# Toe Pain - Extended Rides



## Infomastr

I have a funky issue where my left big toe (only) starts aching after a couple hours or 40 miles into a ride. I've adjusted adjusted the cleat position and ridden with the front strap over the toebox essentially "open" (e.g., it's not crunching the toes together).

As far as I can tell, the pain is localized at the base of the big toe, where it extends from the rest of the foot. I'm no MD so my descriptions are likely defective, but it feels like the bone itself is hurting.

The only way I can "fix" is to stop, take the shoe off and massage my toe, but it's usually hurting the remainder of the ride and I'm forced to bring pain meds with me (ibuprofen usually) just to make it home. Clearly something "wrong" but only on my left foot, big toe. Right foot I can leave it cinched up for hours and no problems.

Any ideas before I try to find a podiatrist? My LBS wasn't very helpful, they just wanted to sell me another pair of shoes and suggested my sole could be too stiff. Unfortunately since this is only something that kicks in after 40 miles, I can't tell offhand whether a different pair of shoes would correct the problem (and my LBS, and most stores aren't going to take a return of a shoe with even that much wear).

It seems like if it's an angle issue (e.g., toebox has too much of an "incline"), another pair of shoes would probably help. However if it's due to the stiffness of the carbon sole, am I out of luck? Most mid- to high-end shoes seem to be carbon sole (and for good reason - the stiffness on climbs and sprints is awesome). 

I've moved the cleat around to try to reposition the ball of my foot, but when I slid the cleat back it felt like my toes were jamming too far into the front of the shoe. 

The shoes are Shimano R220, size 42. The shoes haven't been thermal formed to my foot.

Thanks for any help.


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## 97G8tr

I run into a similar issue on the outside of my foot. That mileage is about right for me as well - at mile 40 I'm working very hard and generally have to tighten my shoe. I think thermally molded shoes are the trick. I'm going to look into this solution as I'm at whits end.


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## Infomastr

I haven't tried thermally molded shoes, but a new pair will likely be in order as everything else has been unsuccessful. Had myself re-fitted to get the seat moved slightly down and forward to ensure proper position over the pedals. Moved cleats back so that pressure was on ball of foot rather than toes (which is what I suspect is the main problem). Tried Dr. Scholl's. Tried Footbalance (custom thermal formed insoles which run a cool $80 a pair). Tried no insoles at all. None of this helped me avoid making long stops on the century I did last Sat just to get my foot out of the shoe to alleviate the killer ache.

Seeing a podiatrist and possibly a sports medicine specialist, but my guess will be they advise me to find some better shoes.


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## spade2you

Are you using thin socks?


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## Rollo Tommassi

*Morton's Neuroma*

possible, given symptoms, but podiatrist will give best diagnosis

http://www.mayoclinic.com/health/mortons-neuroma/DS00468/DSECTION=symptoms


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## jmblg

*ball foot, big toe pain*

i've been having this problem off and on for years. it all depends on the lenght of ride, terrain, and effort. if was initially ball of foot, that somewhat was reduced by larger shoes. then it came back, and for now, the blue specialized bg insoles have fixed this, however, the toe pain has become unbearable during xc races. I have it isolated to inflamming during courses with rocky descents. going to try non carbon sole shoes with the some toe flex. have you found your fix?


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## medimond

Do you ride with your feet level or toe down. I can see if you are riding toe down that you might be causing some discomfort to your foot.


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## Cpk

I had a very similar problem that also got to the 'pain' level at around mile 40 and at 45 I had to take the shoes off. They were sidi 6.6's which have a full carbon sole in a size 43.5. Moved to a specialized s-works in a size 44 and the discomfort so far, have only had them out once, has been greatly reduced. The sidi's fit like I thought a bike shoe should fit like a little bit snug but plenty comfortable until putting miles on the bike, first numbness, then hotspots, then pain. The specialized fit bigger then I thought a bike shoe should fit but my heel doesn't slip, so I guess all good. I think what happens is as the miles tick off the foot swells until pain, just a guess.


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## rhfritz

*Big Toe Issue*



Infomastr said:


> I haven't tried thermally molded shoes, but a new pair will likely be in order as everything else has been unsuccessful. Had myself re-fitted to get the seat moved slightly down and forward to ensure proper position over the pedals. Moved cleats back so that pressure was on ball of foot rather than toes (which is what I suspect is the main problem). Tried Dr. Scholl's. Tried Footbalance (custom thermal formed insoles which run a cool $80 a pair). Tried no insoles at all. None of this helped me avoid making long stops on the century I did last Sat just to get my foot out of the shoe to alleviate the killer ache.
> 
> Seeing a podiatrist and possibly a sports medicine specialist, but my guess will be they advise me to find some better shoes.


