Managing Numbness in Toes for New Cyclists with Scoliosis

Hello, Director Wang?

I recently started as a beginner in road cycling and purchased a flat handlebar bike.
I made some basic adjustments and confirmed that they are generally okay.
However, as a newcomer, I am concerned about my riding posture, especially since I have significant scoliosis with a curvature exceeding 40 degrees.
My doctor advised me to engage in more aerobic exercise to improve my physical fitness, regardless of whether I need surgery.
I am quite thin and worry that surgery might severely impact my recovery.
Therefore, I need to exercise regularly to build sufficient muscle to prevent increasing discomfort and pain over time.
I ride for about 2 hours, and since I am just starting, my training is quite gentle.
On the first day, I noticed that I was wearing road cycling shoes with a stiff sole (not clipless shoes), but I had tightened them too much.
I also did not allow my heels to rest back properly, which caused my big toes to press against the toe box for too long.
I felt discomfort while riding but thought it was just due to my foot position.
However, when I got home and rested, I realized it was due to the reasons mentioned above.
Both of my big toes (located near the tips of my feet, around the toenails) felt numb.
After resting for a day, the numbness persisted, but I didn't think much of it.
On the third day, when I went cycling again, I adjusted the tightness of my shoes to a comfortable level and ensured my heels were positioned correctly, which alleviated the discomfort I experienced on the first day.
I hardly felt anything unless I touched the numb area on my toes.
Over the next few days, the numbness remained, and I have been busier, walking more.
However, I do not feel numbness while walking; it only occurs when I am barefoot at home or when I touch the area.
Since the numbness is still present, I plan to take a break for one to two weeks to see if it improves.
Coincidentally, it is expected to rain during this time, making cycling inconvenient.
I have also soaked my feet in warm water and massaged them, which has significantly reduced the numbness in my left foot, but there seems to be little change in my right foot.
I am unsure if this is due to being right-handed or if my scoliosis has caused my right leg to be longer, leading to more pressure on that foot.
I would like to ask if my symptoms are likely due to the tight shoes and improper foot positioning on the first day, and if resting for a longer period will help with recovery.
If there is no improvement, should I see a doctor? (I have recently consulted with a gastroenterologist and a urologist, and I worry about being scolded by my family for overthinking things.
Of course, if I feel genuinely unwell, I will seek medical attention.)

Mr. Chen, 30~39 year old female. Ask Date: 2022/10/04

Dr. Wang Zhaomin reply Rehabilitation

While stiff-soled shoes can aid in power transfer when cycling, it is important to pay more attention to the fit, looseness, and comfort; otherwise, the risk of injury increases.
Improperly fitting footwear or incorrect usage can indeed lead to the symptoms described.
If there is no improvement after a period of rest, it is advisable to seek medical attention for a proper diagnosis and appropriate treatment.

Reply Date: 2022/10/04

More Info

Managing numbness in the toes, especially for new cyclists with scoliosis, can be a multifaceted issue that requires careful consideration of several factors, including cycling posture, equipment fit, and underlying health conditions. Given your situation, it seems that the numbness you are experiencing in your big toes is likely related to a combination of tight footwear and prolonged pressure during your cycling sessions.

Firstly, it is essential to understand that numbness in the toes can occur due to nerve compression or reduced blood flow to the area. In your case, the tightness of your cycling shoes, particularly if they were adjusted too tightly, could have led to compression of the nerves in your feet. This is especially relevant since you mentioned that you were using hard-soled cycling shoes, which can exacerbate pressure points if not fitted correctly. The fact that you experienced numbness primarily in the big toes suggests that the nerves supplying sensation to that area may have been affected by the pressure from the shoe.

Your scoliosis may also play a role in your overall body mechanics and posture while cycling. A significant curvature of the spine can lead to uneven weight distribution and altered biomechanics, which might affect how your feet interact with the pedals and shoes. This could potentially lead to increased pressure on one foot compared to the other, explaining why you are experiencing more persistent numbness in your right foot.

To address your current situation, here are some recommendations:
1. Footwear Adjustment: Ensure that your cycling shoes are properly fitted. They should be snug but not overly tight. You should be able to wiggle your toes comfortably. If necessary, consider using shoes with a wider toe box or adjustable straps that allow for a more customized fit.

2. Breaks During Rides: Since you are new to cycling, it’s crucial to take regular breaks during your rides. This will allow your feet to recover from any pressure and help prevent numbness from developing.

3. Stretching and Strengthening: Incorporate foot and ankle stretches into your routine. Strengthening exercises for your feet and lower legs can also help improve circulation and reduce the likelihood of numbness.

4. Monitor Symptoms: Since you have already noticed some improvement with rest, continue to monitor your symptoms. If the numbness persists after a couple of weeks of rest and proper shoe adjustments, it would be wise to consult a healthcare professional. They can assess for any underlying issues, such as nerve compression or vascular problems.

5. Cycling Position: Pay attention to your cycling posture. Ensure that your saddle height and position are appropriate for your body. A proper fit can help distribute weight evenly and reduce pressure on your feet.

6. Consult a Specialist: If numbness continues despite these adjustments, consider consulting a podiatrist or a physical therapist who specializes in sports medicine. They can provide tailored advice and potentially identify any biomechanical issues related to your scoliosis that may be contributing to your symptoms.

In summary, the numbness in your toes is likely related to the tightness of your cycling shoes and possibly influenced by your scoliosis. With proper adjustments to your footwear, regular breaks, and attention to your cycling posture, you should see improvement. However, if symptoms persist, seeking professional medical advice is advisable to rule out any serious underlying conditions.

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