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Vibram FiveFingers Cause Metatarsal Stress Fractures?

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  #1  
Old 5th May 2010, 07:09 AM
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Default Vibram FiveFingers Cause Metatarsal Stress Fractures?

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Due to the increased usage of the "minimalist shoe", Vibram FiveFinger, there seems to be an increasing number of reports of metatarsal stress fractures occurring due to running in these shoes. However, since both Dan Lieberman, PhD and Chris McDougall, author of "Born to Run" are pushing these shoes as a "barefoot alternative" running shoe, then maybe they should both be a little concerned about the potentially serious injuries they are causing in runners by suggesting they run in these shoes. In fact, there is a recent report that Chris McDougall himself suffered a metatarsal stress fracture running in Vibram FiveFingers, but this hasn't been confirmed yet.

Here are a few samples of runners that have developed metatarsal stress fractures from running in Vibram FiveFingers from a quick web search. I don't have any patients that wear these shoes regularly and have not seen any metatarsal stress fractures develop as a result from running in them. But it looks like there is a significant correlation here.

Quote:
Tom Baker November 2, 2009 at 3:24 pm
I’d rethink these If I were you! I have run for about a year and a half now with sneakers and had no issues. I bought the Vibrams with the hope to increase my times and gain better form. Well in one month I did get faster and improved my time and pace, however I broke my foot from a stress fracture! These damned things offer no shock absorption and thus caused a stress fracture. Now I’m screwed. I can’t run for 6 to 8 weeks. I’m miserable, Thanks Vibram! Thanks for nothing but pain.

Now I’m fielding questions from every runner that I meet asking WTF was I thinking running with these. I don’t even have an answer…. friggin’ shoes.
Quote:
Chris H April 26, 2010 at 12:30 pm
I also recently broke my 4th metatarsal wearing the VFF. I have been wearing them for 6+ months, about 50 miles per week… and then the pain showed up on an everyday run. I didn’t land on it funny or anything.

I’m really torn about what to do. I’ve never enjoyed running more than in the VFF, but I think they were a major cause of my broken foot. I’ve been running 50+ miles per week for years and this is the first significant injury I’ve had.
Quote:
Brett V April 28, 2010 at 8:01 am
I am responding to all of those that hurt themselves with the VFF’s. I am an avid marathon runner that recently switched to Vibrams in February. I will say that because I was so excited about these shoes, I probably started running on them too much too soon. My first two weeks I only put in 3-5 miles with each run. Granted, I did some barefooting on the beach a few weeks before.

Anyway, I continued my marathon training and didn’t have any big problems, I loved running with them. However, two weeks ago I put a stress fracture on the upper side of my foot, 2nd and 3rd metatarsal. It occurred on a regular, and almost light, run a week after I had run 20 miles. I am so confused and torn what to do/think. I loved running with my VFF’s but received advice from the doctor not to.

I agree with the whole barefoot movement, but I wonder if I am one of those “classic cases” who jumped on the bandwagon before properly researching all necessary prep work. Also, my doctor said he fears barefooting is the next gravity shoe fiasco where people will only realize their injuries after significant time and it becomes a fad. Thoughts?
http://www.madetorun.com/running-equ...roduct-review/

Quote:
Ron Ernst: I loved my VFF but I just got a stress fracture and my Dr. said that he gets a lot of folks with the same injury that are wearing them. Before you assume I am some rookie, I eased into my miles for about 9 months and it was a short run. Now I am bummed and I am unsure if should try them anymore.
April 21 at 12:37am · Report
http://www.facebook.com/posted.php?i...0 &comments=1

Quote:
I am a triathlete based in the UK. Fed up with a constant stream of injuries I started barefoot running early this year. Initially I did this under my own initiative, unaware of the growing community that exists online (unfortunately I'm the only person who has 'seen the light' around where I live!). I have been doing pretty much all of my running in vibram five-fingers but have recently encountered a bit of problem picking up a stress fracture in my second metatarsal. This is a little disconcerting as I had been running regularly in the five-fingers for some months without issue prior to this. I did have very weak, flat feet. Since using five-fingers my foot strength has improved but my feet are still flat and I think I have a way to go before I could call them strong.I was wondering if you could offer any advice as to how to get back into barefoot running (once the fracture heals) in such a way that this does not happen again! I have thought that maybe my transition was not slow enough (despite conscious efforts to built it very gradually over 6 months) and that i should ditch the five-fingers so give me even more feedback and proprioception.

