You are on the right track right there ... only other is a possible forefoot wedge (i.e. LeMond Lewedge, etc.) under the cleat if you have a forefoot varus (very common) as this tends to focus a lot of pressure on the ball of the foot when locked in a shoe and onto a pedal.

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Fatigue is biochemical, not biomechanical.
- Andrew Coggan, PhD

I was hoping you would see this thread and reply. Have any idea what the pebble thing is under the big toe metatarsal? Thought it was a neuroma for a while, then realized it probably wasn't.

The condition first came about after I had been riding a large-geared fixie for a year, then rode it on the Texas MS150. The toes started burning on the very last miles of the last day. Ever since then, it came about earlier and earlier in a ride. I was also very much into barefoot running at the time. Gave that up to eliminate any variables. Could that have been causing the pebble?

Like I said, I pushed the cleats back and that worked well enough to train for and race an IM, but that's more low intensity and long rides - not shorter, harder efforts. I now notice that I do pedal quite a bit with my toes pointed down.

Thanks again.

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Zen and the Art of Triathlon. Strava Workout Log
Interviews with Chris McCormack, Helle Frederikson, Angela Naeth, and many more.
http://www.zentriathlon.com

You mention metatarsal buttons but no overall footbed. If you are toe down a lot you tend to push forward in the shoe and a footbed (I like the Sole brand) can help support the foot better, and also take up some volume so that the top of the shoe is restraining your foot across a greater area, and your toes are not getting jammed. Cranking the straps a little tighter might also be an experiment worth trying. Saves my toes on MTB descents when the feet are jamming forward in the shoes.

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Cyclist turned multisport enthusiast. Human performance technologist and digital health expert in my day job.
https://www.linkedin.com/in/karletzel/
https://www.strava.com/athletes/karletzel

Well, again - lower the seat a little

The "pebble" feeling under the big toe is likely a bit of sesamoiditis (google that). Quite common in barefoot types ;) Offloading the sesamoid usually remedies that - although it can progress to a sesamoid stress fx or complete fracture. Also very common.

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____________________________________
Fatigue is biochemical, not biomechanical.
- Andrew Coggan, PhD

I have had simliar problems. Think I have found some solutions: shoes were too narrow and cleats were too far forward. A year and a half ago i started moving cleats forward thinking i had more power climbing but believe now i moved them too far. Have now gone to the sidi mega one size bigger and moved cleats almost all the way back and feel ok now that i am used to it. I have also been through many insoles and have finally found some that work, out of a pair of my old asics running shoes. I have been taking ibuprofin and stretching and massaging and it is getting better. I thought it was from running at first but then I realized it didn't bother me when I just ran, but always hurt on the bike. PS i have been to a pediatrist and I do have a neuroma between 2nd and 3rd toe but lately have been running up tp 15 miles and riding 150 a week, only bothers me on long hard rides on hills or into the wind where i am really hammering.

thanks so much for the responses! I got plenty of cool things to try now. many thanks.

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Zen and the Art of Triathlon. Strava Workout Log
Interviews with Chris McCormack, Helle Frederikson, Angela Naeth, and many more.
http://www.zentriathlon.com

What shoes? What kind of top strap? I have problems with shoes with velcro top straps- If I overtighten at all my toes will go numb. Does not happen on shoes with a broad strap and buckle???

The stuff I've been reading says to tighten the strap closest to your ankle. That keeps your foot farther back against the heel cup to give your toes more room to wiggle and allows the metatarsals to spread out and not press on nerves. I had been doing the opposite for other reasons/injuries too long to go into here. I'm giving it a try.

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----------------------------------------------------------
Zen and the Art of Triathlon. Strava Workout Log
Interviews with Chris McCormack, Helle Frederikson, Angela Naeth, and many more.
http://www.zentriathlon.com

Yeah, but if that top strap is too tight it pinches the nerve and causes numb toes- at least for me.