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There is no barefoot running debate

Discussion in 'Biomechanics, Sports and Foot orthoses' started by Craig Payne, May 10, 2011.

  1. Craig:

    Thanks for that analysis. You and I are on exactly the same page regarding our thought processes in regards to these matters. Will be looking forward to reading your essay since it sounds like a good one.:drinks
     
  2. Craig Payne

    Craig Payne Moderator

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    As an aside, if the anterior tibial muscle is not working as hard when forefoot striking compared to rearfoot striking, then that muscle would be stronger in the rearfoot strikers ... so it makes a mockery of the myth about barefoot running strengthening muscles :deadhorse:
     
  3. Craig, why do you barefoot running skeptics respond to alerts without actually reading the original blog post and linked posts? If you had, you'd see I was critical of the current research as a means of justifying barefoot running. Your anti-barefoot zealotry is blinding you to the handful of barefoot runners that apply any degree of skepticism to the practice.

    Dogmatic podiatrists... :bang:
     
  4. Jason:

    Welcome to Podiatry Arena.:welcome:

    I have read your postings before on your Barefoot Running University website and do appreciate many of the points you make. I have also read a few of your thoughts about what I have written regarding barefoot running so I can see you are trying to be fair and reasonable at times. http://barefootrunninguniversity.com/2012/02/01/whats-the-deal-with-raised-heels-in-running-shoes/

    And then on other blogs, you and your barefoot running buddies don't seem to think I know anything about running or running shoes or, as you call them, "foot coffins". Very scientific and undogmatic, Jason. http://www.wpcreations.net/barefoot/build2/forum-topic/latest-interview-angry-podiatrist-kevin-kirby

    My one question to you, in the blog that Craig posted up here where you have a list of many articles that discuss shoes and running, how can you come up with a statement like:

    Certainly having a list of 43 articles, most of which show no research evidence that "supports barefoot and minimalist shoe running", and then making the rather unusual statement that "The sheer volume of this list would seem to suggest that science definitely supports barefoot and minimalist shoe running" does not seem at all scientific to me.

    Tell me, Jason, how does listing 43 articles, with none of them having any scientific research evidence that shows that barefoot running produces fewer injuries than running in shoes "support barefoot running"?
     
  5. Kevin- I am impressed you have read as much of my drivel as you have. My penchant for hyperbole and conjecture usually drives the skeptics off. :)

    The "...sheer volume..." quote has to be taken in the context of the rest of the post. I'm not suggesting this research lends conclusive support to barefoot or minimalist shoe running. I'm suggesting the current "research" (quotes intended to note most is not experimental in nature) should not be used as a rationale to recommend barefoot or minimalist shoes.

    This entire topic is fascinating. Contrary to the title of this thread, there IS a debate. There are far too many people that have made a successful transition to barefoot or minimalist shoe running to ignore. Likewise, the dangers of transitioning are real. The points you've made in the media are spot-on. I am annoyed by the extremists on both sides. It should be abundantly clear that the modern running shoe is flawed in both design and the method of fitting/prescribing (think teens conducting gait analysis at Dick's Sporting Goods). It should also be abundantly clear that barefoot running isn't a cure-all solution and shouldn't be recommended to everyone.

    There's a middle ground somewhere, and we'll eventually find it through debate and further research. That requires some degree of open-mindedness.

    By the way, I was the only person that supported you in that Barefoot Runners Society post... until I read your response to Campitelli's article. On that note- you never really did give your opinion on why shoes need heels... ;-)
     
  6. BEN-HUR

    BEN-HUR Well-Known Member

    In short - they don't... & they shouldn't (anyway, that's my opinion).
     
  7. Jason:

    You are not alone in making statements about this subject that may be emotionally-based. I sometimes also go a little overboard in my discussions on barefoot/minimalist running and make statements just for fun that aren't very scientific. I believe that this type of discussion is naturally inherent within these types of blog discussions....these discussions are often more like banter among friends rather than a scientific debate.

    I agree that there is a middle ground that both the barefoot advocates and barefoot skeptics should be able to stand together on. Like most of the more vocal podiatrists here on Podiatry Arena, I really don't have a problem with a runner choosing to run either barefoot or in "minimalist shoes", which we previously called back in the 1970s, 1980s and 1990s, "racing flats". If barefoot or minimalist shoes make you run faster, farther, with less injuries, and run happier, then I am certainly all for it.

