Category Forefoot

The Great Myth of Rotating your Shoes : Here are the Actual Facts as we see them.

Everyone has heard the rules, rotate into new shoes about every 400-500 miles.  We disagree, kind of, and we have talked about it on previous blog posts in the past and on our podcasts.  Many shoe reps have agreed with the methods we employ for our runners.

The EVA foam often used in shoe manufacturing has a lifespan, or better put, a given number of compression and shear cycles. It can go through a rather fixed number of compression cycles before it loses its original structural properties, the older the foam gets the faster the degradation process and the more risks it poses for runners.  It is known that EVA foam compressed into a focal vector or area over and over again becomes softer and more giving into that vector/area over time.  Hence, if you have a compensation pattern or a known foot type (forefoot varus, forefoot valgus, rearfoot varus, rearfoot valgus or a combination of these 4) you will break down a certain region or zone of the shoe’s EVA foam. For example a forefoot varus foot type will often drive some heavy focal compression into the foam under the first metatarsal. However, if you combine it with a rear foot valgus it will drive shear forces and compression into the  EVA foam along the entire medial aspect of the shoe (see the 2 pictures attached, you can see the evidence of excessive medial compression and medial shear in a foot that has severe rearfoot valgus and forefoot varus. This is a very poor shoe prescription for the foot type involved).

Here is what you need to do / know:

1- Know your athletes foot type so you can make more informed decisions.

2- Know the type of foam of the shoes you are recommending (ie. Altra uses A-Bound foam instead of EVA just as an example. A-Bound is an environmentally friendly energy-return compound is made of recycled materials. It reduces the impact of hard surfaces while still maintaining ground feedback. Traditional running shoe foam compresses 70-90% while A-Bound™ compresses 2-3x less so it won’t deform over time.).  Cheap shoes use cheap materials.  Altra goes the extra mile for foam quality and many others are beginning to follow suit. If you think you are getting a deal on shoes, know what “the deal” is, it just may be cheaper materials.

3-  500 miles is not the rule for everyone and every shoe.  If you have a relatively neutral forefoot and you are a forefoot or midfoot strike runner you will get far more miles out of a shoe.  If you depend on a stability shoe with dual densities of foam to slow your pronation and control your medial foot because of a rearfoot valgus and/or forefoot varus know that the shoe’s foam will break down less uniformly because of foam interface junctions and whatnot.  This is a science. Engineers call it “the mechanics of material deformation”.  We wonder how many mechanical engineers shoe companies have on board in their R&D divisions ?  We know for a fact that a few do not. There was a reason we snuck quietly into the mechanical engineering departments of our Alma Mater and sat quietly in the “Materials” classes. At the time our roommates just told us it was  cool class, little did we know why it was so interesting to us, until now.

4- Here is what we recommend. Fit the foot type to the right shoe selection. If you are weak in this territory consider taking our intense “National Shoe Fit” program. Fit is everything. Make the wrong choice for your client and the shoes will break down quicker and into poor and risky patterns. Make the right choice and be their hero. If you are looking for a way to improve clientele happiness and store loyalty our Shoe Fit Program is the way. Just read the testimonials here on our blog. Some of the top stores in the Nation have quietly taken the National Shoe Fit Program from us, they have good reason to. They also have good reason to keep it quiet, to get the edge on the competition.

You can email us to get this information and the e-file program download. Why not certify your entire store staff ?

Email us at   thegaitguys@gmail.com.  This program will teach you foot anatomy, functional anatomy, shoe anatomy, foot types and matching foot type to shoe type as well as many other aspects of gait and lower limb biomechanics.

* 5- Try this recommendation.  At 250 miles buy a new shoe to accompany your shoe that already has 250 miles. Now you are rotating 2 shoes. From this 250 mile point moving forward, alternate the newer show with the older shoe. This way you are never in a shoe that is notably more deformed in a specific area of the EVA foam because of your compensations, limitations or foot type. Essentially you are always just a day away from a newer shoe that has less driving force into abnormally compressed EVA foam.  The older the shoe gets the more it accelerates your foot and body into that deformation and hence why many injuries occur as their shoes get older. Continue to alternate shoes on every other run (new, old, new, old).  Once you hit 400-500 miles on the old shoes, ditch them and get a new pair again to restore the cycle once again.  In fact, to be specific here is what we recommend. Monday, old shoe. Tuesday, new shoe. Wednesday do not run, rather, rest or cross train. Thursday go back to the older shoe. Friday new shoe and repeat. This way you are 4 days between runs in the older more deformed shoe. The one day off running in mid week gives tissues that were challenged by the “old shoe run” a bit more time to repair.

