# Tingling toes?



## r39205 (Aug 8, 2005)

Hey ladies,

I'm hoping that someone else has experienced something similar. Whenever I am sitting in the saddle for a long time (such as on a road ride or fire road, not on trails where I'm up and down all the time), I tend to get a pins and needles feeling in my right foot, the toes and ball of my foot. The same thing seems to happen if I am doing some other repetitive motion exercise, such as using the recumbent bike or elliptical trainer at the gym. It never happens while walking, and I don't run as a rule.  It seems to occur after about 20 mins or so, and it's only in the right foot and never the left.

If I change up the position, such as standing up on the bike, reversing the elliptical, etc, it will go away. But the weird thing is that it will happen in any position if I do the same thing too long? Any thoughs or suggestions? It's mostly only annoying but I'm concerned this is a symptom of some greater nerve problem. I'm not sure if it's possible it could be related to poor blood flow in my foot? My BP is rather low (105/70) and my feet can fall asleep easily too. Strange! Any help would be appreciated

Monica


----------



## Impy (Jan 6, 2004)

Sounds like it could be tarsal tunnel syndrome (similar to carpal tunnel in the wrist) which is impingement of the nerve running through the ankle and to the toes.. Tight shoes can exacerbate this. I am wondering how your shoes fit, and if you have real inserts or just the standard in the shoes you wear?

I can get a numbness in my toes in a similar way, esp on the elliptical.


----------



## r39205 (Aug 8, 2005)

*Hmm...*

That's interesting, it sorta makes sense but it's not something I would have thought of.

My cycling shoes are tight of course, with just the standard inserts. They are, um.., 7 or 8 years old, Nikes. They have a tension system on them that is unusual, there is a nylon strap that starts near the sole on the outside near the ball of the foot, crosses over to the arch area, then attaches via a qwik-clip to a strap on the outside heel. Does that make sense? I could see how this could potentially be the source of the issue.

The cross trainers I wear to the gym aren't particularly tight, and are good quality, but I just have the standard insteps in those too. Though, I have noticed it most on the bike, and never had this before I started biking quite a bit, so perhaps the bike shoes are the source of the issue. I'd been lobbying my husband for a new pair anyhow, looks like I just came up with a good reason! Any suggestions on a type that would help prevent this problem? Thanks for the input!


----------



## joy3868 (Jul 11, 2006)

I have something similar sounding to that. My feet are over-pronated and if I do any running or long walking my metatarsals pinch a specific nerve about 2in below my toe; I get a painful pins and needles sensation. I would say go to a podiatrist if it persists. I was prescribed an anti inflamitory and given injections for it...


----------



## r39205 (Aug 8, 2005)

After doing a little internet research, I have made an appointment with my doctor. One site suggested that if you touch behind the nub on the inside of your ankle and feel tingling, it is a sign of tarsal tunnel syndrome. I felt nothing there, but if I run my hand over the top of my foot, I can feel tingling (and only on the side that has a problem). It is weird, I'd never noticed it before, I guess I don't touch the tops of my feet very often! Definitely seems like some kind of nerve thing. Thanks for the input, I had kida written this off as a merely annoying problem, but I'll get it checked out.


----------



## Berkeley Mike (Jan 13, 2004)

*Before you spend a lot of money on special orthotics and specialists*

get yourself a new pair of cycling shoes, some nice socks, don't tighten the front of your shoe so much and allow for break-in time. Your old shoes and newfound enthusiasm for cycling have brought something to the surface which may simply settle down. Access to incredible amounts of information via the Internet puts us, in our ignorance, proximate to ideas without the balance of context or experience. Not everything is a "special condition." Specialists can express opinions that make it seem that way.

I know. I know. I'm no fun. Good luck.


----------



## r39205 (Aug 8, 2005)

*Thanks Mike*

I understand where you're coming from, but part of the reason that I am concerned is I have not been on my bike for 10 days, and I can still feel tingling just by running my hand over the top of my foot. That seems weird, and I know that you only get one set of nerves so you'd better take care of them. Also, this problem has been going on for about 6 months off and on. I'm only going to my regular Dr., she's great, and it's a lot less expensive than new shoes (thanks to medical insurance). I'll report the results next week.