Many thanks for you help!!
Tom Sturdy
http://runbare.com/bbpress/topic.php?id=6
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Old 5th May 2010, 07:29 AM
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Default Re: Vibram FiveFingers Cause Metatarsal Stress Fractures?

That will teach them for wearing shoes while running , idiots !!!!
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Old 5th May 2010, 07:59 AM
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Default Re: Vibram FiveFingers Cause Metatarsal Stress Fractures?

The following question was asked on a barefoot forum:

Quote:
I’ve read a lot about metatarsal stress fractures as a result of getting too overzealous upon beginning barefoot running. I went to a podiatrist this morning, and although my x-ray didn’t show a clear fracture, he said he was pretty sure that was what is going on.

He gave me a boot cast to wear for the next few weeks, but I feel skeptical that that is the best healing method. I hurt my foot a week ago, and the pain is localized on the top of my third metatarsal. It’s hurt pretty consistently all week, and I have some trouble flexing my foot back and moving my third toe.

My question for all of you is: should I wear the boot during the healing process? Are there other ways of facilitating healing that don’t involve a boot, or could supplement wearing the boot? I know enough to stop running for the time being, and to take it MUCH more slowly when everything has healed.

Thanks!
Here's an interesting opinion/answer from 'Barefoot Josh':

Quote:
Disclaimer: I have no medical training, but I do have a chip on my shoulder when it comes to podiatrists. So take that into consideration.

If it hurts (not just sore, but HURTS) to touch, it’s probably a stress fracture. Do you remember how it happened?

Re the boot, stabilization might expedite the healing process. But if you can walk/move about without pain, then you probably don’t need it.

I have a suspicion doctors will over-diagnose if they think it will prevent what they consider dangerous behavior. A doctor said I had frostbite when I went to the emergency room with a really bad blister. The thing is, it was too warm for frostbite to be possible. But he probably figured he could scare some “sense” into me.

You don’t get a stress fracture from “doing too much too soon” if you are barefoot (truly barefoot – minimalist shoes carry a high risk of injury if you haven’t learned how to run barefoot first). You’re either hitting the ground or you’re not relaxing your ankles to let your heel come down. If your heel doesn’t touch the ground, all the weight of your body is being carried on tiny metatarsal bones.

As far as running barefoot in the future, a podiatrist has about as much business giving advise as a McD’s burger flipper has telling a French chef how to cook.
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Old 5th May 2010, 08:06 AM
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Default Re: Vibram FiveFingers Cause Metatarsal Stress Fractures?

Here's another one to add to your list Kevin:

Quote:
flarunner 6 November 2009 (16:16)
I started running in the Vibram Five Fingers early this summer during a build up to a marathon. My mileage was 60-75 mpw – and I started slowly introducing the VFF’s to where I was using them 2 or 3 times per week. Usually for easy days, no more than 4-6 miles, though I did do a few longer runs on the treadmill with them.

About 8 weeks ago I did a run in them and felt some pain across the top of my foot which I ignored. I stopped running in the VFF’s after that but the pain gradually got worse to the point where I was in pain even to just walk. Finally got an MRI and confirmed a stress fracture.

Question – was my injury caused by the VFF’s – perhaps running too many “barefoot” miles too soon – or was my injury perhaps caused by the return to the regular running shoes which allowed me to strike too hard because of the thick soles? I am pretty sure my overall mileage which had been steady for months before the marathon build-up was not the cause – since the volume was consistent.

There is a suggestion that the bones in my feet may be strengthened by continued and controlled stress to the bones and that perhaps I should still use the VFF’s after my recovery.

Thoughts?
And do you know what the answer was??
Quote:
Comment from JT
Time 2009 November 6 Fri at 5:30 pm


Your stress fractures were caused by not enough barefoot running. You got stress fractures because you were landing too hard with no cushioning. If you land hard, Vibram’s are not the shoe for you.

