Thanks a lot for the thoughtful feedback — I really appreciate it. I’ve checked the saddle again and it does seem properly aligned now, so that part should be OK. Unfortunately, I can’t recall anything else changing around the time the issue started. I had been cycling for almost two years without any problems before this “saddle swap,” so it’s been frustrating trying to pinpoint what really triggered it.
Option 3 actually makes the most sense to me too — that the swap somehow irritated or inflamed something, and now it just hasn’t settled down. I just don’t know how to confirm, diagnose, or fix it without taking significant time off the bike, which I’d really prefer not to do right now
I’m slightly amazed no one has suggested this, but have you considered going to a physiotherapist?
If you pick a decent one they should be able to help you work out where the trigger for the issue is which will help you work out how to best resolve it. Mine has immediately got to the bottom of some really odd sets of symptoms I’ve presented with, and helped get me on the path to resolving them
Is it the whole foot or part of your foot? Do your toes splay? What about your leg? If you’re leg isn’t numb, then it probably isn’t your upper body.
How tight do you lock down your shoes? Cycling shoes have no padding in the upper. They shouldn’t be made to form fit your foot, not tight in any way. You can run them really loose and still sprint. Try running them with the front buckle as loose as possible without the Boa going slack. The top buckle should be just enough to keep your foot from sliding forward, which might be 2-clicks past slack.
Arches and shoe shape- the forward/rearward positioning of the arch is more important than the specific height. Same with the widest point of the shoe. If these points aren’t in the right spots, you’ve got the wrong shoe size - forget about the overall length of the shoe.
Shoe sole drop is another factor, but that difficult to discuss - It looks like Lake has a decent heel drop, but then holds your toes flat. This might force your arch down on the support. Giro tends to point the toe up, more naturally for me.
Saddle height.. .as long as your foot is level at the bottom of the stroke while you’re underway, you’re within range.
Does it happen when you ride outside? Is that on the same bike or a different one? Do you have a bike with a massively different fit that you can test to see if it happens (like an MTB, for example)? As others have mentioned, my bet would be that there’s a minuscule change to your fit that has compounded, but that’s either going to take a lot of self testing or scheduling work with a physio and/or fitter. I’d try moving the saddle around in all kinds of different ways first (up/down, fore/aft, slightly to the left/right, nose down/up) and various combinations.
Just to give a real world example…I have one leg that is longer that the other (we all do, but mine is visible when you start staring at it closely) and no one ever noticed it until my 50s. No doctor or fitter or physio ever mentioned it until I started having issues and a fitter noticed that my saddle was pointing slightly to one side, which meant I was overcompensating for something. Once we accounted for that leg length discrepancy, all the issues went away. I’m not saying this is your problem, but I’ll bet it’s something like that. Maybe too much pressure on one side due to leg length, too much pressure in your groin due to saddle tilt or seat post height or handlebar position, weird arch/insert issues, etc.
It’s the outer part, starting with the smallest fingers, and it always starts about 10-15km into the ride, and gets worse until I step down and unclip. As a result of fingers going numb, the whole left foot strength seems to go down eventually…
Shoes are not the issue as I mentioned, I just tried the new ones today, even wider, and tried riding unbuckled in the front BOA
Try wearing your shoes at your desk without the insoles in them all the way loose… then add the bare insole in another test, then loosely tightened ,then add the arch…
My pain/numbness isn’t totally gone but after many many years of issues, I saw a sports physiatrist doctor who specializes in ultrasound diagnostics and he found a bursitis in my ischial bursa and injected it and it made a big difference when nothing else has in the past.
I have something similar and have since I started on the road 3 years ago.
Outside of the foot goes numb 30-90 mins in, spreads throughout the foot from there. Goes quickly as soon as I unclip.
I’ve tried countless bike fits, shoes and insoles some too loose, some tighter, there’s little change.
Some additional observations from my issue, in case you have similar;
heat helps, it’s better in summer and heated insoles can buy me an extra 60-90 mins in the winter
It doesn’t happen on my mountain bike
Thinner socks seem to help but bigger shoes do not.
I noticed that the more I use my feet, the better it is - ie. An off-road 13km/1000m hike that left my feet muscularly sore, improved my numbness on the bike in the days afterwards.
I’ve half given up, but this thread has offered some interesting ideas in terms of physios and sports professionals
I destroyed the nerves in both my feet, but with the right one being worse, doing a 24 hr race about 11 years ago. I really did go all out to take the win but I couldn’t really walk after for two days and it has left me with permenant issues that have a signficant impact on my comfort when riding both bikes and ponies.
Initially it was disagnosed as a spinal compression due to a slipped disc, however, I have since had nerve conduction studies done and they have said the opposite, with the signal slowing in the lower leg. The nerve conduction studies ruled out the spinal compression and MS. I have also had all the usual tests for diabeties, B12 etc. In addition, I broke my upper back a few years ago and there was no evidence for spinal compression in the lumbar area on the MRI.
In the end they diagnosed me with sero-negative arthritis and blamed the body attacking my nerves for the numbness and tingles.
However, two points make me question this
starting HRT has got rid of all my other arthritis-type symptoms like joint pain (I was perimenopausal early and it was missed by the health professionals), but the numbness remained
if I deadlift heavy or squat badly, the numbness worsens suggesting a spinal compression.
However, if I suffer bloating or fluid rentition in my lower legs, the numbness also worsens. So who knows?
I just try and ignore it most of the time but I always ride in flat pedals now which allow me to shuffle foot and hip position easier. I fidgit and waste energy, but I figure its better than causing even more damage. I am also wary of big events as I know there is a significant risk, but have still stupidly done some since as glory is more important than physical health to my inner chimp
I get a numb left foot periodically. I have found its mostly related to how tight my shoe is and how much power im putting out. I have made a consistent effort to keep my shoes much looser and that definitely helps. I also think it may be related to how tight my hips / butt are so i roll my butt on a softball / lacross ball and stretch. All in, my numbess has been reduced most of the time.
