FOOT CORRECTION part 2: WEDGING

by on March 6, 2011
Last updated: March 10, 2014

Foot Correction seriesPart 1 – Arch Support and Part 3 – Shimming


Note:
  Prior to reading this post, it is advisable that you read Basic Premise and Foot Correction part 1: Arch Support.

From top right: SPECIALIZED INSHOE WEDGE; BIKEFIT INSHOE WEDGE; BIKEFIT 3 BOLT CLEAT WEDGE; BIKEFIT SPEEDPLAY WEDGE; STEVE HOGG HEEL WEDGE; BIKEFIT MTB WEDGE

Having read the 2 posts mentioned above, you will understand the necessity for foot correction and the role that arch support plays.  Arch support eliminates or reduces a mechanical change (the dropping of the arch) to the feet while pedalling, and combined with the correct amount of wedging, subtly affects the relative alignment of all joints of the kinetic chain up to and including the hip.  When this is done perfectly, proprioceptive clarity from the feet is assured.  Optimising proprioceptive clarity from the feet is like a “yes” or “no” answer to a question.  There are no shades of ‘right or wrong’.  Either proprioceptive clarity is achieved or it is not, with the margin for error being 1 degree of correction (canting) too much or too little.

The difficulty in writing about this subject is that I cannot tell you the method I use to gain certainty as to the degree of wedging.  The method is the subject of patent applications (Update: patent granted in U.S., U.K &  New Zealand) in  and providing detail about the method in advance of patent grant will invalidate the patent.  Additionally, applying the method requires sensitivity and skill which can only be taught in person with 3weeks of training under supervision being about the minimum time required to pick up the process.  Which still allows me to say this…

Currently there are 3 brands of wedging available:  Bike Fit Systems and Specialized  and our own.  BFS developed the cleat wedges in 3 bolt, Speedplay 4 bolt and Mtb 2 bolt versions.  They also were the originator of an in shoe wedge that BFS now called the ITS (In The Shoe) wedge.  The original name was ‘Sole Power’ or something like that.

Specialized have a similar concept wedge to the BFS ITS and have a cleat wedge as well.  I’ve only seen 3 examples of the Specialized cleat wedge as it is relatively new to the market and have not yet made a judgement.  Of the 2 brands and various models, I will not use Specialized in shoe wedges because they present a Material Challenge to the nervous system. Before getting into that, we manufacture a heel wedge but more about that later.

A Material Challenge is when a product is composed of materials that have a negative effect on proprioceptive clarity.  It appears to me that Specialized copied the original BFS in shoe wedge without fully understanding the implications of their choice of materials.  What I’m saying is that X number of Specialized in shoe wedges provide the same degree of cant to the foot as X number of BFS in shoe wedges or X number of our heel wedges, but only at the cost of reducing the Central Nervous System’s (CNS) ability to ‘hear’ the feet.  Well, they’re not alone.  Other items that present a Material Challenge are Specialized cleat shims, LiveStrong and Live Free plastic bracelets and most other similar, charity type plastic bracelets as well as Power Balance plastic bracelets, many helmets, most CO2 cartridges, many smart phones and some sunglasses lens coatings and frames.

If you own any of these items or use Specialized in shoe wedges, by all means wear them or use them if that is what presses your buttons.  But I would suggest that you don’t wear them while riding a bike if long term injury free performance is your aim.  If you use these items, will you become injured?  In any individual case, only time will tell.  Your susceptibility to injury and the volume and intensity of your training play a large part in this.  What I am saying is that any using any product that presents a Material Challenge to the nervous system means that you are metaphorically skating on thinner ice than need be.  Whether the ice breaks resulting in injury cannot be known in advance.  But why heighten the risk?

Note: Regarding sunglasses lens coatings and frames, I’m seeing this more often, though now I’m aware of it, I’m looking for for it more.  There seems to be an individual component to this in the sense that a particular pair of glasses may have a negative effect on one person but not on another.  When a fit booking is made, we ask the intending client to bring their bike(s), knicks, shoes and walking / running orthoses if they use them.  To that list will now be added sunglasses or any prescription glasses that are worn on the bike.  As more data comes my way from this, I will sooner or later post on the subject. ( Update: see this post and this post on the subject )

This leaves BFS wedges or our heel wedges as the default option.  BFS wedges come in two varieties:

1. Cleat wedges which are designed to be placed between cleat and sole of shoe (3 bolt road and 2 bolt mtb type) or bolted within the layers of the cleat (Speedplay 4 bolt type)
or
2. ITS (In The Shoe) wedges which are fitted under the forefoot of a cycling shoe insole.

Our Steve Hogg Heel Wedges are fitted into the heel cup of a cycling shoe underneath the insole.

The first thing you need to wrap your head around, is that in many cases, each of these wedges is correcting the rear foot, directly or indirectly. In some cases cleat wedges and ITS wedges are correcting the forefoot directly.To talk about this more, I need to dwell on a commonly misunderstood term:  Forefoot Varus.  As it is used within cycling circles, the term and position is inaccurate though the method of correction using forefoot wedges is effective (sort of – more later) inside or under a cycle shoe.  True Forefoot Varus is rare and after speaking to several podiatrists with cumulative clinical experience of more than 70 years, they tell me that they have only seen a handful of true forefoot varus foot types.

To explain: Forefoot Varus is when the midtarsal joints are fixed.  No rotation into pronation or supination occurs around the long axis and it is fixed in a supinatory position.  Therefore the foot in a standing position or in a closed kinetic chain will pronate the rearfoot, normally to its end of joint range; that is 13 to 17 deg of heel eversion.  This foot type always has an extremely low arch and the medial malleolus and medial side of the ankle complex is very prominent.  However, it is easy to create a forefoot varus in a normal foot (with a flexible midfoot) if you do not load the lateral column; i.e, 4th and 5th metatarsals and cuboids; i.e; pronate.  This loading represents the force from the ground or from applying force to a pedal.