If you want to learn how to land lightly, wait until you heal and run barefoot. You need to be able to feel the ground with the skin of your soles. If you can’t feel the ground, it won’t hurt to land too hard. If it won’t hurt, then you WILL land too hard.
Link

So there you have it.
Barefoot wisdom #1: Stress fractures are not caused by doing too much too soon.
Barefoot wisdom #2: They are caused by not enough barefoot running.
Awesome.
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Old 5th May 2010, 12:28 PM
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Default Re: Vibram FiveFingers Cause Metatarsal Stress Fractures?

Here's another report of metatarsal stress fractures due to running in Vibram FiveFinger shoes.

Now, if Chris McDougall were honest, and not just out to sell books at the expense of the health of other runners, he would come out and say [just like he did in "Born to Run" about "cushioned running shoes"] that these shoes should be banned from being marketed to runners because they are causing injuries, not preventing injuries! How many more of these injuries will occur before one of the barefoot/minimalist runners warns people to not run in these shoes?!

Quote:
slownlow-rw says:
2010/04/ at 11:34 pm
That was a very fair and balanced article, thank you. As a runner who runs primarily barefoot, but does supplement his running with Vibram five fingers, I wish you would have addressed the “dangers” of the Vibrams. The comment above mine demonstrates the problem with them. A second run in Vibrams of 3 miles is too long; the Vibrams need to be adjusted to in the same manner that you would adjust to barefoot running, very slowly. Quite a few of us that started our journey into barefoot running using Vibrams learned the hard way that the Vibrams do a wonderful job of preventing the pain that you would experience if you were barefoot, but that pain is there to warn you that you are doing too much too soon. I am not the only Vibram user that ended up with a metatarsal stress fracture because I ran miles in them that I wasn’t ready to run. Running barefoot with poor form hurts; you eventually will naturally improve your form just because your body wants the pain to stop. That pain just does not happen with Vibrams, you can run far enough to cause damage, not just pain, which is why most barefoot runners recommend learning to run barefoot first, and then use the Vibrams as a supplement for technical trails and such.
http://askcoachjenny.runnersworld.co...d-running.html
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  #6  
Old 5th May 2010, 01:38 PM
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Default Re: Vibram FiveFingers Cause Metatarsal Stress Fractures?

Add this one to the list:
http://www.podiatrym.com/letters2.cfm?id=34664&start=1
  #7  
Old 5th May 2010, 02:55 PM
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Default Re: Vibram FiveFingers Cause Metatarsal Stress Fractures?

Quote:
Originally Posted by Ian View Post

So there you have it.
Barefoot wisdom #1: Stress fractures are not caused by doing too much too soon.
Barefoot wisdom #2: They are caused by not enough barefoot running.
Awesome.
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Old 6th May 2010, 12:25 AM
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Default Re: Vibram FiveFingers Cause Metatarsal Stress Fractures?

I have a friend who participates in recreational rock climbing, and a few years ago he discovered the VFF and bought them around for my opinion, he and some fellow rock climbing friends were looking at investing in becoming retailers of the VFF. I tried them on in my size and just walking the toe bits were pretty uncomfortable for my narrow foot with long toes. they dont offer much in the way of variable sizing to accomodate for this.
His girlfriend had been wearing them and claimed she had run 5km that day and had no problem, but her feet were quite warm after this. I havent done much running for a few years, but did alot as a teenager and managed to do a half marathon when i was 20. I would be particularly concerned if my feet got hot after running only 5km.

It seems that these shoes have a great place in activities where the foot needs to adapt significantly to grip surfaces, like rock climbing and diving/snorkelling and other water sports owing to the close fit and material.

I cant see that any feature makes them suitable for running. I am also quite interested that most of the quotes in this thread claim they drastically reduced their mileage to allow accomodation of the VFF. I dont know many long distance runners who would vary their training schedule so much to accmilatise to a new pair of running shoes, so obviously most people are sceptical from the start

For the record, my friend decided not to go ahead with selling the VFF, they wanted something like $Aus 20,000 start up fee and their girlfriends all decided the shoes where too ugly to warrant that kind of investment :)
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Old 6th May 2010, 12:34 AM
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Default Re: Vibram FiveFingers Cause Metatarsal Stress Fractures?