6- Dedicate your shoes to running only. Running gait is not the same as walking gait. Why would you want to break down the EVA foam at the rear foot during walking (because heel strike is normal in walking) when in running you are a mid-forefoot striker ?  Keep walking shoes for walking, running shoes for running. Otherwise you are just asking for trouble.

Check out our National Shoe Fit program and certification process here as well as links to our other teaching DVD’s & e-downloads:
 http://store.payloadz.com/results/results.asp?m=80204

Shawn and Ivo. Helping you use your head (and shoe knowledge) better everyday.
The Gait Guys  (have you checked out our RebelMouse page ? https://www.rebelmouse.com/TheGaitGuys/

Keeping up with our awesome informative podcasts ? It is all free stuff ! https://itunes.apple.com/us/podcast/the-gait-guys-podcast/id559864138

How about our youtube channel ? http://www.youtube.com/user/thegaitguys

How about our Facebook PAGE ?  https://www.facebook.com/pages/The-Gait-Guys/169366033103080

The Dual Density Foam Running Shoe.

This goes along nicely with yesterdays post. Note the photo attached. This is a great example of something we all see everyday. A laterally tipped foot in a stability shoe.  Clearly a shoe that has been mis-prescribed for the wrong reason. Or has it ?

This client is clearly tipped laterally in the shoe, forcing supination.  Did this client self fit the shoe themselves in a discount store ? Were they fitted in a retail running store ? Where did things go wrong ? Or did they ?  The initial knee jerk reaction is to say this is the wrong shoe for this client.  Lets go a little deeper and ask some harder questions and see if you are considering some alternatives.

The assumption is frequently one of, “you are a hyperpronator so you need a stability shoe”. In this case is this person a hyperpronator ?  There is no way to know, not in the shoe.  On initial knee jerk observation this looks like a supinator in a stability shoe, a poor match.  But read on …

1. What if this person has significant flat feet, pes planus with severe pronation problems, but they find the stability they need by standing on the outer edge of the foot in the mechanically locked out position (supination).  Perhaps this is a less fatiguing posture, perhaps a less painful posture. This is often a comfort thing for hyperpronators to display.  What you see is not always what you get because there are two types of feet, those that drop or collapse into the weakness and those that fight the collapse and weakness the whole way via an alternative compensation.  You cannot tell by looking, certainly not from this picture of someone in a shoe. There must be a functional assessment and some gait evaluation. 

2. There exists the high arched flexible foot that pronates excessively, quickly and for a long time (this is the flexible cavus foot) and then there is the high arched rigid foot (the equinovarus foot).  The first described foot may need support from a stability shoe even though they have a high arch on presentation/examination and the later described foot can often go right into a neutral non-supportive shoe.  Can you tell either of these from this picture ? No you cannot.

3. Maybe the person in the photo has tibial varum (bowed lower leg) combined with a rearfoot varus and forefoot varus. This could mean they pronate heavily through the midfoot-forefoot and less so through the rearfoot-midfoot. In this case they are still a heavy pronator but not through what is typically noted or detected by significant medial arch collapse.  In this case the dual density shoe is not going to help all that much because the pronation is occurring mostly after the bulk of the shoe’s dual density stability foam has been passed through by the foot. Can this be detected by this photo ? Again the answer is no. The shoe fitter needs to be clinically aware that this type of client needs a forefoot varus posted shoe to help post up that medial tripod (1st metatarsal head).

4. Maybe, just maybe this is a typical rearfoot-midfoot pronating client, excessive mind you, and all they need is some foot and gait retraining to break their old compensation pattern of lateral weight bearing (standing or walking) and with this correct shoe they can then engage a healthier motor pattern. 

