IT band / physio / insoles

[240Cup]

So having been getting seriously (well for me anyway) back into cycling (couple of 30 mile round trips twice a week on a roadie) I have an injury to one hip for which I have been under a physio for some time and it is not really getting better, in fact the other side is starting to ache now as well. Apparently it is bursitis / IT band strain and common in cycling. My physio says I am flat footed and put me on some fancy machine which showed where the pressure is applied in my feet and says custom insoles would be a big help to re-create the arches in my feet as it is probably this which is putting a strain on my hips (and I get the odd twinge in my knees as well which she says is related).

Any thoughts on this? In theory I see what she means. when I got measured for ski boots some years back they said the same and put me in some insoles which they had formed on a machine in the ski shop (Snow Rock).

The custom insoles being suggested by the physio are something like £350...! Apparently I can wear them in my normal shoes but also move them from pair of shoes to pair of shoes, trainers etc and even put them in my cleats although the thought of having them in there concerns me (I hate even being able to feel the seam in a pair of socks!).

Cheers all

240

[gazza285]

Have you tried your GP? If you have pain related to having flat feet, then you can get the corrective inserts from the NHS.

[dreamer75]

I have insoles - had aset years ago which were full foot length, but had some new ones made recently which are only half foot length (well they stop just before the ball of your foot) and go underneath the sole of your shoe, so you don't feel the seam. Have helped me with knee pain on the bike and general knee pain which was possibly caused by my knee cap tracking at an odd angle when I bent my leg (too much pronation of the foot - i.e. collapsing inwards). I don't even notice them in my shoes, and def don't notice them in my cycle shoes.

[TwistingMyMelon]

Hi OP

Do you have high arch or flat feet?

I have an high arch and believe it contributes to knee pain at times, ive always struggled a bit with cycle shoes, as they could never accommodate them and I always have to do the straps really tight

Earlier this year I got specialized footbeds: https://www.specialized.com/us/en/shoes/parts/body...

I got the model for high arch, they are around £20 even though I have three pairs of shoes I just swap one insole in different shoes

They are ace, they seem to support the foot as a whole and have helped me loads, they also mean I dont have to do the straps on shoes up so tight, I can see how people argue that most insoles that come with cycling shoes are really poor glorified bits of paper!

Selected specialized shops have a device that measures arches and can advise which model is best, a decent shop could also let you try different arches with different shoes

There are plenty of other footbed options, I would be very hesitant before spending £350 on custom ones, unless I had a very particular condition. Im not knocking the professional advice, im just saying it is an incredible amount of money when off the shelf solutions exist

[Craikeybaby]

The NHS ones are crap. I also have flat feet and have lots of pairs of the "superfeet" off the shelf insoles, including in my cycling shoes, they seem to support my feet just as well as the NHS ones, but don't slip around inside my shoes as much.

[Zigster]

Funnily enough, I had a bike fit earlier this year for a new road bike I bought. I also took in my old bike to be adjusted to the same measaurements.

Three main things: my saddle was raised about 15-20 mm (and I thought I had it pretty high already), I bought those Specialized footbeds (medium) and the angle of my cleats was adjusted slightly. Since then, I've developed some ITB issues around my left knee.

My GP referred me to a physio who I saw yesterday. The physio suggested I take the bike back to the shop and ask them to check that the cleat adjustment and the footbeds weren't, in combination, causing me a fit problem. The bike fit was done without me having footbeds in my shoes.

I also have similar footbeds in my ski boots and my running trainers, so that part of the analysis seems pretty consistent across sports.

[loudlashadjuster]

Mrs LLA has similar long term ITB/flat feet/fibromyalgia problems and has done most things and was going down the same route with expensive custom inserts.

I bought her a few pairs of cheap half-foot insoles from Amazon, gave her a bottle of magnesium citrate tablets and she's in less pain now than she has been for years, to the point she's considering running again which she's not been able to do since about 2014.

Obviously, IANAD, YMMV etc.

[240Cup]

All very good stuff fellas thanks.