----------



## Berkeley Mike (Jan 13, 2004)

*It is all in your post.*

"My cycling shoes are tight of course." "They are, um.., 7 or 8 years old.", Nikes. "a nylon strap that starts near the sole on the outside near the ball of the foot, crosses over to the arch area."

AND

"feel tingling just by running my hand over the top of my foot."

You may have deeply bruised an area around the nerve due to overuse in a shoe design not suited to your foot. Don't get cheap here.


----------



## robdamanii (Sep 27, 2005)

joy3868 said:


> I have something similar sounding to that. My feet are over-pronated and if I do any running or long walking my metatarsals pinch a specific nerve about 2in below my toe; I get a painful pins and needles sensation. I would say go to a podiatrist if it persists. I was prescribed an anti inflamitory and given injections for it...


Morton's Neuroma?

To the original poster: Could very well be your shoes compressing the nerves in the tarsal tunnel. My old shoes did that when I rode on dirt, but not on the road. They are now my road shoes and I don't have any problems.


----------



## r39205 (Aug 8, 2005)

robdamanii said:


> Morton's Neuroma?


From what I've read, this causes generally numbness/pain in a certain area between your toes. Mine starts on the ball of my foot and affects all the toes seemingly equally, so I don't think it's that.


----------



## r39205 (Aug 8, 2005)

Berkeley Mike said:


> You may have deeply bruised an area around the nerve due to overuse in a shoe design not suited to your foot. Don't get cheap here.


I don't doubt that my shoes are the cause of the problem, I'm just not completely convinced that changing them will be enough (on its own) to fix the problem. While I had been riding several times a week at one point, several months ago, I've ridden maybe 6 hours total in the past 6 weeks, and the last time I was out was 7/28, and the signs are still there. Plus I'm not exactly sure what kind of shoes would be best and I'd like to run that by the Dr. also.


----------



## Berkeley Mike (Jan 13, 2004)

*That sounds like a wise consideration.*

Are you on your feet a lot? Are you doing any other exercise? Are you working out on a machine that has straps going over your foot? Have you given your street shoes a good look?


----------



## r39205 (Aug 8, 2005)

Berkeley Mike said:


> Are you on your feet a lot? Are you doing any other exercise? Are you working out on a machine that has straps going over your foot? Have you given your street shoes a good look?


I'm not on my feet a lot, I have a desk job. I do run around to meetings and such, but for the most part I'm not on my feet.

The only exercise I've been doing is the recumbent bike (with foot straps), maybe 1x/week for 45 mins, and elliptical trainer (no foot straps) about the same amount, and weightlifting 2-3x/week.

My street shoes are in good shape, but another factor is that I wear sandals to work most of the time, my Teva sandals most of my non-work time, and do wear high heels once or twice a week. Also, I have a wierd aversion to shoes with no connection to my foot at the heel (like flip-flops, mules, slip-on sandals), I hate the noise and floppiness when I walk. So literally ALL my shoes have an ankle strap unless they lace up or the heel cup keeps them on my foot. I've been doing that since I was a kid, but it could also be aggravating this problem. Until my appointment, I'm sticking to the cross-trainers!

Thanks for the food for thought!


----------



## connie (Mar 16, 2004)

My feet go numb too, but I've noticed that it's only on trails that are "bouncy" for lack of a better term. Gravelly fire road sections, long stretches with a lot of rocks, etc. And then it doesn't matter if I'm wearing soft soled and very comfy Vans with flat pedals, or very stiff soled and rather tight fitting cycling shoes - the vibration makes my feet go numb. Same thing can happen on rough pavement. So for me, I don't think it's a matter of the shoes at all - it's a matter of the riding surface. And if they get numb enough, I just need to stop for a minute and let the blood flow normally and they're fine.

I also run into this on the elliptical trainer - I do sometimes go for a long time - up to 2 hours and if I keep my feet stationary, they go numb after 10 or 15 minutes. I've found that lifting my feet, raising my heels or toes every now and then keeps the circulation flowing. Again, I have this problem whether I wear my expensive, new, professionally fitted running shoes, or the $10 pair of loose and floppy shoes with no support at all. Yes, obviously if they're tied too tight it exascerbates the problem, but I think some of the tingliness is just inherent to keeping your foot in one position, pressed against a solid surface for a long time. 