Very interesting internet research!!
I didn't know that the use of these shoes could cause stress fractures, but thinking about it, it seems quite obvious to me.

Here in Spain they are not very popular yet but more and more my patients are asking about information about them. I will start warning people about the potential risk of running with vibram fivefingers...

Ian, someone should put in jail those who give such stupid advices...
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Old 6th May 2010, 06:30 AM
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Default Re: Vibram FiveFingers Cause Metatarsal Stress Fractures?

Quote:
Originally Posted by Kevin Kirby View Post
Due to the increased usage of the "minimalist shoe", Vibram FiveFinger, there seems to be an increasing number of reports of metatarsal stress fractures occurring due to running in these shoes. However, since both Dan Lieberman, PhD and Chris McDougall, author of "Born to Run" are pushing these shoes as a "barefoot alternative" running shoe, then maybe they should both be a little concerned about the potentially serious injuries they are causing in runners by suggesting they run in these shoes. In fact, there is a recent report that Chris McDougall himself suffered a metatarsal stress fracture running in Vibram FiveFingers, but this hasn't been confirmed yet.
I'm not sure this isn't an urban myth. I have scoured the web looking for confirmation of a McDougall injury, and have come up empty. Given his speaking schedule and public appearances, a stress fracture would be very hard to mask. If he had a metatarsal stress fracture, it would likely affect his gait and probably turn him into a heel striker, wouldn't you think? Unless of course he has a super-human tolerance for pain. I am also fairly certain, that if he pulled up lame during his PR tour, many would have taken notice, and commented about his injury. For now, I am going to chalk this off as a rumor.
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Old 6th May 2010, 06:46 AM
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Default Re: Vibram FiveFingers Cause Metatarsal Stress Fractures?

And another one taken from here:

Quote:
On the first day of my ultra-practice, I noticed that one of my athletes had the Vibram FiveFinger shoes on for practice, which offer no support, and are just one small step up from barefoot running. Our practices typically go through technically challenging trails, with a lot of rocks and rough terrain. Unfortunately, he ended up with a third metatarsal stress fracture, and has decided to go back to his normal training shoes upon his return to running.
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Old 6th May 2010, 06:53 AM
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Default Re: Vibram FiveFingers Cause Metatarsal Stress Fractures?

And another:

Quote:
slownlow-rw says:
2010/04/ at 11:34 pm


That was a very fair and balanced article, thank you. As a runner who runs primarily barefoot, but does supplement his running with Vibram five fingers, I wish you would have addressed the “dangers” of the Vibrams. The comment above mine demonstrates the problem with them. A second run in Vibrams of 3 miles is too long; the Vibrams need to be adjusted to in the same manner that you would adjust to barefoot running, very slowly. Quite a few of us that started our journey into barefoot running using Vibrams learned the hard way that the Vibrams do a wonderful job of preventing the pain that you would experience if you were barefoot, but that pain is there to warn you that you are doing too much too soon. I am not the only Vibram user that ended up with a metatarsal stress fracture because I ran miles in them that I wasn’t ready to run. Running barefoot with poor form hurts; you eventually will naturally improve your form just because your body wants the pain to stop. That pain just does not happen with Vibrams, you can run far enough to cause damage, not just pain, which is why most barefoot runners recommend learning to run barefoot first, and then use the Vibrams as a supplement for technical trails and such
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Old 6th May 2010, 06:57 AM
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Default Re: Vibram FiveFingers Cause Metatarsal Stress Fractures?

Interesting comment here:

Quote:
On the other hand, I’ve heard countless stories of people who tried barefoot running or running with Vibram Five fingers and ended up with stress fractures or other running injuries. To put things simply in my mind, I’ll quote a speaker I heard at the Walt Disney World marathon expo:

“For every person who’s had success with barefoot running, I’ve heard of ten who’ve been injured”.
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Old 6th May 2010, 07:02 AM
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Default Re: Vibram FiveFingers Cause Metatarsal Stress Fractures?