    I do, however, find it rather amusing that many of the bloggers on your Barefoot Running University website speculate that I, or other sports podiatrists, are just out to make a buck by making custom foot orthoses for every runner we see. In fact, I am just as likely to have a runner get rid of a bad orthosis and change shoes as I am to suggest new orthoses. It is all about making the runner healthier and happier in my, and most other sports podiatrist's practices, not about making more money. Of course, podiatric treatment is not a guarantee of success of healing the runner's injuries. However, I do believe that sports podiatrists have a very good record over the past four decades of allowing thousands upon thousands of runners to continue running pain-free and without injury by suggesting appropriately designed running shoes and foot orthoses for our runner-patients.

    I do have a problem with the extremists telling runners that all running shoes with a certain minimulm heel height differential (i.e. heel drop) or shoe sole thickness are "harmful" or are "shoe coffins" or will "cause injury". Since I was racing and training in "minimalist shoes" back in the early 1970s and throughout my long distance running-racing career for the UC Davis Aggies and Aggie Running Club (I ran in the first two Aggie Running Club centipedes at the Bay to Breakers), I know from my own personal 40+ years of running experience that there is a time and place for thinner soled running shoes with less heel height differential. However, I don't believe that all runners will benefit from such a transition, but some may do quite well with the move to either barefoot or "minimalist shoes". Most of the times, it requires a trial and error process to determine what shoe/treatment plan is best for each runner, but most times, we are able to suggest shoes/treatment plans that have high probabilities of success based on previous research and clinical experience of others who also treat injured runners on a daily basis.

    All in all, I enjoy the discussions and ideas that the barefoot/minimalist running debate has brought to us both with more variety of running shoes and different ideas for possible treatment methods for our runner-patients. Even though I'm not as fast or in shape as I previously was back in the 1970s and 1980s, I still run regularly and see lots of runners, ranging from sprinters to ultramarathoners, locally and from other states in my practice on a daily basis.

    Thanks again, Jason, for coming here to Podiatry Arena to contribute your thoughts. Hopefully your visit here wil be enjoyable and productive for all of us.:drinks
     
  8. Jason,

    I have a couple of specific questions for you since you are obviously well read in this field:

    1) What influences do shoe heels have on gait kinematics and kinetics?
    2) How might shoe heel height and/or design be manipulated to alter gait kinematics and kinetics in order to alter the stresses within specific tissues in a positive manner?


    For example, we have some data which suggests that as heel height of shoes increases, knee abduction moment increases. While this may not be too good for someone with medial compartment osteoarthritis of the knee, it might be helpful for someone with lateral compartment osteoarthritis of the knee.

    What sort of shoe heel and/ or strike pattern might you recommend for someone with Achilles tendonosis and why?
     
  9. All, I'm interested in why barefoot running and running in "minimalist" shoes does not result in the same gait:

    "Although the thin condition provided almost no cushioning, differences were still shown between barefoot and this condition. Barefoot running may require a unique solution even compared to running in extremely minimal footwear." http://scholarworks.umass.edu/cgi/viewcontent.cgi?article=1416&context=open_access_dissertations


    This PhD thesis also notes: "Cushioning magnitude is important to changes in running pattern, but other factors are involved. In some instances the most cushioned condition, which was a footwear conditions, resulted in similar behavior to the least cushioned barefoot condition. Footwear also limited tibial internal rotation more than not wearing footwear and altered sagittal thigh kinematics at TD. These results implied wearing footwear affect running patterns regardless of the cushioning shoes provide. More investigation is necessary to fully understand all the factors involved, but our research showed that cushioning magnitude is not the only factor affecting running patterns when footwear or running surface is altered."

    Given that TenBroek investigated true barefoot, "minimalist" and heavily "cushioned" running shoes, I find it interesting that the heavily cushioned footwear "resulted in similar behavior to the least cushioned barefoot condition", whereas (by its omission), the minimalist footwear presumably did not. This is clearly not explained by mass effect nor cushioning. Might it be explained by heel height differential?

    They also note that any form of footwear limits internal tibial rotation, regardless of sole thickness and cushioning (influence of the upper seems to be ignored in many of these discussions, BTW). This might or might not be a good thing.

    I'd venture that the shoes sole can only alter three factors- load/ deformation, topography, and friction- this study seems to suggest that load/ deformation in isolation does not hold all the solutions. Given that the heel height differential was increased as cushioning was added to the shoes and that cushioned shoes showed "similar behavior to the least cushioned barefoot condition", then where does that leave us....?
     
  10. Craig Payne

    Craig Payne Moderator

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    Please show me where I am anti-barefoot. (you also might want to take note of what shoes that I use when I run)

    Perhaps you should read what I write.
    So why did you say in your blog post that:
    Perhaps you could respond to my challenge above:
     
  11. Craig Payne

    Craig Payne Moderator

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    My inbox had some emails this AM ... a couple of them were quite toxic; one accused me of working for Nike (they must be posting the cheques to the wrong place!) ... what does that say?

