Foot Pain - How to Diagnose?

Training
1

Over the last year, I’ve noticed my left foot tends to feel hot spots or “squeezed”. I don’t think I realized how bad it was until I spent the last two months indoors only on a different pair of shoes.

My question is what process should I use to fix the issues? I am assuming I can explore some order of bike & cleat fit, insole fit, new shoes.

Indoors, I’m using a Stages SB20 along with Adidas The Road Cycling Shoes in 9.5. These are laced shoes. I use the 165mm crank settings. The fit is roughly based on a Retul fit I did for my outdoor bike a few years ago, more specifically saddle height and distance from handlebars, not so much saddle to handlebar drop. Since I spend most of the time on this bike on the tops, I am not particular about getting a precise fit for this.

I’ve found that I’m quite comfortable indoors with the Adidas shoes for two hour rides.

Outdoors, I recently switched from S-Works 7 42.5 (9.3) to Giro Imperial 42.5 (9.5). I thought I may have gone too narrow on the S-Works so decided to try the Imperials. I use 160mm cranks. I’ve had similar issues with the S-Works and Imperial, which I’ll describe:

  • I feel the toe area on the left size can feel squeezed, particular to the left of the left foot (smaller toes and bones). If I loosen the Boa dial there, it is better, but I am not convinced the shoe is super constrictive.
  • The arch feels wrong. I don’t have this issue on the right foot, and I’m not sure if this is being described correctly, but I do feel I could use more support underneath. With the Giro, I have 3 arch support options through provided insoles. The medium feels like it’s not enough support and the large (I just tried over the past week) feels like too much - it’s pushing up into the foot.
  • These two issues start to create more pain on longer rides of 2 hours plus as hotspots (I think that’s what to call them), though I don’t think how much better my indoor setup was until last week when I could compare indoor and outdoor so directly. As soon as I got on the outdoor bike again, I knew it was uncomfortable. I then proceeded on an one hour hill climb event…
  • When going from the indoor to outdoor setup this past week, I realized the foot position on the two setups is very different. I don’t mind spending money to get the outdoor issues fixed but I would hope to avoid having to pay someone to resetup the indoor Stages SB20 since all these costs add up.
  • I have not gained weight (I fluctuate between 145-150 pounds) in a way that suggests either foot is changing in size.
  • I’ve tried different cleat positions on the outdoor bike, and some definitely are worse than others. Right now, I think both indoor and outdoor cleats are “centered” underneath their respective shoes.

For history, I am typically very low maintenance in terms of footwear. I’ve worn 9.5 across all types of shoes (cycling, running, etc.) without any real issues. I am not aware of having particularly wide feet and sized arches. I’ve always just used the default setup, cycling or otherwise. There’s nothing special I do with the lacing on the Adidas indoor shoes. I don’t even think I know how to lace properly. I just wear them.

2

Sounds like you’re doing a lot of what’s mentioned here…

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3

Thank you, will watch!

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4

This was great, I was definitely thinking this sounds like me! Just not sure what to do next, if I don’t want to self-diagnose (I feel I’m to close to it) and fix.

5

Try one thing at a time so you can figure out if you’re going in the right direction. My issue was Q factor so moving cleats in (feet out) and adding a washer helped quite a bit.

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6

What happens if you wear the adidas shoes outside?

Or the other way round - use your outdoor shoes inside?

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7

The sb20 is about 10 mm wider than a Shimano crank. Narrow q factor can cause lateral foot pain and most normal sized adults generally benefit from a wider q factor.
Do you have a mtb? Try putting your road pedals and shoes on that and go for a ride and see how it feels.

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I don’t have a MTB, but will try more things around swapping shoes between the SB20 and road bike.

9

Try some form 2 mm pedal washers as well for a cheap way of increasing q factor.

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10

Thanks for that. I remember the previous bike fit put a washer or two on my pedals before.

11

I had foot issues and went to see about orthotics. It really was interesting as they assessed my feet and told me I had too much flexion in my feet. I need some rigidity to my foot to stop it from moving as I walked and cycled. It didnt require orthotics. This was 5 years ago. Every couple of years I go back to get some new inserts.

As I always advise. Go see someone who deals with these issues everyday. You just get to a quicker resolution.

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12

My first shoes were too narrow. They would be bearable with thin socks but painful after 1 to 2 hours. They would just not fit with thicker socks (little toes would be squished). I changed to wide shoes and I can wear them comfortably with thick socks. The new shoes still feel tight in the toe box but not uncomfortable tight.

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13

I made some adjustments to the cleats, first with the problem left foot, moving the cleat maximum down and out (to the right). That did feel a lot better with the SB20, which as mentioned by others, has the +10mm QFactor. Today, I made the same adjustment to the non-problem right foot, and no issues there. I ordered some spacers for the road bike and can match it to the SB20 when they arrive. I don’t think my left foot is “perfect” and would be willing to try a custom insole like the G8 2620, but this feels like a good start.

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14

Yeah I thought it was my shoes and while width was an issue, it wasn’t the main issue by a long shot. Bike Fit James does a great job of breaking down the problem and calling out that “yeah it might not be one thing, but not include the thing you might think.”

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