Just like I found that my butt gets less sore if I stand every once in a while, my feet feel better if I wiggle my toes and shift around regularly. Fit is important, but I think most people who do something a lot get in the habit of incorporating stretching and shifting around into the activity and it becomes second nature.


----------



## Berkeley Mike (Jan 13, 2004)

*Hmm, lets see. Got it!*

I prescribe:
1) a small increase in dark chocolate intake. 
2) regular foot massage. 
Use with care; the combination can be devastating.


----------



## Nat (Dec 30, 2003)

r39205 said:


> I don't doubt that my shoes are the cause of the problem, I'm just not completely convinced that changing them will be enough (on its own) to fix the problem. While I had been riding several times a week at one point, several months ago, I've ridden maybe 6 hours total in the past 6 weeks, and the last time I was out was 7/28, and the signs are still there. Plus I'm not exactly sure what kind of shoes would be best and I'd like to run that by the Dr. also.


Have you seen your Dr. yet? What'd she say?

I'm going to take a wild guess that it's neuropraxia of the intermediate dorsal cutaneous nerve due to pressure from all the different straps across the top of your ankle. If that's the case, it can take up to a year for normal sensation to return (if it does at all) once you get rid of whatever is causing the pressure on the nerve.

Like I said, that's just an poorly-informed guess.


----------



## shiggy (Dec 19, 1998)

Nat said:


> ...Like I said, that's just an poorly-informed guess.


...from a podiatrist.


----------



## Nat (Dec 30, 2003)

shiggy said:


> ...from a podiatrist.


...without the luxury of an actual history or physical exam.


----------



## r39205 (Aug 8, 2005)

Well, I just got back from the Dr., and I will be seeing one of your podiatrist colleagues. Upon futher inspection, the tingling does not occur over the top of my foot, but actually only when you touch a specific area. It's pretty much right in the center of my foot, like where the center of the tongue of athletic shoes would be. There is a tiny bump there, maybe like a large grain of sand size. She thinks it is probably a ganglion cyst that is pressing on my nerve, made worse by the pressure of my shoes. She feels there may also be a neuroma that is contributing to it, but recommended I see a podiatrist to make sure. In the meantime, I'm instructed to avoid shoes that fit tightly over that area. Good thing is most of the sandals I have don't cross at that point, bad thing is bike shoes pretty much all do.  Oh well, it is a million degrees here in Phoenix anyhow, so I'm not missing a lot. I'll let you all know what the podiatrist says!


----------



## Nat (Dec 30, 2003)

r39205 said:


> Well, I just got back from the Dr., and I will be seeing one of your podiatrist colleagues. Upon futher inspection, the tingling does not occur over the top of my foot, but actually only when you touch a specific area. It's pretty much right in the center of my foot, like where the center of the tongue of athletic shoes would be. There is a tiny bump there, maybe like a large grain of sand size. She thinks it is probably a ganglion cyst that is pressing on my nerve, made worse by the pressure of my shoes. She feels there may also be a neuroma that is contributing to it, but recommended I see a podiatrist to make sure. In the meantime, I'm instructed to avoid shoes that fit tightly over that area. Good thing is most of the sandals I have don't cross at that point, bad thing is bike shoes pretty much all do.  Oh well, it is a million degrees here in Phoenix anyhow, so I'm not missing a lot. I'll let you all know what the podiatrist says!


Just curious, which podiatrist will you be seeing?


----------



## Berkeley Mike (Jan 13, 2004)

*Time to work on your stroke.*

Swimming will keep your pipes strong and keep you stamina up and let you work your legs a bit. No shoes.


----------



## r39205 (Aug 8, 2005)

A Dr. William Burke. Recommended by my insurance company. Of course the one my Dr. recommended doesn't take my insurance. Got any recomendations? For Drs. in the Phoenix area who take Cigna? 

Great idea Mike. Now all I need is a pool.....


----------



## Nat (Dec 30, 2003)

r39205 said:


> A Dr. William Burke. Recommended by my insurance company. Of course the one my Dr. recommended doesn't take my insurance. Got any recomendations? For Drs. in the Phoenix area who take Cigna?
> 
> Great idea Mike. Now all I need is a pool.....