    One pointed me to Lieberman's paper in Nature as being proof that barefoot is better!! Apart from the fact that Lieberman published a statement on his website to distance himself from that sort of conclusion, all the study did was show that forefoot striking and rearfoot striking are different! The mean age between the two groups was massively different (this is more than enough to dismiss the study!); the African runners were eliminated from the analysis; they only looked at ground reaction force and did not look at or report what forces are higher in forefoot striking. (discussed here)

    Another email pointed to Kerrigan's study that running shoes cause knee osteoarthritis, therefore barefoot is better. Duh? It was not even a study on osteoarthritis! And if running shoes causes knee OA, then there would be more knee OA in runners compared to non-runners .... every single study that has compared the rate of Knee OA in older runners and the general population have found no differences! (discussed here) ie running shoes do not cause osteoarthritis.

    And then there was the one that recently looked at injury rates between forefoot and rearfoot strikers (discussed here). All the participants were wearing shoes (they were not even barefoot!) and there were 56 participants and they were almost elite level runners (hardly comparable to the typical runner). Compare that to Kleindienst (2003) - 471 runners; no difference between rearfoot and forefoot strikers concerning the frequency of injury. Walther (2005) - 1203 runners; no difference in incidence of injury between rearfoot and forefoot strikers; - who are you going to believe? How does that study prove barefoot is better?

    The final amazing email (that just arrived as I typing this reply) asked me about the research that proves running shoes weaken muscles!!! THERE IS NO RESEARCH THAT SHOWS THAT!!! (discussed here)

    Any wonder that:
     
  12. DaVinci

    DaVinci Well-Known Member

    I thought NIke had a minimalist running shoe?
     
  13. Craig Payne

    Craig Payne Moderator

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    They do! But I do see the irony! Its always Nike that I get accused of working for. Never ASICS (hey Simon, any secret jobs going?) or Adidas. If anyone from Nike reads this, can you please check your records as you must be sending the payments to the wrong place!

    I wear these shill accusations and ad hominem arguments like a badge of honor! If that is all they can do, what does it say about the position they are trying to defend?


    (BTW, if anyone is interested, I just got back from an hour run in my NB minimus follwed by the 100 up drill barefoot!!!)
     
  14. Craig Payne

    Craig Payne Moderator

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    Just back from a school excursion trip with the Arena'ette's to the Botanical Gardens ... beats working.

    My inbox only had one email challenging me and it was a classic and great fodder and goes even further to proving my claim! (not sure why I getting emails and they not posting in this thread?)

    They were under the impression that this study from the list linked above was all the proof I needed:
    1. It was nothing to do with barefoot! (except the lead author is a barefoot runner and wrote the only book on barefoot running I would actually recommend to read)
    2. It was a systematic review that found the prescription of running shoes was not based on any evidence (what does that have to do with barefoot running?)
    3. It did not report ANYTHING that was actually wrong with running shoes (just that there was no evidence!) ... and even if it did find something wrong with running shoes, what has that got to do with barefoot running?

    Could someone please explain to me why people delude themselves into believing this study proves anything about barefoot running? I am sure the lead author, Craig Richards would not come close to making that claim based on this systematic review.

    ...so that challenge has also failed miserably!
     
  15. BEN-HUR

    BEN-HUR Well-Known Member

    Due to time constraints, I'm not going to delve into the topic of possible injuries associated with heel to forefoot pitch... & the chicken vs. egg scenario in association with Achilles Tendinosis. Only to say that runners need to naturally condition themselves to a lower heel profile based on the now long history of the higher heel (to forefoot) profile running shoe... & if there is Achilles Tendinosis present, adding a temporary heel lift to help offload the tensile/eccentric forces would be a wise inclusion as part of the treatment regime.

    I'm interested - I think it's great! Keep it up.

    With that sort of training, it would be ironic if you (Craig) were to rock up to a Fun Run a year from now (by this time you could be wearing a Vibram FF shoe) & win the event - you would then be the 'barefooters' next pin-up boy (caption: "Vibram Fivefingerer wins race")... than later they would find out it was Craig Payne - that dude who runs that Podiatry Arena site :eek:. Possibly invoking an experience/emotions similar to the following...


    [Anyway, it bit of inspiration goes a long way]

    There have been questions in the past asking if this barefoot topic has adversely affected Podiatry/Biomechanics - or something to that effect. I think on the whole it has been very beneficial. It has helped us look at issues from a different perspective as well as give us reassurance in what we do via looking deeper into the associated topics... & maybe even tweak our views somewhat to help gain greater insight into the bigger picture of biomechanics, running & Podiatry. It may even have been a sparking source to get us fitter & stronger during the process. On the other hand, it has certainly been bit of a time zapper - particularly when some people just refuse to follow the evidence & logic because the answers fall outside their world view paradigm.
     
