TRIA Orthopaedic Center Your Cycling Blog

Cycling is a relatively low-impact sport. When joints ache, identifying the cause is crucial to staying on the bike and out on the road or trail. Ankles can be an issue, especially if there are underlying issues leading to ankle pain.

For the answer, we asked asked Dr. Fernando Pena, M.D., an orthopaedic surgeon with the TRIA Orthopaedic Center, whose specialties include foot and ankle issues, reconstruction, and sports medicine.

The ankle is a very forgiving joint. Ankles are most sensitive to weight bearing activities, and mainly to impact or pounding activities.

Even though some cycling activity may take place standing on the pedals and getting up from the saddle, the forces that cross the ankle joint are not comparable to the forces we put on our ankles when we run across the street (nine times body weight in the case of running).

Ankle pain while riding is likely related to the shoe-toe clip relationship. The two most likely scenarios are from having some intraarticular (inside the joint) pathology (cartilage damage, internal scar tissue and so forth), or from having some sort of malalignment (bowed knees or “X” knees) within the kinetic chain of the lower extremities, and this can include the way your feet are clipped into the pedals, the height of the seat, the tendency to turn in your knees while pedaling in an effort to improve aerodynamics, and so forth.

The only “simple” ankle pain that can be improved is the inside (or medial) ankle pain that is more pronounced when riding hard. That pain likely will come from a tendon struggling to maintain the inside arch of the foot in a proper alignment (the posterior tibial tendon).  Therefore an arch support, either custom made or off the shelf, will have a beneficial impact on inside ankle pain. It is unlikely that pain like this would turn into a catastrophic outcome.  But if left untreated the tendon may become more and more inflamed to the point where riding and even walking are severely painful.

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