Things to Read: Taking on Dr. Oz, Don’t Take Your Vitamins, Questions About Barefoot Running,

There are several interesting things out there to check out. Here are a few:

The New Yorker on Dr. Oz

Scientists often argue that, if alternative medicine proves effective through experimental research, it should no longer be considered alternative; at that point, it becomes medicine. By freely mixing alternatives with proven therapies, Dr. Oz makes it nearly impossible for the viewer of his show to assess the impact of either; the process just diminishes the value of science.
– the New Yorker

Dr. Mehmet Oz is hugely popular. I don’t know how many people watch his show but it’s a lot. We all know who he is. He’s a Harvard- and University of Pennsylvania-trained heart surgeon and he directs Columbia Hospital’s Cardiovascular Institute and Integrative Medicine Program. He knows a few things. An article in the New Yorker titled The Operator: Is the most trusted doctor in America doing more harm than good? takes Dr. Oz to task for perhaps crossing a line from science and good doctoring to entertainment.

I agree with a lot of what the article suggests. He seems to veer from scientific-based factual information into entertaining yet scientifically questionable material. He’s had psychics on his show and he often discusses “miracle cures,” and “breakthrough fat-burning this-and-that.” I haven’t seen much of him but what I do see and hear sounds very sensational. He seems to promise miracles to desperate people. Sounds a little kooky to me. From the article:

“The Dr. Oz Show” frequently focuses on essential health issues: the proper ways to eat, relax, exercise, and sleep, and how to maintain a healthy heart. Much of the advice Oz offers is sensible, and is rooted solidly in scientific literature. That is why the rest of what he does is so hard to understand. Oz is an experienced surgeon, yet almost daily he employs words that serious scientists shun, like “startling,” “breakthrough,” “radical,” “revolutionary,” and “miracle.” There are miracle drinks and miracle meal plans and miracles to stop aging and miracles to fight fat. Last year, Oz broadcast a show on whether it was possible to “repair” gay people (“From Gay to Straight? The Controversial Therapy”), despite the fact that Robert L. Spitzer, the doctor who is best known for a study of gay-reparation therapy, had recanted. (Spitzer last year apologized to “any gay person who wasted time and energy” on what he conceded were “unproven claims.”) Oz introduced a show on the safety of genetically modified foods by saying, “A new report claims they can damage your health and even cause cancer.” He also broadcast an episode on whether the apple juice consumed daily by millions of American children contains dangerous levels of arsenic. “Some of the best-known brands in America have arsenic in their apple juice,” he said at the outset, “and today we are naming names.” In each of those instances, and in many others, Oz has been criticized by scientists for relying on flimsy or incomplete data, distorting the results, and wielding his vast influence in ways that threaten the health of anyone who watches the show. Last year, almost as soon as that G.M.O. report was published, in France, it was thoroughly discredited by scores of researchers on both sides of the Atlantic.

Dr. Eric Rose was interviewed for the article. Rose is a professor of surgery at the Mount Sinai medical school. Rose and Oz worked together, most notably on Frank Torre’s 1996 heart transplant. (Frank Torre is the brother of former Yankee manager Joe Torre.) He said this:

“I want to stress that Mehmet is a fine surgeon,” Rose said, as he did more than once during our conversation. “He is intellectually unbelievably gifted. But I think if there is any criticism you can apply to some of the stuff he talks about it is that there is no hierarchy of evidence. There rarely is with the alternatives. They have acquired a market, and that drives so much. At times, I think Mehmet does feed into that.”

I asked if he would place his confidence in a heart surgeon, no matter how gifted, who operated just once a week, as Oz does. “Well,” he replied, “in general you want a surgeon who lives and breathes his job, somebody who is above all devoted to that.” Again he mentioned Oz’s experience, but when I asked if he would send a patient to Oz for an operation, he looked uncomfortable. “No,” he said. “I wouldn’t. In many respects, Mehmet is now an entertainer. And he’s great at it. People learn a lot, and it can be meaningful in their lives. But that is a different job. In medicine, your baseline need has to be for a level of evidence that can lead to your conclusions. I don’t know how else you do it. Sometimes Mehmet will entertain wacky ideas—particularly if they are wacky and have entertainment value.”

