Is your Neck Ache a Foot problem?

Is your Neck Ache a Foot problem?

(or the danger of fitting by numbers)

Through an interesting and largely irrelevant series of events I have been talking to more and more cyclists about how a bike fit works and what makes a Chartered Physiotherapist look at things differently.

I have to start with ‘we are all unique’.

While this helps us feel significant, it also explains why I hear about bike fits not really working for some people.

We have to start somewhere with every fit, so after looking at and listening to the body, why not start with the feet. After all, these are the parts of our body applying the force to pedals that is generated to push us along the road.

Now consider a cyclist who is not completely stable through the core postural muscles of the body, you know, the person who is unable to stand comfortably in a symmetrical position for more than a few minutes at a time, often hitching one hip or pointing either foot out to the side. (To have a good core you don’t need a ‘six pack’ I won’t get started on that here…)

This same cyclist has a foot that displays a slight flattening of the arch on the inside of the foot when loaded with body weight, i.e. the arch gets a little longer.

Now putting this same cyclist on his or her bike and asking for a pedalling effort will result in pressure (or power) being transmitted through that foot at around 90 times a minute on average.

At the interface between the foot and the shoe there is an alteration of the contact area when applying greater effort (or power). As the contact area alters so will the part of the shoe that is applying the major part of the effort to the pedal via the cleat. This is potentially highly inefficient.

Moving further up the leg, the knee will be forced to rotate and may move in towards the bike more than the knee on the other side of the body.

This leads to the thigh moving down further than on the other side of the body and then a rock at the hip and pelvis. In effect the leg is required to ‘reach’ a little further to the bottom of the pedal stroke.

With this happening, the lower back will be forced to rotate as will the rib cage.

Next in line are the shoulders. However, if the shoulders roll excessively then the bike would follow and riding would be very difficult indeed. Instead, what we often see is the shoulders use the attachment of the arms, via the hands, to the handlebar to stabilise and counterbalance the movement.

This leads to increased tension in the shoulders and neck, not to mention a whole lot of wasted effort and energy.

The foot movement may not even be the main issue for the cyclist, but it would be work knowing…  

Like to know more, contact us at Fit Me Up or please have a look at The Physio Bike Fit

Thank you

Fit Me Up

The Physio Bike FOOT Fit

It is here!

After reviewing options and lots of testing, The Physio Bike Fit is pleased to partner with Sidas. In addition to the usual Superfeet  footbeds we have been working with, we are now offering full custom footbeds.

Using the tried and tested Sidas technology and a biomechanical assessment, we are now making the sole of your cycling shoe meet your foot.

Biomechanics

Each footbed is cast following assessment of the foot both out of the shoe and where possible also in the shoe via looking at the on bike position and the pedal stroke.

Podoscope

The 'podoscope' helps the cyclist to see how the soles of the foot can deform under pressure.

Video Analysis

Using video analysis we can discuss how an improved alignment can be gained from the casting.


The Retul System can also be used to further enhance the process.

HDVAC 2

The 'Fitting Station' is equipped with both the HDVAC 2, with improved silicone bags that can be stretched up to 800% to allow adaptation to any foot shape. Precision is key here.

MODUVAC

To ensure the footbed materials are both bonded together and heated to the correct temperature, the MODUVAC is incorporated into the 'Fitting Station' allowing the fitting process to be efficient and effective.

The Benefits?

The following benefits have all been reported following the use of custom footbeds;

• Improve comfort
• Increase stability
• Reduce injury risk
• Reduce unwanted movement
• Improve foot cleat relationship under pedal loading
• Greater connection with the foot and shoe
• Reduced 'hot spots'
• Reduced asymmetry
• Improved pedal stroke

Contact Fit Me Up for more information or to come in and get your set of custom footbeds 

Common Foot Related Injuries

Injury	Common Symptoms	Mechanism
Piriformis Syndrome	Pain in the Gluteal area and or into the leg	Prolonged Pronation of the foot leads to internal rotation of the Femur causing the Piriformis to overwork
Iliotibial Band (ITB) syndrome	Pain on the outside of the knee and or in Patella	Over Pronation of the foot causes the Tibia to rotate medially. The Femur rotates laterally as part of extension during the pedal cycle leading the ITB to ‘rub’ on the Lateral Epicondyle of the Femur. This can also lead to mal-tracking of the Patella
Retro Patella Pain	Pain behind the Patella on bending the knee	Over Pronation of the foot leads to increased rotation of the Tibia relative to the Femur. The normal tracking of the Patella in the groove on the end of the Femur is disrupted
Medial ‘Shin Splints’	Pain on the medial aspect of the Tibia	Over Pronation leads to the Tibialis Posterior muscle acting through its bony attachments to attempt to limit the pronation movement by pulling on the metatarsal heads in the foot
Lateral ‘Shin Splints’	Pain on the upper lateral aspect of the Tibia	Over Pronation leads to Tibialis Anterior muscle acting through its bony attachments to attempt to limit the pronation movement by pulling on the medial aspect of the first metatarsal head
Achilles Tendonitis	Pain on the posterior of the lower leg just above the heel bone	Over Pronation occurs causing the Talus bone to drop forwards and medially. This leads to a medial rotation of the Tibia with the lateral rotation of the Femur the Gastrocnemius portion of the calf muscle is stretched from its insertion on the Calcaneus at its origin on the Femur above the knee
Plantar Fasciitis	Pain on the sole of the foot often towards the rear	As the foot is loaded and the medial arch of the foot is stretched due a stable hind-foot and an overly mobile fore-foot Pronating the fascia is over stressed
Hallux Valgus	Pain on the medial ball of the foot	Due to excessive Pronation of the foot, the ‘toe-off’ phase of propulsion loads the medial rather than the plantar surface of the Hallux leading to joint thickening
Morton’s Neuroma	Pain between the heads of the toes	Over Pronation of the foot can lead to a pivoting on the third and fourth metatarsal heads. The result of this is increased shearing forces
Metatarsalgia	Pain around the ‘ball’ of the foot	Increased Pronation can leads to abnormal weight distribution in the foot and a build up of pressure

Glossary 

Pronation	Flattening of the media arch of the foot
Medial	Towards the Midline of the body
Lateral	Away from the Midline of the body
Tibia	Large ‘Shin’ bone
Femur	Large ‘Thigh’ bone
Talus	Important bone transferring much of the body motion and ‘weight’ into the foot
Patella	Knee Cap
Calcaneus	Heel Bone
Hallux	‘Big’ toe
Valgus	Oblique displacement away from the joint mid-line
Neuroma	Pain, often considered to be due to pressure
Metatarsalgia	Pain in the ‘ball’ of the foot