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Shoes vs barefoot (Read 147 times)
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Shoes vs barefoot
Jan 28th, 2010, 8:41am
 
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Re: Shoes vs barefoot
Reply #1 - Jan 28th, 2010, 9:30am
 
Text copied from here:
http://www.facebook.com/notes/boulder-running-company/a-commentary-on-barefootmi nimalist-running/253203788772
 
My name is Mark Plaatjes and I am a physical therapist and co-founder of the Boulder Running Company in Boulder, Colorado. Originally I am from South Africa and competed in the Zola Budd era. In my practice I treat athletes ranging from five hour marathoners to many Olympic athletes and gold medalists. Personally I have won thirty eight marathons worldwide including the 1993 IAAF World Championships with a personal best of 2:08.58.  
 
I have been observing the minimalist and barefoot running trend over the last two years and I feel it might be time to clarify some issues relating to barefoot and minimalist footwear. The mere fact alone that ninety five percent of runners train and race on asphalt, pavement, concrete, and trails; could close the debate over barefoot running. However, listed below are the obvious and relevant facts about barefoot and minimalist running.
 
1. Running barefoot/minimalist strengthens the intrinsic or postural muscles in the feet and lower leg.
2. Running barefoot/minimalist increases proprioceptive awareness and balance.
3. Running barefoot/minimalist forces a change in mechanics to adapt to the forces of on the feet.
4. There are no clinical trials that show an effect of barefoot/minimalist running for a prolonged period of time.
5. There are no research studies that prove that wearing traditional running shoes increases injuries or that barefoot/minimalist running reduces injuries.
 
No one, including myself, contest the above facts. If a runner has exclusive training on soft trails and/or grass, then by all means eschew running shoes as long as mechanics and gait allow for it.
 
There is also the issue of gait and the best way to run. The majority of people walk and run by landing on the heel and toeing off on the big toe. The anatomy of the foot reinforces this technique because the calcaneus is the largest bone in the foot with the largest fat pad in the foot underneath it. The metatarsals are small bones and have much less fat pad protection when compared to the calcaneus. These small bones are not designed to accept three times the weight of the body. The real issue we have to address is mechanics. Far too many people over stride and land with their center of gravity behind the foot strike, which leads to a braking effect and impact up the chain of the body. This type of running is also commonly mislabeled as heel-strike running. Correct heel strike running occurs by shortening the stride, increasing the cadence, and landing with the center of gravity over the feet. This greatly reduces the impact forces and enhances forward propulsion. This type of running is heel-strike running, but the contact point is not at the back of the heel but rather directly underneath the fat pad. Many people are trying to achieve this type of gait by modifying footwear instead of teaching runners the proper mechanics.
 
At In Motion Rehabilitation and at the Boulder Running Company, we see hundreds of runners each week. People come to us not to buy a pair of shoes, but to help them find a tool that will help and allow them to run with the least risk of injury. At this point it is important to point out the major distinction between the people that are able to run barefoot or wear minimalist shoes and the people who are not. Due to ligamentous laxity and/or biomechanical inefficiencies, sixty-five to seventy-five percent of people are not able to run bare foot/minimalist.  
 
When a customer/patient walks into the store or clinic we ask them to take off their shoes and weight bear one foot at a time. If the longitudinal arch collapses and the navicular bone on the inside of the foot becomes prominent and moves medially toward the ground, no amount of strengthening is ever going to lift that navicular bone. The ligaments cannot support the bones in the normal alignment anymore. It would be irresponsible for me or any of the staff to recommend barefoot/minimalist shoes to these customers. We do have customers who have great mechanics and good foot structure and we certainly place them in the appropriate neutral/minimalist footwear. Our goal is to place the customer in the appropriate footwear and to correct any gait inefficiencies that they may have as well as not to fit them to a shoe that changes their gait.  
 
At the Boulder Running Company and In Motion Rehabilitation, we certainly do not always get it right and we try to learn from our mistakes. For over fourteen years we have helped thousands of runners and walkers continue to do what makes them happy and to achieve their goals. We want runners to consult with their doctors, physical therapist, and podiatrists about their particular mechanics, gait, and foot structure before embarking on the barefoot/minimalist route. In the end, Boulder Running Company is a retailer, and whether we sell a motion control shoe or a minimalist shoe, it makes no difference to us. Our main interest is keeping our customers walking and running with the least amount of problems possible.
 
Walking and running barefoot certainly can serve as a useful tool in strengthening muscles and increasing proprioceptive awareness. It should be done gradually and with the guidance of a professional to analyze if a person’s mechanics will allow for the transition.
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Re: Shoes vs barefoot
Reply #2 - Jan 28th, 2010, 3:34pm
 
"Due to ligamentous laxity and/or biomechanical inefficiencies, sixty-five to seventy-five percent of people are not able to run bare foot/minimalist."
 
Where did he get this number?
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Re: Shoes vs barefoot
Reply #3 - Jan 28th, 2010, 4:04pm
 
Probably out of his ( ; )
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Re: Shoes vs barefoot
Reply #4 - Jan 28th, 2010, 4:06pm
 
I'd hope he'd say that 65-75% figure was based on the number of folks he sees, treats, serves professionally, throughout his years in business/service.  That also means 25-35% of their customers/patients have the bone structure in their feet to be able to benefit from some barefoot/minishoe running, drills, exercises & training, enjoy, d Cool
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Re: Shoes vs barefoot
Reply #5 - Jan 29th, 2010, 9:23am
 
http://www.sportsscientists.com/2010/01/running-barefoot-vs-shoes.html
 
Barefoot running - new evidence, same debate
 
It's been a rather frantic week, and I know there is a series on weight hanging in between Part 3 and Part 4.  I'm hoping to get to that next week, when hopefully I'll have a little more time!
 
