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Podiatrist Recommends Forefoot Striking Versus Orthotics for Treating Running Injuries

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  #1  
Old 18th February 2012, 11:17 AM
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Default Podiatrist Recommends Forefoot Striking Versus Orthotics for Treating Running Injuries

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Nick Campitelli, DPM, a consultant for Vibram FiveFinger shoes, has just posted a blog claiming that runners probably wouldn't need foot orthoses for running injuries if they only ran properly...by forefoot striking.

"In my practice, when runners bring up the question of what type of shoe they should be wearing, I explain that they first need to “learn how to run.” Then shoegear and orthotics become irrelevant."

http://www.podiatrytoday.com/blogged...need-orthotics

I would appreciate if others made some comments on Dr. Campitelli's blog since I have commented before on his blogs and some new voices of reason would be appreciated.
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  #2  
Old 18th February 2012, 11:39 AM
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Default Re: Podiatrist Recommends Forefoot Striking Versus Orthotics for Treating Running Injuries

Just did - it has gone to the site administrators. I wonder if it will go through?
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  #3  
Old 18th February 2012, 01:32 PM
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Default Re: Podiatrist Recommends Forefoot Striking Versus Orthotics for Treating Running Injuries

I have no problems with recommending heel striking or forefoot striking or whatever depending on which tissues need to be offloaded long term as the joint moments are different with different running forms.

However, that article by Dr Campitelli is one of the worst cases of selective referencing, cherry picking and confirmation bias I have seen recently.

Its also interesting to see who is tweeting and retweeting this article .... those blinded by agendas who obviously did not notice the "selective referencing, cherry picking and confirmation bias" As I have repeatedly said:
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Originally Posted by Craig Payne View Post
what I object to is the misuse, misrepresentation, misquoting and misinterpretation of the science
This is going to be another article added to the resource list to illustrate the point!
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Old 18th February 2012, 05:31 PM
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Default Re: Podiatrist Recommends Forefoot Striking Versus Orthotics for Treating Running Injuries

Quote:
Originally Posted by Craig Payne View Post
However, that article by Dr Campitelli is one of the worst cases of selective referencing, cherry picking and confirmation bias I have seen recently.

Its also interesting to see who is tweeting and retweeting this article .... those blinded by agendas who obviously did not notice the "selective referencing, cherry picking and confirmation bias" As I have repeatedly said:This is going to be another article added to the resource list to illustrate the point!
Agreed!

Just look at the paragraph on foot strike patterns in runners which has nothing to do with what the authors actually found in the Hasegawa H, Yamauchi T, Kraemer WJ.
or Larson studies that he references.
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Old 18th February 2012, 05:34 PM
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Default Re: Podiatrist Recommends Forefoot Striking Versus Orthotics for Treating Running Injuries

Quote:
Originally Posted by Athol Thomson View Post
Just look at the paragraph on foot strike patterns in runners which has nothing to do with what the authors actually found in the Hasegawa H, Yamauchi T, Kraemer WJ.
or Larson studies that he references.
Those blinded by agendas tend to that a lot.
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Old 20th February 2012, 09:15 AM
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Default Re: Podiatrist Recommends Forefoot Striking Versus Orthotics for Treating Running Injuries

Hi Keven and all:

something else which has recently come up regarding striking position in athletes, has been discussed . I regularly 'teach' MOD physios in basic biomechanics, and whilst talking over lunch at one meeting it came up that they are now teaching military athletes and recovering squaddies to MIDFOOT strike when running. this takes time to teach and completely changes the running gait of the athlete, but apparently reduces repeat injury rate, and the thought now is that they will 're-educate' squaddies to long march/run in this manner.

it is a model which was initially instigated at Headley Court the main rehab centre for the MOD in the UK.

what are your thoughts regarding this?