I'm getting bored of looking now

Quote:
So as I mentioned last time I believe I have a stress fracture. It happened on a Vibram Five Finger run on the road about four days prior to the Vermont 50K.
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Old 6th May 2010, 07:54 AM
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Default Re: Vibram FiveFingers Cause Metatarsal Stress Fractures?

all I can say is that this is extraordinary!!
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Old 6th May 2010, 08:33 AM
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Default Re: Vibram FiveFingers Cause Metatarsal Stress Fractures?

I am quite shocked at the lack of critical thought associated with most of these posts. Whether barefoot running or wearing Vibrams it is essential that a person work very slowly into this significant change in their training. Did any of these people follow appropriate protocol in moving from running shoe to barefoot or vibram running?! We are blaming the shoe on MAJOR STRATEGIC TRAINING ERRORS. We have to remember that it will take several months to adapt and accommodate this new stress. Just as in the folks who have never run in their adult life need to pick up this new skill (i.e. running) very slowly. I must also add that I would never recommend that someone run exclusively in these shoes and never for marathon mileage. For those of you on this post that have claimed injury to barefoot or vibram running, try the following:

1) Integrate barefoot training in a technique and drill focused warm-up on an accommodating surface such as grass. There will be no actual "running" to start, just technique drills and a single leg strengthening exercises. Time: approximately 10-20 minutes. Frequency: 2x/week. Continue with regular training minus 10% in regular shoes.
2) Progress warm-up over a period of 2-3 months. At the end of the 2-3 months should be the first sign of consistent running. This would be no different than the "Learn to Run" programs offered to adults who have never run, at your local running club. Warm-up + an easy interval or walk/run on an accommodating surface. 2x/week. As above, continue with regular training minus 10% in regular shoes.
3) SLOWLY PROGRESS or continue using this type of training as an implement to improve your running form.

Some important questions to ask:

1) What type of foot does this person have.
2) Have they been running in motion control shoes, stability shoes, neutral or racing flats?
2) Lower extremity alignment and function (i.e. anteverted femur, poor proprioception/balance, weak hip abductors, etc.)
3) Technique (do they actually know how to run with good form?)
4) Previous injuries
5) Weekly training load (training intensity x volume)
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Old 6th May 2010, 08:48 AM
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Default Re: Vibram FiveFingers Cause Metatarsal Stress Fractures?

Quote:
Originally Posted by Michael Maxwell View Post
I
Some important questions to ask:

1) What type of foot does this person have.
2) Have they been running in motion control shoes, stability shoes, neutral or racing flats?
2) Lower extremity alignment and function (i.e. anteverted femur, poor proprioception/balance, weak hip abductors, etc.)
3) Technique (do they actually know how to run with good form?)
4) Previous injuries
5) Weekly training load (training intensity x volume)
Michael, you post is well made. A question you may need to answer: What difference should the answers to your questions above make to the decision of whether, or not, someone should run in Vibram five fingers? So, a few questions back to you:

1) So certain foot types should never run in these shoes? Which ones?
2) The previous shoe preference dictates whether or not an individual should run in these shoes?
3)(the second: 2 in your list) How does lower extremity alignment such as (your example) femoral anteversion influence the ability of an individual to run in said shoes?
4) What is "good form"? Moreover, how does this influence an individuals ability to run in these shoes?
5) How does a history of previous injuries influence an individuals ability to run in these shoes?
6) How does the weekly training load (training intensity x volume) influence an individuals ability to run in these shoes?
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Old 6th May 2010, 11:42 AM
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Default Re: Vibram FiveFingers Cause Metatarsal Stress Fractures?

Quote:
Originally Posted by Michael Maxwell View Post
I am quite shocked at the lack of critical thought associated with most of these posts.
Surely you jest?

I assume you are saying the same thing on all the barefoot running websites when they make all the unscientific nonsense claims about running shoes as well?

See this thread:
http://www.podiatry-arena.com/podiat...ad.php?t=43282
  #19  
Old 6th May 2010, 12:08 PM
JB1973 JB1973 is offline
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Default Re: Vibram FiveFingers Cause Metatarsal Stress Fractures?

