How Can I Halt Hot Foot?

Question: I'm a fitness-oriented rider and do about 3,500 miles each year. I've developed pain and numbness in the ball of my foot while wearing a new pair of road shoes.

I mentioned this problem to one of my cycling buddies who had an even more severe foot problem. He had custom insoles made for his cycling shoes, and this worked well for him. Do you think this might be appropriate for me, too? -- Wayne R.

Coach Fred Replies: Ah, now we know it's the heart of the season! Sufferers of "hot foot" are writing for help. It's a common problem, especially on long rides, and sometimes tough to solve.

Hot foot describes a burning sensation in the ball of the foot, often accompanied by tingling and numbness. It's usually caused by compression of the nerves between the metatarsal bones in the forefoot. It's most apt to happen as feet swell slightly during long rides.

Wayne, your friend got relief because of the built-in "metatarsal button" that most orthotics (custom-made insoles) have. It's actually a dome located just behind the ball of the foot to spread the metatarsal bones, taking pressure off the nerves.

Orthotics would probably work for you, too. So might Specialized Body Geometry shoes. Andy Pruitt designed their patented insole with a button built in. You can find our review of the road shoes at Product Tests.

A podiatrist or sports medicine clinic can custom-make cycling orthotics. A less-expensive option is a generic insole with the button, sold over the counter at drug stores, running stores and some bike shops. To learn more about these products, search for "cycling orthotic" at www.google.com

Or, you can make your own buttons from moleskin (an adhesive material that's used to prevent blisters). Cut one or more pieces in the right shape and stick them to the bottom of your regular foam insole just behind the ball of your foot. Check your friend's orthotics to see the approximate size of the bulge and its location.

Here are two more ways to cool hot foot:

First, try thinner socks and/or a thinner insole. Pressure on nerves is causing the pain, so give your metatarsal bones more room to spread.

Second, move your cleats fully to the rear. This puts the ball of your foot ahead of the pedal axle to change the pressure point. Sometimes this will do the trick without any insole adjustments.