To met dome or not to met dome. That is the question....

Without doubt the most frequently requested footbed/orthotic option is the met dome (Metatarsal dome).  These have been included on cycling footbeds for years and are a commonly purchased add on item.  We even see many home made versions floating about.  Do we need a met dome on our cycling orthotics?  Lets look at what they can/can’t do then go from there.

Metatarsal domes are great tools for displacing load/force.  Their primary function is to at least ‘change’ the load through the forefoot.  Ideally, a met dome should be used to achieve a clinical outcome rather than as an arbitrary addition.  What met domes don’t do is provide arch support.  The job of a well fitted cycling insert is to provide the contour.  As I have made mention to many of our cycling clients, a met dome is no substitute for a badly made/low quality cycling footbed.  We find many riders think they need a met dome, only to find comfort from a properly fitted insert/shoe.  Once the shoe/footbed combination is dialled in, then the need for a met dome depends upon what type of symptoms you are dealing with.

One example where met domes may be required is where there is painful load through a specific metatarsal head.  This may be because it is inflamed, ‘dropped’ or overloaded.  In these instances, the met dome is normally shaped to elevate pressure from a specific region in the forefoot.  These met domes tend to be smaller and placed directly behind the problematic metatarsal head.

In other instances, the cyclist may suffer from discomfort in the whole forefoot due to a reduced fat pad or sensitive foot.  In this scenario, larger domes with differing levels of density may be used to provide the desired level of pressure relief.  Occasionally this may need to be combined with forefoot cushioning for targeted forefoot pressure relief.

The other frequent use of a met dome is to treat numbness/altered forefoot sensation.  This includes neuromas, intermetatarsal bursitis and other compression based ailments.  The specific action of a dome for these conditions relates to the ‘spreading’ effect of the met dome on the forefoot allowing a slight reduction in compression stress through the metatarsal heads.  Domes for these conditions need to be placed with accuracy and occasionally require the cyclist’s feedback to find the ‘sweet’ spot.  Once again the size, density and location of the domes for these conditions needs to be as accurate as possible to provide the desired effect.  As an important side note, sometimes the numbness is being caused largely by an ill fitting shoe.  If the shoe is too tight, adding a met dome will provide no solution and may even make the problem worse, especially if it occupies too much space.

There are a few more slightly technical reasons for met domes that I won’t go into as they exist rarely and are fairly complicated to discuss.  There are also a few cyclists who insist on met domes purely for comfort.  

As you can see, metatarsal domes are not as straightforward as you would think.  It is the job of your fitter/technician to decide what is the best cause of action and to choose the dome best suited to you. We use domes on probably around 15% of our devices based on clinical history and foot assessment in the clinic with our custom Pro devices.  If you think you need some domes to survive the rigours of cycling, see our instructions on affixing the supplied metatarsal domes that come with our SemiPro devices.

Happy riding.  Cobra9