In a cycling shoe what is being corrected in many cases,indirectly via a cleat wedge or in shoe forefoot wedge; or directly via a heel wedge is rear foot varus.  The forefoot wedge, whether under cleat or inside the shoe corrects the rear foot because the heel is not fixed to the ground.  The important thing here is that if you try to correct rear foot varus by using forefoot wedges in normal walking gait when the heel is fixed on the ground, the midfoot will pronate around its long axis and damage joints by jamming them together.  This is not the case with varus wedges in cycle shoes or underneath a cleat as the heel is not fixed to the ground and is more or less in an open kinetic chain.  However, it may be preferable when using an in shoe forefoot wedge to add a rear foot wedge as well, especially if there is a large amount of Tibial varum.

With that understanding, it becomes apparent that wedging to correct the rear foot can be applied in 3 different locations or in any combination of them:

1.  Forefoot wedging using BFS ITS wedge

2.  Cleat wedging using BFS cleat wedge(or if using SPD mtb pedals, an option is the BFS VV1 cleat)

3.  Heel wedges placed under the heel of the shoe insole.  (pic below)  

A word of caution.  Regular readers will know that my view of foot correction in general is that optimal foot correction (wedging and arch support) is the only way to ensure that the proprioceptive feedback from the feet is heard loudly and clearly by the cerebellum while cycling. This in turn ensures the highest level of neuromuscular coordination and the lowest risk of developing overuse injuries because there is less need, or no need to compensate for lack of feedback.  I have developed a method of determining optimal foot correction; that is the correct balance of arch support, wedging and the placement of that wedging, that is the subject of patent applications in several countries, so I won’t go into detail. The research involved in developing that method tells me that a cleat wedge or a forefoot inshoe wedge will directly correct the forefoot if that is where the problem is and indirectly correct the rear foot because there is no rear foot contact with the pedal if the rear foot is where the problem lies. However, if the problem needing correction is a rear foot issue and it is corrected indirectly with cleat or inshoe forefoot wedges, the CNS response initially is fine. But over time, a week, a fortnight or occasionally, only a few days, the proprioceptive feedback from the feet becomes muted and is treated as background noise by the cerebellum. This happens because though wedge numbers may be optimal, wedge placement is not! This leaves the rider mechanically corrected but less well coordinated than would otherwise be the case.

Furthermore, a ton of time and experience with wedging has caused me to form the view that around 70%-75%  of riders need heel wedging, either alone or in combination with cleat wedging. Around 25%-30% need cleat wedging alone. There is a tiny, tiny minority that are best served with an inshoe forefoot wedge. Occasionally, and assuming Level 2 arch support is in place, I find someone that doesn’t need any wedging for one foot and more rarely, a client who doesn’t need wedging for either foot.

I prefer to use BFS ITS wedges as a diagnostic tool to help determine the number of wedges necessary. The value of an inshoe forefoot wedge is that it is a shotgun, not a stiletto. Because it is over the point of contact with the pedal, ITS wedges correct the forefoot directly and have an indirect effect on the rear foot of many, it is easy to determine wedge numbers (whereas a heel wedge will only correct the rear foot). Then a determination has to be made as to where to wedge.  The key thing to understand here is that cleat wedges are also like a shotgun. They affect everything; at least temporarily, and only temporarily in the majority of cases where heel wedges are needed.  Once the correct number of wedges is determined using in shoe wedges, then BFS ITS wedges equate one for one with the same number of BFS Cleat Wedges or Steve Hogg Heel Wedges in terms of corrective effect.  This demands further explanation and I’m not totally satisfied with what I’m about to say for reasons that I’ll explain; so if any one cares to contribute their 2 bob’s worth, please feel free.

A BFS ITS wedge has a taper of 1.5 degrees whereas a BFS Cleat Wedge or one of our Heel Wedges has a taper of 1 degree, yet they work one for one.  Why?

The best explanation I’ve got is that as the BFS ITS wedge is correcting the heel indirectly, to do so it requires any movement in the joints of the midfoot to be taken up before the corrective effect can reach the rear foot via a torsional load.  And that 50% more taper is needed per wedge for this indirect rear foot correction to achieve any given degree of cant of the rear foot as when using the same number of Cleat Wedges placed under a cleat (which cants the entire foot) or when using a Heel Wedge placed under the heel (which cants the heel directly).  The hole in this explanation which occurs to me and which has been pointed out to me several times by others as well, is that there has to be a limit to the amount of free movement in the joints of the midfoot, and that once that is taken up, any increase in ITS (1.5 degree taper per wedge) forefoot wedging should not be comparable to the same increase in number of Cleat Wedges (1.0 degree taper per wedge)…  Yet, proprioceptively speaking at least, it is.

Which is the best location for wedges?  A brief summation of my experiences follows:

Forefoot wedging using BFS ITS wedges

Pros

  • Quick and easy to change wedge numbers to assess the effects of wedging and to determine the ideal number of Cleat Wedges needed.
  • On rare occasions needs to be used for forefoot correction or as part of forefoot correction when  indicated.

Cons

  • Takes up often limited vertical space in the toebox, potentially causing hot foot and discomfort if more than 1 is used. Often this first becomes apparent on long rides such as Audax brevets and 12 and 24 hour mtb racing.
  • Poor choice if need to walk any distance in cycling shoes; i.e; in touring or mtb shoes for reasons outlined earlier in this post.

Cleat Wedging using BFS Cleat Wedges

Pros

  • Corrects fore foot directly but cants the entire foot.
  • Indirectly corrects the rear foot.
  • Doesn’t take up any space inside shoe.

Cons

  • If multiple 3 bolt cleat wedges used under cleat on carbon soled shoes, slippage of the cleat can occur unless cleat bolts torqued tightly and checked regularly.
  • A similar problem occurs if using multiple 2 bolt mtb cleat wedges.  Mtb cleats rely partly on projections on the underside of the cleat biting into the sole of the shoe for security against movement.  If more than one mtb cleat wedge is placed under an mtb cleat, the projections do not bite into the shoe sole and the risk of cleat slippage increases markedly.
  • In the 70% – 75% of cases where heel wedging is best practice, a cleat wedge will only prompt an optimal proprioceptive response temporarily.

Heel Wedging using Steve Hogg Heel Wedges.

Pros

  • My preference philosophically, because this method deals directly with the area that needs correction in most cases.
  • Avoids cleat slippage issues on 3 bolt and 2 bolt cleats.

