Dr. Amol Saxena, DPM
Palo Alto Foundation
Medical Group
Dept. of Sports Medicine
3rd Floor, Clark Building
795 El Camino Real
Palo Alto, CA 94301
Office: 650-853-2943
Fax: 650-853-6094
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Dr. Amol Saxena, DPM


Amol Saxena   Karen and Amol Saxena
Karen and Amol Saxena

Cool Your Hot Dogs (PDF)
Four simple steps to take the pressure off swollen, burning feet
Article from

The foot is the contact point with the cycling pedal. Because of this, foot problems are not uncommon to cyclists. Most of these are nuisance problems that can be easily fixed.

Shoes with Carbon-fiber soles were shown in a 2003 study to focus more stress under the forefoot. If you are susceptible to a common burning feeling, known as Neuromas  a.k.a “Hotfoot” (pinched nerves near the 3rd & 4th toes) and/or have minimal fat padding, then consider Nylon soles. Wider forefoot configuration, particularly with shoes made in the Far East help avoid forefoot compression. Moving the cleat back behind the ball-of-foot area also reduces the force (see illustrations below).


Pedals with a wider platform disperse force better than smaller pedals. Sometimes regardless of these changes you will still get some discomfort if you cycle far enough. In fact just like with running, the more you cycle, the more the fat padding under the ball of your foot wears thin. Then it may be time to consider seeing a Podiatrist or other specialists that deals with cyclists’ foot problems.

Biomechanical abnormalities such as a shorter (or longer) limb can be addressed with an extra insole in the forefoot (up to ¼ inch if you have enough volume in the shoe), adding washers/shims between the cleat and the shoe or moving the cleat back on the longer leg’s shoe. Foot orthoses with a forefoot extension can help control excessive internal leg rotation which can cause knee pain (Patello-femoral Syndrome/Chondromalacia). (See Below)


Keep in mind a seat too low or high, and pushing too high a gear can contribute to knee pain as well.

Achilles Tendon problems are not uncommon with cyclists, particularly those doing heavy mileage. The covering of the Achilles known as the Paratenon can get inflamed from the continuous friction (see Heel Pain). Physical therapy, staying in the saddle, and lower gears can help. Sometime surgery is needed and is very helpful.

Winter/Rainy rides can be made more pleasant by placing your shoes over a heater vent prior to rides, placing extra insoles or foil to cover that ubiquitous hole in the bottom of the forefoot of most shoes, and using wool-blend (Smartwool™) or Thermax ™ socks. Various shoe covers that enclose the toes and even the whole shoe are very helpful.

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