    Last edited by a moderator: Sep 22, 2016
  16. Craig Payne

    Craig Payne Moderator

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    Probably not going to happen ... :pigs: tomorrows run (the 1000 Steps in Fern tree gully - those in Melbourne know this run) will be in my supermaximalist Hoka One One's.
     
  17. markleigh

    markleigh Active Member

    What do you think of the Hokas Craig?
     
  18. I love my Hokas. They are now my preferred running shoe for running on harder surfaces.
     
  19. markleigh

    markleigh Active Member

    Which model do you use Kevin?
     
  20. I'm currently in a location with limited access, which is one of the caveats of being a nomadic hobo. As such, I don't have the opportunity to respond to all the messages. I think this one is important, though.

    The debate about barefoot running is important, but I think it should be reframed Change the word 'debate' to 'learning' and this takes on an entirely new life. Over the last few years, I've purposely sought out people that have opposing viewpoints. My opinions on a myriad of topics have dramatically changed... there are too many to list. One of my goals is to open honest dialogue between people and groups that have similar goals. There are a lot of divergent groups with seemingly different opinions that could benefit from collaboration.

    One such goal is to bridge the gap between barefoot runners and podiatrists. The biggest current obstacle is our tendency to make outlandish statements about the other group, which places people in a defensive mindset. Kevin had it right- when we're in the friendly confines of our respective forums, we tend to use language that's inflammatory. In most cases it's just a bunch of people being antagonizing for fun. Unfortunately those comments are posted on a public forum, so it's easy for an opposing group to cherry-pick the comments as evidence of the other side's fanaticism. Sometimes the comments are made in a more neutral media, which adds to the perception of zealotry.

    In essence, it comes down to a classic in-group-out-group and confirmation bias. If we can get past that problem, we can learn a great deal from the other group. It can be frustrating trying to bridge that gap because it requires a great deal of empathy, but a quest for the greater good (and a healthy dose of curiosity) is a great motivator.
     
  21. Good posting, Jason!:good:
     
  22. Is it really though, Kevin? Over on his own channel Jason wrote:

    Craig said here:
    I haven't seen Jason refute Craig's contention (I have seen him attempt an ad hominem against Craig), and if Jason is being honest in his post above, and truly wants to "bridge gaps" and encourage "learning" it might be helpful if he went back to his site and stated for the record that he was wrong in making that statement because the research he listed does not support that, or state here why it does.

    Somehow I doubt very much that this will happen though.
     
  23. Simon- congrats. You just responded to my call to stop cherry-picking statements by reiterating Craig's points made when cherry-picking my statement.

    Here's the entire paragraph:

    The sheer volume of this list would seem to suggest that science definitely supports barefoot and minimalist shoe running. It is important to note that most of these studies have limited sample sizes or other methodological flaws that limit their generalizability. Some are literature reviews. Some are published in questionable journals or websites. At the very least, it highlights the need for further research.

    I didn't respond to Craig's challenge because I agree with him. My entire post was a call for skepticism when consuming research and a call for more research, which is a drum I beat frequently. Just because I posted the studies doesn't mean I was using them to justify barefoot running.

    I suspect Craig was lumping me with the barefoot runners that emailed him with citations that "proved" barefoot running was better when he took that sentence from my post. Read through the three links I posted in the "research" post (Myths surrounding barefoot running, Misconceptions of barefoot running, shoes, and the industry, and Things to avoid when you start barefoot or minimalist shoe running).

    I think you'll find I'm not quite the stereotypical barefoot zealot. And before you read through those three posts and cherry-pick one or two statements to discredit me, I'm not pretending to have all the answers. The ideas presented in those three posts are evolving ideas recorded at a specific point in time. My exact opinions may have already changed or may change down the road. After all, that's why I'm posting here. ;-)
     
  24. Jason, you made the statement, not I. Sample size and methodological weakness aside, how many of those studies "suggest that science definitely supports barefoot and minimalist shoe running"? Indeed, how many of them had anything at all to do with barefoot running? Please answer the questions, rather than attempt further distraction. You have still not responded to Craig's challenge, nor responded to my questions regarding the kinematic and kinetics of shoe heels on gait.

    If you have indeed, "already changed your mind" are you willing to go back to your blog site and and state something like: "despite the list of research articles I posted above, absolutely none of them scientifically support barefoot running as being superior to shod running, indeed many of them have absolutely nothing to do with barefoot running so I had no reason to post them in the list. I am sorry if I have mislead anyone with my sentence structure and use of language here" which would provide a more accurate appraisal of the literature, would it not? Or can you actually rise to Craig's challenge?

