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Tuesday, July 12, 2011

Cycling & Plantar Fasciitis Part...?

I want to expand a bit on plantar fasciitis and cycling.  I previously talked about this several blogs ago.  I’ve had a lot of interest in this post and requests for more information on this. 

Bear with me; I have to be serious here in the next couple of paragraphs!

The reason why cycling does not affect plantar fasciitis:

The sudden loading and impact of the heel up through the toes are absent.  The required work of the plantar fascia is absent when in cycling shoes.  The muscles in the foot and toes are working, but it is a different kind of work being performed.  When cycling, the movement or the joints and muscles in the foot are minimized.  

There are 26 bones in the foot.  One reason for the many bones is that the foot has to adapt to a multitude of surfaces and absorb large amounts of force with ballistic types of movement such as running and jumping.  If the foot were rigid, the amount of force would not be dissipated and our knees and hips.  This in turn could cause injury in our knees, hips, and back.  A second reason why there are so many bones in our feet is so our feet can wrap and adapt to surfaces to give us stability in an upright and weight bearing position on multiple surfaces. 

So, how does all this relate to cycling?  If forces going through the foot are such that the leg and foot muscles are too weak to handle, then the joints of the foot, the muscles within the foot, and the plantar fascia will absorb this excess force.  The plantar fascia will to a point be able to handle this extra load.  If the muscles of the foot and leg do not become stronger in a relatively quick time frame, the plantar fascia will then become affected, especially at the origin on the heel.  When your foot is in a cycling shoe, the sole of the shoe is very rigid.  The force going through the foot is much less than would be with dynamic and sudden loading or weight bearing force such as would be present with jumping, walking over river rocks, etc.  The foot, when in a cycling shoe, is held securely.  The 26 different bones with the multitude of articulating surfaces are held more securely and are only moving a fraction of what they would be doing if in a sandal or running shoe.  Of significant importance - the plantar fascia when in a cycling shoe and pushing on a pedal is not under nearly the load as a foot would be when performing an easy jog or run.  There is no sudden loading and unloading of the plantar fascia.  Additionally, when cycling and your pedal stroke is performed in a correct manner, the calf muscle, and flexor muscles of the ankle and foot are being strengthened.  Even the anterior tibialis muscle is being strengthened from the up stroke on the pedal when clipped into the pedal and using a proper pedal stroke.     

So, this is a small explanation of why cycling can really help when recovering from plantar fasciitis.  You are able to maintain cardiovascular fitness, maintain lower extremity strength, and even improve strength in the calf and foot muscles.  

Brief Summary of a Proper Pedal Stroke

If you get a chance, pay attention to cyclists and the way they push down and pull up on pedals.  Most likely you’ll see quite a difference between peoples’ pedaling.  Sometimes the heels are held high when pressing down on the pedal.  Sometimes, the heels are in an exaggerated down position. 

So, what is the correct or most efficient way?  

What you want to do is make sure you attempt to lead with the heel on the down stroke just after you cross over the top dead center position of the crank.  This ensures that the leg muscles (you know, the muscles in your lower extremity from the knee down, not the hip down, are fully engaged).  You’ll get the best leverage this way and be able to increase power output through the improved positioning and leverage.  Once the foot approaches and then passes bottom dead center, the hamstring muscles along with the muscles that pull your foot up (dorsiflexion) perform more work.  By distributing power evenly through the pedal stroke, you develop a proper muscle balance throughout the lower extremity.  

Here's a little trivia:  In the mid to late 80's when triathlon and biathlon were booming with the Bud Light and Coors Light race series, it was very common to see cyclists in a training ride with their heels held high through the entire pedal stroke.  What seemed to be a common denominator amongst these cyclists were each one of them was that they each had a very strong background in running.  They weren't adjusting their body mechanics to the activity of cycling. 

Happy Bipeding!

Brad Senska, PT, DPT, BS, ASTYM.