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I have right foot problems caused by a bad medial malleolus break that was repaired with screws, never felt right after, got it reviewed 3 years later and yurned out 1 of the screws was not flush and rubbed a hole all the way through my posterior tibial tendon, stretching 6cm. This tendon basically holds your foot arch up from your calf and is one of the biggest contributors for people with feet problems radiating to the rest of the leg. I get paid in my knee from this problem myself.
I did a hospital based rehab program that lasted 8 weeks initially after the break and fix. I have subsequently had a few other physio programs for this problem. I have also broken my leg 4 times, so have done a fair bit of getting back on my feet. Definitely see your gp for diagnosis and request for physio. Most of the things they will advise you will be strengthening and stretching, especially single leg exercises, where it is important to do both legs. I can write some ones that I found best bang for your buck if you want, depends where it hurts and where is swollen.
On the bike I found insoles and really stiff shoes really useful. I balanced this with lateral positioning of spd cleats on my shoes. The softer the shoes the more you collapse into the weaker areas of your leg to compress power off as you push. I would be very careful with angled cleats as it may seem like you want to ease the muscle off where it feels weak but what you need is a solid level platform with support to give the rest of your leg its optimum biomechanic leverage. All on bike optimisation won't be as useful without off bike work.
Like all advice for things, change one thing at a time, give it a bit of time to evaluate. Don't over do it.
Thankshallots-
Oof that sounds rough man. I’d like to think I haven’t accrued any major damage like you’ve been though, all last year I cycled fine albeit perhaps not with my leg in the idyllic ‘straight pumping piston’ position on my one side. I just think dialling in the cleat position and fit on a new bike combined with perhaps trying to cycle too much too quickly after a pretty relaxed last couple months cycling wise has brought to light what damage can be done/it is doing gradually.
My thinking with the cleat angle thing is to try force my foot to pedal at the ideal flat angle instead of trying to shift the weight diagonally outward from the heel to the outside of the foot, obviously like you say this is risky and requires off bike work; if my muscles and tendons aren’t used to that manner of walking/cycling then it’s not going to help so I definitely need to work on stretching and strength training. So I’d definitely appreciate any knowing of the exercises you found most useful! Currently it’s the front/inside of my right knee, and some definite tension/overstretching in the back of my right from overstretching the outside of my right foot I’d presume
ojwithbits
Ah that’s really kind of you, I’d definitely take you up on it as a test if I had road shoes but not to worry. I’ve bought one of those silly 20mm pedal extenders just to test the theory that it is the Q factor/stance width of that bike that caused the flare up, not intending to ride with it permanently. In a slightly less extreme way to bandage the issue I’ve bought a couple pedal washers to put on my fixie and bring the Q factor out a little more closer to what my gravel bike is (neither bike has caused me pain in the knee before, but I’m always aware of the slightly awkward way my right leg pedals on them)
Also going to test an angled cleat wedge and insole to try support my arch and stop my weight transfer going solely from the heel -> outer edge of foot -> to the middle of my toes. If anyone has any experience of a similar issue I’d love to hear how you tried to solve it - or if it’s even possible to convince your muscles/ligaments/brain to go ‘back to normal’