Yeah it is defo flat feet I have as opposed to high arch. I have both hips giving me grief and inside of left knee. Problems I currently 'work around' by letting them calm down a bit between rides and then for each ride trying to warm up properly, bit of physio etc but I feel it is really holding me back from a. piling on the miles and b. going hard at it!

I might check out those specialized insoles and also been meaning to do a bike fit for ages. Is it the case that a decent bike fit specialist might suggest the insoles as well as getting the bike set up right, i.e. do they assess your physiological make up as well?

[Magic919]

My wife uses custom insoles for running. She's managed to up running distance to 20 miles using them. They were provided by our Physio.

[dreamer75]

240Cup said:

All very good stuff fellas thanks.

Yeah it is defo flat feet I have as opposed to high arch. I have both hips giving me grief and inside of left knee. Problems I currently 'work around' by letting them calm down a bit between rides and then for each ride trying to warm up properly, bit of physio etc but I feel it is really holding me back from a. piling on the miles and b. going hard at it!

I might check out those specialized insoles and also been meaning to do a bike fit for ages. Is it the case that a decent bike fit specialist might suggest the insoles as well as getting the bike set up right, i.e. do they assess your physiological make up as well?

Have you got a foam roller and a good stretching routine? ITB rolling and stretching, plus the usual quad, hip flexor, calves, soleus and glute/piriformis stretches probably couldn't hurt and might help?

(btw I'm a layyydeeeeee not a fella )

[240Cup]

sorry for assuming you were all fellas...!

Yes I have a foam roller given (sold £££) to me by physio - don't get on with it at all as I find it really hard to balance while stretching the IT band..!

I visited Snow Rock yesterday evening and they have fitted a pair of superfeet (blue) in my cycling shoes. I was going to have the custom ones made in store but there is a 60 day refund policy on the superfeet so the very helpful chap said see how I get on with those and come back if I feel I need to go the custom (more expensive) route.

First ride out tomorrow so will see how it goes...

[Craikeybaby]

How did you get on? Superfeet blue is what I have in my MTB shoes.

[240Cup]

Did 50 miles yesterday and the insoles felt fine (as in I didn't notice them in the shoes) but my hips still hurt last night - have physio booked for tomorrow and Thursday and will see what the physio says. My pedal stroke felt better though, kind of straighter through the leg without as much over rotation. I think the damage has probably already been done and it is a case of fixing that and the insoles are at the very least not making it any worse..!

[red997]

another +1 for custom fit insoles
Had a set produced some years ago in Vail whilst ski-ing
made a HUGE difference to my ability on Ski's - much more even & consistent edge control

I still have them - but fitted now into my cycling shoes.
I'm by no means a regular cyclist these days, but I still notice the difference.
Used to suffer numb toes without the insole; with it fitted, numbness gone, knees feel better too .
An expensive purchase (relatively) but one thats lasted me years, and continues to keep me pain free

[240Cup]

The plot thickens.. took my bike into a decent bike shop today to get them to look at bottom bracket (faint squeak /clicking) for which they are changing the bearings.

But all three blokes in the shop went "woah how far forwards is your saddle??!"

I have a Boardman road team carbon and it has a 120mm handlebar stem which has always seemed very long and a bit of a stretch so to compensate the saddle has been set at it's maximum forward setting - so far forwards it is not even on the measurement markings underneath.

Could that be setting my legs in a bad position (too far forwards) relevant to the bottom bracket and possibly the root of all the problems?

Made contact with a bike fitter today to try and get some time with them. I might change the stem to say 100mm in the meantime and put the saddle 20mm backwards.

Didn't realise it was this complicated, thought you just got on a bike and rode it until you ran out of puff .... :-)

[TSCfree]

240Cup said:

The plot thickens.. took my bike into a decent bike shop today to get them to look at bottom bracket (faint squeak /clicking) for which they are changing the bearings.

But all three blokes in the shop went "woah how far forwards is your saddle??!"

I have a Boardman road team carbon and it has a 120mm handlebar stem which has always seemed very long and a bit of a stretch so to compensate the saddle has been set at it's maximum forward setting - so far forwards it is not even on the measurement markings underneath.

