podiatry paddington

Common question number 1. Do I need a new shoe or a cycling orthotic to help my foot pain?

When we have clients book an online appointment at our Milton headquarters, or in one of our satellite locations at North West Physiotherapy, the most common added note to the booking is “I’m not sure if I need new shoes or whether the problem is coming from my feet”. This is an entirely appropriate question to ask and one which requires a little bit of analysis on our end to work out a solution. However there are a few clues as to where your problems are coming from.

Typically as we progress through the sport of cycling, our duration and frequency of activity increases. The toughness of the terrain also changes enormously as our confidence grows. I’m often surprised how quickly some riders progress from beginners to Gran Fondo warriors! (You know who you are guys) Cycling is certainly a sport that rewards you for your endeavours. That said, as we build our volume of riding the risks of developing issues with our shoes also grows.

Typically feet begin their pathway to pain insidiously. The exact timing isn’t always clear yet once a pattern emerges, the trend becomes very strong. That said if you change your shoes and the pain commences it’s highly likely the shoes are responsible! Aside from that simple scenario shoes can still be to blame if your volume increases to a point where you begin to feel discomfort on longer rides.

Some signs that it is likely the shoes are causing the problem are:

  • Numbness in your toes or the ball of the foot on longer rides

  • Isolated pressure points in the upper of the shoe

  • The sensation that your feet are swimming in the shoe causing your toes to claw down

  • Heel slippage

  • Reaching the limit of tension on your closure system (either maxed out or dialled in)

  • Red marks on bony prominences after your shoes come off

  • A sloppy foot feel inside the shoe

  • Pain which has gradually emerged as a shoe has become older and more worn out

  • Painful toes especially the little toes

  • Sore bunions on the inside or the outside of your foot

There are instances where the foot pain is caused by both foot issues and the shoe being inappropriate. In these cases working on a solution for both will likely get the best outcome. Generally when we do this we will tick off one box at a time to ensure we are getting an outcome clearly defined by the variable we have changed and avoiding confusion. I also find many clients who typically wear orthotics inside their normal shoes benefit somewhat when we create a cycling orthotic solution as well.

In either case, if you are getting pain in your feet when you ride, let us know and I am confident we can find a solution. All our shoe fitting takes place on the indoor trainer to ensure we are spot on and ready to roll. We also have a fantastic relationship with Lake Shoes internationally and Cobra9 Cycling Orthotics that allows to create awesome solutions for all cyclists.

Nathan White Podiatrist

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EOFY Health Funds Reminder - Use it before you lose it

Carbon Fibre Orthotics for running and cycling

Carbon Fibre Orthotics for running and cycling

It’s approaching Jun 30 and for those with health funds that turnover at the end of the financial year, now is the time to ensure you get that last massage, physio, dietetics or podiatry appointment in before it resets again on Jul 1.

It’s also a good time to remind our loyal clients that everyone who has had orthotic therapy with us previously is entitled to one fund only (no gap) set of orthotics a year using the same foot molds. If you are in doubt, fire us an email and we can let you know when you last reviewed with us for your cycling, walking, running or pressure relief orthotics.

If you are after a second set, contact us with your name, details and orthotic request and we can ensure we have the whole process finalised before June 30. If you have other queries, call us on 07 31296331.

The Pedaler Health Milton

Massage / Podiatry / Physiotherapy / Nutrition / Exercise Physiology

Use it before you lose it

It's December, and now is the right time to make sure you have received the best value from your amazing health insurance.  If you haven't been to see us this year, need a quick orthotic review or body tune up, now is the time to get it done.  With most health insurers resetting on January 1, make sure you don't waste your benefits.

 

Contact us now to make an appointment.  Get ready for 2017!

 

Benefits of being a 'Pedaler' Patient.

If you're lucky enough to be one of our special podiatry/orthotic clients and your feet reside at our 'macabre' storage facility, then you're set for life.  All of our orthotic customers are able to organise a second set of orthotics for no out of pocket expense if they have applicable health insurance.  

 

Simply make a time to see us and we can ensure that we have your prescription and needs met, then we can fabricate and get your new orthotics out to you within a few days.  This may be a set of walking, running or cycling orthotics.  

This may be a set of walking, running or cycling orthotics

 

If you're unsure regarding your entitlements, contact your Private Health Fund today and make sure you are getting the most from your coverage.