For those of you on this post that have claimed injury to barefoot or vibram running, try the following:

1) Integrate barefoot training in a technique and drill focused warm-up on an accommodating surface such as grass. There will be no actual "running" to start, just technique drills and a single leg strengthening exercises. Time: approximately 10-20 minutes. Frequency: 2x/week. Continue with regular training minus 10% in regular shoes.
2) Progress warm-up over a period of 2-3 months. At the end of the 2-3 months should be the first sign of consistent running. This would be no different than the "Learn to Run" programs offered to adults who have never run, at your local running club. Warm-up + an easy interval or walk/run on an accommodating surface. 2x/week. As above, continue with regular training minus 10% in regular shoes.
3) SLOWLY PROGRESS or continue using this type of training as an implement to improve your running form


Hiya Michael
i'm just curious as to why? why would anyone want to follow this program when there is no evidence to suggest that what the end result will be is better than what they are doing just now? why should anyone waste 2-3 months with this? give me ONE good evidence based reason.
also as Simon alludes to above in response to your 1st question : are VFF only for certain foot types?
cheers
JB
  #20  
Old 6th May 2010, 12:43 PM
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Default Re: Vibram FiveFingers Cause Metatarsal Stress Fractures?

Michael,

We are of course being facetious, and if you were a regular on the forum or had read previous discussions such as the Barefoot Running thread you would see that we (the Podiatry Arena community) demand a far more rigorous level of evidence to suggest causality. Personally when posting all of the snippets here from websites I found, my tongue was firmly placed in my cheek.

But now you have rocked up and 'got involved' I await your responses to Simons questions.
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Old 6th May 2010, 03:32 PM
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Mark Russell Mark Russell is offline
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Default Re: Vibram FiveFingers Cause Metatarsal Stress Fractures?

Bugger. I quite like mine and no met fractures either. That said I haven't run in mine (but haven't run anywhere in 29 years) but they do carry 17st around during a diverse range of activities from baking profiteroles to cleaning the lavatory. And wee sharp bits hiding in the carpet don't seem to carry as much of a threat as they used to before. Maybe folk expect too much from them; barefoot running has a certain appeal, but perhaps evolution works faster than we think. What's next: platform shoes for high-jumpers?

I prefer the gold and black ones myself.
  #22  
Old 6th May 2010, 07:52 PM
Michael Maxwell Michael Maxwell is offline
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Default Re: Vibram FiveFingers Cause Metatarsal Stress Fractures?

Quote:
Originally Posted by Simon Spooner View Post

1) So certain foot types should never run in these shoes? Which ones?
2) The previous shoe preference dictates whether or not an individual should run in these shoes?
3)(the second: 2 in your list) How does lower extremity alignment such as (your example) femoral anteversion influence the ability of an individual to run in said shoes?
4) What is "good form"? Moreover, how does this influence an individuals ability to run in these shoes?
5) How does a history of previous injuries influence an individuals ability to run in these shoes?
6) How does the weekly training load (training intensity x volume) influence an individuals ability to run in these shoes?
Kevin, no, I haven't paid much attention to the forum and didn't catch the "tongue in cheek", so sorry if I offended you.

My quick answers to the above:

1) I don't believe I said this (i.e. never run...). The acknowledgement of foot type is less about the typical classification of pes planus and pes cavus and more about how stable are they in a single leg, forefoot stance. However, any foot on the end of hypermobility and tendency to over-pronate or hypomobility and tendency to under-pronate would be a warning sign that barefoot running may not be the best idea... or at least extreme caution warranted in its application.
2) The previous shoe preference indicates what type of shoe the person has previously run in, injury free or possibly with injuries. If a person has run injury free in the Brooks Beast, one might think they would have a tough time going from this to barefoot running. If they were previously running in racing flats, injury free, a transition to barefoot running will be an easier transition.
3) Femoral anteversion places increased demand on the hip abductors and predisposes to excessive adduction and internal rotation of the hip during stance phase of gait (or during the push phase of cycling). This will lead to a couple possible scenarios: a) adduction and internal rotation of hip transfers internal rotation to tibia with a lateral shift of the pelvis (trendelenburg gait) that is insufficient to off-set the medial momentum resulting in over-pronation (often seen as over-pronation late in stance phase or lack of supination towards toe off). b) adduction and internal rotation of the femur that is off-set by a lateral shift of the pelvis. The lateral shift of the pelvis causes a COG shift to the lateral side of the foot. In this case the person has compensated away from the medial arch because they `know`they will be unstable in this position.
4) this question requires at least 4 hours of lecture and practical instruction...
5) If your patient has had a history of medial tibial stress syndrome, anterior compartment syndrome, plantar fasciosis, metatarsal stress fractures, or any other injury deemed to be related to excessive pronation... barefoot running may not be the best option to start with.
6) Probably not the best idea to throw in any foreign training during the building phase of a competitive season. Athletes are often already at the maximum capacity and their bodies or working to the max in order to recover from their already demanding schedule. Adding a new stressor that isn`t off set by a decrease in training volume and or intensity, whether this is barefoot running or taking on a big project at work, may push you over the edge and into over-training. Over-training results in the decreased ability to recover and adapt to an already excessive amount of physiological stress (due to fluctuations in testosterone ratio, cortisol, growth hormone...) leading to an increased risk of over-use injuries.

