Tuesday May 5, 2009

I went shopping yesterday with my friend Lenita who is a non-practicing physician. I was telling her about my ankle and anterior tibial tendon issue. She sent me an email this AM with a possible cause of the problem, which sounds good to me. I'll mention it to Dr. Gray next week at my appointment. She quoted an article.

It seems possible that you are not using cycling shoes , the kind that has a rigid sole and prevents you from pedaling wrong and stressing the ankles and the Achilles tendon....also pay attention to the proper length between the seat and the pedals, Please read:The Achilles tendons are the tendons at the back of the ankle, connecting the calf muscle to the heel. If you have pain in these tendons, it usually indicates a problem in pedaling technique. Achilles tendon problems often result from "ankling" during the pedal stroke. This is occasionally related to having the saddle set too high, forcing the cyclist to point the toes excessively to reach the bottom of the pedal swing.It can also be caused by having your cleats set too far forward, or otherwise pedaling with the toes. The farther forward the contact between the foot and the pedal, the greater the stress on the Achilles tendons.There is a widespread belief that you should pedal with the ball of the foot centered over the pedal shaft. I believe this is not necessarily desirable, though it dates back to the high-wheeler era.Back in the high-wheeler era (1870s through early '90s) long legged riders had an advantage, because they could straddle a larger diameter wheel, effectively giving them a higher "gear." By pedaling on the balls of their feet, they could get a bit more leg extension, permitting a given rider to straddle a larger, faster machine. The development of the safety bicycle rendered this concern obsolete, but the habit (and advice) persisted.The other reason for pedaling on the ball of the feet is if you are riding in soft-soled shoes, the ball of the foot is better able to bear weight than the arch is. However, with rigid-soled shoes this is a non-issue. For short distance, low intensity riding even with soft-soled shoes this is not generally a problem in practice.AnklesAnkle pain while cycling is often the result of "ankling" while pedaling. It may also result from being flat-footed, in which case orthotic shoe inserts are a likely remedy.Another possible cause of ankle pain is a bent pedal or crank, causing the foot to wobble back and forth as the pedals turn.

That might explain it since the problem only developed after the surgery. In any event, I'll mention it next week.