# Varus wedges



## PoorCyclist (Oct 14, 2010)

How do you know you need one without having an expensive video analytic fit session?


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## PJ352 (Dec 5, 2007)

Knee pain would be an obvious indication, but you'd have to be fairly knowledgeable in pinning down the exact location of the pain, because that dictates the specific 'fix'. And many (actually, most) don't require the use of wedges.

Another (albeit very inexact) method would be to have someone watch your pedal stroke. I personally wouldn't depend on that method beyond the person confirming my suspicions that my knee(s) actually strayed, and from there seek an experienced fitters advice.


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## krisdrum (Oct 29, 2007)

No need for video. A good fit with a trained professional using a laser guide should be more thant sufficient. I've been using stuff to account for varus angulation for a few years now and definitely see an improvement in comfort.


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## Dinosaur (Jan 29, 2004)

I used them for a couple of years (Specialized). There is a transition period (they can feel uncomfortable for a week or so), and your shoes have to run a tad size large in order for them to feel comfy as they fill up your toe box. I stopped using them. I can see no real need to use them unless you have a problem. I guess the only way to find out is to use them. If you encounter problems, you can just stop and pull them out. I did like the Specialized High Performance footbeds, but they started to break down after two years. I went back to Superfeet blues.


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## DaveG (Feb 4, 2004)

*really easy method*



PoorCyclist said:


> How do you know you need one without having an expensive video analytic fit session?


Look at the soles of a well-used pair of your regular street shoes. If the heel and sole are worn more on one side (likely the outside) than you have an issue.


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## PJ352 (Dec 5, 2007)

DaveG said:


> Look at the soles of a well-used pair of your regular street shoes. If the heel and sole are worn more on one side (likely the outside) than you have an issue.


This assumes a correlation between walking and cycling and IME there is none in this regard. I underpronate (supination) when walking (toes out) but have my cleats set up toes pointing straight and use no wedges. If I followed your advice I'd need wedges, but I've ridden pain free with this setup for (literally) years.


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## DaveG (Feb 4, 2004)

*not a doctor*



PJ352 said:


> This assumes a correlation between walking and cycling and IME there is none in this regard. I underpronate (supination) when walking (toes out) but have my cleats set up toes pointing straight and use no wedges. If I followed your advice I'd need wedges, but I've ridden pain free with this setup for (literally) years.


but it makes sense that there is some correlation between your foot position while walking and when riding due to an inherent abnormality in your knee alignment. However, I can believe that the correlation is not one to one. Just because you are not having pain does not prove you don’t have a varus issue. I rode for 20 years until I started using wedges. The last couple of years I started having some light knee pain on the outside of my knee. That could simply be me becoming more sensitive to it in my old age. The folks at Bike Fit systems also expound the street shoe wear advice although admittedly they are in the business of selling wedges and other fit gear


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## PJ352 (Dec 5, 2007)

Points taken, and I agree that the causes of knee pain should be pursued. I was simply relaying that your advice didn't jive with my experiences. If I have a varus 'issue' it's not apparent on the bike, and riding pain free/ efficiently is (in my view) about all most can expect from bike fit. 

I would advise the OP to use caution regarding employing wedges (or most other fixes). If there are fit issues present IMO it's best to work with an experienced fitter rather than guess on a course of action.


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## PoorCyclist (Oct 14, 2010)

I know you guys are not doctors or fitters but,
can you take a look at my well worn sneakers? I don't wear them to walk now only to sit at my desk.
my right foot outside is worn out fairly well.

I do have a pain only with my right knee.
I have been fitted but this alignment aspect was overlooked. Specialized fit system is particularly good at that but I didn't use specialized.

I am about to go to another fitter and tell them about my knee pain
but I feel the rest of my fit is working out really well for me.
If I put the wedge in there and my pain goes away, did I just save $100-$200 for another opinion?


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## alexp247365 (Dec 29, 2009)

Going through the exercise of rehabbing a knee for the past 5 weeks due to an improper fit, I can say that there is a wealth of info on the net in order to help you self-diagnose your problem.

The two take-aways I learned that might help others were

1) - Don't wear your wallet in your back pocket - It acts as a shim that forces your poster to lean to one side. This causes one of your pelvic bones to sit farther forward/or back from the other leading to perceived leg-length discrepancies. 

2) Try to get both the inside and outside of your quads to fire equally in the pedal stroke. This is where a shim came in handy for me. Once I had my seat/cleat position dialed in, the pain in my left knee went away. However, I noticed the inside of my quad was firing substantially more than the outside. This is where the shim came in handy(inside of foot) in getting both muscles in the leg to fire more evenly.


a good source of internet info: 

-Cptips.com, for example, has a good section on knee pain. Don't forget to click on the link within that section as it links to good info as well.


