Custom foot orthotics in cycling

NewsBot · May 24, 2011

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Custom formed orthoses in cycling.
O'Neill BC, Graham K, Moresi M, Perry P, Kuah D.
J Sci Med Sport. 2011 May 20. [Epub ahead of print]

To assess the effects of currently used prescribed in-shoe custom foot orthoses (CFOs) on a number of biomechanical variables during the power phase of cycling, including: hip adduction, knee abduction and tibial internal rotation. Before and after cross-over study recording subjects' biomechanical variables with and without their CFOs. Twelve competitive cyclists, currently using prescribed in-shoe CFOs, performed two exercise bouts on a stationary trainer, with 3-dimensional data recorded on an 8 camera Vicon Mx system. 2-way ANOVA statistical analysis of Null vs Orthotic condition, and left leg vs right leg. No systematic effects from the CFOs were seen. A trend towards reduced tibial internal rotation range of movement was found (P<0.072). Significant subject-specific effects from the CFOs were seen (P<0.05). Three distinct patterns of knee movement were observed. All subjects had significant left to right leg differences. CFOs do not produce systematic effects on cycling biomechanics. Significant subject-specific biomechanical effects can be produced by CFOs utilizing rearfoot and/or forefoot wedges. An individualised approach to orthotic prescription, and attention to the forefoot-rearfoot relationship, is recommended.
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Admin2 · May 24, 2011

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NewsBot · Jun 5, 2012

Contoured in-shoe foot orthoses increase mid-foot plantar contact area when compared with a flat insert during cycling.
Bousie JA, Blanch P, McPoil TG, Vicenzino B.
J Sci Med Sport. 2012 Jun 1

OBJECTIVES:
To determine the effect of contouring of an in-shoe foot orthosis on plantar contact area and surface pressure, as well as perceived comfort and support at the foot-orthosis interface during stationary cycling.

DESIGN:
A randomised, repeated measures control study.

METHODS:
Twelve cyclists performed steady-state seated cycling at a cadence of 90rpm using a contoured orthosis and a flat insert of similar hardness. Contact area (CA) and plantar mean pressure (PP) were measured using the PEDAR(®) system, determined for seven discrete plantar regions and represented as the percentage of the total CA and PP respectively (CA% and PP%). Perceived comfort and support were rated using a visual analogue scale (VAS).

RESULTS:
The contoured orthosis produced a significantly greater CA% at the medial midfoot (p=0.001) and lateral midfoot (p=0.009) with a standardised mean difference (SMD) of 1.3 and 0.9 respectively. The contoured orthosis also produced a significantly greater PP% at the hallux (p=0.003) compared to the flat insert with a SMD of 1.1. There was a small non-significant effect (SMD<0.4) for the perceived comfort measures between conditions, but perceived support was significantly greater at the arch (p=0.000) and heel (p=0.013) with the contoured orthoses (SMD of 1.5 and 0.9, respectively).

CONCLUSION:
Contoured orthoses influenced the plantar surface of the foot by increasing contact area as well as a perception of greater support at the midfoot while increasing relative pressure through the hallux when compared to a flat insert during stationary cycling. No difference in perceived comfort was noted.
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NewsBot · Jul 25, 2012

Influence of carbon fiber foot orthoses on plantar pressure distribution in cycling.
Baur H, Hoffmann J, Reichmuth A, Müller S, Mayer F.
Sportverletz Sportschaden. 2012 Mar;26(1):12-7

Background: Several equipment interventions like optimizing seat position or optimizing shoe/insole/pedal interface are suggested to reduce overuse injury in cycling. Data analyzing clinical or biomechanical effects of those interventions is sparse. Foot orthoses out of carbon fiber are one possibility to alter the interface between foot and pedal. The aim of this study was therefore to analyze plantar pressure distribution in carbon fiber foot orthoses in comparison to standard insoles of commercially available cycling shoes.

Materials and Methods: 11 painfree triathletes (Age: 29±9, 1.77±0.04 m, 68±5 kg) were tested on a cycle ergometer at 60 and 90 rotations per minute (rpm) at workloads of 200 and 300 Watts. Subjects wore in randomized order a cycling shoe with its standard insole (control condition CO) or the shoe with carbon fiber foot orthoses (Condition CA). Mean peak pressure out of 30 movement cycles were extracted for the total foot and specific foot regions (rear, mid, fore foot (medial, central, lateral) and toe region). Three-factor ANOVAs (factor foot orthoses, rpm, workload) for repeated measures (α = 0.05) were used to analyze the main question of a foot orthoses effect on peak in-shoe plantar pressure.