But today, I have to comment on this latest study, which I know will become bigger in the coming days - it is a new study that will reignite the barefoot vs. shoe debate, one of the more controversial issues in running.  
 
I am actually planning a whole series on this topic, because I was recently interviewed by a Dutch Running magazine, Run2Day, and I'm going to post that entire interview (with additions) on the site at some point in February.
 
 
The study  
 
 
For now though, the paper is called Foot strike patterns and collision forces in habitually barefoot versus shod runners, and it is published in Nature (Full reference: Lieberman et al., Nature, 463, 531 - 535).  
 
The scientists took five group of runners and had them run both barefoot and in shoes. The groups were: Habitually shod adults in the USA, Recently shod adults in Kenya, Habitually barefoot adults in the USA, Barefoot adolescents in Kenya, and Shod adolescents in Kenya.
 
Each group ran in shoes and barefoot and they measured foot-strike pattern (whether the runner lands on the heel, midfoot or forefoot) and kinematic and kinetic variables like impact force, loading rate, and joint angles.
 
The findings - a shift in landing, a reduction in force  
 
 
It turns out that people who run barefoot, even when shifting from shoes to the barefoot condition (the habitually shod groups),  shift the landing point to the forefoot.  There's nothing new there - it's been known for many years that running barefoot changes the footstrike.  Hundreds of studies exist to show this.  The next difference is the ankle angle - the barefoot runner has a more plantarflexed ankle when they land - what this means is that the toe is pointed away from the body more (compared to dorsiflexion, when you pull it back towards you at the ankle).  Again, hundreds of studies have shown this.
 
 
Next are the impact forces.  Here's where there is some disagreement.   Previous studies have occasionally disagreed on how barefoot running affects impact forces - some say it actually increases them, with high variability between individuals.  Most suggest a reduction, particularly early on during impact (first impact).   The Nature study has found that being barefoot AND landing on the forefoot reduces both the loading rate and the peak impact force.  In fact, it's three times lower in barefoot runners who forefoot strike (which is most of them) than in heel strikers wearing shoes.  In theory (though this too is disputed), higher impact forces and loading rates equals greater injury risk, and so the study is suggesting that perhaps people who are barefoot or minimally shod have a better chance of avoiding injury.
 
 
A stimulus plan for physical therapists and podiatrists?
 
And here is where it gets tricky.  I must point out that the title of the paper is Foot strike patterns and collision forces in habitually barefoot versus shod runners.  I highlight the word "habitually", because it's quite important to appreciate the impact that this word may have on how you apply this finding.
 
I guarantee that the media are going to be all over this and they are going to tell you that you should be running barefoot or in Vibrams.  You will hear how science has proven that being barefoot will prevent injuries, and that those of you who are injured should blame your shoes as you lob them into the garbage bin.
 
None of these suggestions is true, yet.  And Dan Lieberman who headed up this latest study would not even be suggesting this himself.  The final sentence in the paper in fact reads "controlled prospective studies are needed to test the hypothesis that individuals who do not predominantly RFS either barefoot or in minimal footwear, as the foot apparently evolved to do, have reduced injury rates" (good science always recognizes what it DOESN'T say, and Lieberman and co fit this category).
 
What the Nature study hasn't measured is the long term (or even the short term) effects of the change on loading rates on different joints.  If you wish to guarantee yourself an injury, then go out for a 2km run barefoot on a hard surface, and you will be asking your calf muscles and Achilles tendons to do work that for perhaps 30 years, they haven't had to do.
 
And I will illustrate this with our own insight into footstrike and injury.  When the Pose research was done in Cape Town, athletes basically had their footstrike patterns changed through 2 weeks of training in the new method.  The biomechanical analysis found lower impact forces (sound familiar? Same as the Nature paper), and even less work on the knee joint.  This was hailed as a breakthrough against running injuries, because lower impact plus lower work on the knee meant less chance of injury.  Jump ahead 2 weeks, and 19 out of 20 runners had broken down injured.  Why?  Because their calves and ankles were murdered by the sudden change.  And the science showed this - the work on the ANKLE was significantly INCREASED during the forefoot landing.    
 
The point is, changing how you run, whether by technique training or a change in shoes (like running barefoot) will load muscles that may be very weak, and joints and tendons well beyond their means.  If however, you are a habitually barefoot runner, then you can do this, because your body has been prepared for it.  For everyone else, I think we may be underestimating the time it will take to transition successfully to barefoot running (or forefoot striking, if you're going to force that change 'unnaturally').
 
And there is my point - taking this kind of interesting study, and dispensing advice, is a risky business.  As a friend pointed out yesterday - the media's interpretation of this study will be a "stimulus plan for physical therapists and podiatrists".  Going from years of shoes into minimal shoes or barefoot will injure you if you are not careful.  
 
 
Conclusion
 
The Nature study provides a good discussion point.  It's intriguing, and certainly does suggest advantages to barefoot running.   It is not the last word, but rather the latest word in this debate.  Nor is it revolutionary, because for many years, we've known that being barefoot changes ankle angle on impact, footstrike and loading rates (though quite how they change is not agreed upon).
 
I'm sure a lot more will be written - I'll even cover some of it when I do that interview series on this topic in the coming weeks.  For now, that's the last I'll say on this particular issue, but debate is always welcome!
 
Ross
 
P.S.  Daniel Lieberman has launched a website on this topic, and it's well worth a look.  It is obviously based on his research (this study forms the bulk of it), but it's a good, clear explanation of the concepts.  Again, the same word of caution applies - don't jump from one to the other.  If there is one section of that website that you should read over and over, it is the Training tips section.  Most will not, and they'll become the statistics (and the stimulus for physical therapy), but if you manage it right, then the site will be a great help to you!
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