Regards

Robby
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Old 20th February 2012, 10:56 AM
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Default Re: Podiatrist Recommends Forefoot Striking Versus Orthotics for Treating Running Injuries

Quote:
Originally Posted by Craig Payne View Post
If you forefoot strike --> increased forefoot dorsiflexion moments on rearfoot; increased dorsiflexion moments at ankle; increased rearfoot inversion moments --> all these will do is increase the risk of injury in the structures that those moments.

If you rearfoot strike --> increased rearfoot impacts --> increase the risk for injury associated with higher rearfoot impacts.
BTW, this is partly was I mean by cherry picking, confirmation bias and selective referencing in reference to the article that KK started this thread with. The author was only to willing to cite references re the rearfoot striking, but ignored the forefoot striking risks.
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Old 20th February 2012, 11:17 AM
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Default Re: Podiatrist Recommends Forefoot Striking Versus Orthotics for Treating Running Injuries

We have some good replies going now in Dr. Campitelli's blog. Thanks to Robin Perrie and Doug Richie for chiming in.

http://www.podiatrytoday.com/blogged...need-orthotics

It would be nice to see others also contribute.
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Old 20th February 2012, 12:06 PM
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Default Re: Podiatrist Recommends Forefoot Striking Versus Orthotics for Treating Running Injuries

Quote:
Originally Posted by robby View Post
Hi Keven and all:

something else which has recently come up regarding striking position in athletes, has been discussed . I regularly 'teach' MOD physios in basic biomechanics, and whilst talking over lunch at one meeting it came up that they are now teaching military athletes and recovering squaddies to MIDFOOT strike when running. this takes time to teach and completely changes the running gait of the athlete, but apparently reduces repeat injury rate, and the thought now is that they will 're-educate' squaddies to long march/run in this manner.

it is a model which was initially instigated at Headley Court the main rehab centre for the MOD in the UK.

what are your thoughts regarding this?


Regards

Robby
Hi Robby,

I think Dr Andrew Franklyn-Miller is the MOD sports Doctor that is driving these changes in foot-strike patterns for MOD recruits.

There is an audio podcast available from the BJSM website below which is interesting. He discusses his thoughts about what he terms "biomechanical overload of the lower limb on the podcast.

http://podcasts.bmj.com/bjsm/2011/10...anklyn-miller/

Worth a listen for sure.

Cheers,
Athol
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Old 20th February 2012, 12:15 PM
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Default Re: Podiatrist Recommends Forefoot Striking Versus Orthotics for Treating Running Injuries

Quote:
Originally Posted by Athol Thomson View Post
Hi Robby,

I think Dr Andrew Franklyn-Miller is the MOD sports Doctor that is driving these changes in foot-strike patterns for MOD recruits.

There is an audio podcast available from the BJSM website below which is interesting. He discusses his thoughts about what he terms "biomechanical overload of the lower limb on the podcast.

http://podcasts.bmj.com/bjsm/2011/10...anklyn-miller/

Worth a listen for sure.

Cheers,
Athol
You may want to ask Craig Tanner about this, as Andrew F-M is now over at Aspetar in Qatar with him.
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Old 20th February 2012, 10:48 PM
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Default Re: Podiatrist Recommends Forefoot Striking Versus Orthotics for Treating Running Injuries

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Originally Posted by Ian G View Post
You may want to ask Craig Tanner about this, as Andrew F-M is now over at Aspetar in Qatar with him.
Really??!! wow.. when did that happen? i saw him at UKSEM in December and there was no mention of that at all..
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Old 21st February 2012, 12:29 AM
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Default Re: Podiatrist Recommends Forefoot Striking Versus Orthotics for Treating Running Injuries

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Really??!! wow.. when did that happen? i saw him at UKSEM in December and there was no mention of that at all..
Yep- He arrived about a month ago. Look forward to working with him.

I will pick his brain further about the gait retraining, but my understanding is that they have had good success particularly with anterior compartment problems...
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Old 21st February 2012, 12:57 AM
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Default Re: Podiatrist Recommends Forefoot Striking Versus Orthotics for Treating Running Injuries

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Originally Posted by CraigT View Post
Yep- He arrived about a month ago. Look forward to working with him.