    The trouble with t'internet is anyone can write anything. Jason, could you give me a run down of your C.V. please so that I and others might better understand where you gained your expertise in lower limb running biomechanics such that might qualify you to run a "barefoot running university"?

    Yep, it comes across as agreement:

    Really?
    Not at all, Jason. Not at all.
     
  25. Simon:

    I have to give Jason credit from what I have read from him in the past. He seems fairly reasonable in many of his observations, even though I don't agree with all of what he says. He is to be congratulated for coming here onto Podiatry Arena to want to discuss things so he can learn more about how we feel on the subject of barefoot versus shod running. For these reasons, I am trying to find common ground here with Jason, since, as a published author on the subject of barefoot running, I think we can all learn from each other.:drinks
     
  26. Thanks Kevin. :)

    Simon- did you miss the seemingly obvious implication that I'm not a podiatrist, rather I'm hanging out here to learn?

    Out of curiosity, just how much padding would a person need on their CV to pass your "I can learn something from this person" filter? What's the threshold people have to meet to make useful contributions to a body of knowledge?

    The more diverse the ecosystem, the greater its ability to survive. Don't be so eager to judge others as unworthy. ;-)
     
  27. Kevin, with the greatest respect, I am yet to read anything that this man has written here to convince me of anything other than the fact that he cannot admit when he is wrong. The moot point being that he made a statement which he cannot substantiate.

    I'd give Jason credit and congratulate him if he went back to his own blog site and made it clear to the followers there that he could not substantiate that sentence and that the wording was poorly chosen. But each to their own, Kevin.
     
  28. Jason, there goes yet another ad hominem. I'll reply in kind. Did you miss the fact that this is "a forum for podiatrists and other foot health professionals"? When you deal with "experts" every day at work "who have read on the internet that...", it soon becomes tiresome when it's patently obvious that they don't know their arse from their elbow on a subject that you have dedicated your whole professional career of 20+ years on. How much padding have you got? I got plenty.

    Answer the questions posted previously please, since it's obvious you now have a good internet access, despite your "hobo caveat". I reiterate: discuss the kinematic and kinetic effects of heels on shoes; which of the studies you listed on your blog site support barefoot running over shod running? And I ask again, are you willing to go back to the blog site which you run and state for the record that you were wrong?- a simple yes or no will do here.

    As for judging people as unworthy, from your first post here a couple of days ago-
    Nice carte blanche of an entire profession.

    BTW, within eco-systems the fittest survive and the weakest get eaten. This maintains the health of the eco-system.
     
  29. Since no-one has picked this one up, I'll tell you where I think this leaves us: for some people who want to run with a gait pattern that closely emulates their barefoot running gait, but want some environmental protection for their feet, they should be better off running in heavily cushioned shoes rather than running in "minimalist footwear". Lets see how long it takes the "barefoot" running shoe manufacturers to pick up on that one... I won't hold my breath.
     
  30. Simon- I get the feeling there's a little bit of transference going on with your reaction to my presence.

    If it helps, what if I said I am your intellectual inferior and my writing skills are sub-par at best. You clearly know significantly more than me and I am humbled to grace the same little corner of the Internet as someone with your expertise. I'm sure you could kick my ass in a street fight and your sexual performances put me to shame. I bow to you, sir.

    Now will you accept the idea that I'm here to try to learn so I can work to bridge the gap between our own little worlds?

    Oh, and it appears as though we agree on the cushioning issue: http://barefootrunninguniversity.com/2012/01/03/merrell-bare-access-review/ ;-)
     
  31. Craig Payne

    Craig Payne Moderator

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    Sorry Jason, I probably over reacted and take your point about the other comments you made in your blog post (..perhaps its a shame that so many of those who commented on your blog did not get that either!)

    Its just that my bull**** detector goes off at least weekly with claims such as things like "the overwhelming evidence support barefoot/minimalist running over shoe running" when in reality there is NO evidence that this is the case at all!

    Perhaps you could explain why so many in the barefoot community make that claim up for? What motivates them to do so?


    I also can't speak for Simon, but assume his comments are motivated by all the nonsensical one liner posts we have had here from barefoot runners over the years who never come back to engage or never answer the questions they get asked or straight out lie about the research or ...
     
  32. I get the feeling you are avoiding answering the questions put to you.... It might help your learning if you did. It would be helpful to your teachers if they had a better understanding of your learning needs. So rather than trying to be a smart arse with your replies, when someone asks you about your C.V. or where you gained your expertise in lower limb biomechanics, think on the fact that they might be trying to get a better feeling for you as a "learner" rather than trying to win a cock fight. It's of little use trying to discuss the kinetics of heeled gait with you, if you don't know what kinetics are; it's of little use trying to discuss the flaws in a statement regarding inferences from scientific literature with you, if you don't hold the knowledge or skills to critically evaluate the literature.

