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  1. #1
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    Flat Feet, Arch Support, Orthotics

    In the last six months, I've been diagnosed with bad knees (chondromalacia patellae) and almost-fallen arches (plantar fasciitis).

    I'm seeing a physical therapist for the knees. They're having me do stretches to loosen up my outer quads, so the rest of my quad muscles can get stronger.

    I got a pair of custom orthotics from my podiatrist. They are more robust than anything I've ever bought off the shelf.

    My question for the Clydesdale forum:

    How do you deal with your bad knees and/or feet, as a cyclist?

  2. #2
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    I wear Sidi wide shoes for my orthotics to fit in.

    I also make sure to have my clipless pedals adjusted in the shop to be sure I have them at a comfortable pronation to not hurt my knees. I had a horrible problem with my knees and quads hurting after about 30 miles on the bike on just bike paths. I had the pedals adjusted for a little more float and the knee pain went away. I think so wider spacing between the crank arms and the crank would help me out a lot.

    I just make sure I stretch well before rides and take glucosamine sulfate to lubricate my joints. I also wear knee supports to be sure nothing slips out of place.
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  3. #3
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    Same issues different problem

    I also wear orthotics and they are kind of weird at first. After a few months you will notice a big difference. I have really High arches so it puts allot of stress on the inside of my knees. Just a little friendly advice make sure you take them out of any pair of shoes you throw away. I lost one pair that way and it is a costly mistake plus you have to wait to get another pair. On the bulky issue, they make titanium ones that are ultra thin and light. I have seen them but cannot afford them (or justify the price).
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  4. #4
    Fat boy Mod Moderator
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    i'm very flat footed and have leg length discrepancy... i just suffer it out... but with good shoes (top of the line specilized with the BG insoles) i'm pretty good... i need to get some shims for the LLD but neither bother me so i don't worry about it.

    I realy should talk to the doc about it though
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  5. #5
    rock crusher
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    My advice:

    1) loosen up your IT band substantially by spending time on a foam roller. It hurts so good! Also work on trigger points in your anterior, lateral, and posterior hip muscles, they do a LOT to control knee mechanics.

    2) train your VMO with biofeedback exercises: it is the little oblique muscle area just proximal and medial to the patella... it is one of the root cause deficiencies of many patella-femoral problems

    3) move your pedal cleats to the inside of your shoe, so you are pushing more through the ball of your foot... this will usually improve the kinematics of your knee to encourage more activity in the medial quads.

    4) stretch your lateral retinaculum (kind of part of the IT band) by gliding your patella to the inside of your leg: push it in as long as it is comfortable, and hold it for at least 20".

    5) another option is taping to retrain your knee mechanics and unload the painful part of your kneecap.


    6) Strengthen the hip extensors and external rotators

    7) slide your seat back on the rails to encourage more hamstring activity and reduced anterior knee stress

    8) if you are indeed riding clipped/strapped in, focus on the pull part of the pedal stroke, not just the push.

    Orthotics will help while walking or running, but IMHO, be only marginally beneficial when pedaling, unless specifically made for that application. They primarily control your rearfoot motion and pronatory habits, which usually are a non issue on a fixed pedal system. Also look at your float in the pedals, or consider rotating them a few degrees if possible.

    Some of this may be over the lay persons head... just ask these things of your PT. If they are versed in knees, it should all be in your game plan.

    Good luck!

  6. #6
    rock crusher
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    ahh, forgot about the feet:

    1) the easiest thing to try is rubbing your bare feet on top of a tennis/golf ball for about 3-5' per day.

    2) try a neoprene or similar strap around the highest part of your arch... you may have to play with the right tension and length, but it can help unload the fascia a bit and make life a little more bearable.

    3) stretch, stretch, stretch your achille's tendon complex

    4) strengthen the muscles of your feet: pick up marbles for instance

    5) if you are not already: avoid bare feet, flip flops, and slippers. Comfy for 5 mintes, but wear your peds out quickly!

  7. #7
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    Pitch, that is some excellent advice. Thank you.

  8. #8
    turtles make me hot
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    The tennis ball is awesome. My arches were killing me and nothing helped. Even the 400 dollar boot the podiatrist told me to sleep in. I read an article in Men's Health that mentioned rolling a tennis ball under your foot. The first time I tried it, I had tears in my eyes, it hurt so bad. Now it's a daily regimen.
    I also do lifts from my flat feet to my toes a couple of times a day. I start out by doing 50 on both feet and then 25 on each foot one at a time. It's really strengthened up everything.
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  9. #9
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    Paging Pitch

    Pitch, if you are still subscribed to this thread, I was hoping you could expand on the value of orthotics for cycling.

    I don't use cycling shoes or clip-in pedals. I've been using Vans skate shoes and BMX style platform pedals.

    Would it be a good idea to use orthotics in my shoes if I'm not clipping in?

    Does it make a difference what kind of shoe I wear if I'm not clipping in?

    Thanks!

  10. #10
    rock crusher
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    Quote Originally Posted by beanfink
    Pitch, if you are still subscribed to this thread, I was hoping you could expand on the value of orthotics for cycling.

    I don't use cycling shoes or clip-in pedals. I've been using Vans skate shoes and BMX style platform pedals.

    Would it be a good idea to use orthotics in my shoes if I'm not clipping in?

    Does it make a difference what kind of shoe I wear if I'm not clipping in?

    Thanks!
    Hi Beanfink, I hope this addresses your concerns, but I included some general recommendations towards all orthotic users.

    Most orthotics that are off the shelf, custom, and semi-custom address foot mechanics during walking/running from the point of heel strike through the mid foot, this makes them of negligible importance while riding a bike where pressure is put through the forefoot. Explained: when you walk, your heel hits the ground first (for 98% of the poplulation). Since you pedal your bicycle by placing your foot pressures alost exclusively through the forefoot, the effects of an orthotic designed to correct how your heel or arch meet the ground is minimally important.

    If you walk a lot when you ride (hike-a-bike), or wear the same shoes before and after the ride, then it makes sense to use your orthotics that were designed for that purpose.

    A cycling-specific orthotic would typically appear very different from the usual orthotic that people wear during the day. It would address issues of forefoot varus/valgus (the angle of the front part of your foot to the "rest of your leg"), and 1st ray (the big toe and the bones directly behind it going towards the ankle) issues . In most cases, pedal selection can address any specific needs that a rider has. If not, shims are used on the outside of cleated shoes (between the cleat and the shoe), or a forefoot orthotic could be created and inserted into the shoe (I don't know of any that are commercially available). Most of the time, orthotic needs on the bike are negligible, since pedal float or cleat adjustablility accommodate peoples needs on a cleated shoe, or merely foot placement changes on a platform pedal.

    All of that being said, 99% of the time, your "every day orthotic" will not be detrimental to your riding, and could even help with the time spent off the bike. If your orthotics designed for walking fit into your Vans... rock 'em. But, I would not be concerned if your $400 podiatrist orthotics don't fit into your new $250 Dominators. If you are only a casual rider, it should not matter. If you are riding techy stuff that involves walking a bit... you will be even better prepared for the walking with your orthotic. For long road rides, or mt. bike trips when you rarely need unclip, they are unnecessary.

    I too have an orthotic that I wear in my Vans... cause they have no support! But, on my cleated shoes, no orthotics, no problems.

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