Cons

  • A practical limit to how many can be fitted under heel before fit of heel in heel cup of shoe is compromised.  Usually 3presents no problem when fitted this way; 4 can be a problem in smaller size shoes and 5 only works well in large shoes without compromising fit. This is rarely an issue because the vast majority require between 0 and 2 heel wedges when used in conjunction with Level 2 arch support.
  • Of no help in the minority of cases where forefoot correction only is needed.

Which still leaves the question of how to determine the correct number of wedges, whatever their location?

I can’t answer in any way that is satisfactory because, as I said earlier, I need to protect the validity of patents pending.  Paul Swift, Mr. BikeFit (BFS) and the developer of the Cleat Wedge and ITS wedge uses a combination of observation (using laser line projectors as a reference), rider feedback and educated guess work to determine wedge numbers.  In the absence of my method which ensures certainty, this seems as good a method as any and better than most. However, my strong view formed from experience is that arch support comes first and is necessary before any wedging is attempted. Paul sells a device called the ForeFoot Measuring Device (FFMD) which quantifies the relative static alignment of forefoot to rear foot.  His company BikeFit, publishes recommendations which I’ve taken the liberty of cutting and pasting below:

0 – 2 degrees
3 – 7 degrees
1 wedge
8 – 12 degrees
Up to 2 wedges
12 – 20+ degrees
Up to 3 wedges

These recommendations are reasonably accurate plus or minus 1 wedge providing arch support has already been fitted at Level 2; mildly intrusive.

I need to qualify my statement of “reasonably accurate” for several reasons:

1.  The FFMD measures relative alignment statically, i.e; without load applied.  Usually the functional picture of what the foot is doing changes when load is applied. One mistake that many fitters make is to take a reading of say, 20 degrees and think “I need to use 3 wedges”.  Have a look again at the table.  For a 20 degree reading it says “Up to 3 wedges” NOT “Definitely use 3 wedges”.  What the FFMD is measuring is the static relationship between the plane of the forefoot and plane of the rear foot.  There is no close relationship between this and the amount of correction needed to optimally correct the rear foot (and occasionally the forefoot), particularly when Level 2 arch support is used.  For approximately 80% of cases my test gives results similar to the FFMD recommendations plus or minus 1 wedge, which is frankly, too much of a margin for error for my liking.  The other 20% vary, sometimes substantially.  The variance tends to be more common on the left foot than the right foot.

Why?

Because I’m testing the entire kinetic chain under load and most people (no correlation with handedness) favour and protect their right side on a bike. In the sense that if there is a challenge to their position (and there always is), the patterns of compensation that have evolved will typically protect the right side to a greater degree than the left side.  Any thoughtful bike fitter will have noted that there are more people complaining of left knee pain on a bike than right knee pain.  This is why.  More often than not, the rider autonomically protects the right side from a challenge but pays a price for this on the left side.  The greater frequency and degree of intervention on the left side is a product of this general pattern of globally compensating for the ‘favoured’ right side.  Do this on and off the bike for a life time, particularly when young, and there will be morphological differences between left and right side, not only in the in feet, but in how the body functions on each side that need addressing.  Note that I say “general pattern” not “universal pattern” as there are plenty of exceptions; probably 5 – 10%.

2.  I’ve had enough correspondence with Paul Swift in the past to know that he is fully aware that the table above is not necessarily accurate in any individual case.  It can’t be.  It is the product of his experience and is a means to give wedge users a starting point as to wedge numbers that they will likely benefit from at some level.  There is always an individual component to each case.  Wedging affects the relative relationship of the entire kinetic chain up and including the hip, whereas the FFMD measures the foot in isolation.  Don’t be scared to depart from the table recommendations, but have a reason for doing so; particularly if the reason is “X number of wedges in combination with arch support makes my feet feel more stable on the pedals on both sides and my knees seem to track better.”

In summary, the FFMD is a useful tool but don’t blindly follow the recommendations.  Think, observe and feel.

I realise now, that for many years I was not giving clients enough arch support, simply because the means available to me at the time didn’t allow it in most cases. During that period, and using an earlier version of my testing protocol, I was using an average of just under 6 wedges per rider (aggregate of wedging for both feet) with a bias towards the left foot.  Some figures from a typical year pre eSoles Supportive:

  • Average no. wedges per rider: 5.70
  • Average no. wedges for left foot: 2.98
  • Average no. wedges for right foot: 2.71
  • Wedging frequency on one or both feet: 99.44%
  • Wedging frequency for left foot: 92.50%
  • Wedging frequency for right foot: 97.22%

With the advent of proper arch support, this changed to:

  • Average no. wedges per rider: 4.02
  • Average no. wedges for left foot: 2.09
  • Average no. wedges for right foot: 1.94
  • Wedging frequency on one or both feet: 96.25%
  • Wedging frequency for left foot: 85.00%
  • Wedging frequency for right foot: 95.00%

From both tables you will deduce that less people need wedging on the left foot than need wedging on the right foot but that the total number of wedges used per left foot is greater on average.  There can be substantial individual variation.

So if you want a simple starting point, play the averages and once you have sufficient arch support, try 2 wedges on each foot to start with.  Is this right?

In most cases, of course not, but it is somewhere to start.  The right number of wedges (assuming sufficient arch support is already present) should make each foot feel like the pedaling pressure is spread evenly across the foot. In more than  99% of cases, wedge placement should be such that the thick side of the wedge(s) faces the crank arm.

Be aware too, that fitting wedges, whatever the location of the wedges, can affect the rotational angle that feet sit on the pedals.  So after each addition or subtraction of wedge numbers, make sure that the angle of your cleats allows your feet some free rotational movement either side of that point.

Proprioception is a curious thing. During your wedging experiments, you will often find a combination of wedge numbers between feet that feels fantastic…  At least initially, and then feels less wonderful over time.  Why?

Because your body is responding to a change in the quality of proprioceptive stimuli and initially, this is like raising your voice above the chatter at the party, to continue the analogy from Part 1 of this series.  If you don’t have the degree of wedging or the placement of wedging spot on for each side, then over time, that better (for the moment) but not perfect change in the quality of stimuli from the feet drops back to “background noise” level.

