Podiatry: Cycling

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Summer and bikes

Now that summer is officially here, have you noticed the massive proliferation in bikes of every type?

As a born-again cyclist (fair weather only) and podiatrist, I was interested to see an article in the USA magazine 'Bicycling 'about specialized footwear for cyclists with inrolling feet (actually made by the cycle group Specialized, too). Basically, these shoes promise relief from riding discomforts such as ankle, knee hip or back pain, caused or made worse by cycling. There are two salient points in the background to this.

The first is that it is well recognized that a mild twist in the foot (such as one caused by the feet inrolling) can cause increased twists in the joints of the leg. Specialized talk about 87% of Americans have inrolling feet, and I wouldn't argue with these figures, which are no doubt pretty much the same for the UK too.

The second is that clipping your feet into a pedal allows a much more efficient link between the power (derived from the rider's muscle groups) and the drive (derived from the bike drivetrain -pedals, crank, gears and chain, and the back wheel), than is the case if the feet simply sit on top of the pedals.

The trade-off is that a foot which sits on top of a pedal is free to move around, and can absorb extra twists and turns in the legs without putting strain on the joints, but in doing so it is less efficient for powering the bike.

Some time ago Shimano came up with special pedals with a tiny cleat in them which slotted into a matching cleat on Shimano-designed cycling shoes. They worked well, but there were plenty of reports of knee problems among previously uninjured cyclists. These, and similar design cleats and shoes have been refined to the point where they provide a satisfactory link between the foot and the pedal, but without the risk of injury. Look actually manufacture cleats which are designed with an adjustable cant.

Specialized have gone one step further with their new shoes, taking the twist out of the foot before it can possibly cause any damage. However, there is a downside - these shoes are, essentially, a medical device. More than that, as a one-size-fits-all remedy they may cause, rather than cure, problems in those cyclists who do not have inrolling feet. My information is that these shoes are not destined for the UK market for some time. No doubt when they do arrive they will be enthusiastically embraced by some, and shunned by others.

The idea is good, and the shoes are evidently excellent.'Bicycling' makes the point that although this shoe may work for you, be aware that it is offering a biomechanically altered platform for your pedalling. In the USA only board-certified podiatrists are licenced to provide foot correction. This is perhaps not the kind of change you want to make lightly, especially if you ride high mileages.

Please feel free to use the enquiry form at www.ortho-pedclinic.com for all foot-health and foot-related matters.
David Holland BSc(Hons), MSc(Dunelm), MChS
Consulting Podiatrist.