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## PJ352 (Dec 5, 2007)

Going back to what I posted previously, I don't believe there's a direct correlation between how we walk and our pedal stroke. What I can see from your pics is that _when you walk _your right foot underpronates. The fact that you have pain in your right knee may (or may not) be related, and depends on where specifically the pain is. 

As one example, deficiencies in cleat set up (q-factor, fore/ aft, angular, degree of float) can all cause assorted knee issues, so IMO it shouldn't be assumed that a wedge is the fix. 

If you had a standard LBS fitting, I wouldn't say that the alignment issue was overlooked. Most standard fittings don't include that, but a pro fitting would (or should).

It's your money and they're your knees, so your call on going with a wedge or getting an experienced fitters advice. Since I think you're guessing at the fix, I'd go with the latter.


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## Peter P. (Dec 30, 2006)

Shoe wear is not necessarily a good indicator of the need for wedges because when we walk our feet are HEEL POSTED versus when we ride our feet are FOREFOOT POSTED. When we walk we land on our heels; when we ride, the force is through the forefoot. The information MAY help, but it's not the be all/end all.

What you're interested in is how your feet are tilted around THE BALL of the foot, or rather under the metatarsals, which are the bones which connect the toes to the foot. I checked my self for varus/valgus by simply taking some digital photos of my feet. I did this with them hanging naturally AND flexing my feet so they were roughly at a right angle to my shins. Here's a sample:

<a href="https://www.flickr.com/photos/[email protected]/3674987066/" title="Analyzing Foot Angle by Peter Polack, on Flickr"><img src="https://farm3.static.flickr.com/2618/3674987066_6b45e935d4.jpg" width="500" height="375" alt="Analyzing Foot Angle" /></a>

Notice the right foot tilts more than the left; you don't necessarily have to treat both feet when you have the condition.

Take the photos from the front AND the rear. And get a copy of Andy Pruitt's book, Complete Medical Guide for Cyclists. It has useful information regarding addressing such issues. Another source worth purchasing is Bike Fit by Dr. Arnie Baker. It is very detailed.


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## DaveG (Feb 4, 2004)

*follow-up*

I think you should also consider other possible causes of knee pain. Those might include using cleats without float, improperly set up cleats or even crud preventing the cleats from providing float. An overly low or high seat position can cause problems. If you do want to try wedges, they are not very expensive and if you have a trainer you should test them there. There are both external wedges and insole wedges (Specialized, Bike Fit) that have varus correction. Start with a small change and see what happens. It is doubtful you will see an immediate, dramatic change. Setting up a camera on a tripod and watching your knee while pedaling may provide insight into issues such a knee wobbling of other abnormalities in your pedal stroke. I know that some here swear by fitters but I think that you can do a lot yourself with some research and making small changes in a systematic method. The disadvantage a fitter has is that he sees you only a short time and he doesn't not know how your knee is feeling


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## PoorCyclist (Oct 14, 2010)

Can you help me with the latin names

What is the difference between Varus and Valgus?
I think one is heel and one is toe?


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## PJ352 (Dec 5, 2007)

A couple of thoughts...

Sorry Peter, by some stroke of luck it may have worked for you, but I'm not seeing how your method is going to net any reliable info (or results). Dangling in mid air, flexing at the ankles and angle of shot all leave room for error- or misdiagnosis. Beyond that, I don't see the link with the pedal stroke. 

Regarding alex's and Dave's 'do it yourself' suggestions, I think the info available on the web is a double edged sword in that one _may _be able to sift through enough to find _reliable_ info, but before implementing any, the rider has to correctly diagnose the cause(s) of their fit issues, match the remedies and implement them. IME most aren't very good at one or more steps in this process.

A fitter only _needs_ to see the rider a relatively short time, assuming they're experienced at what they do. There are tools available to them, experiences to draw on and the knowledge of how to use both, and most know enough to communicate with the rider to see how changes feel - and make adjustments accordingly. 

Going it alone and using the trial and error method is fine as long as a rider enters into it knowing that's what they're doing. I've seen a number of posts here on RBR where riders ended up with a muddled mess, not remembering half of what they did, where they started and what to do next. There are never any guarantees, but IMO/E unless someone has a fair amount of experience and knowledge of bike fit, it's best left to fitters that do. As always, YMMV.


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## PJ352 (Dec 5, 2007)

PoorCyclist said:


> Can you help me with the latin names
> 
> What is the difference between Varus and Valgus?
> *I think one is heel and one is toe*?


That would be incorrect.

Here's a good source:
http://en.wikipedia.org/wiki/Varus_deformity


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## PoorCyclist (Oct 14, 2010)

I talked to a foot product shop and told me the wear pattern on the shoe does not necessary mean anything, just means that leg is stronger and dominanant.
But anyway, I did a bit of research last night.. I remember while riding my road bike I brushed my right knee on the top tube a few times when I was being sloppy. 