I cannot apply my test to myself and so have no one to test me, so I have had to work out my own wedge numbers.  I found this a time consuming process, as you will, because every change has to be habituated for some time as well as tested on longer rides and in races before any certainty is assured.  Here is what I would suggest in an attempt to streamline the time necessary.

Once a week, have a ‘wedge ride’.  This is a longer solo ride with a bit of climbing so that you will be forced to put solid pressure on the pedals from time to time.  You will need half a dozen heel wedges and say 4 ITS wedges and a roll of electrical tape in your jersey pocket.  Prepare the heel wedges by cutting them to the outline of the heel of your shoe insole.  Fit one ITS wedge under each of the arch support insoles that you are already using.

Ride and observe the plane of each knee’s tracking and the feeling of stability and solidity of each foot on the pedal.  Is the pressure on the foot evenly distributed across each foot?

Does this single wedge per side feel better?

If it does, add an ITS wedge to each foot and see if there is a difference in how either knee is tracking and how either foot is feeling in terms of distribution of pressure.  The ITS wedge will take up space in the toebox but try and differentiate that feeling from any changes in the distribution of pressure.  Do you feel more fluent in your pedaling action?

Once you have ridden for long enough to ensure (at least provisionally) that the ITS wedge has improved your situation, stop, remove it and replace it with a heel wedge under the heel of the insole of the same side shoe.  Then ride again and feel for any lack of fluency or uneven distribution of pressure across the fore foot. If switching from an ITS wedge or wedges to an equivalent number of heel wedges feels like a negative change, and for 10 – 15% it will, then it is very likely that this group needs to use cleat wedges.

If you perform a ‘wedge ride’ like this once per week over several weeks and keep records of wedge numbers and, wedge placement and how you feel; and if the changes survive your other rides while still feeling good, you will sooner or later arrive at the individually correct number and placement of wedges that you need to use, or at least very close to it.  You may end up with the same number under each foot or the number may differ on each foot.  If a change in wedge numbers feels worse, then it is unlikely adding more on that side will help.   Once you have arrived at wedging number per foot that has felt good for several weeks, you can choose where to place them, whether under the cleat, under the heel, under the forefoot or various combinations.  I stress that the major purpose of forefoot wedges is use as a diagnostic tool and it is rare for me to use one as a permanent fixture.

You may find that altering the wedge location while maintaining the same total number alters the feel of your foot or feet on pedal(s) in a positive or negative way.  Act on this to refine your placement while staying with the same total number per foot.  If you are patient, you will get a good result.

Note: My experience is that few people cope with more than one forefoot wedge as a permanent fixture on really long rides.  This has more to do with lack of available space in the shoe toe box than anything else, though I’ve seen instances where too many forefoot wedges created a torsional load through the midfoot.  So 1 ITS is safe if you need to use a forefoot wedge, but in most cases, heel wedging for the majority, heel wedging for the minority or a combination of both, is a better bet.

My apologies if this post isn’t entirely satisfactory at giving you an easy method of determining wedge numbers but this is the best that I can do, publicly at least, at this stage.  All feedback is welcome so let me know how you get on.

P.S. I need a break from this series for a while but will continue it.  In the meantime, there is other stuff to post about.

P.P.S. Note on fitting heel wedges:  Some care must be taken when taping multiples of cut down heel wedges to underside of the heel of an insole (ideally an arch support insole).  Don’t just make a stack of wedges and then tape them in one operation.  The following way works best.  Using an example of a 3 heel wedge stack; use thin adhesive tape; packing tape is ideal.  Tape the top half of the first wedge to secure it.  Closely match its position with the next wedge and tape the bottom half of that wedge to secure it.  Then closely match it with the final wedge and tape the top half of the final wedge.  Now that all are secured, tape over the stack carefully.  Once you have decided that the fitting is permanent, cover over the stack with adhesive backed gauze surgical type tape which will prevent slippage and soak up perspiration.  Any queries; yell via Comments below.

Foot Correction seriesPart 1 – Arch Support and Part 3 – Shimming

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126 Responses to FOOT CORRECTION part 2: WEDGING

  • Jason Warner says:

    I wait over two weeks for this, and you leave us hanging again ;) ?! You didn't say it, but I don't want to assume they are OK. What about out Polar heartrate monitors worn on the wrist?

  • Steve Hogg says:

    Sorry Jason, time is often issue here. If I could clone myself, we would both be gainfully employed. Every wrist mounted HRM (including Polar) that I've tested to date has been fine.

  • FOM says:

    Steve

    If the feet are two different sizes, is it best to place the cleat in the same place on each shoe or in the same place relative to the ball of the foot on each side (which then locates the cleat differently on each shoe)?

    Craig

  • Steve Hogg says:

    G'day Craig,
    The latter. If there is a large disparity in foot length or in foot proportions between left and right, and if the consequence of this means a marked difference in cleat placement on the sole of each shoe,then a shim may be necessary under one shoe to address the functional leg length difference (LLD) that this can lead to.

  • Anonymous says:

    Wow! This has stimulated some further reading on foot mechanics. If a client has a rear foot varus which is dragging the forefoot into what appears to be a varus position I understand the varus cleat wedge. Some people have that same rear foot varus but a forefoot valgus.( frequently high arches and more rigid foot.) I would assume the appropriately intrusive arch support will still help with proprioception but would you use a valgus cleat wedge? and how far would you correct?

    Thanks look forward to your comments and future writing.
    Bill

  • Steve Hogg says:

    G'day Bill,
    I can see you are a thinker which is a good thing and not as common as it should be in the bike biz. I can't answer your question quite the way that you frame it because I act on the results of my testing protocol which I have found to be bulletproof. Also, the testing is done with load applied. What I can say is that the majority of the foot type you describe need varus correction. If you use an FFMD, it's a great tool but it shows static alignment only. Often the picture changes under load; occasionally dramatically. I've found that the majority (not all) of people that have valgus reading on the FFMD need varus correction. I've also found the occasional varus FFMD reading that needs valgus correction. Remember the foot in only one part of the kinetic chain. I'm testing the neuromuscular response from the entire kinetic chain. That is the beauty of the testing protocol; it elicits a yes or no response from the CNS to any change in stimuli with load applied to the pedals. So achieving certainty as to the right degree,orientation and mix of correction is as simple as playing 20 Questions.