And there is this observation from researcher Eric Topol:

“Mehmet is a kind of modern evangelist,” Eric Topol said when I called him at the Scripps Research Institute, where he is a professor of genomics and the director of the Translational Science Institute. Topol, one of the nation’s most prominent cardiologists, founded the medical school at the Cleveland Clinic and led its department of cardiovascular medicine. “He is keenly intelligent and charismatic,” Topol said. “Mehmet was always unique, but now he has morphed into a mega-brand. When he tells people the number of sexual encounters they need each year to improve their lives in a specific way, or how to lose weight in three days—this is simply lunacy. The problem is that he is eloquent and talented, and some of what he says clearly provides a service we need. But how are consumers to know what is real and what is magic? Because Mehmet offers both as if they were one.”

Dr. Oz seems like the latest in a long line of American snake-oil salesmen. The best ones mix truth with fantasy and it sounds like Dr. Oz is doing just that. On the positive side, the article tells us that Dr. Oz is pro-vaccine. Read the full article on the cult doctor here.

The New York Times: Don’t Take Your Vitamins

The likely explanation is that free radicals aren’t as evil as advertised. (In fact, people need them to kill bacteria and eliminate new cancer cells.) And when people take large doses of antioxidants in the form of supplemental vitamins, the balance between free radical production and destruction might tip too much in one direction, causing an unnatural state where the immune system is less able to kill harmful invaders.
– the New York Times

I’ve discussed various questions about supplements. Now, a recent opinion piece called Don’t Take Your Vitamins is in the New York Times and it goes into more information on the topic. Here’s a bit:

“Antioxidation vs. oxidation has been billed as a contest between good and evil. It takes place in cellular organelles called mitochondria, where the body converts food to energy — a process that requires oxygen (oxidation). One consequence of oxidation is the generation of atomic scavengers called free radicals (evil). Free radicals can damage DNA, cell membranes and the lining of arteries; not surprisingly, they’ve been linked to aging, cancer and heart disease.

To neutralize free radicals, the body makes antioxidants (good). Antioxidants can also be found in fruits and vegetables, specifically in selenium, beta carotene and vitamins A, C and E. Some studies have shown that people who eat more fruits and vegetables have a lower incidence of cancer and heart disease and live longer. The logic is obvious. If fruits and vegetables contain antioxidants, and people who eat fruits and vegetables are healthier, then people who take supplemental antioxidants should also be healthier. It hasn’t worked out that way.

The likely explanation is that free radicals aren’t as evil as advertised. (In fact, people need them to kill bacteria and eliminate new cancer cells.) And when people take large doses of antioxidants in the form of supplemental vitamins, the balance between free radical production and destruction might tip too much in one direction, causing an unnatural state where the immune system is less able to kill harmful invaders. Researchers call this the antioxidant paradox.

Because studies of large doses of supplemental antioxidants haven’t clearly supported their use, respected organizations responsible for the public’s health do not recommend them for otherwise healthy people.

So why don’t we know about this? Why haven’t Food and Drug Administration officials made sure we are aware of the dangers? The answer is, they can’t.”

The article goes into how the supplement makers have tied the hands of the FDA. Seems this sort of thing happens in many different arenas from food and drugs to environmental regulations. It seems over and over again we’re shown that we should get our nutrition from real food, not pills and powders.

The New York Times: Is Barefoot-Style Running Best? New Studies Cast Doubt.

(Somehow all these article came from the great city of New York. Wasn’t really intentional but… there it is anyway.) I’m a big fan of minimalist or barefoot-style running. I believe in my case it has helped me regain proper mobility and strength, and has helped me overcome pain and regain my running ability. That said, simply donning a pair of Vibram 5-Fingers and hitting the road WAS NOT a cure-all for me. A lot more work went into my efforts to fix my running. The New York Times discusses things in this direction in this recent post in the Well Blog section.

