Current Pedorthics | May-June 2017 | Vol.49, Issue 3 | Page 40

CYCLING AND PEDORTHICS orthotic can help alleviate these problems. A cycling orthotic should add to the rigidity of the cycling shoe, integrate a metatarsal pad if needed and support the plantar fascia. The cleat and the interface to the cycling shoe is adjustable. How much play in in the shoe/cleat/pedal interface is referred to as float. Zero-degree float pedals should be for expert level cyclists. The lack of play in the pedals can cause pain up the kinetic chain- mainly in the knees. A lateral twist with the heel can easily remove the foot from the retention cleat in the pedal—its an easy move practicing with one hand on the wall, but trying it in traffic at a stop sign can be an humbling experience. Buying pedals that allow for tension adjustments is important for cyclists new to cycling shoes. The amount of tension has a lot to do with how eas- ily the foot can be removed from the pedal. Like a ski boot, the foot is attached to the pedal by a cleat similar to ski or snowboard binding. You're locked in. Getting separated from your gear either takes a conscious move on your part or enough physics to jolt you from the pedal. Ouch. In rigid stance sports, any play in shoe fit results in loss of power transmission to the piece of equipment. This looseness creates dangerous situations. In expert level road racing, high speeds are maintained through solid control of the bicycle—through the pedals. Loose fit = unsafe. Proper placement of cleats on cycling shoes must address cleat fore/aft position, cleat medial–lateral posi- 38 Pedorthic Footcare Association www.pedorthics.org tion, a 1°-3° forefoot varus wedge, toe vs. toe out and leg length discrepancies. In everyday causal cyclists, poor foot position on the pedal can strain the plantar fascia as the foot bends over the rear support on the pedal. The position of the first metatarsal relative to the pedal spindle in many ways dictates how the cyclist will be riding. In very aggressive road racing stances—the rider's mass nearly vertical over the pedals for power—the 1st MTP joint will be over or behind the spindle on the pedal con- necting it to the crank of the bicycle. This creates a more performance stance that would likely put strain on the muscles of a casual rider. Conversely, position- ing the foot so the 1st MTP joint is forward of the pedal spindle is generally more comfortable for the rider less concerned with performance. Cleat medial/lateral position aligns the toe and the knee in a manner that helps mitigate knee pain due to misalignment. Avoiding cleat adjustments that cre- ate/enhance genu valgum is an easy fix. Being knock kneed on the bicycle is the most common reason for knee pain in the everyday cyclist. Pedorthically an easy fix, this adjustment will knee pain at bay. For advanced bicycle fits, using spacers on the pedal shim may be needed- lengthening the spindle to accommodate for different body frames. Many cyclists have a natural forefoot varus that needs shimming under the forefoot. Brands of pedals, shoes and cleat systems all have different ways of address- ing these biomechanics. Top notch cycling shoes have excellent off the shelf fixes and wedges included in the box. Placing shims in the shoe's forefoot is the easiest way to accommodate for this. A competent Pedorthist