    Yep, that'll be it. And I have an aversion to duplicity too. Speaking of which...

    Here we get:
    While over on his own site we get:
    http://www.youtube.com/watch?v=lnu3TqDKXZY

    Jason, the first stone in the bridge you claim you wish to build might be to admit that your statement is at best highly misleading.
     
  33. Jason:

    Since you say you want to come here to Podiatry Arena to learn, let me try to first explain why myself, and many other podiatrists, are, in general, not in favor of moving away from shoes to the barefoot condition for running.

    First of all, as health care providers to our patients, the barefoot condition, even though it may be beneficial to a minority of patients, is something that most podiatrists just don't want to recommend due to medical liability associated with it.

    Let me give you an example. If you, as a blogger for Barefoot Running University, recommended that a runner try abandoning their running shoes and ran barefoot on your Barefoot Running University website, and that person stepped on a sharp object that cut into their foot, cut one of their plantar nerves and caused them permanent foot pain and disability, this poor person would have no legal recourse against you since you are just a lay person, who has no medical training and there is obviously no expectation that you are any sort of medical expert that knows anything about all the potentially harmful things that can occur with barefoot running.

    However, since I am a podiaitric physician, I must carry malpractice insurance for what I recommend to my runner-patients since I do have medical training in foot pathology, I do have extensive medical training and lecturing experience on shoe biomechanics, and do have training on surgery, I have treated thousands of injured runners over 27+ years, and I have been lecturing on running biomechanics for the past quarter century. Now, if I tell a patient that they should run barefoot as part of a treatment plan for their injury, and they stepped on a sharp object while running barefoot that cut into their foot, cut one of their plantar nerves and caused them permanent foot pain and disability, I would likely be successfully sued for medical malpractice by this patient since I would have been considered to have breached the standard of care for the medical community by recommending barefoot running. Why would I then want to potentially risk my patient's health and my medical career by recommending barefoot running?

    Secondly, as Craig Payne has said, there is not a single scientific study that shows that barefoot running produces fewer injuries than running in shoes. My experience as both a competetive distance runner and sports podiatrist for four decades has not given me any evidence that barefoot running is the preferred method to run for all types of running and running surfaces.

    Having been a long distance runner for 40 years, running my first marathon at the age of 17, a 2:39 marathon during my senior year of high school at age 18, and having run barefoot workouts in college back in the late 1970s, I certainly have experience both at barefoot and shod running for many years. I know for certain that barefoot running has its benefits since I enjoyed an barefoot workouts on a grassy field as a member the UC Davis Aggies Cross Country team. However, I also knew that my tender feet couldn't have withstood the 70-90 miles of running per week that I did during that time on asphalt, concrete, rocks, fields, grass and the track at temperatures often over 100 degrees F if I ran barefoot. In addition, none of the distance running athletes I competed and trained with at UC Davis, including the first members of the Aggie Running Club and some of the best runners in the United States at that time (one of them was a 2:16 marathoner, one was a 2:17 marathoner, and one won the Western States 100 Mile Endurance Runn two years in a row) ran a significant amount of miles while barefoot. All of us did, however, run in training flats, racing flats (which are now called "minimalist shoes") and in racing spikes for track. In all the hundreds of races I competed in during junior high school, high school, four years at UC Davis and during podiatry school and my early practice years, I never saw a barefoot runner in any of the races I competed in and certainly never saw a barefoot runner win any races, or even place in any races. And many of these races occurred before Nike was even a shoe company!

    Now, over three decades after I ran my first marathon, Chris McDougall comes along, who is an overweight non-runner who gets injured while running (no surprise there), and decides to write a piece of semi-fiction he calls "Born to Run" where he cherry-picks all the things that "prove" that barefoot running and running in minimalist shoes (i.e. racing flats) is much better than running in thick-soled shoes. To the uneducated neophyte runner who is plagued with running injuries and likes conspiracy theories, Chris McDougall seems like a messiah since he is a very good writer and can obviously weave a compelling story based on half-truths. Unfortunately, McDougall has little to no long distance running experience, has even less knowledge of running biomechanics and the effective treatment of running injuries, and thinks he now is an expert in running shoes and running biomechanics since he wrote a semi-fiction book on the Tarahumara Indians and barefoot running. Tell me, Jason, do you honestly expect me to believe what Chris McDougall says in regards to running biomechanics, running shoes and running efficiency when he has absolutely no academic credentials or long distance running credentials that should allow him to be considered an expert from someone like me?