The article discusses research from the Journal of Applied Physiology that looked at forefoot vs. heel striking in runners. (Advocates of barefoot-style running suggest that barefoot running promotes forefoot striking which is suggested by some to reduce injuries.) The pertinent findings are these:

In the end, this data showed that heel-striking was the more physiologically economical running form, by a considerable margin. Heel strikers used less oxygen to run at the same pace as forefoot strikers, and many of the forefoot strikers used less oxygen — meaning they were more economical — when they switched form to land first with their heels.

Most of the runners also burned fewer carbohydrates as a percentage of their energy expenditure when they struck first with their heels. Their bodies turned to fats and other fuel sources, “sparing” the more limited stores of carbohydrates, says Allison Gruber, a postdoctoral fellow at the University of Massachusetts Amherst, who led the study. Because depleting carbohydrates results in “hitting the wall,” or abruptly sagging with fatigue, “these results tell us that people will hit the wall faster if they are running with a forefoot pattern versus a rear-foot pattern,” Dr. Gruber says.

That covers running efficiency of two different foot-strike styles. The article says this about injuries:

The news on injury prevention and barefoot-style running is likewise sobering. Although many barefoot-style runners believe that wearing lightweight shoes or none at all toughens foot muscles, lessening the likelihood of foot-related running injuries, researchers at Brigham Young University did not find evidence of that desirable change. If foot muscles become tauter and firmer, the scientists say, people’s arches should consequently grow higher. But in a study also presented at the sports medicine meeting, they found no changes in arch height among a group of runners who donned minimalist shoes for 10 weeks.

Other researchers who presented at the meeting had simply asked a group of 566 runners if they had tried barefoot-style shoes and, if so, whether they liked them. Almost a third of the runners said they had experimented with the minimalist shoes, but 32 percent of those said that they had suffered injuries that they attributed to the new footwear, and many had switched back to their previous shoes.

This isn’t terribly surprising considering that from a biomechanics standpoint, running is a complicated task. There are numerous joints and muscles involved in the kinetic chain. If any part of that chain isn’t functioning properly then we may get a problem. If we’re conditioned to running in one type of shoe then abruptly change to another shoe, then conditions are very different under our feet and thus the way we run will be altered.

Minmal shoes have been a component of my overcoming various chronic aches and pains–which I should say were acquired while running in conventional “good” running shoes. I initially simply running in my old, bad style in my new minimal shoes. It didn’t work! I had to regain competency in my feet, hips, and torso to fix my running issues. Minimal shoes allowed me to become more aware of my feet and more aware of how I land on the ground. So again, I think minmal shoes can be a very good idea so long as they’re not looked to as a be-all-end-all cure to running injuries.

Born and Evolved to Run

This article titled Born and Evolved to Run comes from the New York Times Science section–and you should read it. It’s a Q&A with Daniel Liberman, an evolutionary biologist from Harvard. He’s also a barefoot runner. He’s done a significant bit of research on barefoot running that any and all runners should look into. Beyond our feet, Liberman also discusses some unique characteristics of our necks and why most of our tooth and gum ailments are a result of the modern age. Here’s an exerpt:

Q. Your other specialty is the evolution of the foot. Why this emphasis on the farthest points of our bodies?

A. Actually, I’m interested in the entire body. However, I got into feet because of my interest in heads. Some years ago, I was doing an experiment where I put pigs on treadmills. The goal was to learn how running stressed the bones in the head. One day, a colleague, Dennis Bramble, walked into the lab, watched what was going on, and declared, “You know, that pig can’t hold its head still!”

