CYCLING & YOUR FEET
More than Fun
In the early 1900s, cycling was
one of the more popular ways to get around town. Ironically, cyclists
clamoring for improved roads helped set the stage for the automobile,
which relegated the bicycle back to where it started: as a recreational
mode of transportation.
Today, cycling is more than just
fun. It's an extremely efficient way to keep in shape and improve cardiovascular
fitness. More than 100 million Americans still ride for pleasure on
occasion. In New York City alone, 100,000 people cycle to work each
day.
The bicycle was not invented by
one single person, but was gradually developed throughout Europe beginning
in the late 1700s. Invention of steering, the wheel crank, and the chain-and-pedal
system is attributed to various Europeans.
An important American contribution
came in 1889, when John Dunlop developed the first air-filled tires;
in 1898, the first coaster brake brought the bicycle into the modern
age.
The Feet's Link to the Pedals
Besides selecting a bicycle that
meets your specific needs, proper shoes are the most important piece
of cycling equipment. Cycling shoes must have a stable shank to efficiently
transfer power from your feet to the pedals. The lack of shank support
in sneakers allows the foot to collapse through the arch while pedaling,
which may cause arch pain, tendon problems, or burning under the bottom
of the foot. A rigid shank protects your feet from the stress of pedaling.
Investing in a cycling-specific
shoe is a good idea if you have had preexisting problems with your feet
or wear orthotic shoe inserts. Most orthoses control the arch and heel,
and for cycling, usually require critical forefoot balancing. Riders
with mild bunions or hammertoes should select a wider, deeper shoe that
will accommodate the deformity.
Select a shoe that's right for you
among models designed for racing and mountain biking. For the casual
rider without known foot problems, cross-training shoes provide the
necessary support across the arch and instep in a shoe that can be used
for other purposes. They also provide the heel lift that cycling shoes
give. Combination cycling-hiking shoes meet the needs of the casual
rider well, and have recently become popular.
The use of toe clips, and their
degree of sophistication, begin to separate the casual rider from the
more serious devotee. Toe clips range from traditional clips to newer
shoe-cleat ensembles -- "clipless systems" -- that resemble ski bindings.
Many companies model their units on the French manufacturer Lookª. A
Look-compatible unit will offer the most diverse combinations of shoes
and clips from which to choose.
Proper shoes and clips or cleats
working as a unit are important to achieve maximum efficiency in transferring
power generated by the hips to the foot. For most efficient pedaling,
shoes should extend fully under the ball of the foot.
Biomechanics and Cycling
Biomechanics, the study of external
forces on the living body, plays a crucial role in efficient, satisfying
cycling. For example, when seated on a bike with hands on the handlebars,
the hands, shoulders, and front axle should all be in line.
By enhancing the biomechanics of
the foot, podiatric physicians specializing in sports medicine can improve
the mechanical functions of related body parts. If, for example, an
experienced cyclist's knees hurt after a 30-mile ride, the problem may
be a biomechanical imbalance. A podiatric physician can alleviate the
pain by correcting that imbalance through prescription orthotic shoe
inserts. Training and conditioning methods should also be evaluated.
To preclude pain before it starts,
podiatrists advise stretching the major muscle groups used in cycling
-- the gluteals, the quadriceps, calves, and hamstrings -- before and
after getting on the bike. Riders should start slowly and work up to
normal cadence, or rate of pedaling. The seat is at the proper height
when knees are slightly flexed and hips are over the knees.
Podiatrists recommend the use of
a pulse monitor for a cycling-based training regimen. Some models strap
around the chest, while smaller units wrap around the wrist or the thumb
and display the pulse rate as you ride.
Ask your podiatrist about an appropriate
pulse rate while you ride. Usually, the same criteria applies as with
running: your pulse should be 60-70 percent of the maximum for efficient
training.
Injuries and Treatment
Every day, podiatrists treat cyclists
who have sustained overuse injuries by pushing themselves beyond their
limitations. Here are some of the most common cycling injuries and their
causes. As with all athletic injuries, pain that is persistent indicates
a need to seek treatment from a sports medicine specialist familiar
with cycling injuries.
Knee Pain: Some intrinsic
knee problems like swelling, clicking, or popping should be immediately
evaluated by a sports medicine specialist. Cartilage irritation or deterioration,
usually under the kneecap, can be caused by a biomechanical imbalance,
improper saddle height, or faulty foot positioning on the pedals. Riding
in too high a gear, too far uphill, or standing on the pedals all may
aggravate the problem. Cleated shoes or touring shoes with ribbed soles
that limit side-to-side motion can cause knee pain if the knees, feet,
and pedals are misaligned.
Shin Splints: Pain to either
side of the leg bone, caused by muscle or tendon inflammation. This
may be related to a muscle imbalance between opposing muscle groups
in the leg. It is commonly related to excessive foot pronation (collapsing
arch). Proper stretching and corrective orthoses for pronation can help
prevent shin splints.
Achilles Tendinitis: Irritation
and inflammation of the tendon that attaches to the back of the heel
bone can be caused by improper pedaling, seat height, lack of a proper
warmup, or overtraining. This condition is usually seen in more experienced
riders, and can be treated with ice, rest, aspirin, or other anti-inflammatory
medications. Chronic pain or any swelling should be professionally evaluated.
Sesamoiditis: Sometimes
known as the "ball bearings of the foot," the sesamoids are two small
bones found beneath the first metatarsal bones; the sesamoids can inflame
or rupture under the stress of cycling. Sesamoiditis can be relieved
with proper shoe selection and orthoses.
Numbness: Impingement of
small nerve branches between the second and third or third and fourth
toes can cause swelling that results in numbness, tingling, or burning,
or sharp shooting pains into the toes. Wider shoes, or loosening toe
straps or shoe laces can alleviate the problem. If the problem persists,
try a clipless system.
Numbness or tingling with leg pain
may represent a serious problem known as "acute compartment syndrome,"
which requires immediate medical attention.
Competitive Cycling
Undertaking a successful cycling
regimen frequently results in the desire to match skills with others.
There are four categories of competitive cycling. Category I denotes
world-class competition -- with conditions and strategies an average
cyclist would not be able to navigate. Category II is also advanced,
and employs such techniques as drafting, and involves certain "courtesies"
of cycling etiquette.
Categories III and IV offer opportunities
for fit cyclists to go out and test their mettle against other enthusiasts
of the sport. No special equipment is required, only the desire to compete
and an adequately trained, biomechanically tuned body. See your local
bike shop for schedules of races in your area. As with all competition,
start at a low level and work your way up the categories. Remember,
put safety first, and enjoy yourself.
Before beginning any exercise program, be sure to check with your physician.
The American Podiatric Medical Association operates a toll-free telephone
service, 1-800-FOOTCARE (1-800-366-8227), from which consumers
can obtain informative literature on a variety of foot health topics.
The American Academy of Podiatric Sports Medicine, an affiliate of APMA,
may be reached at 1-800-438-3355.
Produced in cooperation with the American Academy of Podiatric Sports
Medicine