I don't know if he takes Cigna or not, but I'd go to Lewis H. Freed, DPM. Smart as hell, ethical, and skilled. He's also an avid cyclist. Tell him Nat said "hi."

215 S. Power Rd.,
Mesa, 480-924-1552

Or if Freed is unavailable, I trained with David Laurino, DPM at Advanced Foot and Ankle Specialists. He's a good guy, smart too.


----------



## shiggy (Dec 19, 1998)

Nat said:


> ...without the luxury of an actual history or physical exam.


...but it explains the big words!


----------



## shiggy (Dec 19, 1998)

r39205 said:


> Well, I just got back from the Dr., and I will be seeing one of your podiatrist colleagues. Upon futher inspection, the tingling does not occur over the top of my foot, but actually only when you touch a specific area. It's pretty much right in the center of my foot, like where the center of the tongue of athletic shoes would be. There is a tiny bump there, maybe like a large grain of sand size. She thinks it is probably a ganglion cyst that is pressing on my nerve, made worse by the pressure of my shoes. She feels there may also be a neuroma that is contributing to it, but recommended I see a podiatrist to make sure. In the meantime, I'm instructed to avoid shoes that fit tightly over that area. Good thing is most of the sandals I have don't cross at that point, bad thing is bike shoes pretty much all do.  Oh well, it is a million degrees here in Phoenix anyhow, so I'm not missing a lot. I'll let you all know what the podiatrist says!


You may be able to use a chiro felt donut around the cyst to reduce the pressure on the area when riding.

Then look for lace up shoes. By using two sets of laces and/or other creative lacing methods you can skip the area over the cyst.

(not a podiatrist but I do have an athletic shoe fetish)


----------



## r39205 (Aug 8, 2005)

Thanks for the references, I'll look into it! Thanks!


----------



## r39205 (Aug 8, 2005)

*The foot dr. says....*

That I probably do have a little bit of neuroma. Apparently I have very flexible feet, which is good and bad. In manipulating them he could get my right foot (the one having a problem) to click the bones in my forefoot a bit. He put a pad on the insole of my riding shoes, to seperate the bones a bit. It's interesting that this problem is essentially right over the toe cleat.

I also have some "neuritis" (fancy name for inflammed nerve - I could have told you that!) on the top of my foot. The little spot is right over the higest point of my arch, on the highest part of my foot. He suggested keeping my laces a bit looser right over that spot.

He also suggested that I get some "Superfeet" insoles - conveniently available at REI (outdoor sporting goods store for those in other parts of the country). $170 later I walked out with some Superfeet, 3 pairs of comfy casual shoes (2 by Keen, one by Simple), and a new pair of bike shoes. I got these ones:

http://www.mtbr.com/reviews/Shoes/product_126458.shtml

They didn't seem to squeeze my forefoot as much, and with the laces they are more customizable to be tight in places and looser in others. Hopefully they will be the ticket. I have to go back in a few weeks to follow up.


----------



## Nat (Dec 30, 2003)

Did you end up seeing Burke?


----------



## r39205 (Aug 8, 2005)

Yes. He seemed like a good guy and said his partner is an avid road cyclist. Now to see if it gets any better....


----------



## shiggy (Dec 19, 1998)

r39205 said:


> That I probably do have a little bit of neuroma. Apparently I have very flexible feet, which is good and bad. In manipulating them he could get my right foot (the one having a problem) to click the bones in my forefoot a bit. He put a pad on the insole of my riding shoes, to seperate the bones a bit. It's interesting that this problem is essentially right over the toe cleat.
> 
> I also have some "neuritis" (fancy name for inflammed nerve - I could have told you that!) on the top of my foot. The little spot is right over the higest point of my arch, on the highest part of my foot. He suggested keeping my laces a bit looser right over that spot.
> 
> ...


I use the Superfeet inserts in most off my riding shoes and in my trail work boots. They work great.

If you have issues keeping the shoes tight enough while keeping the laces loose over your hot spot you can use two sets of laces and skip the tender area. Other creative lacing is possible, too.


----------