This was my “eureka!” moment. I’d observed pigs on treadmills for hundreds of hours and had never thought about this. So Dennis and I started talking about how, when these pigs ran, their heads bobbed every which way and how running humans are really adept at stabilizing their heads. We realized that there were special features in the human neck that enable us to keep our heads still. That gives us an evolutionary advantage because it helps us avoid falls and injuries. And this seemed like evidence of natural selection in our ability to run, an important factor in how we became hunters rather than just foragers and got access to richer foods, which fueled the evolution of our big brains.

The Minimal Shoe Debate Heats Up

If you’re an exercise geek like me then you may take interest in the latest goings-on over at Zero-Drop, a very fine minimalist running blog. Three posts are worth reading: “ASICS Have Really Dug In Their Heels,” “The ASICS ‘Minimalst’ Shoe Debate Continues…,” and “The Other Shoe Has Dropped: Dr. Craig Richards Challenges ASICS and Other Shoe Companies.”

It seems that shoe company ASICS is not jumping on the minimal shoe bandwagon like most of their competitors. ASICS shoe designer Simon Bartold is quoted in the article and he speaks fairly derisively of the movement toward flatter, thinner and more flexible shoes. He demands proof that minimal shoes are healthy and useful for runners. (Meanwhile, there’s certainly no proof that modern, “good” running shoes are healthy either.)

What’s most interesting however isn’t the article itself but rather the spirited exchange that follows in the comments section where Bertold and the blog author go back and forth over the scientific particulars of this issue. The discussion gets quite heated and the drama even spills over to another blog. “ASICS vs Zero Drop, Minimalist vs. Maximalist” comes from the great minimalist site, Runblogger. It’s a very thorough examination of the type of proof that Simon Bertold demands. The article in fact draws a comment from ASICS’ Bertold that that might be seen as a little bit of backpedaling.

The issue of science and scientific “proof” is a prominent feature of these discussions. It’s unlikely that any one study will prove 100% whether or not any type of shoe–or no shoe at all–will cause or prevent a given type of injury. There are many many variables that go into an injury or lack thereof. (Interestingly, several studies suggest that conventional “good” running shoes matched to foot type do nothing to prevent injuries.) Further, just because a rigorous study hasn’t been done doesn’t mean that a given cause-and-effect relationship doesn’t exist. Minimal shoe/barefoot running may or may not in fact be healthier for most people than running in a conventional running shoe but there may be no powerful study that exists that proves either condition.

There’s nothing wrong with examining the anecdotal evidence either. It’s often the anecdotal stuff that motivates someone to study something, and there’s a lot of anecdotal evidence out there supporting the idea that less shoe is better than more shoe. I can speak from my observations of clients in the gym (as well as my wife and my own condition) that many people move better and feel better in minimal shoes. I’m not the only one observing this. In fact the shoe companies making minimal shoes are responding to the requests of their customers.

Finally, if you find all of this interesting, then you should get over to a recent post at the Science of Sport. The barefoot running debate: Born to run, shoes & injury: the latest thinking is a remarkably in-depth discussion on the shoe issue. The Sports Scientists take their subjects very seriously and they always get deep into the science behind athletics. They discuss the important of running technique and the idea of how to transition from a conventional running shoe to the barefoot/minimal running style. Very informative stuff there.

My First Barefoot Excursion & What is Tightness?

1st Barefoot Run

Anyone who reads this blog knows I’m a fan of minimal footwear. I believe the best foot is a strong foot, not a foot that’s been made weak by modern “good shoes.” The foot has been a foot for a looooong time. Relative to the span of human existence, “good shoes” and orthotic-type devices are a very new trinkets. The ancient Egyptians, Greeks, Romans, Vikings, Gengis Khan’s Golden Horde, Comanches, Apaches, Aztecs, Zulus… and the vast majority of our fellow humans who’ve ever marched across the earth have done so while wearing nearly nothing on their feet. It wasn’t until the 1970s that we got the modern running shoe from Nike. In terms of research & development, one has a huge head start over the other. All kinds of new research suggests that “good shoes” may not be all that good for us at all.