Which is it ?

Do you know how to navigate your way through these issues to make the right decision ?  There is no way to know here without seeing the foot naked and moving across the floor, and with a clinical examination to boot.

You can get all these things through our National Shoe Fit Certification program found here.

LINK:  http://store.payloadz.com/results/results.aspx?advsearch=1&m=80204

Email us and we will share the necessary info to get you started.  thegaitguys@gmail.com

Shawn and Ivo, The Gait Guys

Podcast #14: Forefoot Strike & Evolution

Podcast #14

Here is the live link:   http://thegaitguys.libsyn.com/webpage

iTunes will load it likely by the afternoon. Find it on iTunes through this link:

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Payloadz link for our DVD’s and efile downloads: http://store.payloadz.com/results/results.asp?m=80204

1- National Shoe Fit Program and Certification

2- email from a reader
from: Mikkel
I am currently treating a 15-year-old boy who as a child suffered from left sided equinovarus deformity and was operated. His left gastoc/soleus complex is underdeveloped, and he has impaired ankle rocker due to bony limitations anteriorly in the mortise joint causing anterior ankle pain when running and jumping. He has a distinct limp on the left leg due to decreased ROM and pain. He has an inverted calcaneus and forefoot valgus deformity on both feet (left more than right). He pronates heavily through the mid and forefoot to progress forward. Treatment thus far has had limited effect on the pain symptoms. I’ve manually mobilized the tibiotalar joint with posterior glides of the talus + given him exercises to strengthen the anterior compartment.
Would you consider orthotics? I’m thinking stability shoe with medial arch support maybe with a forefoot drop. Normally I would prefer stability and strength training and foot tripod exercises, but due to bone structure I have started to think, this isn’t enough. The pain limits him from running and playing soccer.
How would acupuncture fit into a treatment program in this case? which points could you recommend?
Any additional info and inspiration is welcomed.
kind regards – Mikkel

 http://en.wikipedia.org/wiki/Club_foot

2- Know your foot strike
http://sweatscience.runnersworld.com/2012/10/do-you-know-your-footstrike/

3- Caffeine: A PED ?

http://news.menshealth.com/chew-gum-before-races/2012/04/12/

Chew on this: Caffeinated gum can improve your athletic performance—if you start chewing it at the right moment, finds a new study from Kent State University.

 http://www.energyfiend.com/the-caffeine-database

4- DISCLAIMER:We are not your doctors so anything you hear here should not be taken as medical advice. For that you need to visit YOUR doctors and ask them the questions. We have not examined you, we do not know you, we know very little about your medical status. So, do not hold us responsible for taking our advice when we have just told you not to !  Again, we are NOT your doctors !

5: more lectures available  on www.onlineCE.com   Go there and look up our lectures

6- EMAIL FROM A Blog follower: 
Why do some muscles go weak and others not ?
First lets talk about tightness vs shortness. We are getting exhausted from always hearing about tight piriformis, psoas hip flexors and IT Bands.
Now, lets define 2 types of weakness…….
a- physiologic /  disuse
b- neurlogic inhibition

7- Our dvd’s and efile downloads
Are all on payloadz. Link is in the show notes.
Link: http://store.payloadz.com/results/results.asp?m=80204

8 – Creatine:
 http://www.foxnews.com/health/2012/10/11/creatine-myths-and-facts/

9- The one perfect test for a runner ?
 http://news.menshealth.com/find-your-perfect-running-pace/2012/10/14/
The Talk Test
Researchers for the study put 18 well trained cyclists through two identical fitness tests. In one test they measured the above thresholds with traditional medical equipment. In the second test they asked cyclists to say a paragraph while exercising. What they found was that the cyclists’ “out-of-breathness” matched the thresholds. “From our standpoint, the TT is very useful and almost ‘idiot-proof,’” Foster says.

Gait, Running and Sound. Are you listening to your body ?

A few months ago we tried something new.  We tested your gait auditory skills while listening to a video of a runner on a treadmill. We queued you to listen to the foot falls listening for the one foot to slap or impact harder than the other at foot strike. Most of you got it right, we  got plenty of positive feedback on that piece. Here is that piece (link).