    • Philipboons says:

      Dear Steve,

      I’m from Belgium.
      Interesting point you make about valgus forefoot who need varus shimming and vice versa.
      I’ve been struggling for months now.
      I have a shorter right leg (1 cm shorter). There’s a ” mm shim under my right SPD SL pedals on my old carbon shimano shoes.
      I have a longlasting patellar tendinopathy on the left side and try to keep the saddle as high as possible.
      My troubles started when I bought myself a paoir of s works BG fit shoes.
      Since then i have sufferd from hamstring issues and recently achilles tendon issues. Nothing severe but enough to feel pain after every ride ( 6000 km a year, love climbing low gears).
      Lowered the seat, advanced the seat. Got a flare of patellar pain as a consequence after trip in dolomites and Stelvio.
      I’ve tried the ++ in sole and inshoe valgus shim with little effect. Since couple of days adductor pein at the lower third of the tigh as appeared as well.
      Should i get rid of the shoes? Buy shimano again.
      I’ve purchased your cleat wedges and consider trying a valguscleat wedge and taking the inshoe wedge out.
      What induces the adductor pain.
      Any thoughts?
      Thanks

      Philip

      • Steve Hogg says:

        G’day Philip,
        Firstly, readings from an FFMD or similar devices are a static measure only. I find that static valgus readings almost always require varus correction dynamically. I have found the occasional varus static reading that requires valgus wedging, but it is exceedingly rare.

        Next, when you mention using “valgus inshoe wedge” with your new Specialized shoes, was it a Specialized in shoe wedge?

        If so, don’t use Specialized inshoe wedges or cleat shims ever. They inhibit the central nervous system and increase risk of overuse injury. There is a video post called MATERIAL CHALLENGES/Scary Movie coming in a couple of weeks that will graphically illustrate what I’m saying. They are not alone.

        Most plastic charity style bracelets and many black sunglass frames have the same negative impact on the nervous system. I am seeing more and more Material Challenges with new fit clients.

        Specialized shoes are fine (providing they fit well) so they are unlikely to be the source of your problem. Specialized arch support insoles are also fine but in my view, they have the range of arch support heights wrong. Even their highest option is only suitable for low arch feet from a corrective point of view. If you have low arch feet, then they may be ideal.

        Based on the (incomplete) info you have given me, my best guess is that you haven’t fully compensated for your shorter right leg (how high is the shim, you don’t specify) and that lack of compensation, or other functional issues, mean that you don’t sit squarely on the seat. I say this because adductor pain is ALWAYS due to pelvic movement on the bike.

        You also mention that you keep your seat height on the high side to alleviate patella issues.
        It maybe that a combination of a thinner shoe sole (Specialized), a high seat height and riding in the mountains was enough to push you into injury.

        Hamstring and Achilles tendon issues at the same time are almost always related to too high a seat height.

        Read ‘How To Avoid Bike Fit Hell’. Then I’d suggest returning to your original position settings and shoes and start again. You should be able to use the Specialized shoes but as you seem to function within a narrow zone, make changes carefully and incrementally with only one change at a time.

      • Philipboons says:

        Steve,

        thanks for your quick reply.
        Intuitively your advice sounds great and spot on.

        I made a typo with the height of the shim. It is 3 mm thick.
        I had already read about material challenge and I have bought your shims and wedges a couple of days ago.
        Correct me if this is stupid: I think I’ll try to lower the seat, put your 3 mm shim under the shoe together with one valgus cleat wedge and give the Specialized’s one last try ( because they fit so well)
        If this doesn’t work I’ll start from scratch again.
        The thing is my shimano shoes were worn out and i would need to buy a new pair .
        Can I ask you a few more questions:
        Are all shimano shoes similar ??
        Is there a difference in stack height between shimano and specialized shoes??

        Again thanks for your reply.
        Really impressed with your taste for DERANKE

        Philip

      • Steve Hogg says:

        G’day Philip,
        That sounds fine. One point though. My experience with 10mm leg length differences like yours is that a 3mm shim is rarely enough. Usually the shim would need to be in the 6 – 10mm range. There are exceptions but that is my general experience. What that means is that source of your left knee tendinopathy is likely to be caused by either:
        1. The lack of enough shim height under the right side causes you to drop the right hip which in turn challenges the plane of movement of the left knee

        OR

        2. You have the seat low enough to ensure that the right leg reaches the bottom of the pedal stroke well with only a 3mm shim but that seat height is too low for the left knee which in turn can cause anterior knee pain.

        To answer your other questions; currently all carbon soled Shimano shoes have the same last shape to the sole and the same degree of heel and toe lift.
        I don’t know the difference between Shimano and Specialized shoe sole thicknesses. I tend to position every one as a reflection of their degree of function and the equipment they use and have never bothered measuring relative shoe sole thicknesses. A quick glance suggests that Shimano have a thicker sole, though I haven’t measured the difference.

        De Ranke XX?
        What a beer!

      • Philipboons says:

        Thanks a lot for your helpfull comments

        Philip

  • FOM says:

    Steve

    Timing of this is spectacular as this is an issue I have been trying to wrap my head around for a bit and have been chatting with Paul at BFS about. I assume you mean "cut down BFS ITS wedges" rather than cleat wedges when referring to heel wedging … if not, can you explain how that works?

    Have you any experience with Time ATAC cleat wedging – I struggle with it as the interface really struggles when using cleat wedges.

    Again, thanks for the help,

    Craig

  • Steve Hogg says:

    G'day Craig,
    I mean exactly as the text says "Heel Wedging using cut down Cleat Wedges taped under the heel of the shoe insole".
    Have a look at the pic I've just loaded at the start of this post.

    Re ATAC's and similar. It is for this kind of application that heel wedges are ideal with the caveat that enough can be fitted. In most cases this isn't an issue. Occasionally it is and the solution is as per the text of the post; i.e; shoe modification to fit wedges at the heel between sole and upper. If it is not possible to fit enough heel wedges without compromising the fit of clients heel in the heel cup for an ATAC or similar user, then a bootmaker needs to partially remove the sole from the upper, have you insert the desired number of wedges between sole and upper at the heel, and then reglue the heel of the sole to the upper.