    From the time that Amby Burfoot first asked me to be involved in the Barefoot vs Shod Debate for Runner's World in February 2010, I have tried to be very open minded to barefoot runners and their anecdotal observations since I know that there are many ways to run both comfortably and without injury. However, I also know from my long distance running career, medical training, extensive research on running injuries, running shoes and running biomechanics and clinical experience of being a sports podiatrist for over a quarter century that there is insufficient scientific and/or clinical evidence that running barefoot produces fewer injuries for all runners or should even be considered as the best way to run for the habitually shod population that I advise and treat here in Northern California.

    If you do have any scientific evidence that barefoot running is better or produces fewer injuries than running shod, than I am certainly willing to consider that my current opinions regarding this subject may be flawed. Until then, I will continue to make recommendations to other medical professionals, runners and my own patients which are guided by my clinical experience and the scientific research on this fascinating subject.
     
  34. Kevin, I think we're on almost the exact same page regarding your points. I understand the reluctance of podiatrists (or other medical professionals) to recommend barefoot running. In fact, I've written about that very point repeatedly. We definitely do not want our medical professionals recommending medical advice based on the anecdotal experiences of a few. There's no methodology to control variables, no way to limit bias, or even a systematic way to measure "success." For example, I recently wrote a post about the concept of earthing. If a medical doctor supported the idea based on the "research" done, they probably should not be practicing medicine.

    Regarding the available research: I believe this is a major reason barefoot runners and podiatrists seem to disagree. A typical exchange goes something like this:

    Barefoot runner: "Hey look, this new study proves barefoot running is better!"
    Podiatrist: "No it doesn't. That study has nothing to do with barefoot running. There is no research that shows barefoot running is better than shod running."
    Barefoot runner: "Okay, but there's also no research that shows shod running is better than barefoot running."
    At this point the conversation usually devolves into name-calling.

    The point- I think there's a fundamental lack of understanding on both the limitations of any research and the practical implications of said research. One of my personal goals is to help people understand that all research is limited to lending support to or refuting a hypothesis. That's it. Science doesn't "prove" anything. It doesn't provide definitive answers. I like to think of any given question as a puzzle. Science helps us complete the puzzle, but it will never allow us to complete the entire puzzle. Furthermore, the size of the pieces (thus the relevance to answering the question) is dependent on the quality of the research. Specifically, the relevance is determined by the study's reliability, validity, generalizability, ability to be replicated, degree of bias, and a host of other factors. Popular media (and crappy science teachers) propagate the idea that science is a collection of facts, which simply isn't true. THAT is a source of endless frustration for me and I suspect for you guys, too.

    Regarding McDougall, I agree. Great story, great conversation starter. Unfortunately, McDougall vilified the shoe and medical industry by hinting that the modern shoe is a grand conspiracy. That idea has fueled a lot of the dumb-ass comments about the motives of both shoe manufacturers and medical professionals. Unfortunately there was a time where I was guilty of this, too. Dig back a few years in my blog and you'll find them. Since that time, I've spent considerable time trying to get an accurate picture of the running industry and medical community's changing landscape over the last 30-40 years. What I've found thus far is a stark contrast to McDougall's claims. This is one of the reasons I wrote this post:

    http://barefootrunninguniversity.com/2012/05/11/shades-of-gray-starfish-how-barefoot-runners-need-to-change/

    The more connections I make with those barefoot runners supposedly oppose (shoe companies, running stores, podiatrists), the better understanding I have of the current landscape. I then talk about my findings, which helps educate other barefoot runners so we can start to figure out where barefoot running fits in the giant puzzle that is running gait.

    If you begin to dig through my writings, I think you'll find we agree far more often than disagree. Furthermore, there's a pretty decent chance our areas of disagreement are the very things I want to discuss. Conversations with the medical community have been invaluable, but they've mostly involved discussions with PTs, Chiropractors, and family doctors. Podiatrists have a degree of expertise that touches on some fundamental issues related to running gait and the accompanying biomechanics.

    After that long-winded response, I'd like to get your opinions on this particular issue:

    Would the entire issue of barefoot running be better discussed as a question of running form? Specifically, is there a better way to run? A great deal of anecdotal evidence (and some empirical evidence) suggests a shorter, faster stride is advantageous. Issues like shoe design (or lack of shoes), degree of cushioning, foot strike pattern, etc. doesn't seem to play a significant role. Even more specifically, would a runner that severely overstrides become more efficient and reduce injury by shortening the stride length and increasing cadence?
     
  35. Craig Payne

    Craig Payne Moderator

    Articles:
    8
    The difference here is who is making claims that running in traditional running shoes are better?

