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Tuesday, January 17, 2012

Cycling Followed by Plantar Fasciitis...

So here's a tricky dilemma.  There seems to be some confusion about whether or not cycling can cause plantar fasciitis.  It has been my experience as well as to the best of my knowledge from the multiple case studies and literature review that cycling alone does not cause plantar fasciitis.  Here's the reasoning why this conclusion is made.

I need to first set some parameters.  When talking about cycling, I'm talking about someone who is using clipless pedals, you know, cycling shoes with cleats to click in to the pedals.  Cycling shoes have a very rigid sole on them.  This allows the force through your leg and foot to be directly applied to the pedal for increased power transfer through the drive train.  Having a rigid sole allows only a very small amount of movement through the foot and plantar fascia.  Your toes aren't extending, excursion of the joints in the foot are small, and therefore, the amount of movement and tensile forces through the plantar fascia are minimal.

The muscles in the legs are working to move the ankle, but there are no impact forces through the heel and foot.  The impact force of which is absent in cycling, along with weak leg and foot muscles are the main causes of plantar fasciitis.  For the layman, the number one go to cure for plantar fasciitis is to get fitted with orthotics.  The orthotic's purpose is to change the way you are weight bearing through your feet and restrict and limit motion of the foot.  The sum of these changes in your foot is that tensile stress is reduced on the plantar fascia.  When stress is taken from the plantar fascia, the plantar fascia has time to heal (that is of course until you begin to perform the same sports or recreational activities even with the orthotic.  The orthotic is only a band aid.  The cause of the plantar fasciitis has not been remedied or removed!).  Remember, the sole of a cycling shoe is very rigid.  The plantar fascia is not under duress when cycling.

So why is it then that people are relating plantar fasciitis to cycling?  Cyclists typically just cycle.  What are they doing when off of their bike?  Walking, maybe jumping in on a pick up game of soccer or basketball! When a person is sport specific, then the incident of receiving an injury from an occasional change in activity can easily be the mechanism of introduction to plantar fasciitis.  A cyclist will train several hours per week participating in a sport with out impact through the leg, foot, and heel.  When switching to an impact sport without the proper conditioning, these impact sports are an opportunistic moment for plantar fasciitis in the right individual.  The whole idea behind cross training is to keep your muscles and joints balanced.  If you are a cyclist, a couple times in the gym per week to cross train is only going to enhance your cycling.  By having synergistic muscles conditioned and strong, they provide a very nice compliment to the primary cycling muscles.  Stamina and overall strength of your cycling will improve!

So, in summary, cycling is a non-impact sport that requires a significant amount of time if you are riding competitively.  You are conditioned for this specific sport.  When suddenly changing sports from nonimpact to impact such as even a casual stroll on the beach on a very soft surface or to a rigid boardwalk, this is a drastic contrast to the movement of cycling!  And remember, some people are just much more susceptible to plantar fasciitis due to foot type, strength in the legs, sports background, overall body weight, and how suddenly you switch from an impact sport to a non-impact sport.

I certainly hope that this clarifies some of those questions about cycling causing plantar fasciitis!

Peace and Happy Bipeding!!

Brad Senska, PT, DPT, BS, ATYM.