    At the risk of sounding like a broken record, the beauty of the testing protocol I use is that it gives certainty as to the orientation and degree of cant and the number of wedges or combination of wedges and arch support needed to achieve it.

  • FOM says:

    Brilliant … thanks for pics – I understand now.

  • Jason Warner says:

    Steve – Thank you for your time and efforts providing so much information to the cycling community! I'm sure you're helping many people.

    Can wedging or the lack of wedging cause hamstring issues? I know improper wedging can cause medial or lateral pain.

    Thank you,
    Jason

  • Steve Hogg says:

    G'day Jason,
    You're welcome. Call it therapy. Re your question – I've got to say yes, but there are usually other factors associated.

  • Anonymous says:

    Great information. Any idea how soon your patent will be approved. Being able to test if you have it correct(arch/canting) seems critical. Correct me if wrong but often just looking at the knee tracking is not enough as the rider makes compensations.Any other clues short of revealing your plans to tell when it is correct. Weight distrbution over the feet? Knee tracking or combination. Thanks Bill

  • Anonymous says:

    If a rider has pelvic assymetry and drops down and forward to the left. Rt gluteal lifts off the saddle slightly and causing increased reach to the pedals on the right and a turning in of the knee on the left side at bottom of pedal stroke.(there is some chronic knee pain mild on the left) Often when I think of the knee turning inwards and moving medially it suggests a need for a varus wedge on that side is this the case here or because the mechanism is different dose it change? I have also set seat hieght for the longer (functionaly left leg) and shimmed the right cleat(functionally shorter) 4mm in hieght.(before the shim rt side was challenged at the bottom of the stroke and lost fluidity) Addtional comment is the pedal stroke on the right improves with the right eye closed and I assume this means some of the pelvic assymetry decreases. Hard to ride around though with 1 eye closed. I would appreciate comments or suggestions. Bill

  • Jason Warner says:

    Hi Steve – I was wondering how Specialized shoes factored into your wedging stats? I think I remember reading somewhere (maybe Paul's blog) that the built-in wedging the shoes have usually didn't equate to a full 1.5 degrees as stated. Many thanks, Jason

  • Steve Hogg says:

    G'day Bill,
    Patent approval?
    Who knows?
    These things move slowly. I can say patent pending at the moment in the U.S, but final approval still some years off. Elsewhere, still a while to go.
    Re whether varus wedging would positively affect your pelvic asymmetry; I can only speculate. Each case is different and it depends on what root cause or causes are for the pelvic asymmetry. If foot alignment is the sole reason or a large part of it, I would expect your left foot to be morphologically quite different to your right. If this isn't the case, it is still a reasonably safe assumption that wedging is necessary to some degree (on both feet)as most people require it.

    That closing one eye has a positive effect on symmetry on bike is something I've been delving into for several years. This isn't the place to go into detail here as some of that info is IP I am trying to protect for the moment. I know that doesn't help you much but if you can track down a chiropractor who is trained in Applied Kinesiology diagnostic methods and who uses coloured lenses as part of their 'tool kit', I'm happy to speak to them about your case and what I've found over the last few years. I speak enough of their 'language' to make sense to people with that training but perhaps not to a layman without writing War and Peace about it.

    G'day Jason,
    I like Specialized shoes but sad to say,I have never seen any evidence of the 1 degree of varus correction that Specialized say is built in. I have fitted numerous people who had more than one pair of shoes with one of the pairs being Specialized. Using the same methodology (which is bulletproof if applied correctly) in every case, from a proprioceptive point of view, the wedging numbers needed on both brands was always the same. This suggests to me that either the correction isn't there as claimed, or if it is, it is ineffective.

  • Anonymous says:

    Hi Steve,
    You seen to know a lot about the feet. but little evidence. Where did you study Podiatry? or was it Orthotics? Not sure you did.
    You seem to refer to a lot of the people you see needing FF varus correction with wedges…hmmm interesting. And foot mechanics you write of is all smoke and mirrors with no clinical or empirical evidence of the junk you place under cleats. Skill and experience you seem to have is not evidence based or proven, purely subjective musing.
    You rightly acknowledge FF varus is extremely rare…so get your terminology correct. Further. How do you correct RF motion of the foot with FF wedging….AMAZING!!!
    What the hell is proprioceptive clarity stuff you purport extensively. Never read that in a foot and ankle journal. If you could provide some references to this phenomenon it would be appreciated.
    Thanks
    Andrew
    BSc BPO (Hon)

  • Steve Hogg says:

    G’day Andrew,
    Thank your for your comment. I think you should re read the posts because you are implying a couple of statements on my part that I have not made.
    Secondly, the quickest way to answer your charges is this.
    I am used to scepticism from health professionals, particularly some podiatrists, about some of the things I’m saying and don’t mind it in the least. I think scepticism is healthy. I gave 2 workshops on just this subject, foot correction for cyclists, at the Tour Down Under Sports Medicine Conference in Adelaide in 2010. Amongst the audience were 2 orthopaedic surgeons, 1 professor of medicine, several GP’s, 4 or 5 physios and at least 1 podiatrist.
    They are the ones I remember, though the bulk of the rest were health professionals. Your scepticism was shared by many of the audience initially, though they were more polite about it than you have been. By the end of the workshops, there were no more sceptics.
    Additionally, I count amongst my fitting clients, 2 professors of anatomy, several podiatrists and numerous other mainstream health professionals. None of them have an issue with what I have done with their feet or those of other fit clients, as they have experienced the process first hand.
    I expect that the best way to resolve your scepticism is to make you the same offer I make to anyone. I am happy to give personal demonstrations on request. If it is not possible for you to visit us (you don’t say where you are from), podiatry is a wide spread profession and it is likely that you know someone in Sydney who can act as your surrogate; or know someone who knows someone etc. Send them in. They don’t have to announce themselves as your surrogate; they can tell me any story that they like and I will happily demonstrate in person.

  • ETrust says:

    Hi Steve,

    You have sure got my interest with the Sunglasses coating!

  • Steve Hogg says:

    G'day ETrust,
    It came as a surprise to me initially but I suppose it shouldn't have. The ability of dyslexis to process some aspects of the sense of vision can be influenced by using coloured filters. There are other applications as well as I'm finding.

