fayzane

This is a long shot, but hoping to find someone else with the same arthritis I have. Sesamoiditis sufferers might have some feedback too.
Sesamoids are under the big toe and act like levers for the tendons that help bend the toe. I generally bike in tennis shoes but with the road bike here in 2 weeks went back to practicing with the clipless pedals. I chose SPD cyclocross because they're easier to walk in when I have to make a 'pit stop' and I theorized it would be easier on my feet when I have to do that. The length and width of the shoes feel fine, but when I ride in cleats it seems to make the arthritis on the bottom of my feet flare up - this doesn't happen in tennis shoes.
Do cycling shoes put more pressure on the ball of your foot, and does anyone else have this issue and what did you do to mitigate it?

I got some cushier insoles yesterday knowing this may dampen power transfer but I need to wait for this last flareup to settle before I can evaluate. I'd like to ride with cleats if possible, or has anyone with this kind of arthritis had to give up and ride platforms or possibly use clips with regular tennis shoes?

OUGrad05

What kind of soles are in your bike shoes? Also have you tried adjusting the cleats? I had to make a couple of 1 or 2mm adjustments to my cleats but generally no real issues. I've also found that Carbon soles seem to minimize hot spots, at least for me. I guess the stiffness of the sole helps spread the pressure out vs flexing? I don't really know, but I know my feet feel a long better on long rides with my carbon shoes.

fayzane

I have women's Giro Riela R II shoes so I don't think they're carbon soles, it's nylon with rubber. I bought Superfeet Berry insoles for the next ride to provide forefoot cushioning and also moved the cleats back a bit from 'center' so they aren't directly under the arthritic area, thanks for the tip! I think the cushion is why regular tennis shoes have worked so well. Had them on the toe-side set of threads directly in the center of the ball of foot. Did you shift yours forward/back, or left/right? I may be able to try moving the cleats out a bit. Also, have you had better luck with specific brands of carbon soled shoes?

Cyclist0108

I have no experience with your condition, but have had multiple issues associated with breaking my ankle awhile ago. Briefly, if you can't tolerate the bike cleat shoes, you might want to go back to the shoes that are more comfortable, and focus on finding pedals that will complement them. Perhaps mountain biker flat pedals with spikes in them will work, and they will hold your shoes in place almost as well as cleats do, and the large platform provides the support the soft shoes lack.

canklecat

Profoot Miracle insoles work for me. Cheap too, only $8-$10. Lightweight, thin but dense and resilient foam (not "gel").

I've had problem feet since I was a kid -- narrow, high arches, bony, prone to hotspots on my metatarsals. Without the rigid soles of clipless shoes I'll get painful arch spasms when pushing hard. But with rigid soles and inadequate arch support and cushioning I'll get other problems.

I've had everything from custom made shoes and orthotics to off the rack insoles. Dr. Scholls work okay for my walking shoes, but Profoot Miracle insoles are the most comfortable I've found for my clipless shoes (Scott and Fizik). So far in more than a year of using the Profoot Miracle I've never had to pull over due to spasms and hotspots to stretch and massage my feet -- before then I had to bail out on a couple of fast group rides with foot pain.

fayzane

I think I'm going to have to keep the hybrid pedals on the bike. With the new insoles and cleats moved back, right foot seems ok, left foot not quite dialed in. The shoes are actually very comfortable the issue is lack of sufficient padding at the forefoot, so my feet are unhappy after my 10mile commute this morning with the new setup. No hotspots or pinching, just after a while my sesamoids are singing the song of their people.

Could be I need to try some different orthotics or a pair of carbon soled shoes as suggested above. Failing that, I'll be having to accept my feet need to be in tennis shoes no matter how bad I want to ride in cleats. Drat.

wfp

The solution to my sesamoiditis ended up being removal of the bone causing the problem. It turned out that it was fractured. Before getting it removed I'd have bad swelling in my foot after every ride. Now it's fine. I get a little bit of soreness sometimes, but no swelling or other issues.

