Bilateral Toe Numbness & Cycling
Numbness of the toes can be an annoying condition if you are a cyclist, especially when it interferes with your training. Bilateral toe numbness, which refers to numbness in both feet, is most likely secondary to an external factor that compresses your feet or toes while you cycle. This can easily be corrected with the proper selection of shoes, insoles, socks or toe straps. If the problem cannot be corrected with changes in footwear, call your doctor to determine the underlying cause.
Compression of the Feet and/or Toes
Bilateral toe numbness that occurs while cycling and disappears with rest is most likely due to a compression of the nerves in the feet by tight fitting shoes or toe straps. This is analogous to your foot "falling asleep," which occurs when the nerves that run through your foot become compressed and are no longer able to transmit nerve signals to the brain. As a result, all feeling in the foot is lost and your foot becomes numb. Sensation returns slowly in the form of "pins and needles" and then returns to normal when the nerve is no longer compressed.
According to a study published by a pair of University of Washington researchers in the May 15, 2001 edition of "American Family Physician," metatarsalgia is the most common cause of foot pain in cyclists. Metatarsalgia is a term used to refer to pain located in the ball of the foot, but many individuals also complain of numbness or tingling that radiates to the toes. This pain is typically more pronounced while you exercise, flex the toes or walk barefoot. Unlike numbness caused by tight shoes or toe straps, metatarsalgia causes numbness that tends to persist even after cessation of activity and is reproducible when pressure is placed on the balls of the feet. The primary underlying factor for this condition is excessive pressure on the ball of the foot. For cyclists, this can occur if one participates in too much hill climbing. Other risk factors include wearing ill-fitting shoes, engaging in high impact activities, obesity, arthritis, bunions, high foot arches or hammertoes.
Other Potential Causes
Other possible causes of toe numbness include injury to the nerves of the foot, herniation of a spinal disc, diabetes, multiple sclerosis, Raynaud's phenomenon, low levels of vitamin B-12 or calcium in the blood, certain medications, a stroke, shingles or diminished blood supply to the foot from atherosclerosis.
What to Do
Examine your cycling shoes and toe straps first to rule out compression of the foot and/or toes. Make sure that your shoes fit properly and there are no seams pressing on the area of concern. Loosen your shoelaces or toe straps if necessary to allow more space for your foot. Also check your insoles and socks to determine if they are too thick for your shoes. Next take a look at the position of your foot on the pedal. The ball of your foot should rest over the axis of the pedal and your toes should be pointed forward, not upward or downward.
When to Call Your Doctor
Once you have eliminated any possible causes of numbness due to compression of the foot and/or toes, it is best to contact your doctor to determine the underlying cause. Also contact your physician if you experience numbness or tingling that radiates down your legs, an increase in the frequency of urination, a rash, muscle spasms or dizziness. Go to the emergency department immediately if you experience paralysis or weakness of the feet and/or toes, numbness or tingling after an injury to the foot, confusion, loss of bowel or bladder function, slurring of speech, difficulty ambulating or changes in vision.
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