Foot Pain and Cycling: a survey of frequency, type, location, associations and amelioration of foot pain

Abstract

The foot – pedal interface is the primary site for energy transfer from the cyclist to the bicycle, with anecdotal evidence that foot injuries from cycling are common. However, there is little research regarding the prevalence, aetiology and/or management of such injuries. 1) What is the distribution of age, gender, foot/pedal interface use and distances cycled amongst cyclists who experience foot pain? 2) What type of pain and what region of the foot do cyclists experience pain? 3) What amelioration techniques are used for this cycling foot pain? 4) Are there key groups of cyclists at greater risk of foot pain than others?. Cyclists over 18 years of age riding a non-stationary, upright bicycle at least once a week (minimum of one hour) were invited to participate in an electronic questionnaire. The electronic link to the survey was distributed through three large databases Bike SA, (the peak representative body for South Australian cyclists), Mega Bike (a large bicycle shop in Adelaide) and staff and students of the School of Health Sciences at the University of South Australia. The survey asked about cycling participation, pedal interface and foot pain. The survey was returned by 397 participants (93.9% responses eligible for analysis). Foot pain was reported by 53.9% respondents.  The forefoot, inclusive of the toenails, toes and ball of the foot, was the highest reported region of foot pain (61%). The pain was described as ‘burning’ and ‘numbness’. ‘Stopping’ for a period of time during the cycle and ‘removing their shoes’, ‘walking around’, ‘massaging’ and ‘stretching’ the foot was the most commonly reported amelioration technique. The group of cyclists at greatest risk of experiencing foot pain are those who ride with an attached (cleated-in, strap, cage) foot-pedal interface.

This paper found a high frequency of foot pain in cyclists (53.9% of cohort). The pain was overwhelmingly described as ‘burning’ and ‘numbness’ with the forefoot region most implicated. ‘Stopping’ for a period of time during the cycle and ‘removing their shoes’, ‘walking around’, ‘massaging’ and ‘stretching’ the foot was the most commonly reported amelioration technique. The group of cyclists who are at the greatest risk of experiencing foot pain are those who ride with an attached foot-pedal interface (2.6 odds ratio); followed by the combination of those who use an attached foot-pedal interface and who are 26 years of age or older (2.2 odds ratio). Our study highlights the importance of addressing the current knowledge gap regarding foot pain and cycling and the need to investigate effective interventions for this problem.