OK so a bit of a weird one.

I have a problem with my right foot in that i cannot twist the ankle outwards (weird birth defect). AFAIK this means I am stuck with MTB SPDs as road SPDs and speedplays only allow outward twisting to disengage the pedal. I currently twist the heel inwards to disengage.

Slight problem with this is that my feet cant cope with SPDs - after about an hour i get a completely numb and painful foot. On a 200 mile ride recently, i ignored the pain and now it's worse than ever. I tried a really expensive and rigid MTB shoe which is like a road shoe but with a very stiff sole and SPD cleats to no avail - the same pain.

Riding on flats is fine as i seem to prefer the pedal under the arch of my foot than the forward position of cleats anyway.

Toe clips are just too far forward and hurt in the same way so not entirely sure any type of clipless isn't going to hurt anyway.

I have also tried some fancy inserts - same problem.

Any bright ideas apart from sticking flats on my canyon...?

Falling over usually results in me coming unclipped every time when I get stuck in them...try this!

Sounds like there's two separate issues here:

1) You're limited to the inward twist to release. Never tried inward releasing road cleats, but I don't think it'll work. So stick with SPD's

2) You seem to have an issue with pedaling with the ball of your foot.

Moving to road cleats will not change 2) one iota. Main difference is in how it spreads the load on the shoe, the difference between a stiff shoe with SPD's and road cleats isn't something you're going to notice. Would close to guarantee it's not to do with contact area. All your foot knows is it's pushing on the shoe, what's under it is largely irrelevant. That's backed up by you not liking toe clips either.

Personally I'd try to fix 2 - starting by figuring out why/what the problem is. Pedaling with the arch is kinda screwed up - if that's all you can do, fine, but I reckon a decent physio / sports physiologist will be able to sort you out.

thanks Mark - tend to agree I probably need to see a foot doctor!

Benny that answer has probably been staring me in the face. GF has a set similar to the one sided trecking pedal in the spares parts bin. going to fit them give them a go this afternoon. i think the extra platform might be a goer. I will let you know later today hopefully.

There is an article out there which advocates the use of using the middle of the foot, that sounds like just what you are doing naturally, I'll try and see if I can find the link for you...

OMG midfoot cleat position. This is so me and now i don't feel at all like i'm doing cycling wrong! Thanks for digging that out.

FWIW i went out just now with the trekkie pedals for an hour. Same pain so a larger platform does not fix the issue for me but they are one sided so i can clip in for the hills and then midfoot on the flats! it will do for now until i find some midfoot shoes!