Robert Rosenstein, DPM
Jennifer Zienkowski, DPM
Michael Coppers, DPM
CONDITIONS AND TREATMENTS
CYCLING
Plantar fasciitis is the term commonly used to refer to heel and arch pain traced to an inflammation on the bottom of the foot. More specifically, plantar fasciitis is an inflammation of the connective tissue, called plantar fascia, that stretches from the base of the toes, across the arch of the foot, to the point at which it inserts into the heel bone. Overpronation is the most common cause of plantar fasciitis. As the foot rolls inward excessively when walking, it flattens the foot, lengthens the arch, and puts added tension on the plantar fascia. Over time, this causes inflammation.
Also known as heel spur syndrome, the condition is often successfully treated with conservative measures, such as the use of anti-inflammatory medications, ice packs, stretching exercises, orthotic devices, and physical therapy. Note: Please consult your physician before taking any medications. In persistent cases, Extracorporeal Shock Wave Treatment (ESWT) may be used to treat the heel pain.
Extracorporeal Shock Wave Therapy (ESWT) is used to treat chronic heel pain (plantar fasciitis). "Extracorporeal" means "outside of the body." During this noninvasive procedure, sonic waves are directed at the area of pain using a device similar to that currently used in nonsurgical treatment of kidney stones.
Extracorporeal Shock Wave Therapy is prescribed for patients who have experienced plantar fasciitis for an extended period of time -- six months or more -- and have not benefited from other conservative treatments. The brief procedure lasts about 30 minutes and is performed under local anesthesia and/or "twilight" anesthesia. Strong sound waves are directed at and penetrate the heel area to stimulate a healing response by the body. ESWT is performed on an outpatient basis. Although there are no bandages, someone will need to drive the patient home.
People who are not candidates for ESWT include pregnant women and individuals with neurological foot disease, vascular foot disease, pacemakers, or people taking medications that interfere with blood clotting (such as Coumadin).
This therapy is a safe and effective alternative treatment for heel pain and only requires a short recovery time. Clinical studies show a 70 percent success rate for treatment of plantar fasciitis using Extracorporeal Shock Wave Therapy.
Since the bicycle's invention in the early 1900s, it has been a favorite form of recreation and sport in the U.S. More than 100 million Americans enjoy biking, either for recreation or, increasingly, for commuting to work each day. While a great workout for most of the body, feet play a vital role in cycling. They are responsible for the transfer of energy from the body to the pedals, which makes the bicycle move.
Keeping the alignment between the hips, knees, and feet is the most efficient way to operate a bicycle. Lack of proper body alignment and overactivity are responsible for the most common foot problems related to biking: Achilles tendonitis, sesamoiditis, shin splints, and foot numbness or pain.
Cycling Shoes
For the casual or recreational cyclist, a typical athletic shoe used for running, walking, or cross-training is perfectly fine for biking. Just be sure that the sole is firm and not worn down so that it grips the pedal to avoid slipping.
For more serious cyclists, next to bicycles themselves. proper shoes are the most important piece of cycling equipment. In general, cycling shoes should have a stiff sole and fit snugly around the bridge of the foot and heel. The more stable and less movement inside the shoe, the more power can be transferred through the entire foot to the pedal. Also look for shoes with ventilated uppers to keep feet more comfortable. Closure systems vary, including lacing, buckles, straps, and Velcro -- or some combination. You can choose whichever feel most comfortable to you. However, be careful that any loose ends (from straps or laces) and buckles don't hang over, as they can pose a safety hazard if you elect to use toe clips.
The type of biking you do can impact your choice of shoes as well. For road cycling and racing, shoes that have stiff soles, a narrow heel, and snug fit are best. For mountain biking, the shoes also need a decent tread for better grip and a more rugged sole.
Many serious cyclists use some form of a toe clip system. These allow the rider to transfer power from the body to the pedal in both the up and down motions of the leg. Simple toe clips have metal or plastic clips that attach to any type of shoe with strapping. However, they are not as efficient at energy transfer because they allow the foot to bend. Additionally, hanging straps can pose a danger. Clipless systems use metal or plastic cleats in the sole of a shoe that attach to bindings on the pedal. These are a good choice for road or race cycling, but they do take some adjusting to initially. Also, the cleats make the shoes unwearable for walking. Clips are generally not advised for mountain biking since the foot comes off the pedal frequently.
Remember to take the socks you plan to wear with you when trying on cycling shoes to make sure the fit is right.




