The reason for this is pressure under the ball of the foot resulting in irritation to the soft tissues within the foot. There can be irritation of the nerves which run under the 'metatarsal' joints. The problem often only manifests during events which makes it difficult to address in training. There are two ways to alleviate this problem:
- Cleat position:
If the centre of pressure is directly under the ball of the foot it will most likely exacerbate the problem. Most people are more efficient if the cleats are positioned approximately 1cm behind the metatarsophalangeal joint. This is the widest point on the medial side of the foot where bunions can develop. Cleats for time trial and triathlon are therefore better positioned further back which reduces stress on the calf muscles and also removes the pressure from under the ball of the foot as the shoe plate takes the stress.
- Correct fitting shoes
If your cycling shoes don't fit you and in particular are too narrow, they can cause excessive stress under the ball of the foot and 'pinch' the widest point.
- Shoe inserts
Using insoles can help a great deal as they prevent the foot from 'collapsing' and therefore reduce the amount of pressure on the underside of the 'metatarsal' joints. In particular using a 'matatarsal' pad/support, which is under the ball of the foot.
Hot spots can be debilitating and for Ironman competitors, can cause significant pain on the marathon course. A simple cleat adjustment and fitting inserts can resolve this issue. If you'd like to book a bikefit, we can discuss this issue and our qualified podiatrists can help to resolve the problem. Email firstname.lastname@example.org
Nick Thomas is the resident bike fitter at The Endurance Coach. He is a fully qualified bike fitter and expert in lower limb mechanics, holding a BSc (Hons) in podiatry. You can contact him using the email address: email@example.com or see more about his fitting services by GOING HERE.