While minimal shoes have gained in popularity so has barefoot running and I’ve pondered playing around with the concept. So I was quite interested when our local running store the Runner’s Roost advertised a barefoot/minimal shoe seminar. My wife and I attended the seminar last night and it was really fascinating. It got me all excited to start experimenting in a shoeless direction. Today was my first day out.

Of the four speakers, Michael Sandler of RunBare.com was the most interesting informative. (Among other issues, he’s missing the anterior cruciate ligament on one leg–the result of a roller blade crash. So for people who say running is bad for the knees, you might think again. He was also an orthotic addict and orthotic designer.) He suggested that newly barefoot runners must listen to their feet. The moment you feel a little bit of irritation, the run is over. Put on your shoes and come back to run barefoot another day. He suggested a first barefoot run of 200 meters. Then take a day off. Next run is 300 meters. Day off. Next run is 400 meters and so on. It is a very slow starting process this barefoot running.

So today I went for a walk with our dog. It was great weather: sun and 70-ish degress. I walked out barefoot but I had my shoes in a backpack. I ran down the sidewalk to the end of our block. My steps were very quick and light and everything felt fine. First run done and done. I walked another couple of blocks barefoot then put on the shoes. No barefooting tomorrow but I plan to hit it again on Friday. As I sit here writing this, my heel and Achilles pain is non-existent. Seems like a good start.

What is Tightness?

In a somewhat different direction, one of my favorite exercise geek blogs is Begin to Dig. It’s written by a fellow Z-Health practitioner, a woman named MC. (I actually don’t know her full name.) The latest post discusses the whys and hows of tight muscles and how to address them. Among other things, she describes why using a foam roller is probably not the best idea. If you want to learn a bit about the underlying cause(s) of tightness (first and foremost it’s all about your survival) then you should check it out. Beyond that, there’s a lot more informative stuff on her blog about getting strong, lean, fast and pain-free.

Personal Running Experiment: Brooks vs. Vibrams

I’ve been dealing with Achilles pain since the end of last summer. (The Achilles pain is very likely the latest symptom of a variety of dysfunctions which seem to be rooted in foot and glute function.) This week I’ve gone on the first couple of what you might call “runs.” One day I wore my Brooks then the next day I ran in my Vibrams. There were very interesting and different results. Overall, I felt far more comfortable in the Vibrams. I experienced less shock and impact and I felt better at the end of the run. Running in the Brooks seemed to bother my left hamstring and my low back. Not everything was perfect in the Vibrams. I seem to have some irritation in part of the medial plantar nerve which results in a bit of burning/numbness type feelings in the big toe and 2nd/3rd toe area. It wasn’t too terrible though. I will continue to play around back and forth with footwear and see what happens.

Thus far, I love my Vibrams for work and gym exercise. I hiked in them this past weekend and I felt very good in them. I’m wearing them more and more and I encourage most exercise enthusiasts to experiment with wearing minimal footwear.

Achilles Tendon Issues: Help from Dr. Ivo at Summit Chiropractic

My wife and I just recently enjoyed a long weekend in the mountains full of skiing/snowboarding, sleeping in, and wishing we had a condo near the slopes. Part of that weekend included a visit with Dr. Ivo Waerlop at Summit Chiropractic in Dillon, CO. I went in hopes of 1) getting help with my sore left Achilles tendon that’s been bothering me for months, and 2) get some of his thoughts on barefoot running. The visit was very helpful and enlightening.

Dr. Waerlop was featured in a Denver Post article on barefoot running. My wife looked up his web site and it grabbed my interest. Dr. Waerlop is involved in the biomechanics of cycling, running and skiing (three things I love), and he’s involved in barefoot running. In fact, he’s a biomechanics advisor for Vibram. He’s also an accupunturist.

I won’t go into every detail but his asessment of my gait was very precise and his explanations very thorough. He assessed my feet, legs and trunk; observed my gait; and presecribed several exercises for me plus a sole lift for my shoe.