Also, please note that when I say critical thought I mean using the best evidence available while using your noggin to evaluate the best method for treating or recommending a prevention or performance based training methods. There is limited evidence for many effective interventions.
  #23  
Old 7th May 2010, 09:52 PM
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Default Re: Vibram FiveFingers Cause Metatarsal Stress Fractures?

Its not rocket science, but its obvious why there could be so many stress fractures with the vibram:

  #24  
Old 8th May 2010, 07:09 AM
Michael Maxwell Michael Maxwell is offline
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Default Re: Vibram FiveFingers Cause Metatarsal Stress Fractures?

If you are referring to the barefoot running on cement I totally agree...
  #25  
Old 8th May 2010, 07:31 AM
Michael Maxwell Michael Maxwell is offline
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Default Re: Vibram FiveFingers Cause Metatarsal Stress Fractures?

Quote:
Originally Posted by JB1973 View Post
[color="Red"]

Hiya Michael
i'm just curious as to why? why would anyone want to follow this program when there is no evidence to suggest that what the end result will be is better than what they are doing just now? why should anyone waste 2-3 months with this? give me ONE good evidence based reason.
also as Simon alludes to above in response to your 1st question : are VFF only for certain foot types?
cheers
JB
When discussing foot wear and running shoes there is limited evidence for all of the above. All I have to offer you is anecdotal evidence that technique and performance improves with the application of barefoot training. Please note that I never actually said I encouraged the athletes that I work with to run barefoot. I was trying to provide a more logical progression for those who apparently don't get the importance of very slow integration into such activity, in addition to a thorough evaluation and critical thought as to how beneficial or safe this would be for that person. I do however, encourage athletes to do some barefoot training such as the warm-up I previously discussed. We typically do a drill focused warm-up that promotes coordination and balance/stability followed by some easy accelerations focused on technique.

Why should anyone do this? Well, this isn't just for ANYONE. This is for the serious athlete looking to gain a competitive edge. Most athletes depend on their performance to put food on the table and the margin of victory is often small.

Evidence? Is there good evidence to suggest running in specific types of shoes prevents injury? Last I checked, no there isn't. Further, various forms of bodywork and massage have been used for centuries without ANY evidence-based reasons... other than the fact that people noticed it worked and continued to do it. We have been manipulating spines for centuries too... again, with no scientific studies to prove its benefits. But now, in the year 2010 we have 100's of studies demonstrating the physiological effects and benefits of the above.

The bottom line is that if you wait for the evidence to tell you what to do you will be behind the leading-edge practical application needed to get the best athletes better and the chronic patients to become athletes. It just so happens, though, that there is a lot of evidence in this day in age to support a lot of things we do. But, the evidence will still always lag behind.

Thanks, Michael
  #26  
Old 8th May 2010, 08:22 AM
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Default Re: Vibram FiveFingers Cause Metatarsal Stress Fractures?

