Shoes for bad knees Road/MTB

Looking for recommendations for shoes that people have used on their bikes who have knee issues. I am up for some new pairs and I battle some cartilage issues in both knees. My fitter recommended that I should always use a good insole and I do, it keeps my foot well supported and reduces any excess movement. He spoke highly of specialized shoes and they don’t even sell them so he has no allegiance to them. Anyone used them before? His reasoning is the shoes has built in Varus support and will keep the ankles, knees, and hips more inline and reduce the stress on all those joints. Makes sense but looking for feedback from all the experts on here.

Mike

There are some shoe fit videos on Francis Cade’s YouTube channel that are of interest.

One in particular goes into one specific feature of Specialized shoes that could cause issues. There’s plenty of talk about insoles in there as well.

https://youtu.be/2ksO6iIZbhg

FWIW I use both Lake and Specialized.

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Thanks I’ll check it out

I have Specialized S-Works 7 road shoes in wide, and they are phenomenal in how stiff they are, which means I have zero hotspots. As far as I understand the MTB version uses essentially the same sole. However, I reckon knee issues are more related to insole, shims (to compensate for leg length discrepancies), cleat placement, pedal choice and the like.

Yes only major issue he noticed was that I needed insoles and my feet naturally sit with my medial side higher than my lateral side. So arch side sits higher. So he recommended the specialized shoes for that very reason. They sell Shimano and lake shoes so I will have some good options.

Mike

I have owned a few pair of S-Works road and MTB shoes. They are super stiff and wear well. I have wide feet and find they could stand to be a bit wider, but that’s a different topic.

I am currently riding wide S-Phyre shoes and they are a bit wider than the S-Works. They’re also very good shoes, but I find them to be a little hot inside. I love the “cat tongue” fabric in the heel that seems to really lock things in place well.

No matter the shoe though, you can get custom insoles that will help your arch issues, so I would buy the most comfortable stiff soled shoe you can buy and then get custom inserts and shim the cleats.

Interestingly, I took the opposite approach to my knee issues. I switched to Speedplay pedals so my knees could have as much movement as they want and not be locked in and one constant arc.

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Just like there isn’t a universal ‘good’ saddle choice for everyone, the ideal shoe for different situations will be different from person to person. Generally speaking, a well made, perhaps custom or variable sized off the shelf, insole will make more difference than shoe brand. Different brands have different fit characteristics as far as toe box width, heel cup width/stiffness/height, overall midfoot height, etc. Cleat placement and insole stiffness/mid foot posting/calcaneal varus-valgus support will have a bigger effect than shoe brand on knee tracking.

As a general rule, you want even weight distribution between the lateral and medial condyles of the femur and their respective menisci and the tibia. It’s also good to minimize rotational forces at the tibia throughout the pedal stroke. There might be exceptions here, if you have symptomatic meniscus tears or spots of condylar pathology (various forms of arthritis, softening, etc). Assuming your fitter was aware and educated about your specific knee anatomy and issues, he may have made the recommendation towards Specialized brand shoes to help even out that force. If your foot doesn’t jive well with a Specialized shape, know that a similar varus effect can be had in any shoe (if that shoe doesn’t already have varus posting) by putting a very small (1-3mm) shim under the length of the medial ~1/3 of the insole, from just behind the ball of the foot to the front part of the heel. This is a crude solution, and I usually like to find more elegant (comfortable/durable) fixes for long term use, but it’s a great way to sample various amounts of calcaneal varus/valgus without having to continually buy new shoes.

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Also - It’s my job as a PT to remind everyone that hip strength is important here. It’s like the fight song and we are the high school band. We can’t shutup about it :slight_smile:

The knee doesn’t have its own lateral stabilizers; while very strong in sagittal plane (front back; think pedaling), in the medial-lateral plane, its basically a slave to whatever is happening at the ground (pedals/ankle) and the hip. In this post, you’re addressing the foot/ankle component, but don’t forget the hips. While we are mostly fixed in place on the bike, there is some wiggle room that can cause or exacerbate issues at the knees. Plus, we are [hopefully] not on the bike for more hours than we are on it, and the hip strength you gain in the name of improved cycling tolerance will in fact carry over to everything you do throughout the day.

There are tons of exercises for hip strength/endurance/neuromuscular control out there; I think Jonathan and Chad have gone over a few before on the podcast. If you’re not already doing so, I’d look into getting a little hip strength program in place.

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I have a number of lower leg/foot/knee issues from old running injuries and have always gotten on well with Specialized shoes.

I currently use the S Works 6 on the road and love them. I run the high arch insole with another piece of an old insole to bring it up even further. Just this week I got some of their Varus Wedges, $9.99 for a pair. They really do make a difference and keep knee movement to a minimum. Easily worth trying at that price.

Also, FWIW I use a lower float cleat (Blue Shimano) and while they take longer to dial in I have less issues than I have with the higher float in the past.

I too need medial support, may people do because the natural mechanisms to prevent inward motion of the foot are negated by the pedaling poison. Often time cycling shoes have a very narrow and lateral sole through the mid foot leaving the medial part of ur foot standing on air. Makes for good looking sleek light weight shoes but lacking in support of the longitudinal arch of the foot. Which some would argue shouldn’t be supported while maybe true in normal gait, may not be accurate in cycling. I suggest to look at BONT cycling shoes. Spendy but not as costly as knee cartilage. They are absurdly light & stiff and use a “bath tub design” basically a carbon bowl that cradles ur foot they are available in wide. I just got a pair of their gravel shoes, yes yes let the mocking begin. Stiffer than any of the dozen carbon Road shoes I’ve had and they have tread so I can walk in them without doing my impressions of Disney on ice. They also allow space for a insole custom which are often super helpful for alignment. I know I sound like a rep for them I’m not just the nicest shoes on the market in my opinion just some what obscure. Best of luck

Ive heard really good things about Bont for wide feet too. Just be prepared to wait a long time to get them. At least in the US.

Thanks for responding. Yes when it comes to hip strength and my knee issues I started doing hip exercises last summer. Typical exercises I do them 3-4 times a week. Ones that really focus on the glute medius. Also I focus more on my posterior chain muscles with free weight exercises since cycling really hit’s the Quads hard. Deadlifts and Bulgarian spilt squats and seated and standing calf raises. Hip bridges as well. My issues is softening on back side of my knee cap. Everything normal in medial and lateral compartment of my knees. Even the joint spacing on the backside of my kneecap is still showing normal. So just very early softening is what they diagnosed me with after an mri and xrays. My bike fitter is very good. He’s not a PT but is knowledgeable enough to tell all his clients about the hip strength issues that can affect cyclist. Thanks for all the info though. I appreciate the knowledge on here.

Mike

I use giro insole - you can modify the arch support…I’ve found that useful