 So welcome back to the 24th edition of the RCA Training Tips Show where it's today. I'm joined again by bike fitting expert Neil Stambry, who's been fitting road cyclists for around 10 years in conjunction with being a sports physiotherapist. So in this video, we're gonna talk about a topic that Neil actually wanted to raise because it's an issue that a lot of his clients face and that is numb or sore feet while cycling. So Neil's gonna pinpoint three areas or causes and then what you can do in order to fix the issue. Now, if you've evaluated this video today, please don't forget to like it. And if you're yet to subscribe, please do so if you wanna see more content like this in the future. And for those road cyclists that are keen to take their performance to the next level, the up-level road cycling course is reopening. At the end of October, I'm gonna be welcoming in 50 people only. So stay tuned. In the interim, you can download my free book. So let's get into it. I'll try and break it down into discrete parts so that it's kind of easier to understand. There's two main causes of foot numbness on a bike. There's foot numbness which occurs from something happening inside the shoe and then there's numbness which occurs from greater positional issues happening further up the chain. So starting with the foot ones, the logical one that everyone thinks of is my shoe is too tight. So if the shoe is restrictive around the forefoot, particularly laterally, if you've got quite a wide foot trying to cram it into a narrow shoe, the foot will get squished from the side. That's a technical medical term. That's what it's called. It'll get squashed from the side and as it gets squashed, there's a whole bunch of intrinsic nerves which run between each one of the rays of the toe. I think they're called the inter-digital nerves and depending on which textbook you look at, they're called different things. But as the foot gets compressed in laterally, those nerves get squeezed. You can, if it gets quite bad, you can get a thing called a neuroma which is a bit of scar tissue built up around one of the nerves. But most of the time, neuromas are fairly rare. Most of the time it's just that generally the shoe is too tight, squeezing the foot, the nerves get squashed and the foot goes numb. The toes spreading forward go numb. There's also circulatory issues that occur for the same reason because there's vascular structures in between each one of the toes. So if the shoe is too tight around the forefoot, it can compress all those nerves and blood vessels. There are, the best way to get around that is obviously by a wider shoe. So the particular shoes of note which are quite wide across the forefoot. Lake are excellent and I've got a set of lakes just in the standard width, the old CX237 which has now been superseded by the CX238. Really high quality mid-range shoe and the standard width of lakes is quite wide. But you can also buy them in a wide width which is really wide. So if you've got quite a splayed triangular foot which spreads across the forefoot a lot where you're just looking for more space around there. Lakes are great. Bonts are pretty good as well. They've got a fair bit of space around the forefoot although they can tend to be really rigid which is not good for foot numbness for a lot of people because it prevents the foot from flexing and pumping circulation through the foot. But Bonts have got quite a bit of room around there and then you've got things like the City Mega and a couple of other ones. The new range of Shimano shoes are quite wide across the forefoot as well. So having a shoe which is wide enough to accommodate your foot is a no brainer. In terms of other intrinsic things you can do in the foot to reduce problems with these nerves and these vascular structures. Let's say that you've got the beginnings of a new Roma or even though you've got a wide foot you're still getting a bit of this kind of compression occurring and you've got quite a wide shoe that's accommodating it. You can trial using a thing called a metatarsal dome and I've got a couple here just to show you. These are ones which David from G8 has now supplying with his ArchTech 2620 modules and these come in two different heights but there's all different shapes and sizes. And these are basically just a little dome which essentially sits, if this is your foot, they sit underneath the forefoot and then they spread those metatarsal joints apart a little bit. So they create a situation where there's this kind of spreading effect, particularly useful if you've got a new Roma, I think called a Morton's new Roma, which is a scar tissue formation around the nerve. But generally if you're looking for a bit more circulation through the forefoot, a slight little metatarsal dome like that can splay the forefoot and create the conditions needed to pump a little bit more circulation through the foot. So a metatarsal dome, relatively inexpensive way of testing that theory, it's one of the things that we use occasionally. How much are those things? Oh, a couple of bucks. These come with David's insoles. I don't know if he sells them individually, but you can buy stuff like this on eBay. These are just ones which come with those inserts. And there's different shapes of them and stuff like that and different heights and different softnesses and so forth. But these ones are quite nice. Yes. So in terms of the compression around the forefoot, you can reduce it with a wider shoe. You can reduce it with stuff like this. And then one of the kind of logical methods of reducing forefoot pressure is to spread the pressure over a larger area. So let's say that you're putting pressure down on the pedal and there's 10 kilos of force going through with every pedal stroke. If you've got a foot that's got, let's say you've got quite a high rigid arch which doesn't deform much. When you place pressure on that foot on the bottom of the shoe, all of the load will go through the metatarsal heads just behind the toes, right? And if your arch isn't actually contacting the bottom of the shoe, all of the 10 kilos goes through a fairly small patch, right? So if you spread that pressure over a larger surface area, you get less focal pressure on the met heads. And so the logical thing to do here is to add arch support. If you create a situation where you're lifting up the arch just moderately, it basically takes load away from the metatarsal heads and spreads it over a larger surface area on the bottom of the foot, it might increase the surface area of contact of the bottom of the shoe by double or triple depending upon the shape of your foot and how rigid the arch is and how your met heads are contacting the bottom of the shoe. And that can be enough to just spread pressure away from the metatarsal heads and reduce hot foot and foot numbness and all that kind of stuff quite a lot. So arch support is probably one of the biggest things to get right, particularly if you've got that type of high rigid arch foot. In terms of the other stuff, the stuff that higher up the kinetic chain which can cause problems, there's a bit of background to this. The way that the circulation works in your foot is it works on a muscle pump system. So when your calf muscle contracts when you're riding, walking, running, whatever you're doing, part of that contractile effort, the part of the way that the vascular structures have evolved in the back of your leg is that will then pump