Call us for more details.  If you aren't an existing client of ours, then rest assured, once you are part of The Pedaler family, you too will be entitled to the same generous treatment.

The Pedaler Cares.  Your LBS and LPP (Local Podiatry Practice).

Why Ben built a bike? - Johnson Bikes Part 1.

The Pedaler chats to Ben Johnson from Johnson Bikes about frames, carbon and his unfulfilled Grafton ambitions. 

Nathan White (The Pedaler):  When did you start up Johnson mate?

Benny Johnson (Johnson Bikes):  Ahh, would have been 2012/2013.  When I finished up with Uni in Queensland, I came back up to work in the shop (Noosa), and being around bikes and seeing what was happening in the store, I wanted a bike for myself.  Between the brands, I just couldn't find something that was exactly what I wanted.  I guess it stemmed from that.  Looking at the stores and across the brands, they were all making very similar bikes. a so it all started with the development of the Esquire frameset.

Across other brands you would either get bikes that were very long in the head tube, with a longer wheel base that were sort of more a comfort bike.  Or from that, going to a very aggressive race road bike. I guess I wanted something that was a balance in between, and I just couldn't find that on the market.  They were either going for that comfort option or going too racey.  

The Esquire Frameset is a good balance between.  You are still very low in the head tube, because I'm not a big believer in going higher for comfort.  I think getting the balance between the back and the front of the bike and getting into a better position is the best way to go.  I think you can achieve that with the Esquire Frameset and that's where the Johnson stemmed from.

 

NW:  How long did it take to go from idea to fruition?

BJ:  It was an arduous task.  It took a few trips to Asia.  I went to the Taiwan bike show which was a real eye opener.  From that, going to different manufacturers, it was hard, pleading my case and trying to get things in such small quantities.  It made getting things get off the ground very difficult.  Then trying to find a company you could be quite hands on with, and be involved with the R and D and the development of the bike as much as I could.  I was learning a lot about carbon fibre, and how to manufacture a bike, and the differences between carbon fibres and resins.  I was quite particular with what I wanted to achieve and with the outcome of the bike.

Then trying to find a company you could be quite hands on with, and be involved with the R and D and the development of the bike as much as I could.

NW: I guess in a era now with so many people talking about Carbon frames, and getting Carbon Framesets from Taiwan, it really important to separate yourself from that market.  I guess you do this through your own input and your own design features around the bike rather then relying upon stock framesets landing then getting them painted up yourself and calling it a bike company.

BJ: Yeah exactly.  There is a huge difference.  Just because it is carbon, doesn't make it good. The whole manufacturing process and how carbon fibre is laid and the whole moulding process is incredibly important regarding stiffness and how you can manipulate the carbon fibre to suit your desired design outcomes.  Yeah there is a big difference between just your basic carbon frame and we have tried to demonstrate that.  The carbon we have used is the most expensive carbon that you can buy, whereas a lot of other company's to reduce costs have used different carbon fibre, but I wanted to produce the best bike we possibly could.

NW:  Where did all your graphic inspiration come from.  They're amazing bikes to ride but they look just, for want of a better word, pretty.  Where did that come from?

BJ: (Laughs) When I was growing up, I was a mad keen cycling fan from Jacques Anquetil and Merckx and all those old bike racers. I loved the look of old steel bikes and wanted to create a unique looking bike and I don't think there was anything else on the market at the time like that.  I wanted the vintage aesthetic and have the bike branding as well look like it had been around for fifty years.

I loved the look of old steel bikes and wanted to create a unique looking bike and I don't think there was anything else on the market at the time like that.

Benny J's Dad Chimes in: He was obviously watching bike racing on Black and White Television then. 

BJ: (Laughs) I was obviously born in the wrong generation.  So trying to balance the vintage aesthetic but still utilising all the modern building techniques and technology that we could.

NW: Do you still get a buzz seeing your own name on the bikes all the time?

 

BJ: Yeah I still get a buzz.  It's great seeing your own bikes on the road and it is really satisfying seeing people looking good on them.  I've become quite passionate about bike fitting and making sure your bike fits you well so I get a great buzz from that too.  

NW:  So if we wanted to gain access to some quick cash, we could just use that same signature (on the top tube on every Johnson Bike) on a bunch of blank cheques and go to town?  That's the same autograph on the company cheque book?

BJ: (Laughs) Yeah it is mate.  I might have to change that now. (Laughs)

Part 2.  Tomorrow.   