Michael as your a little pro VFF and barefoot running. When making the decission on who could, should and should not. Do you take into account metatarsal lenght.

ie a person with a short 1st ray and therefore long 2nd, will as studys have show have increased Ground reaction force applied to the 2nd met. In barefoot running forefoot striking is the norm, therefore increased GRF to the forefoot and increased bending moments to the metetarsals- increased likelyhood of stress fractures. Do you consider this or do you think barefoot runners should consider this?
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  #27  
Old 8th May 2010, 10:48 AM
Michael Maxwell Michael Maxwell is offline
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Default Re: Vibram FiveFingers Cause Metatarsal Stress Fractures?

Short answer, yes. But, I wouldn't consider this an absolute contraindication.
  #28  
Old 8th May 2010, 03:30 PM
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Default Re: Vibram FiveFingers Cause Metatarsal Stress Fractures?

From Vibram FAQ's

Quote:
I WEAR ORTHOTICS. CAN I STILL WEAR VIBRAM FIVEFINGERS?
FiveFingers footwear is designed to promote better foot mechanics— naturally. An orthotic is an assistive device to support your foot’s function and help you compensate for any biological aberrations. If you have an extremely flat foot, you will need to work into wearing your FiveFingers® gradually, as your muscles will need time to adapt and strengthen.

CAN I USE MY ORTHOTICS IN MY FIVEFINGERS?
FiveFingers are designed to be worn directly against the sole of your foot. Putting something between the two would defeat their purpose.
http://www.vibramfivefingers.com/technology/faqs.cfm
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  #29  
Old 9th May 2010, 01:01 AM
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Default Re: Vibram FiveFingers Cause Metatarsal Stress Fractures?

Quote:
Originally Posted by Michael Maxwell View Post
I am quite shocked at the lack of critical thought associated with most of these posts.
Michael

You have to take the posts made in the context of previous discussions of barefoot running. We have had a succession of barefoot runners here making all sorts of claims that are just not true and when asked to back it up, we never hear from them again.

Look at the claims for the kerrigan research. You read on barefoot running websites that running shoes cause osteoarthritis, when they did not even do a study on osteoarthritis. Look at the way that the Lieberman et al research was interpreted by the barefoot runners and the media - it was so bad that Liebermann had to take the step of posting a disclaimer on his website to distance himself from the way the research was being interpreted.

Then there is the claims about Abebe Bikila - he could run faster in shoes to break the world record.

Then there is the claims about Zola Budd - she had to resort to running shoes to stop all the injuires that she was getting.

Then there is the "cult" like worship of Born to Run, when there is so much fiction in it. Are people that gullible that they fall for it?

Then there is all the claims about high impacts of heel strike causing so many of the running injuries ... I do not know of a single overuse injury that is caused by high impacts and there is NO evidence that high impacts increase the risk for any injury.

Then there is the claims re muscle strength. There is NO evidence that running shoes weaken muslces (there is evidence that foot orthotics actually increase muscle strength). Weak intrinsic foot muscles actually cause a high arched supinated foot.

There is no evidence that running shoes increase the risk for injuires, but how often do you see those in the barefoot running community claim that?

There is no evidence of barefoot running or running with shoes being better or not - the evidence is that they are different.

You see claims being made by barefoot runners that they have PROOF that running shoes cause injury and that proof is that they got an injury in a running shoe!! Based on that logic, they have to accept that the report of just one stress fracture (let alone the number reported above) in a Vibram Five Fingers is enough proof that Vibram Five Fingers is bad for you.

You and I might see how absurd that kind of conclusion is, but this is what we continually come across when it comes to barefoot running.

The comments above needed to be interpreted in that context.

(and for the record, I will restate it again: I have NOTHING against running barefoot; all I object to is the rationale used by the barefoot community, the nonsense way they misuse and misinterpret research; and the unsupported claims they make. We are very brutal on podiatrists who make supported and unsubstantiated claims, so we not just picking on the barefoot runners.)
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  #30  
Old 9th May 2010, 07:03 PM
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Default Re: Vibram FiveFingers Cause Metatarsal Stress Fractures?

How silly can you get. All this analysis of what should be common sense. Dr. Kirby presents anecdotal statements re: stress fractures, DUH! Is anyone really surprised that running with minimal or no protection is stupid. End this thread as, my mother knew as much "biomequactics". Open up your internal medicine book!Robert Bijak, DPM
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