circulation through your foot, just like your heart pumps, right? Same kind of idea. Because the human nervous system has evolved sorry, the human body has evolved to walk and run, we've adapted in this way such that our calf musculature pumps circulation through our feet when we use our feet, right? So anything which challenges that on a bike can create a problem. So let's say for example that the seat is far too high, the rider's riding with the seat way too high and their compensatory adaptation to that is to point their foot really rigidly down. On the down stroke, their calf muscle is contracting really heavily to keep that rigid toe point happening and on the up stroke, it's never coming off the pedal. So they just ride like this. Their calf muscle is contracting all the time, which means that there's no circulation pump occurring so they get numb feet. So if the seat is too high, you can get numb feet. If the seat is way too low, you can also get numb feet because on the down stroke, the pressure, sorry, on the up stroke, the pressure doesn't come off your foot. So this is kind of a harder one to visualize but if the seat is way too low, the pressure will always be on the pedal if it's way too low. So if we put your seat that far too low and your knees are up around your chest, you would never experience a situation where the pressure would go on and then off the pedal. It would just always be on through the whole pedal stroke. So that can cause numb feet. If the seat's way too far forward or way too far back, it can create issues with the calf engagement at the bottom of the stroke, which can cause similar issues. And I guess the big one, which is probably the most common causation of numb feet in my experience, of all of them except for possibly lack of arch support is if the cleat position is too far forward. So if the cleat position is too far forward on the shoe, the rider will over engage their calf, like we spoke about in one of the other videos, just to stabilize the foot on the down stroke. And that will then lead to this lack of circulation through the foot. So depending upon the individual rider, if they're a massive heel drop or a toe proro or whatever, there'll be a point at which, when the cleat gets far enough back on the shoe, their calf muscle will go, oh, that's better. And it will come on and off, on and off and pump circulation through the foot and then numbness will probably disappear. So there's a couple of products out there which can help you if you need the cleats a long way further back. There's a Speedplay Extender Baseplate. This is an alloy device made by Speedplay, which has just got some much longer slots in it to enable more rearwards translation of the cleat. And it's also got two sets of bolt holes, which will enable another 10 millimeters of rearward translation on the cleat as well. So for people like myself who need their cleat a long way back on the shoe for whatever reason, and one of them can be foot numbness, this is a good way of getting in a fair way back. Another option is there's been a few of these come out over the years and these are probably the best ones I've ever seen. These are made by like in Switzerland. These website you might put a link in the description. Yeah, these are really good. These are a three bolt adapter. So you can see that they're curved to suit the bottom of most shoes and they come with some shims and stuff to suit the curvature of most road shoes. And they basically bolt onto the bottom of the shoe using the three bolt locations there, the traditional triangular cleat, and then they've got a 12 and a 24 millimeter stagger. So you then screw your cleat further back in however far you want it. And so this can be another good option. These are made out of really high grade alloy I believe and they're strong as anything. They're one of the best solutions I've ever seen for a three bolt cleat. The only downside is they do increase the stack height of the cleat a little bit by three millimeters. The good news is that when you go this far back on the cleat, the stability of the foot over the pedal is so good that extra stack height almost doesn't matter. It's almost irrelevant. So you can use these to approximate a mid-foot cleat position as well. If you're having really difficult problems or you've got peripheral vascular problems and your circulation through your feet is no good. Or for other reasons, which we'll talk about in another video. If you wanna run the cleat a long way back and approximate a mid-foot cleat position or get fairly close to it, these will enable you to get fairly close as well. So we'll talk about mid-foot under different circumstances in more detail. But if you've got a rider with really compromised circulation in the feet and nothing else works, almost always mid-foot will give them relief from their foot numbness because it just completely resolves any calf engagement across the bottom of the stroke at all. And mid-foot, obviously what that means is to have the center of the cleat directly under the middle of the foot or very close to it. So the foot becomes inherently very stable on the pedal. The calf relaxes and does nothing. Circulation is free to pump through your foot and all of the load through the bottom of the shoe tends to go up through your arch and splay the foot that way rather than up through the metatarsal heaps. So it's a last-ditch effort mid-foot if you've got a person who's really struggling with foot numbness. But it almost always works. Right. So where would you start if someone's experiencing it? Like you've obviously outlined a lot there. Is there any specific starting point you'll just un-lush in your shoes first? Yeah. Start with that, see how that goes and then maybe try changing shoes? What would you do? First of all, the easy stuff that's free and easy to experiment with, sticky foot inside your shoe and do it up moderately and just have a feel around the lateral parts of the foot on the left and right hand side. If the shoe is really constrictive or you can feel your fifth metatarsal or your first metatarsal bulging the shoe out, it might be too constrictive around the front. If you cannot feel when you stand in your shoes, if you cannot feel any contact across the arch of the foot, it's pretty likely that you need some type of arch support to spread the pressure away from your metatarsal heads. Something like David's G8s or any off-the-shelf orthotic that's got a sufficiently high enough arch so that when you stand in them, you can feel that arch pressure quite solely across the bottom of your foot. It's a good place to start. In terms of the seat height and all that kind of stuff, have a look at the other videos we did on that. Yes, or link to below, yep, good idea. That'll get you pretty close and the balance stuff, the four and a half position is less likely to be causing trouble. But the cleat position, if you want to experiment with that, go further back, just move the cleats far back as it can go. You might need to lower your seat a little bit at the same time to keep everything else in balance and then see if that gets rid of the numbness. And that way, using those kind of three major ideas, you might be able to figure out at least roughly where it's coming from. And then it's less likely that you'll need something like a metatarsal dome. I give them out fairly rarely because most of the time we solve the foot numbness issue using one of these things. Okay.