Most importantly we focused on attending to the causes of my problems (faulty biomechanics in the feet and toes) rather than the symptoms (pain in the Achilles–oh yeah, and my low back and my left shoulder).

He also advised me on barefoot running. I probably won’t ever be a full-on barefooter but I likely will be doing some barefoot running in the near future. (Gotta take it slow!)

There’s more. Dr. Waerlop is part of the Homonculus Group. (What is the homonculus? Excellent question. Click on the word to find out.) This is a group of physicians and sports performance/injury rehab professionals who are “committed and driven to better understand the problems of pain and movement impairment in this world (basically the aches and pains that ail individuals.)” The Homonculus site is rich with podcasts, articles and discussion threads (though it appears their discussion board has received a lot of spam which should be removed. Go to page 1 of the discussion board for legitimate information.) Finally, Dr. Waerlop is one of the Gait Guys whose lectures on gait assessment are found at Youtube.

I am very excited to dig into the articles and podcasts. If you’re a trainer, coach, or injury rehab professional–or if you’re just a fitness geek with some spare time, I highly recommend you investigate some of this material. I can’t get enough of this stuff!!!

Counterpoints to Barefoot Running

I think it’s important to analyze any trend or issue from several viewpoints. In the world of fitness and nutrition we see all sorts of fads come and go. Today barefoot running is gaining in popularity. I’ve posted recently on some of the research that suggests barefoot running may be healthier for the joints than shod running. So, I believe it’s worth considering doing some barefoot work whether it be gym work such as weight training or agility work; or perhaps very short runs on a soft surface such as grass. It may in fact be beneficial to work toward a full transition from shod running to barefoot running. That said, it’s vital to consider other views.

First, the Science of Sport gives us Barefoot running – new evidence, same debate. One notable point the writers make is this:

“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.

(This sort of observation can go for just about every new study that’s reported in the press.) I think it’s entirely likely that runners may latch on to barefoot running thinking that it’s an instant magic cure for whatever is bothering them and the results may be disastrous. (Then what will the press, physical therapists, and podiatrists say? “Barefoot running is the worst thing in the world! No one should do it ever! Then we’ll have discarded a potentially helpful tool from our toolbox.)

The article goes on to give an example of what happens when the pendulum swings too far and runners adopt something very new and very different into their training:

“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.”

Thus we get the very clear point that barefoot work must be added gradually into your routine. A rapid switch in running technique is probably a very bad idea. DO NOT move rapidly to replace all your shod miles with barefoot miles.

Over at the Running World According to Dean you can read Another Barefoot Running Story. He seems a bit skeptical on the issue of barefoot running. Owen Anderson at Educated Runner has presented two posts on barefoot running: Barefoot, Nearly Barefoot and Bearfoot Running; and Barefoot Running: What the Harvard Study Really Said. Both articles are again somewhat skeptical of barefoot running and running in Vibrams. Anderson’s second post is most valuable I believe in that he points out some of the limitations of the study “Foot Strike Patterns and Collision Forces in Habitually Barefoot versus Shod Runners” that appeared recently in the journal Nature.

Anderson makes this point: “The Nature investigation did disclose some interesting information about the effective mass of the foot and shank (which we won’t discuss here), but it offered no other information about the potential links between barefoot running and either injury or performance.”

He’s correct. This study was not a long term study. The study indeed showed lower impact forces at the ankle, knee and hip during barefoot running when compared to shod running, however the runners were not observed over the long term. Thus we only know what happened during the short duration of the study. This situation is indicative of most barefoot running studies. Nor did the study investigate which method–barefoot or shod–results in the fastest performances.

Further studies should be conduced looking at several points. First, long-term studies should look at injury rates of shod runners compared to barefoot or minimally shod runners. Second, we need to move beyond injury issues and look at racing performance. In other words can we run faster barefoot/minimally shod or in shoes? Third, it might be interesting to see how many people have tried to convert from running shoes to barefoot running but were unsucessful. What happened to these people?