This is something we do during the initial evaluation for each and every patient that comes to see us, no matter what their issue. We ask them to walk. We ask them do they notice anything. The answer is almost always, “no”.  This is because they are accustomed to their walking habit.  The first queue we notice much of the time is that there is either a bilateral heavy heel strike (because heel strike is normal in walking) or it is  heavier on one side. We ask them to hear and feel that heavier strike once we point it out to them. Not only can they feel it, they can hear it. It is something they have rarely been aware of until that moment.  We then do the same for forefoot loading. If the anterior compartment is a little weaker on one side or if they departed abruptly off the opposite leg for some reason (decreased hip extension, tight calf, loss of ankle rocker etc), a heavier forefoot loading response will be felt and heard as well (opposite side of the mentioned issues).  These are great initial gait queues that anyone can use to gain diagnostic information.  It also draws the client into greater body awareness of their habitual patterns of movement. We then draw out the numbers and forces for them so they understand what several thousand cycles of this event can cause into their body and their clinical problems they are presenting with.  This is typically a new skill they will develop and always be aware of and be able to report to you as they progress through their care with you.  Sound and feeling are key biofeedback tools.

Just remember, they are feeling and hearing what they are doing, not what is wrong ! It is your job to take this information and figure out the “Why” it is happening, and the “how” to fix it.  This is the hard part.

More research on Forefoot Running: Forefoot Varus and the toe extensor muscles.

Lately we have all seen much in the news about the forefoot strike loading in runners and many of the proposals and rebuttals regarding injury rates.  Our dialogue less than 2 weeks ago on some of Lieberman’s recent comments (our blog article “Dear Dr.…

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Midfoot strike 5 year old running barefoot in grass.

So, heel strike you say ?  Have  a closer look.  This is a near perfect midfoot strike. What you cannot see is his torso progression. As long as the torso has enough forward lean heel strike cannot occur. Heel contact can occur, but not heel strike or impact.

We have talked about this on many occasions here on The Gait Guys Blog. No one else is talking about this fine line difference between heel strike and heel contact.  Everyone still seems hell bent on talking about forefoot strike. Forefoot strike in distance running is not normal, midfoot strike like you see here in this young child is natural and normal. This 5 year old was likely just asked to run barefoot, he was not likely coached. This is because midfoot strike is natural and normal.  As we said, as long as the torso is directly above or in front of the foot contact position there is no way that heel STRIKE can occur, rather heel CONTACT can only occur (unless you have hamstrings like cirque du soleil acrobats and do not mind going into a posterior tilted pelvis at contact). 

We tell our runners to:

  • lift the chest and lean
  • raise the toes and dorsiflex the ankle  (engage the anterior lower leg compartment) so that the arch is maximally prepared
  • a heel KISS of the ground is fine, just no impact
  • you do not need to forefoot strike to run naturally
  • * and, here is one more reason why we like a midfoot strike over a forefoot strike…. because a midfoot strike means that the body continues forward whereas a forefoot strike that then allows into a heel kiss/touchdown means that there is a posterior progression and eccentric lengthening of the posterior chain (hamstrings and calf muscles). This posterior directed motions is not exactly wise when forward progression is the goal of running !

This little fella is doing it right. Largely because he has not been in shoes long enough to corrupt the natural tissues and mechanisms (both the body parts and the natural neuromotor patterns).

* Addendum: after a really productive FAcebook dialogue with some readers we felt we needed to be more clear on some of our unspoken assumptions here.  If the heel hits first, it will be a STRIKE and not a KISS and the load will be high. The only way the heel can kiss the ground like we mention above is if the heel is absolutely contacting at the same time as the forefoot, one could say that there is a more dominant load on the mid-forefoot but the heel can still strike at this same time.  Striking clearly on the forefoot and then touching down the heel is satisfactory but there is still a retrograde movement which we believe is not as economical yet certainly better than heel impact/strike.  To get the perfect midfoot strike with barely a subtle heel CONTACT (not impact or strike) requires greater skill and more mastery as a runner.  And if you are wearing a shoe that is not minimalist or zero drop developing this skill will be a challenge and you will be misleading yourself.    This ammendment added 1 hour post blog post launch.