I've got a similar problem. Left foot, but the pad of the big toe. By the end of my Century a few weeks ago, it felt like it was on fire. It was tingly and numb for a day or two after. Seems to be 98% better now. Anyway, did you get any more information? Funny thing about going to specialists. I have an unrelated ankle issue which took 5 different doctors to get two to agree on the approach to take.


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## Infomastr

rhfritz said:


> I've got a similar problem. Left foot, but the pad of the big toe. By the end of my Century a few weeks ago, it felt like it was on fire. It was tingly and numb for a day or two after. Seems to be 98% better now. Anyway, did you get any more information? Funny thing about going to specialists. I have an unrelated ankle issue which took 5 different doctors to get two to agree on the approach to take.


I did end up seeing a specialist and was recommended superfeet inserts to provide additional arch support. Apparently my toe was/is flexing at the joint closer to the tip as opposed to at the ball where it should, because the arch collapses.

My cleat position on both shoes is far back. On the left it is as far back as it can get. The idea is to get the cleat under the ball of the foot so the pressure is there instead of on the toes.

I stopped riding out of the saddle entirely. This has been a great disappointment and makes me a less versatile rider, but has alleviated much of the pain. I found that riding out of the saddle puts far too much strain on my toes, at least in the shoes I currently own.

While I can't say these cured my issue (I still get pain), it has helped a fair amount. Recently did another century and unlike the earlier one I was not in crippling, unbearable pain by the end of the ride. On very long rides I do usually stop at points and take off my shoes to get the blood flowing again.

I suspect my shoes are too angled near the top and/or have bad position relative to the ball of my foot and will probably buy new shoes to see if my theory is correct.


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## rhfritz

I've had a professional fit, but I'll have to check my cleats. Glad things appear to be working out for you.


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## FeydR

I've got this same pain right big toe directly on/in the joint.


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## iliveonnitro

I have the same exact problem and an almost-fix. I'll post it in a few hours.


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## Infomastr

iliveonnitro said:


> I have the same exact problem and an almost-fix. I'll post it in a few hours.


certainly curious to hear what worked (or almost worked!)


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## rhfritz

I moved my left cleat about 3mm back towards the heel and 3mm towards the outside of the foot. It doesn't seem like a big change, but I could tell that I'd redistributed some of the force away from my big toe. I did a 2 hour ride and felt like I wasn't irritating the hot spot.

I had spoken last week to the guy who had done my professional fitting. He indicated that thermally molded shoes were mostly marketing. The problem they solve is special fit issues for people whose feet move too much in a regular shoe, e.g. too much space in the heel. I've been using an A-Line insert in my shoes for pronation correction (http://epgtonline.com/alineshoeinsert.aspx). But he said that I could also be fitted for a forefoot wedge if adjusting the cleat didn't give me any relief. Interesting article on that topic here: http://forums.competitor.com/topic.php?id=683


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## wipeout

A few people claim that midsole cleat position will cure toe pain... 

http://www.trainingbible.com/joesblog/2009/12/custom-midsole-cleats.html


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## iliveonnitro

Sorry. Steps I took:

1. cleats all the way back
2. custom insoles (not orthotics) -- something like specialized or mysole heat moldable ones. custom orthotics did nothing for me except lighten my wallet
3. wool socks, the thicker the better. i actually use them even in 100+ degree weather. if not, i will use two pairs
4. new shoes will probably be the final answer. investing in an expensive pair (200-300) is difficult to justify, but important considering how many times you put pressure on each foot during the down stroke.

make sure you keep your toe nails short. you'd be surprised how much it actually will deform your foot.


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## Infomastr

wipeout said:


> A few people claim that midsole cleat position will cure toe pain...
> 
> http://www.trainingbible.com/joesblog/2009/12/custom-midsole-cleats.html


_very_ interested in this concept and since i'm likely to end up getting a new pair of shoes anyway, might be worth a shot if I can find someone with some talent with the drill

thanks for the link


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## DBJPB

*toe pain while cycling*

I have experienced the same pain at the 40 mile mark while cycling
in my toes on my left foot. I also have sidi shoes. I went to a podiatrist
and he told me to try a new pair of shoes. I talked to some other cyclists and came up with a solution. I cut off the front of the shoe.
It seems that my toes were over heating and causing the toes to swell
and the nails would dig into the skin. If I took the shoe off the pain
would go away. I only get the pain when it is warm out. By warm I mean above 50 degrees. I also hear that the carbon sole is too stiff
and the root of the problem? I think I will try a different brand of shoe.
Maybe he specialized shoe someone else recommends. It was an old 
pair fo shoes. I had bought a few different pairs thinking the size may
have been the problem. My pain is not in my big toe. It is with the two 
toes next to it ? My podiatrist told me I have irish feet ? The second toe is a bit longer then the big toe ? Someone else also recomended to 
cut the sole to make it more flexible ? Not sure how to do this ? I may try this next ? My shoes are also black. I think I will try a lighter color next ?


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