Could that be setting my legs in a bad position (too far forwards) relevant to the bottom bracket and possibly the root of all the problems?

Made contact with a bike fitter today to try and get some time with them. I might change the stem to say 100mm in the meantime and put the saddle 20mm backwards.

Didn't realise it was this complicated, thought you just got on a bike and rode it until you ran out of puff .... :-)

Before you splash out on a fit....

Watch this as a starter for 10
https://www.youtube.com/watch?v=1VYhyppWTDc

then
https://www.youtube.com/watch?v=FVu5Zrktm40

Light reading for issues
https://www.stevehoggbikefitting.com/bikefit/2011/...

[TwistingMyMelon]

240Cup said:

The plot thickens.. took my bike into a decent bike shop today to get them to look at bottom bracket (faint squeak /clicking) for which they are changing the bearings.

But all three blokes in the shop went "woah how far forwards is your saddle??!"

I have a Boardman road team carbon and it has a 120mm handlebar stem which has always seemed very long and a bit of a stretch so to compensate the saddle has been set at it's maximum forward setting - so far forwards it is not even on the measurement markings underneath.

Could that be setting my legs in a bad position (too far forwards) relevant to the bottom bracket and possibly the root of all the problems?

Made contact with a bike fitter today to try and get some time with them. I might change the stem to say 100mm in the meantime and put the saddle 20mm backwards.

Didn't realise it was this complicated, thought you just got on a bike and rode it until you ran out of puff .... :-)

Not running out of puff is fine if you use a bike to go to the shops or pub a few times a week, once you start doing more miles with more power and your feet strapped in the same place issues occur

The saddle setback should be just used to accommodate and enable a good position for the pedals and pedal motion, never to accommodate reaching the handlebars loads of people dont realise this.

I would consider getting a bike fit, or at least follow the links above

Your bike might be a bit too big atm, but you can go down to a 70/80/90/100mm stem to make the handlebars closer and then just focus the saddle setback on accommodating your legs and not your arm shortness

Ive gone from a 120mm stem to a 90mm on a couple of bikes with no issues as 120 made the bike far too big. Im always borderline too big for a small frame and too small for a medium. 3 of the bikes ive owned have been mediums with 90mm stems (reduced from 120) and one has been a small with a long stem on. Annoyingly I like a mega long stem for climbing out the saddle as I can stretch out and use more muscle groups, but im then too stretched out when sitting in the saddle

How tall are you to be riding a large?

[Matt_N]

240Cup said:

The plot thickens.. took my bike into a decent bike shop today to get them to look at bottom bracket (faint squeak /clicking) for which they are changing the bearings.

But all three blokes in the shop went "woah how far forwards is your saddle??!"

I have a Boardman road team carbon and it has a 120mm handlebar stem which has always seemed very long and a bit of a stretch so to compensate the saddle has been set at it's maximum forward setting - so far forwards it is not even on the measurement markings underneath.

Could that be setting my legs in a bad position (too far forwards) relevant to the bottom bracket and possibly the root of all the problems?

Made contact with a bike fitter today to try and get some time with them. I might change the stem to say 100mm in the meantime and put the saddle 20mm backwards.

Didn't realise it was this complicated, thought you just got on a bike and rode it until you ran out of puff .... :-)

Have a look at some videos and guides to setting saddle height and fore/aft position based on knee over pedal, sounds like you are way to forward on the saddle.

100mm stem is about as short as you'd want to go on a stem, 90mm at a push, anything less and you're on the wrong size bike with a top tube length that is too long for you.

[240Cup]

Thanks all. Saw my physio again today and she said not to fiddle around with stem lengths etc myself and strictly no more riding until I have a bike fit so have booked one for Friday - a 3 hour Retul.

Will post back with the gory details - will be interesting to find out what adjustments need to be made...!

Cheers, 240

[Bill]

Tbh I'd be asking the bike shop guys/local club etc who they use and get a recommendation for a physio who understands cycling. She should have seen you on the bike and started with the bike fit rather than ridiculously expensive insoles. (And I say that as a Physio...)