Shawn and Ivo…….. the Devil is in the Details. 

Researchers at England’s Northumbria University analyzed the gait and oxygen uptake of 18 recreational and elite runners performing a series running tasks both barefoot and shod.Dr. Michael Wilkinson, lead researcher and avid barefoot runner determined the following in their study:- a significant saving in energy from taking off running shoes- mechanical differences in the foot strike patterns (shod runners did more heel strike, unshod were more midfoot striking)- there were immediate foot strike changes in previously shod  runners who suddenly changed to unshod foot strike- there is less oxygen use during barefoot running compared to running shod at the same speed. Hence improved running economy.Characteristically, skilled unshod runners have a distinctive running gait utilizing:- mid-foot landing- shorter stride lengths- faster stride rates- reduced ground contact time- lower impact force and loading rates which dampens injury inducing forces- reduced oxygen utilization. The 6% improvement in economy was the same as that previously reported after a nine-week training program for shoe-wearing runners, who also enjoyed a 3% improvement in running performance.Click on the link above for the Science article.

Is Barefoot more economical ?

More research on Forefoot Running: Forefoot Varus and the toe extensor muscles.

Lately we have all seen much in the news about the forefoot strike loading in runners and many of the proposals and rebuttals regarding injury rates.  Our dialogue less than 2 weeks ago on some of Lieberman’s recent comments (our blog article “Dear Dr. Lieberman”, click here) seem to be ringing true again. Here are just two more insightful and important studies when it comes to looking at some of the proposed ideas and causes of forefoot varus. Naturally, a thinking mind would wonder if some of these weaknesses in anterior and posterior tibialis muscles as well as extensor toe musculature, as proposed in just these 2 articles, are causal to the forefoot injuries that seem inevitable as Lieberman seems to suggest (again, see our blog post). Naturally, weaknesses and poor motor patterns of some or all of these muscles is going to create and insufficient and possibly inefficient and pathologic forefoot loads because of the forefoot varus foot type these muscular imbalances can functionally produce.  We have been pounding sand on this issue for years but still no one listens.  The medial research, as evidenced here is supportive of our theories and everyday clinical findings.

To summarize, ONCE AGAIN, not everyone is suited or possibly ready for forefoot load/contact/strike running.  And if you have injury or problems in doing so, don’t blame your minimalist shoe……. it is either a foot type that needs functional repair or a foot type that is fixed an must opt for midfoot strike.

There is SO MUCH MORE to this game than just strap on some minimalist shoes and start forefoot loading your way on your next run.  Buyer beware !

Shawn and Ivo…….. the gait guys……..two guys who are “Gandhi’d” regularly. 

“First they ignore you, then they laugh at you, then they fight you, then you win.”

- Mahatma Gandhi

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http://www.ncbi.nlm.nih.gov/pubmed/20307453

Foot (Edinb). 2009 Jun;19(2):69-74. Epub 2008 Dec 31.

Foot varus in stroke patients: muscular activity of extensor digitorum longus during the swing phase of gait.

Reynard F, Dériaz O, Bergeau J.

Clinique romande de réadaptation, SUVA Care, Av. Gd-Champsec 90, Sion, Switzerland. fabienne.reynard@crr-suva.ch

Abstract

CONCLUSIONS: The activity of extensor digitorum longus muscle during the swing phase of gait is important to balance the foot in the frontal plane. The activation of that muscle should be included in rehabilitation programs.

_______________

http://www.ncbi.nlm.nih.gov/pubmed/16882899

J Bone Joint Surg Am. 2006 Aug;88(8):1764-8.

The contributions of anterior and posterior tibialis dysfunction to varus foot deformity in patients with cerebral palsy.

Michlitsch MG, Rethlefsen SA, Kay RM.

Department of Orthopaedic Surgery, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USA.