    As was discussed in the thread on the lawsuit against Vibrams, the traditional running shoe manufacturers are not making these claims. The only injury claims are being made by the minimalist running shoes makers. The burden of proof should be on those making the claims.
    No. You still get the same religious fanaticism among those promoting their particular 'form' (as an aside, anyone noticed how sensitive those who tout Pose running are to criticism?).

    For the sake of boring people, I repeat:
    Heel striking = greater impact load; greater forefoot plantarflexion moments --> greater risk of impact injury (ie tibial stress fracture) and anterior tibial muscle issues (eg anterior compartment syndrome)
    Forefoot striking = greater rearfoot eversio moments; greater foot dorsiflexion moments; greater forefoot dorsiflexion moments --> greater risk for injury of invertor muscles (eg posterior tibial tendonitis) and planatar flexor muscles (eg achilles tendonitis) and forefoot dorsiflexion problems (eg 'top of foot pain')

    The best running form is the one the reduces the load in the tissue that they have an injury history with ... ie there is no one best way.
     
  36. Craig- I agree with the fanaticism comment. I've been battling this same thing myself: http://barefootrunninguniversity.com/2012/05/07/which-method-should-i-use-to-learn-better-running-form/

    In regards to specific form causing specific injuries: I believe this idea is beginning to spread in the barefoot and minimalist community. More of us have backed off claims of reduced injuries and now discuss a shifting of probable injuries from one location to another. This has led to an "If it isn't broken, don't fix it" approach.

    Working off your comment that there is no one best way to run: What are your thoughts on prescribing shoes to healthy children? Is there a default design that's ideal? Do we put kids through a battery of tests like gait analysis? If so, do we do the tests barefoot?

    This is a particularly interesting question I get on a regular basis from parents.
     
  37. Jason:

    There is no one best way to run for every person. Some people do just fine being heel-strikers, some do best being midfoot strikers and some do best being forefoot strikers. We have known for decades that as running velocity increases, footstrike percentage increases or, in other words, as people run faster they strike more toward their midfoot and forefoot and less on their rearfoot. However, we really don't really know why people self-select certain running forms and footstrike patterns, but the research evidence tends to point to the fact that most experienced runners will self-select the most metabolically-efficient kinematic pattern for running for each given running velocity.

    I have been teaching runners to not overstride for over a quarter century. This is nothing new and I certainly wasn't the first to suggest that overstriding is a very common beginning runner's error. I agree that many runners would definitely benefit from decreasing their stride length and increasing their stride frequency. However, running with greater stride length will increase running velocity for a given a constant stride frequency. Therefore, there will be, for each individual, an optimum stride length and stride frequency for each given running velocity.

    I am not so certain that the current focus on "running form" is the end all and really deserves all the attention it seems to be currently getting. There are so many other factors that go into improving running performance and decreasing injury rate in runners that have nothing to do with running form, have nothing to do with what running shoe is being worn and whether running shoes are being worn at all. I am attaching a paper I wrote during my senior year of podiatry school, 30 years ago, that reviews the many other factors we should be considering when treating injured runners (Kirby KA, Valmassy RL: The runner-patient history: What to ask and why. JAPA, 73: 39-43, 1983).

    Hope this helps.
     
  38. Kevin- My own observations of runners over the years align with your points. A follow-up question regarding this: "However, we really don't really know why people self-select certain running forms and footstrike patterns, but the research evidence tends to point to the fact that most experienced runners will self-select the most metabolically-efficient kinematic pattern for running for each given running velocity."

    Barefoot and minimalist shoe running advocates note that almost all children seem to run with a midfoot/forefoot landing and avoid overstriding when barefoot and wearing zero-drop shoes regardless of velocity. When placed in raised heel shoes, they tend to begin overstriding with a heel strike, especially at lower velocities. The shoes definitely affect gait. My review of the literature hasn't turned up any empirical evidence measuring this phenomenon, it's based entirely off direct observation.

    When new runners begin running, their initial shoe choice also seems to affect gait with that same pattern. The assumption is that the runner isn't self-selecting; the shoe design encourages a specific gait. The two-part question:
    1. Is that accurate based on your observations?
    2. If so, should we assess gait using a baseline of sorts (like being barefoot)?

    To your last point about performance- I've had quite a few conversations with track and cross country coaches. There's a definite cohort effect with teaching running form. It seems teaching running form fell out of favor around the mid-1980's as research on VO2 max and other physiological mechanisms flourished. Some of the more successful coaches seem to have continued teaching running form, though. Even though performance (and injury prevention) is multifaceted, do you think there's still some benefit in teaching running form, especially to novice runners?
     
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