From my point of view, none of these other posts or viewpoints have changed my thinking that some degree of barefoot work is very likely healthy for a fair number of people. It’s not necessary for anyone to permanently discard their running shoes for bare feet, but perhaps it would be valuable to consider taking the shoes off from time to time and letting the feet behave like feet.

News on Barefoot Running: Part III

To this point we’ve looked a couple of aspects of the human foot and running. In Part I we looked at research showing the unshod or minimally shod foot worked quite well at running for the vast majority of human history. In Part II we looked at the following: 1) research linking knee osteoarthritis to high loading forces on the knees, 2) higher loading forces were associated with stability shoes, and 3) lower loading forces were associated with shoes such as flip-flops that allow a more natural foot movement. Thus we can conclude that in order to avoid ailments such as knee osteoarthritis (and I might guess the same for hip, ankle, and low back arthritis) we should do whatever we can to allow our feet to move unencumbered.

[Researchers] concluded that running shoes exerted more stress on these joints compared to running barefoot or walking in high-heeled shoes.

So here are the lastest findings on this issue. Running Shoes May Cause Damage to Hips, Knees and Ankles, New Study Suggests details the findings of a study published in the December 2009 PM & R, the journal of the American Academy of Physical Medicine and Rehabilitation. (Here’s the abstract, and the full text.) Researchers studied 68 healthy adult runners as they ran on a treadmill both in modern running shoes and while barefoot. Significantly higher torque forces were observed in the subjects when they were in running shoes. The study reports “An average 54% increase in the hip internal rotation torque, a 36% increase in knee flexion torque, and a 38% increase in knee varus (inward) torque were measured when running in running shoes compared with barefoot.”

Those are significant forces! And why do most people wear running shoes? To protect the feet, provide stability, to be comfortable… Very interesting that these shoes actually increase the forces which we’re looking to minimize. In closing, the researchers say,

“Reducing joint torques with footwear completely to that of barefoot running, while providing meaningful footwear functions, especially compliance, should be the goal of new footwear designs.”

So with that statement in mind, I’ve recently purchased a pair of Vibram 5-Fingers model KSO. I’ve worn them the past couple of days at work and they’re quite interesting. I plan on wearing them exclusively when I weight train, and I plan on running in them fairly soon. (There’s a little too much snow on the ground here in Denver right now.) I’ll probably try some running on the grass first and then try short runs on pavement. We’ll see what happens…

News on Barefoot Running: Part II

Previously I discussed how wearing shoes alters the human running stride. For millennia, our feet functioned well enough to get us to the 1970s when we put them into running shoes. The result seems to be our adopting a running stride (heel strike) that may be more stressful and injurious than an unshod stride (forefoot strike). I want to continue the discussion by looking at a few more studies of our feet and the effect of shoes.

The original ATV...

I’ll go back to a Science Daily article from November of 2007 called Your Knees Want to Take you Shoe Shopping. The research was originally presented in 2007 at the American College of Rheumatology Annual Scientific Meeting. Researchers analyzed the effects of various footwear on patients with knee osteoarthritis. Specifically, they looked at loading of the knees.

The first point the researchers make is this:

“In knee osteoarthritis, there is abundant evidence that patients with abnormally high loading knees (high amounts of stress on part or all of the knee joint) are at increased risk of both injury and disease progression.”

Now, the important research findings were these:

“Researchers found that clogs and stability shoes were associated with significantly higher loading of the knees, while the walking shoes and flip-flops resulted in lower knee loads similar to those occurring when walking barefoot. Therefore, shoes that allowed natural foot motion and flexibility appeared to be more beneficial in terms of knee loading.”