Abstract

RESULTS: The muscular contributor to varus deformity was the anterior tibialis in thirty feet, the posterior tibialis in twenty-nine feet, both the anterior tibialis and the posterior tibialis in twenty-seven feet, and another contributor in two feet. Seventy feet had varus deformity during both stance phase and swing phase. Of these seventy feet, twenty-five exhibited dysfunction of the anterior tibialis, twenty exhibited dysfunction of the posterior tibialis, and twenty-three exhibited dysfunction of both muscles. Therefore, the timing of varus was not predictive of the contributing muscle or muscles.

CONCLUSIONS: The current study demonstrated a higher prevalence of anterior tibialis dysfunction, both alone and in combination with posterior tibialis dysfunction, as a contributor to pes varus in patients with pes varus and cerebral palsy than had been reported previously. Dynamic electromyography provides clinically useful information for the assessment of such patients.

Cites lack of conclusive evidence By Jordana Bieze Foster http://www.lowerextremityreview.com/issues/may/biomechanist-challenges-idea-that-forefoot-strike-pattern-reduces-runners-injury-rate
“UMass researchers have demonstrated that, although forefoot strikers do not experience a vertical ground reaction force “impact peak,” they do experience impacts during running, albeit at lower frequencies than rearfoot strikers. This research, presented last summer at the American College of Sports Medicine meeting in Denver, suggests that because those lower frequencies are attenuated by muscle tissues, while higher frequencies are attenuated by bone, forefoot strikers may actually face a higher risk of muscle injury than rearfoot strikers. Claims that loading rate is significantly lower in forefoot strikers than rearfoot strikers also may not be entirely accurate, Hamill said. He cited research from Iowa State University, scheduled to be presented in August at the annual meeting of the American Society of Biomechanics, suggesting that when natural forefoot strikers switch to a rearfoot strike pattern, their loading rate actually decreases. Research, most notably the oft-cited Harvard study published in Nature in 2010, have found higher magnitudes of ground reaction force in rearfoot strikers than in forefoot strikers. However, Hamill noted, the heel is a much less delicate structure than the forefoot and therefore may be better suited to absorb higher forces.” 

Biomechanist challenges idea that forefoot strike pattern reduces runners’ injury rate