I will pick his brain further about the gait retraining, but my understanding is that they have had good success particularly with anterior compartment problems...
OK!!

guess he is not running UKSEM 2012 anymore!! pass on my best mate1
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Old 21st February 2012, 03:43 PM
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Default Re: Podiatrist Recommends Forefoot Striking Versus Orthotics for Treating Running Injuries

Simon Spooner and Simon Bartold have also jumped into the discussion....Campitelli seems to have gone into hiding!

http://podiatrytoday.com/blogged/do-...need-orthotics
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Old 21st February 2012, 06:35 PM
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Default Re: Podiatrist Recommends Forefoot Striking Versus Orthotics for Treating Running Injuries

Ian Griffiths has also made some excellent comments....while Dr. Spooner keeps hammering away!

http://podiatrytoday.com/blogged/do-...need-orthotics
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Old 23rd February 2012, 12:07 AM
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Default Re: Podiatrist Recommends Forefoot Striking Versus Orthotics for Treating Running Injuries

Sorry, I think in a previous post I should have said internal moments and not external.

On a note, I see the latest issue of PM News carries this letter to the editor about the article that started this thread:
Quote:
RE: Do Runners Need Orthotics? (Kevin Kirby, DPM)
From: Robert Scott Steinberg, DPM
I read Dr. Campitelli's comments on Podiatry Today's forum. I had to read it three times to believe that a podiatrist could be so clueless about orthotics and shoes. Dr. Kirby has given me the answer. Dr. Campitelli gives all the appearances of having been "bought" by Vibram 5-Fingers. He is using unscientific urban rumor to support his position. It is a clear violation of his oath and the code of ethics of the APMA and his state society. What will be so damaging is that he will be quoted by this tiny faction of the in-need-of-an-ego-boost subset of runners. On a positive note, it's good for my practice.
Robert Scott Steinberg, DPM
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Old 23rd February 2012, 12:13 AM
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Default Re: Podiatrist Recommends Forefoot Striking Versus Orthotics for Treating Running Injuries

Quote:
Originally Posted by Craig Payne View Post
I had to read it three times to believe that a podiatrist could be so clueless about orthotics and shoes.....He is using unscientific urban rumor to support his position. ....... What will be so damaging is that he will be quoted by this tiny faction of the in-need-of-an-ego-boost subset of runners.
Ouch!
Quote:
On a positive note, it's good for my practice.
Agreed. All this has been great for business. We should be encouraging it.
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Old 23rd February 2012, 12:48 AM
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Default Re: Podiatrist Recommends Forefoot Striking Versus Orthotics for Treating Running Injuries

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Ouch!Agreed. All this has been great for business. We should be encouraging it.

Really, encouraging people to get injured - get some perspective
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Old 23rd February 2012, 12:57 AM
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Default Re: Podiatrist Recommends Forefoot Striking Versus Orthotics for Treating Running Injuries

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Really, encouraging people to get injured - get some perspective
Sorry, I was being facetious. Podiatrists have been accused of being afraid of the barefoot running trend because of all the injuries that will be prevented and the business that we would loose. The opposite has happened. As what was said in the PM News letter that CP posted, this has been good for business.
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Old 23rd February 2012, 01:31 PM
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Default Re: Podiatrist Recommends Forefoot Striking Versus Orthotics for Treating Running Injuries

A number of posts in this thread have been split off to: Joint moments in forefoot vs rearfoot strike running
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Old 23rd February 2012, 01:42 PM
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Default Re: Podiatrist Recommends Forefoot Striking Versus Orthotics for Treating Running Injuries

From the letter in PM News
Quote:
Originally Posted by Craig Payne View Post
What will be so damaging is that he will be quoted by this tiny faction of the in-need-of-an-ego-boost subset of runners
You only have to see who is posting this blog post on Twitter to see what Robert Steinberg is talking about. They have fallen for it. They blindly tweet stuff without even realizing that none of the references used actually support what is being claimed! ... don't figure!
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