Seth Hosmer
shoes that fit + healthy foot/ankle + the right footbed = happy feet for most people
There are a few quick checks you can do on your own to start troubleshooting foot pain and numbness:
1. shoes wide enough? take your insole out of your bike shoes, lay it on the ground, and place your foot on top. If your foot is significantly wider than the insole, you should probably solve that problem first. If you need help making this evaluation, I can help.
2. make sure you are not over-tightening your shoes. Sometimes backing off on the velocro a bit and using thinner socks helps if the shoes are on the cusp of being too narrow
3. less common these days - now that most people have very stiff carbon shoes - but sometimes older shoes with a somewhat soft sole will cause pressure related pain (think older Sidis or Carnacs)
Next things to try:
1. some better than stock insoles (such as Specialized Body Geometry, Superfeet etc) and choose an arch height that seems to give some support when you stand on it. Anything that you can easily bend through the arch with your hands is not likely to help much.
2. professional help. Working with somebody that has experience helping people through problems like this will likely shorten the process significantly and improve the outcome.
When I work up a case like this in my clinic, I start with the shoe evaluation and make sure that the most likely cause (wrong shoes) is fixed first. We do an examination of the foot/ankle etc and see if there are any underlying problems that might be contributing to symptoms, and work to correct those if present. The next step is to look into some custom footbeds to distribute the pressure more evenly across the foot, and improve support and alignment of the pedal stroke.
Seth Hosmer, DC
HPChiro.com
503-227-2279