Abstract
Individuals experiencing knee pain related to cycling often demonstrate excessive medial excursion (ME) at the knee. Generally, greater excursion leads to a higher risk of cycling related injury. A common cause of excessive ME is forefoot varus malalignment. A prototype shoe (SBG) was developed which incorporates a 1.5mm forefoot varus cant to correct forefoot varus malalignment. PURPOSE To identify the effect of forefoot varus shoe design on extent of ME in trained cyclists with known forefoot varus malalignment. METHODS Data were collected on 20 male cyclists training a minimum of 8hrs/wk and exhibiting a minimum of 5 degrees forefoot varus malalignment. Subjects rode their bikes instrumented with a hub based power measurement device on an ergometer at two common training workloads: 60% VO2max and lactate threshold. Subjects rode at each workload with both the prototype shoe and a traditionally designed cycling shoe (TRAD). A double-blind protocol was implemented with random assignment of shoe order. Medial excursion was calculated from three-dimensional computerized video analysis system using reflective markers placed at the tibial tuberosity and second toe. Paired t-test analysis was used to identify differences in ME of the knee between the two shoe conditions at each workload. RESULTS No difference in ME was noted between the SBG and TRAD shoes at the 60%max [11.3%, (p = .103)] and LT [8.2%, (p = .327)] workloads. When using an excursion criteria of > 2.5cm (n = 11 at 60%max, n = 12 at LT), a statistically significant difference (p = .04) of 16.8% less ME was found with the SBG vs. TRAD shoe at 60%max. No statistical difference in ME (13.5%) was found between the prototype and traditional shoe conditions at LT (p = .103) when using the > 2.5cm excursion criteria. CONCLUSION These results suggest that individuals with greater than 2.5cm of ME have good potential for decreased risk of cycling related injury when using a forefoot varus cycling shoe design versus a traditionally designed cycling shoe. Supported by Specialized Bicycle Components, Inc., Morgan Hill, CA
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