Results: Peak pressures in the total foot were in a range of 70-75 kPa for 200 Watts (W) (300 W: 85-110 kPa). The carbon fiber foot orthoses reduced peak pressures by -4,1% compared to the standard insole (p = 0,10). In the foot regions rear (-16,6 %, p < 0.001), mid (-20,0 %, p < 0.001) and fore foot (-5.9 %, p < 0.03) CA reduced peak pressure compared to CO. In the toe region, peak pressure was higher in CA (+16,2 %) compared to CO (p < 0,001). The lateral fore foot showed higher peak pressures in CA (+34 %) and CO (+59 %) compared to medial and central fore foot.

Conclusion: Carbon fiber can serve as a suitable material for foot orthoses manufacturing in cycling. Plantar pressures do not increase due to the stiffness of the carbon. Individual customization may have the potential to reduce peak pressure in certain foot areas.
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NewsBot · Aug 16, 2016

INTERVENTION AT THE FOOT-SHOE-PEDAL INTERFACE IN COMPETITIVE CYCLISTS
Sinead FitzGibbon, Bill Vicenzino, and Sue Ann Sisto
Int J Sports Phys Ther. 2016 Aug; 11(4): 637–650.

Background
Competitive cyclists are susceptible to injury from the highly repetitive nature of pedaling during training and racing. Deviation from an optimal movement pattern is often cited as a factor contributing to tissue stress with specific concern for excessive frontal plane knee motion. Wedges and orthoses are increasingly used at the foot-shoe-pedal-interface (FSPI) in cycling shoes to alter the kinematics of the lower limb while cycling. Determination of the effect of FSPI alteration on cycling kinematics may offer a simple, inexpensive tool to reduce anterior knee pain in recreational and competitive cyclists. There have been a limited number of experimental studies examining the effect of this intervention in cyclists, and there is little agreement upon which FSPI interventions can prevent or treat knee injury. The purpose of this review is to provide a broader review of the literature than has been performed to date, and to critically examine the literature examining the evidence for FSPI intervention in competitive cyclists.

Methods
Current literature examining the kinematic response to intervention at the FSPI while cycling was reviewed. A multi-database search was performed in PubMed, EBSCO, Scopus, CINAHL and SPORTdiscus. Eleven articles were reviewed, and a risk of bias assessment performed according to guidelines developed by the Cochrane Bias Methods Group. Papers with a low risk of bias were selected for review, but two papers with higher risk of bias were included as there were few high quality studies available on this topic.

Results
Seven of the eleven papers had low bias in sequence generation i.e. random allocation to the test condition, only one paper had blinding to group allocation, all papers had detailed but non-standardized methodology, and incomplete data reporting, but were generally free of other bias sources.

Conclusions
Wedges and orthoses at the FSPI alter kinematics of the lower limb while cycling, although conclusions about their efficacy and response to long-term use are limited. Further high quality experimental studies are needed examining cyclists using standardized methodology and products currently used to alter SPFI function.
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NewsBot · Dec 10, 2016

Effects of structural foot support on lower limb kinematics and electromyography during cycling
Gordon, Brian, M.S.,
CALIFORNIA STATE UNIVERSITY, FULLERTON, 2016, 41 pages; 10145360

There is little research on the effects of foot orthotics on cycling kinematics and hip muscle electromyography. This study investigated the effects of longitudinal arch support and forefoot varus wedges on cycling kinematics and hip electromyography in a sample of trained cyclists, and whether hip muscle activity was correlated with orthotic support. Twenty-two trained cyclists (mean cycling hours = 12 ± 2.83 per week for past 12 weeks) performed four randomized trials with variations of orthotic support while kinematic and electromyography data were collected. Kinematic variables explored were knee valgus angle and tibial internal rotation. Gluteus medius, tensor fascia latae, and vastus medialis electromyography data were also collected. Knee valgus angles were significantly less in the arch support+wedge condition than the control (p = 0.022) and arch support (p = 0.046) conditions. Gluteus medius activation was significantly greater in condition control versus wedge (p = 0.011) and arch support+wedge conditions (p = 0.037). Vastus medialis activation was significantly greater in control condition versus wedge ( p = 0.031), arch support (p = 0.05), and arch support+wedge (p = 0.013) conditions. The arch support+wedge trial led to a significant reduction in knee abduction; there was no significant correlation in peak muscle activation between examined hip muscles (r(20) = 0.118, p > 0.05). Results in this study suggest that adding supportive orthotics to cycling footwear may help reduce valgus collapse at the knee which has been associated with knee overuse injuries.
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NewsBot · May 14, 2017