That final statement goes to the point that a natural stride, unaffected by modern high-tech footwear seems to be more healthy for us. Here’s more supporting information. Footwear Alters Normal Form and Function of the Foot is a 2009 Science Daily article that profiles a study on barefoot walking. Specifically the researchers studied people who’d never worn shoes. The researchers wanted to observe the biologically normal function of the foot which had evolved for millions of years without the influence of shoes. They indeed saw habitually unshod feet moved performed differently from shod feet. The article notes:

“Barefooters have a relatively wide forefoot and manage at better distributing pressures over the entire surface of the foot sole, resulting in lower (and most likely favourable) peak pressures. As such, the fundamental scientific results are also important for clinicians and for the design of quality footwear, which should not hamper the foot’s biologically normal function.”

In Part III of this series I’ll discuss new research that demonstrates running shoes actually contribute to greater stress at the ankles, knees and hips.

The cutting edge of running technology!

First of all, a disclaimer: I am NOT telling everyone to throw out their running shoes/inserts/orthotics and go barefoot to run all the time forever. If you’re having success then keep doing what you’re doing. I do however suggest reconsidering what you think you know about the human foot and the shoes we put on them. If you’re in pain then you MIGHT consider changing from a highly structured foot environment to something less structured. Alright, on to the important stuff.

The case against running shoes (or maybe FOR going barefoot from time to time) seems to be mounting. What we’ve got here is more evidence that for running, the human foot all by itself is likely the most highly advanced instrument for the job.

I’ve posted previously on the issue of running and human evolution, and the issue of running shoes vs. barefoot running. Research continues on the issue. An article in Science Daily titled Barefoot Running: How Humans Ran Comfortably and Safely Before the Invention of Shoes tells us of research on three groups of people: those who had always run barefoot, those who had always worn shoes, and those who had converted to barefoot running from shod running. (This analysis of different types of runners is one strong point of the study.) Runners in Kenya and the U.S. were subjects. The project was a joint effort between Harvard, University of Glasgow, and Moi University. The full article can be accessed for a fee in the journal Nature.

The researchers observed very different patterns during barefoot running vs. shod running. Barefoot runners land on the mid-foot or the forefoot whereas running in shoes tends to promote a heel strike. Barefoot running results in a more spring-like step by utilizing the arch of the foot rather than driving the heel into the ground.

“Our feet were made in part for running,” Daniel Lieberman (researcher) says. But as he and his co-authors write in Nature: “Humans have engaged in endurance running for millions of years, but the modern running shoe was not invented until the 1970s. For most of human evolutionary history, runners were either barefoot or wore minimal footwear such as sandals or moccasins with smaller heels and little cushioning.“

The researchers suggest than in fact barefoot running may be less injurious than running in modern running shoes. They caution that running barefoot or in minimal footwear must be a gradual process if one has been running in shoes for a long time. Lieberman delves further into the biomechanics of barefoot running on his web page called (surprise!) Barefoot Running. I haven’t read this site yet but I’m planning on digging into it ASAP. Looks very interesting.

From what I’ve learned as a personal trainer I recognize the immense importance of properly functioning feet. If you take a look at your feet and how much movement is available to those things you may be surprised. There’s a lot of potential movement there! Proper foot movement brings on proper knee movement which brings on proper hip movement which makes the trunk and the shoulders move properly. Liberman observes that humans have been using their feet for far longer than the modern running shoe has been around. In our modern age we’ve decided that much like our food, we’re going to out think nature and “improve” on something that’s worked well for a very long time. But what happens when we put our feet in running shoes? We start to take away movement. We put a big piece of foam between us and the ground so that we desensitize our feet. (Compare this to going to a movie in sunglasses or listening to music with earplugs in.) In other words, we seriously alter something that’s been working pretty well for thousands of years. This alteration in function is made even more dramatic if we use orthotics. So it seems entirely likely to me that many cases of knee pain, hip pain, even shoulder and neck pain may well be rooted in what we’ve done to our feet. At the very least, I think it’s worth examining the issue. I’ll discuss more on the issues around barefoot vs. shod running in upcoming posts.

Denver Fitness Journal

All Things Health and Fitness by Kyle Norman, MS, CSCS, FMS, RRCA Running Coach

barefoot running