Wheels aren't wheels and the thirst for G2I.

...

 

New Attaquer Lands Soon - All New core range on the way.

We are only a few weeks away from the new range of Attaquer hitting the shelves.  We have been very lucky to preview the range in Sydney and it's quite special.  A few neat little technical improvements paired with some epic new designs.

 

We will be running a release party for the new gear including an open invite to a pre launch ATQ / The Pedaler Bunchie (as it will be a morning reveal).  Keep an eye of Instagram and Facebook for more details.  

 

The Pedaler, where more Attaquer is never quite enough.

Cycling Orthotics. What do they do?

I've covered this topic previously in fairly scientific terms and unfortunately, the jargon contained therein makes for pretty heavy reading.  To simplify, let's approach the topic in a more example driven context and explain what we can achieve when using orthotic therapy in cycling.  But first, let's run through a couple of the frequently presented pathologies to us at The Pedaler and across our sister brand Cobra9 Cycling Orthotics.

1. Hot foot - Either focal regions or the whole forefoot.  Very common.

2. Numb foot - Again, either focal regions or the whole foot.  Very common.

3. Painful boney 'lumps' - These can be over bunions or soft tissue swellings.

4. Lower limb overuse injuries - Knee pain, hip pain or ankle impingement.  Very common.

5. Arch strain / pain - Typically in the arch or on the outside of the foot.  Less common.

 

The use of cycling orthotics to treat these conditions depends on the circumstances behind their emergence and no broad generalisation of treatment options is possible.  However the method by which a cycling orthotic may effect these conditions is set out below.

1.  Increasing the surface are for reduction is pressure.  Simply, Pressure = Force / Area of distribution.  

By providing an increase in the surface area, you can reduce the peak pressure (as long as the force remains constant).  We shouldn't over estimate our influence here as the orthotic in the shoe is an inert object.  It doesn't 'push' back.  However, a stable and well designed shell can alter the pressure.

2. Reducing overuse injuries by altering the direction of force of the pedal stroke.  By shifting the angle of the orthotic we can adjust the direction that the load passes through the foot and ankle.  Again, we shouldn't over estimate the impact here and imagine meteoric shifts in visual outcomes, but given the repetition involved in cycling, small changes can make a huge difference.  

3.  Altering focal areas of pressure via prescribed additions.  We can modify an orthotic and add a range of options to alter pressure points.  Domes, deflection cut outs, dual density materials, memory foam and camber shifts are a few examples whereby you can improve pain by moving load to a tolerable location on the foot.  

When treating a cyclist or any patient for that matter, providing generalised treatment prescriptions is impossible.  There are far too many other variables to simplify the process down to a pure formula.  However, you can begin to see where the relationships emerge.

Someone who complains of focal forefoot burning may benefit from an increase in area of pressure distribution along with selected topical orthotic modifications to shift the load away from boney, swollen or painful regions.  

A cyclist with a sore knee due to repetitious knee movement may benefit from altering the direction of load from the 'foot up'.  

A cyclist suffering from 'numb foot' may benefit from a reduction in insole thickness paired with changing shoes and/or the alteration of the forefoot load by modifying the shape of the forefoot of an orthotic with a dome / cut out or a combination of both.

 

As you may have noticed, the concept of power has not been discussed.  That is simply because there is no scientific study to back it up and what current studies that do exist within this field are either statistically imperfect or not relevant to the use of prescription orthotics.  It is unlikely this will change as placebo double blinded trials with prescription orthotic therapy are incredibly difficult given no two prescribed orthotics are the same and a placebo prescription cycling orthotic is virtually impossible to create.  There is however, a great deal of good research into other cycling orthotic based outcomes from a variety of institutions including some very good examples from Brisbane's own University of Queensland.

As a consequence, most studies end with similar conclusions supporting the notion of a case by case approach to orthotic therapy whilst using as much evidence based practise as practically possible. This is our approach at The Pedaler and Cobra9.  Our 16 years of experience treating cyclists certainly helps as well.

So when you are considering whether a cycling orthotic is what you need, remember that they aren't magic wands.  They are one treatment option among many others and may require fine tuning.  Make sure your condition is explained to you first, then the basis behind why orthotic therapy may help your pathology needs to be clearly outlined.  Be informed......then get something cool from your Private Health Insurance for a change!!

Nathan White B Hth Sc (Hons) Podiatry, M A Pod A, AAPSM, SMA