Bunions Shmunions

Look at my feet...

My right foot has a pretty pronounced bunion.

Personally, I think this demonstrates I am further evolved than other people who don't have bunions because my feet appear to be developing the same opposable thumb that my hands were born with ;).

In all seriousness though, bunions can be a pain, in more ways than one. This is espcially true for a grinder-type cyclist like me. So, I've had to manage the problem for many years now. In the last several years, I've taken it more seriously.

This is partly because of my 75 year old mother's feet. Men often inheret a number of their genetic tendencies from their mothers. My mother has had major problems with her feet. She has bad bunions in both feet. She's had pins inserted in several of her toes, she's had a festering infection in one of her big toes that took months to heal (or is it heel?). She's had her achilles tendon's lengthened (they make cuts not quite all the way through the tendon. Large gaps form where the tendons are cut but the tendon regrows to fill those gaps, thereby lengthening the tendons). After all of these procedures, my mother has experienced only marginal improvement in her feet. She frequently still has pain and is less able to walk long distances or at her typical fast pace.

I think my bunion started developing as early as high school. I ran cross country and track in high school. I've noticed my big toe had a funny shape to it even back then. And, sometimes the main joint at the ball of my foot would hurt. I continued running in college but gave up running in my early twenties for the bike. But, now in my fifties, I've recently started picking up running again. But, so far, I've been doing it all on a treadmill. At any rate, I've noticed the bunion is more pronounced than it once was and am worried I am heading for the same problems my mother is having.

So, I am in the market for ways to halt the progression of my bunion. I don't think it can be reversed. At least not without surgical help. And, my understanding from my PCP is that surgery doesn't too often fix the problem.

Numb Toes

Up until about 2011, I rode in tennis shoes with platform pedals and toe straps. It worked fine. But, caving to peer pressure and the belief that clipless pedals would improve my efficiency (or speed), I switched to Look pedals and a pair of $150 Specialized shoes. 

In the new shoes and pedals, after 2-3 hours of riding, my toes were going numb. I tried all sorts of remedies. I removed the basic orthodic inserts that came with the shoes and replaced them with several different kinds of orthodics including SuperFeet (the orange ones). I tried pronation and supronation wedges. I tried different thickness of sox and even orthopedic sox. All of these remedies helped to a minor degree but didn't really solve the problem. Eventually, on longer rides, no matter what I tried, my toes would go numb.

I went back to platform pedals temporarily to see if the numb toes would go away. They did! But, I was  stubornly committed to clipless pedals at this point. I concluded that the reason platform pedals worked is that they allowed the ball of my foot to move out over and in front of the pedal spindle. I wanted to see if I could achieve the same pedal/foot geometry with my clipless pedals.

However, the bolt pattern on the bottom of most shoes to support 3-bolt cleats like Look's do not permit enough fore/aft adjustment of the cleat for me to get the ball of my foot out in front of the pedal spindle. What to do?

I decided to drill new holes in the bottom of my $150.00 shoes (more about the details of that in a later post). I moved the cleat back on the bottom of the shoe almost 1/2 an inch. It worked! The balls of my feet now extend just ahead of the pedal spindles. My toes no longer go numb on long rides. The only problem is that I now have a slight toe overlap with the front wheel which I need to be cognizant of when making turns tight enough to cause the trailing edge of my front wheel to steer outside my pedals.

From the picture above, you can just barely see the original bolt holes now partly obscrued by the cleat attached in the new holes.

Third Party or Custom Insoles

The insoles that come standard with Specialized shoes are not very good. Specialized also sells a few different kinds of higher quality replacement insoles. I've tried those and several different kinds of third party insoles including SuperFeet, Dr. Schoals and Spenco. I usually have to do a 3-4 hour ride several times before I'm sure a particular product is or is not working for me. So, once I settle on a product, I tend not to want to change it. I settled on Spenco Full Lenght Orthotic Arch Supports together with metatarsal pads pictured below.

You will notice the arch support involves a solid plastic support component. It is a very strong arch support but weights a tad more than most people may be willing to tolerate too in their cycling shoes. I don't mind it at all given the comfort and support it provides.

Bunion Releif

There are a number of products out their to provide bunion releif. Many of these are designed simply to cushion the area around the bunion. I don't recommend these because they don't actually do anything to address the problem. They only address the symptoms of the problem. The symptoms are typically pain around the area of the bunion or perhaps added pressure against the skin due to the bunion pressing against the wall of the shoe.

The product that has helped my bunion problems the most is a metatarsal pad. It is a bit counter-intuitive though. You can see it as the white ovular pad in the upper part of my insole on the picture above. It actually isn't designed so much to pad anything as it is to lift something. It is designed to lift the part of the foot just behind where all the toes (metatarsals) connect. You can get pads in different thicknesses to achieve different amounts of lift. Lifting the region of the foot where the metatarsals connect takes pressure off the ball joint of the foot.

After ignoring my bunion for several years, I had lost most of the feeling on the outer edge of my big toe. I lived with it like this for several years. But, after using metatarsal pads for less than a few months, all of the feeling came back to my big toe and pain in my ball joint when away as well. I was stunned how effective these pads were.

However, when I first saw a podiatrist, he didn't take the time to explain to me proper installation of a metatarsal pad. So, when I first used them, I didn't have them installed correctly and they didn't offer me much relief. It is just very important that you place the pad so its leading edge matches the ridge where all your toes connect.

Finally, I would recommend felt as opposed to foam pads. There are a couple of problems with foam pads. First, they don't last me more than a week. So, I have to continually replace them. Thats fine. You can purchase 100 pairs of pad on Amazon for around $20.00. But, they are hard to remove due to the adhesive necessary to keep them in place. A second problem with foam pads is that they create a lot of friction with your sox. So, as you try to slide your feet in or out of your shoes, the pads grab your sox and wind up forming wrinkle ridges in your sox under you feet. Or, you can sometimes wind up peeling off a part of the pad as you slide your foot in and out of your shoe. Felt pads last much, much longer and your sox can slide over them much more easily.