  • Anonymous says:

    Hi Steve,

    I have read your blog with interest and I must be honest I do truly believe that your methods of fitting cyclists must work.

    But, I read your blog because I am keen cyclist and runner and from time to time different cycling related injuries pop up on me which I am sure are related to positional issues on my bike.

    So i first read your basic premise then onto arch support. Your argument for arch support is that unlike natural running (natural being running that occured for the many 1000's of years before raised heels and supported arches became the norm back in the 1970's)cycling has no need for a flexible arch due to the fixed nature of the pelvis and much lower force through the feet, legs and pelvis. So I am going to take your advice taken get some arch support for cycling shoes.

    Onto proprioception, I fully agree that proprioception is vital in any activity and using the analogy of running again, the perfect proprioceptive foot set-up is running barefoot (assuming you have always run this way) but I couldn't understand why arch support helps with proprioception can you simplify for me again please – if you have time?

    Finally, having decided that arch support is the way forward for me I then read wedging and I am at a complete loss as to how I know I need wedging other than to put some wedging in certain places and see how it feels, is this summary unfair.

    Best regards

    rich

  • Steve Hogg says:

    G'day Rich,
    Re your last 3 paragraphs; I think your summary is fair. To explain more fully; I use a testing protocol that quantifies proprioceptive feedback from the feet when force is applied to the pedals. The testing protocol only gives a 'yes' or 'no' response. There is no 'nearly right' or 'slightly wrong', just 'yes' or 'no'. I use the protocol to determine the necessary degree of wedging vs arch support as well as the ideal placement of the wedging; i.e. heel, cleat or forefoot.

    Unless you and I were in the same room at the same time, you don't have access to that testing protocol. So here is what I would do in your case. Fit your arch support at Level 2, slightly intrusive and once you are used to that and aren't aware of it any more except when focusing on it consciously, pedal away and ask yourself where you feel pressure on the forefoot in your cyclng shoe. Is the pedaling pressure evenly spread across the foot?
    If yes, you may not need wedging. Not needing wedging isn't rare (particularly on the left foot) but isn't common either. However if you feel more pressure on the outside of the foot which is quite common, wedge towards the outside of the foot. That is progressively fit 1 or more wedges oriented so that the thick side of the wedge(s) faces the crank arm until you feel that the pedaling pressure is evenly distributed. That will get you fairly close to the mark in most cases. If though, you feel more pressure on the inside of the foot, then do the converse. Just be aware that very, very few people need wedges oriented with the thick side of wedges facing away from the crank arm. Most people who feel like there is more pressure on the inside of the foot only feel that because they are not sitting squarely on the seat and are dropping the hip on one side.

  • Denisonlife says:

    Steve,

    Quick question for you. I see that you mentioned 1 ITS wedge is = to 1 CW. But is 1 heel wedge = to an ITS or CW? Thanks.

    Jonathan

    • Steve Hogg says:

      G’day Jonathan,
      1 cleat wedge = 1 heel wedge (which is a cut down cleat
      wedge) = 1 in shoe (ITS) wedge except in the rarest of circumstances.

  • Chris says:

    Hi there
    Wow this is so complicated!
    I recently had Specialized +++wedges put in, after advice, and they seemed to straighten my pedaling so no longer knee inwards. However, like a recent comment on cyclingnews I developed a little knee pain under the patella. However, it doesn’t help that my Speedplay X’s are wobbling due to worn bearings. I will try some steady rides like you suggested and new pedals.
    Your dislike of the Specialized ITS caught my interest. Is the proprioceptive blocking by the material of the ITS changed by simple measures such as wearing socks? If not why not? With the bracelets (I don’t wear one) do they effect proprioceptive clarity in the body regions below the vertebrae they link with or just one area of the body or is this enough to impinge on the processing capacity of the CNS so that all areas of the body are affected?
    The sunglasses point has really aroused my interest. I strongly encourage some form of scientific endeavour to validate this, perhaps a local undergrad of sports science could assist as part of a dissertation? One would think that sunglass lenses would attenuate the CNS to competing stimuli since the lense would reduce CNS excitation?
    I only wish that I lived in Australia or Sydney so that I could get you to fit me! I just want to ride my bike without this hassle.
    Thanks
    Chris
    Hawkes Bay
    NZ

    • Steve Hogg says:

      G’day Chris,
      Re your experience with Specialized in shoe wedges, you’ve got a number of variables with your situation so it isn’t possible to sheet home blame to one factor alone. Loose pedal bearings won’t help. If the number of wedges used is too many, then again, a problem will likely arise. Re the Specialized in shoe wedges themselves, they will perform the same mechanical correction (if used in the individually correct number) as other wedges. However, they are made from material that has a negative effect on fine motor control abilities. Wearing socks won’t help. The effect of those things is so pronounced, that they don’t have to be touching you, just close to you.

      Another way to put this is: No one has clear proprioceptive feedback from the feet when cycling unless the cant of their feet is perfect. In a typical year, and using the testing protocol I’ve developed, 97% of riders need wedging on one or both feet to individually varying degrees to restore proprioceptive clarity from the feet. This lack of neural information causes the CNS to compensate for that lack. Humans are world champion compensator’s but ALL of our patterns of compensation on a bike are asymmetric and that is where the problem lies. So it is possible to potentially have the correct number of Specialized in shoe wedges from the view point of mechanical correction but still be in asymmetric compensation mode with the increased chances of overuse injuries developing that result.

      I also hasten to add that in any rider’s case, there are multiple triggers for compensatory patterns to develop, of which the use of the wedges you have is only one.

      Re the bracelets; no it effects the whole of body response.

      Re the glasses, and this problem is not epidemic, though I see it regularly. It differs from the Material Challenge of the Specialized in shoe wedges and shims by having an individual component. I had 2 elite athletes in earlier in the year from the national squad of another country. To colour coordinate with their kit, they wore blue mirror finish sunglasses with white frames, though each used a different brand as the team doesn’t issue sunglasses. One of them had a negative response to the lens coating on his glasses but not to the lens coating of his team mates very similar different brand glasses. Nor did team mate 2 have a negative response to the glasses that team mate 1 did. So they swapped glasses.