Right now I got a specialized 1.5mm varus under my right foot and will observe, I ride the same route every day for commute so I know exactly what changes caused me trouble. I will change nothing else except riding that route.

I hope you understand my dilema, I am trying to take it very slow, very easy. Both my MTB and road bike gives me the same issues, and I have a fit on my road bike once already.
I have started to ask different shops if they are confident to figure out some answers for $100 instead of $300.


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## Peter P. (Dec 30, 2006)

PJ352 said:


> A couple of thoughts...
> 
> Sorry Peter, by some stroke of luck it may have worked for you, but I'm not seeing how your method is going to net any reliable info (or results). Dangling in mid air, flexing at the ankles and angle of shot all leave room for error- or misdiagnosis. Beyond that, I don't see the link with the pedal stroke.
> 
> ...


I fully agree with your comments. Fortunately, I have decades of experience in the sport so understanding and experimenting with this stuff is not a problem, and I recognize all the mitigating factors. Most cyclists lack this experience but I don't prejudge them for it. I can only provide them with the information and as part of their cycling education they choose to use it to learn or they don't.


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## PJ352 (Dec 5, 2007)

PoorCyclist said:


> I talked to a foot product shop and told me the wear pattern on the shoe does not necessary mean anything, just means that leg is stronger and dominanant.
> But anyway, I did a bit of research last night.. I remember while riding my road bike I brushed my right knee on the top tube a few times when I was being sloppy.
> 
> *Right now I got a specialized 1.5mm varus under my right foot and will observe*, I ride the same route every day for commute so I know exactly what changes caused me trouble. I will change nothing else except riding that route.
> ...


Dilemma is a good way to describe fit issues that evade quick fixes (and many do).

Good luck with the wedge. Pls let us know how it works out for you.


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## PoorCyclist (Oct 14, 2010)

Could just a different footbed fix my problem?

I put in a specialized footbed on my road shoe, using no wedge under to try it out and it was relatively pain free ride. The sole that came with my road shoe has a shape for the arch but it's completely foamy and soft. 
The specialized footbed without shim held my arch, I can feel it cantilevered my foot slightly, even without the varus. Less foot numbness also. Hey if that is placebo I will take that.

The varus I added, is on my commuter bike / commuter shoe, but I think I will restart my testing with another specialized footbed on that without the shim first.

Another good news, one of the good fitters said he can analyze my ride for $100 basic fit without video equipment.


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## PoorCyclist (Oct 14, 2010)

Tonight I found these instructions that came with the footbed, It shows a simple test to determine whether one need to use the varus / valgus shims or none.

I have a laser level shooting a vertical lever line. I consistently can see my right knee cross over to the inside. I also repeated the test and checked with a varus shim under my foot and it tracks straighter doing the same test. My left knee is much more straight.

So if the test is any accurate, at least find a difference between the left and right knee.
I will take it real easy with 1 shim under the right foot and increase the ride time gradually.


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## DaveG (Feb 4, 2004)

seems easy enough to try. I will have to give it a go and see if it matches with my current wedge setup


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## PoorCyclist (Oct 14, 2010)

Just want to report back the 1.5mm varus shims really helped my knee problems on both of my bikes. 
I repeated the same rides with significantly less problems during or after.
It was great to climb without constantly worrying about the knee pain.

It's not because I babied my knees or let it rest / adjusted to riding. I ride everyday and monitor it carefully. Once I started to torque my knee the wrong way I notice it fairly quickly.


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## olapequena (Jan 23, 2009)

As someone who has a) cycled as rehab and b) completely f'd himself through cycling I would just offer the following suggestion:

Think about seeing a physio or intergrative massage/fitness person to learn how to strengthen the muscles that allow your feet/knees/legs to track off kilter. 

It's awesome that you have figured out how to ride pain free, but... these things can come back at the darndest' times if you don't actually address the root issue.


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## PJ352 (Dec 5, 2007)

Thanks for the update/ feedback. 

You mentioned previously that you were using the footbeds alone and they seemed to help. Are you now using them in conjunction with the shims?


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## PoorCyclist (Oct 14, 2010)

PJ352 said:


> Thanks for the update/ feedback.
> 
> You mentioned previously that you were using the footbeds alone and they seemed to help. Are you now using them in conjunction with the shims?


Yes I am, I gradually added shims, the footbed replaced the very soft footbed that came with my shoes.
The footbed with it's stiffer arch, I suppose has a mild varus effect, but the varus shim placed underneath reinforces it more and the amount can be increased.

I still plan to go see a fitter to get my mtb commuter looked at..


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