Video on their custom made orthotic for cycling from Footwork Podiatric laboratory

https://www.facebook.com/video.php?v=1480974115299034

Riverside Podiatry · May 17, 2017

I'm a podiatrist and amateur competitive cyclist. I am of the firm belief that foot function in a cycling shoe and while on a bike is static, and that orthotics are in 90% of cases unnecessary. The vast majority of cylcling foot issues concern "hot foot", neuroma type pain, that devlelops while cycling. This occurs due to a varus, or supinated forefoot, inducing excessive pressure from the firm cycling shoe to the lateral forefoot. While this can be treated with orthotics, a much better and elegant treatment, assuming a properly fitted shoe, is to place a varus wedge at the level of the shoe cleat, and thereby allow the foot to press evenly on the inside of the shoe without inerference of additional material in the shoe. I have treated many of my fellow cyclists with great sucess in this maner.

Thanks,

Rob Hope, D.P.M.

NewsBot · Nov 2, 2017

Acute effect of biomechanical foot orthotics on gross efficiency in cyclists affected by an anatomic asymmetry in time trial position.
Bouillod A et al
Comput Methods Biomech Biomed Engin. 2017 Oct;20(sup1):23-24. doi: 10.1080/10255842.2017.1382842. (Full text)

This study demonstrates a trend for biomechanical foot orthotics to improve both the GE and comfort, which are determinant in cycling performance
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NewsBot · Dec 2, 2017

Hardness and posting of foot orthoses modify plantar contact area, plantar pressure, and perceived comfort when cycling
Jaquelin A. Bousie, Peter Blanch, Thomas G. McPoil, Bill Vicenzino'
JSMS; Article in Press

Objectives
To evaluate the effects of hardness and posting of orthoses on plantar profile and perceived comfort and support during cycling.

Design
A repeated measures study with randomised order of orthoses, hardness, and posting conditions.

Methods
Twenty-three cyclists cycled at a cadence of 90 rpm and a perceived exertion rating of twelve. Contoured soft and hard orthoses with or without a medial forefoot or lateral forefoot post were evaluated. Plantar contact area, mean pressure and peak pressure were measured for nine plantar regions using the pedar®-X system and represented as a percentage of the total (CA%, MP%, and PP% respectively). Perceived comfort and support was rated on a visual analogue scale.

Results
The softer orthosis significantly increased CA% (p = 0.014) across the midfoot and heel with a decrease in the toe region and forefoot. MP% (p = 0.034) and PP% (p = 0.012) were significantly increased at the mid and lateral forefoot with reductions in MP% at the midfoot and in PP% at the hallux and toes. Forefoot posting significantly increased CA% (p = 0.018) at the toes and forefoot and decreased it at the heel. PP% was significantly altered (p = 0.013) based on posting position. Lateral forefoot posting significantly decreased heel comfort (p = 0.036).

Conclusion
When cycling, a soft, contoured orthosis increased contact across the midfoot and heel, modulating forefoot and midfoot plantar pressures but not altering comfort or support. Forefoot postings significantly modified contact areas and plantar pressures and reduced comfort at the heel.
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NewsBot · Jul 18, 2023

The Effectiveness of Hard Insoles for Plantar Pressure in Cycling: A Crossover Study
Israel Casado-Hernández et al
Bioengineering 2023, 10(7), 816; https://doi.org/10.3390/bioengineering10070816

Background: Hard insoles have been proposed to decrease plantar pressure and prevent foot pain and paresthesia due to repetitive loading. The aim of this research was to analyze the effect of three different hard insoles in cycling on healthy subjects. Methods: A crossover randomized trial was carried out. The mean age of the subjects was 35 ± 3.19 years, and all of them were men. While the subjects were cycling on a stationary bicycle, their plantar pressure was recorded with nine in-shoe sensors placed in nine specific foot areas to test a standard ethylene-vinyl-acetate 52° Shore A hardness insole, a polypropylene 58° Shore D insole, and a polypropylene 580 Shore D insole with selective aluminum 60 HB Brinell hardness in the metatarsal head and hallux. Results: The maximum plantar pressure decreased significantly with the polypropylene insole containing selective aluminum in the metatarsal head and hallux areas. The maximum plantar data of the polypropylene aluminum insole in the M2 area (5.56 kgF/cm2), fifth metatarsal styloid process (6.48 kgF/cm2), M3–M4 area (4.97 kgF/cm2), and hallux (8.91 kgF/cm2) were of particular interest compared to the other insoles. Conclusions: The use of insoles made of polypropylene with aluminum in the metatarsal head and hallux areas decreases the maximum plantar pressure in cycling compared to standard EVA and polypropylene insoles.
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