A clay pot sitting in the sun will always be a clay pot. It has to go through the white heat of the furnace to become porcelain. -Mildred Wite Stouven.
Today’s blog article is likely to bring flames to our feet, but we are not afraid of the heat.  At the very least we will settle for the heat this article may bring so that our work can get the recognition we feel it deserves and so the truth can be brought to light for the good of all mankind.
“Forefoot strike causes less impact force on the body,” says co-author Daniel Lieberman, Ph.D., a professor of human evolutionary biology at Harvard and scribe of a popular barefoot running manifesto in 2010. “People forget that running is a skill, and if you don’t run properly, you’ll get injured.”
Amen to that; we have been saying that for years before this all became popular talk … We recently read
this article in Men’s Health, yet another one supportive of minimalism running. And once again some of the most important facts are being left out. We just cannot sit here and watch the inaccuracies of minimalism and forefoot running continue to root themselves without policing. So, let us once again set foot into the raging battle. According to the article (LINK) Sturtz says, “Landing on your forefoot, the way humans have run for thousands of years, produces almost zero impact on joints and bones, according to Lieberman’s 2010 study. But 75 percent of us now land heel first—cushioned running shoes made that possible (and comfortable)—which slams up to 3 times the body’s weight in impact force on your knees and legs.” Our question is, ” Why is no one paying attention to foot types?” In every lecture we do, to clinicians or everyday runners, about “forefoot type” variants (valgus and varus to be precise) we comment that this is something that should be talked about during Running Form Clinics where forefoot landing is promoted. 
“… forefoot running is not the whole answer to injury prevention, just a component”, says Lieberman. “This is not a simple solution to a complex problem—you can’t change one thing and have everything be fine. You can still forefoot strike with poor form.”
And we would add to that quote that “you can get a resultant compensatory running form if you forefoot strike with a forefoot varus or forefoot valgus”. Not everyone has that pristine neutral forefoot bipod architecture that the internet articles are assuming exists in everyone, and thus there is no way that everyone has fully competent pristine forefoot biomechanics that will not eventually trigger injury. This is a fact, not our opinion.  Dr Lieberman then goes on to say: ” If it ain’t broke, don’t fix it.” We respectfully disagree. We do this on a daily basis (as do many of you).  If the check engine light on your dashboard is flashing at you every day for a week you would be remiss not to consider the repercussions.  “The car ain’t broken… YET” is a more precise comment. You would be wise not to go on a long distance car trip knowing this fact.  Translating this to forefoot load/strike running, ignoring a potential injury because of flawed forefoot anatomy and biomechanics is a recipe for injury.  Just because it isn’t broken YET doesn’t mean ignoring the issues will make them go away or make you immune. A few hundred or thousand miles on a forefoot variant can be an issue clinically and injury wise. Just because the body isn’t broken YET doesn’t mean it cannot work better and prevent a problem down the road. Dr Lieberman then goes on to quote, “Remember, almost every distance runner gets injured”.  Why is he batting from both sides of the plate here? If “Landing on your forefoot, the way humans have run for thousands of years, produces almost zero impact on joints and bones”, according to Lieberman’s 2010 study then why would he go on to say “Almost every distance runner gets injured”?  There has to be a reason !  Forefoot running is either the answer or it isn’t.  Our valid and ignored proposal above, and our repeated comments throughout our 500+ blog posts on this topic on foot types, is a valid answer to his injury assumption.  It is quite possible that these inevitable injuries occur because people take the advice of “if it ain’t broken, don’t fix it”.  It is also most likely that ignorance of the deeper facts is bliss for most people. .Had they spent the time to find out about their forefoot type and learn to modify subtle biomechanical flaws of forefoot loading strategies of their foot type, perhaps we wouldn’t hear “Remember, almost every distance runner gets injured”.   Maybe that is why you SHOULD look into fixing things that are not YET broken and at the very least learn about foot types, particularly which one you have and the potential risks it exposes you to. Our blog here has done this in depth over the last year. 
“An ounce of prevention is worth a pound of cure” -Benjamin Franklin.  Anyone is medicine knows this is true (or should).
We prefer midfoot strike when possible, for many reasons but mainly because it takes into account a tripod contact loading response.  A tripod load is more stable than a rear foot unipod load and more stable than a forefoot bipod load, particularly when there are rear or forefoot variants (rearfoot valgus, rearfoot varus, forefoot valgus, forefoot varus) from the pristine normal that is always assumed in many articles.   A tripod loading response (midfoot strike) can dampen some of the mechanical flaws of either heel or forefoot strike patterns and of the foot type variants that are the norm, not the exception. We see this stuff everyday in our practices. We are the guys that get the injury cases that are driven by the inaccuracies, or better put “overlooked facts”, of articles on the internet. To be fair, we have also written a fair number of articles for magazines and we know how they can get so chopped down that truth, honesty and full disclosure can be lost for the sake of publication limitations. None the less, our strong opinion, this article could have been far more complete had it talked about the issues we have brought to light here.  We love and respect the work of Lieberman and his colleagues.  He and his colleagues have done a huge service to the runners of the world and we have learned from them. Learning is a lifelong journey for us all and we just think that there is a huge information gap that is being missed and we feel it is time that the runners of the world hear the whole truth. We believe our work is filling that gap.
“First they ignore you, then they laugh at you, then they fight you, then you win.” - Mahatma Gandhi
For the past year, we have been feeling a bit like Gandhi must have felt. We realize that some of our work is complicated, difficult to understand, and tough to digest. We know we are laughed at by some who prefer to seek the safety of ignorance. And yes, despite 600 blog posts on these very topics (yes, we have one of the most informative blogs and YouTube Channels on the web for runners and athletes looking for answers) we feel somewhat ignored. None the less, we continue to stick our necks out far and long to set the record straight to make sure that everyone knows the facts they deserve to know.   We hope you will forward, link, Facebook and tweet the hell out of our blog post today, for the good of every runner and athlete you know and for the whole of mankind.  We are in this for the long haul. Stick and stones … .       – Drs. Shawn and Ivo …  The Gait Guys here is the article that spurred our post: http://news.menshealth.com/fix-your-running-form/2012/01/24/

Dear Dr. Lieberman : Some vital facts on forefoot running are not being discussed.

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