rumrunn6

you sure it's not gout? I once thought I had sesamoiditis but it was gout. now I lay off the meat & alcohol & ingest lots of regular water w lemon juice & apple cider vinegar

fayzane

I'm 100% positive it's not gout. I've had 3 foot surgeries with hardware installed by a podiatrist surgeon and he assured me it was arthritis and not gout sometimes I kind of wish it was gout because then I would have more control over when I had issues via diet. He wasn't willing to remove the sesamoids either, citing my age and activity level (very active late 30's when first surgery was done and I'm 44 now). I guess I'm just kind of frustrated because I had to give up running because of this and I turned to cycling which is FUN...but now I want to use cycling shoes those silly little pea-sized arthritic bones are making things difficult again. And stubbornly looking for a way around the situation so I can engage more of my leg muscles as I progress in cycling. I LOVE being able to pull up on the pedals so I'm trying to figure out how to make that happen without paying for it later. I'm going to jimmy around with the cleat placement more, and possibly shim up the rest of the foot leaving a 'dip' to offload pressure on the arthritic part - and may try toe clips with tennis shoes because there's so much cushion in my tennis shoes I pretty much never have issues there.
Maybe someday I can get the Dr to remove them like they did for WFP. Arg!

rumrunn6

OK, gotcha. so your discomfort is with the underside of the big toe. my gout always caused discomfort on the side of the big toe. so my experiences probably won't be helpful. but here are a cpl things anyway. I recently switched cycling shoes & that relieved pressure on the other side of one of my feet. so maybe, by random chance, different shoes will help you, maybe clipless sandals, even? regarding "clips" aka "toe cages" I use mini clips or strapless toe clips. I can use whatever shoe I like. when my gout flared up my Keen sandals were more comfortable in my sore spot. I only switched to clipless last summer for the road bike but still use 1/2 clips on the mountain bike. hope that's not all too irrelevant. good luck!

fayzane

Rumrunn6 that's super relevant, thank you!

rumrunn6

started looking at some pics I had regarding my feet & pedals.

my Keens w 1/2 clips


when using the 1/2 clips I had to make extension to get the ball of my foot placed where I wanted it. these are clipless ready MTB shoes (w/o cleats)


these are the extensions I made


these are the Lake MTB shoes I was using for several years. I thought they would add some stiffness over the hiking shoes I was wearing. & they did! but last summer I developed a hotspot over my right pinky toe. thought I laced them poorly that day but it was always a slight nagging problem



then I switched pedals & added cleats, etc. the hotspot came back but worse. tried shims to change the angle of the right shoe & it helped a little. also tried wider pedals to provide more support thru the stroke, even tho they connect in just one spot




the shims




cpl months ago I switched to these shoes & the hotspot is gone completely w/o any shims. I think it's the wider toe box that did the trick (the Lakes were more pointy)





btw I have read about cycling specific insoles

Vince Canepa

I had a sesamoid issue a number of years ago. My orthopedic doc prescribed adding "dancer pads" to my insoles just behind the sesamoin bones. It took the pressure off and helped a lot.

fayzane

Great stuff guys thank you! I'm going to see the foot Dr to see what kind of insoles and shoes. Maybe he'll give me dancer pads too! And thanks for all the pics, I've been stewing over them the last few days, trying to figure out which to try first. I can show the Dr the pics and see what he thinks. Sesamoid arthritis is kind of like a permanent case of sesamoiditis so I won't be surprised if he picks one or more of your options. Tennis shoes work good but I like how cleats handle and id like to move up to long distance, and the flexibility of tennis shoes may not work for that. Meantime I think I'll slap my nylon platforms on the Domane when it arrives next Fri until we get the shoe/insole/pedal formula assessed. But these are all great ideas!

fayzane

I found the magic recipe! Thanks Rumrunn6 For my particular situation I needed beefier pedals like yours. I did move the cleats back a bit, so that combined with the orthotics and touring pedals - just finished a 30mile ride with no foot pain. I had previously been using Shimano m324 pedals and upgraded to the PD-T8000 to decrease localised pressure (spread it over a larger surface area).

rumrunn6

good! funny how sometimes small things make a big difference. reg, cleat position, when I switched shoes I made sure to put the cleats in the same spot (down & in) as the previous shoes. at least as a starting point & wound up keeping them there. altho looking at these the new shoes have the cleats further in. oh well, they work