      Research?
      I’m a bike fitter so don’t look at me. However I have demonstrated this stuff to tens of health professionals of various stripes and contacted behavioural optometrists and neurologists about this. In each case it was news to them though they were very interested. The first behavioural optometrist I contacted gave me the impression that what I was saying was not new, but once a face to face meeting took place, I found that they had misconstrued what I had said and it is apparently news to them.

      If anyone out there is interested in doing the research, contact me.

  • Waynesulak says:

    From a previous post your said:

    A question was asked “…..With the bracelets (I don’t wear one) do they effect proprioceptive clarity in the body regions below the vertebrae they link with or just one area of the body or is this enough to impinge on the processing capacity of the CNS so that all areas of the body are affected? ……”

    You responded “……Re the bracelets; no it effects the whole of body response….”

    How does silicon bracelet effect the central nervous system?

    Thanks Wayne

    • Steve Hogg says:

      G’day Wayne,
      To answer unequivocally, publicly, strays into IP that it
      has taken many years to nut out. Happy to demonstrate in person and do so
      daily with fit clients who use them or other plastics that have a similar
      effect on proprioceptive clarity. I suspect you are not in Australia but if
      we’re ever in the same part of the planet, happy to demonstrate. I know this
      is not the answer you seek but it is the best I am prepared to give, other
      than face to face.

  • Nickdinsdale says:

    Hi Steve

    From my personal experience and own published research, the vast majority of cyclists will benefit from varus wedging i.e. increased power output, especially when performing short, high intensity efforts. Furthermore, those cyclists presenting with the highest levels of forefoot varus (or forefoot supinatus – an acquired soft tissue adaptation as a result of excessive pronation) demonstrate the greatest increases in power output – when corrected using varus wedges.

    As you say, limited robust research exists on the topic of ‘Forefoot Varus’ related to gait – and even less in the world of cycling. It is highly likely that ‘Forefoot Varus’ (forefoot supinatus) develops over time as a result of excessive pronation at the subtalar joint during gait activities and cycling. I strongly believe this is a result of tibial varum (rearfoot heel varus). Therefore, in general terms, I believe tibial varum should be compensated for by the use of ‘Cleat Wedges’ in preference to ITS forefoot wedges. Usually, the greater the degree of tibial varum, the more wedging is required.

    I also agree with your comments on using a longitundinal arch support to assist in controlling pronatory forces. I use the red high density formothotic (manufactured in NZ) which has a small intrinsic varus heel wedge built in. We advise cyclists to use an insert one size smaller. This moves the arch support further back towards the heel, thus allowing the metatarsal heads to ground effectively. All too often arch supports extend too far forward….this means the pedal forces are ttransfered through the arch rather than the met-heads.

    Something often referred to in the cycling literature, but it’s highly likely modern technology in bikes and cycling equipment , particularly the advent of carbon, exacerbates the problem of foot dysfunction. Whilst frames, wheels, cranks, pedals and shoes and so on, have all advanced and become significantly stiffer, the human foot remains unchanged. Consequently, in a system that has very little flex for energy to dissipate, pressure on the foot increases considerably. While these rapid technological advancements, compounded by ever-improving rider fitness/strength provide for more efficient power transfer, they come at the expense of increased forefoot pressures causing the foot to collapse inwardly, which in turn, can be responsible for forefoot problems and increased pronation.

    Finally, we recommend cyclists use appropriate orthoses for gait activities when excessive pronation is present. We believe that failure to control pronation during gait can result in postural asymmetry being taken onto the bike. Furthermore, failing to control pronatory forces during gait may lead to further increases in Forefoot Varus (forefoot supinatus).

    Nick
    Based in the UK

    • Steve Hogg says:

      G’day Nick,
      Thank you for taking the time. I’m in complete agreement with
      you with a couple of minor exceptions. I used to use the red Formthotics
      but moved away from them because I could not get enough arch support out of
      them for those with really high arches. There is a way to measure the
      clarity of the CNS response to the proprioceptive output of the foot under
      load, and I have refined a testing protocol to the point where it tells me
      how much correction is needed and the relative degree of where it is needed;
      forefoot, midfoot, rear foot. That is what led me away from Formthotics.
      They are still valid for many.I don’t know what feet are like in the U.K.,
      but I see a lot of very high arch feet and found that modified eSoles
      Supportive insoles were a better option in many cases.

      From the detail in your mail, I assume you are a physio, podiatrist or
      similar with an interest in cycling. I hope to have a better method than
      cleat wedges to address rearfoot varus available in the very near future. If
      you contact me privately with your postal address, I’ll make sure samples
      find their way to you for experimentation and comment.

      Yes, also not crazy about ITS wedges but use the occasional one (in
      conjunction with rear foot and arch correction) for those whom the test
      protocol tells me need a forefoot wedge rather than cleat wedge. This isn’t
      common, and hovers around 1 and bit per cent of riders in most years.

    • Ericj076 says:

      Hi Nick,

      Quick question about your comment about using corrective orthoses off the bike. How do you define excessive pronation and what kinds of postural asymmetries do you see as a result (both on and off the bike)?

      There is a fast growing movement in the field of running and injuries that discourages orthoses and corrective shoes…the school of thought argues that, for most people with overly flexible feet, orthoses weaken the foot and corrective shoes don’t really correct pronation. If I understand correctly, those with rigid flat feet are an exception and most(?) should wear orthoses.

      I know this might be veering off topic a bit but I manage a running store and work with injured runners daily so your comment piqued my interest. Many runners, with what some would define as excessive pronation, run extraordinarily well in neutral or minimalist shoes (which are generally defined as those having less elevated heels, wider toeboxs, and less cushioning). For example, Haile Gebrselassie: http://www.youtube.com/watch?v=EAW87NsiGuI

      I’ve met with several world experts in running biomechanics in the last year (not because I’m particularly important) and many are embracing this idea. Jay Dicharry at the University of Virginia and Irene Davis at the University of Delaware are two whom have both published recently on this topic are are fairly well known.

      May I ask your field of work and how this line of thinking agrees or disagrees with your training?

      Steve, I would be interested to hear your thoughts on how off-the-bike footwear affects on-the-bike posture/performance.

      I am not a medical provider and don’t pretend to be an expert. I am just hoping to continue learning.

      Thanks.
      Eric Johnson
      in the US