More News From Podiatry

"Dr. Gregory Clark, head of podiatry at Scripps Clinic Medical Group in Rancho Bernardo, concedes that the conceptual advantages of barefoot running may have some valid benefits for elite runners who are in tune with their bodies and able to alter their gait and running style. But Clark cautioned the average or beginning runner that the laundry list of potential injuries is extensive, ranging from stress fractures to skin lacerations and infections.

"'The foot, which is the body’s primary shock absorber, is an absolutely amazing anatomic structure,' Clark said. 'Unfortunately, the majority of people are not in good enough physical condition or have not trained appropriately to take advantage of these things.'"

Doc, we're not all cripples out here, you know.

Believe it or not, I feel bad about indicting an entire profession.  But I keep reading things like this coming from podiatrists, and I happen to know that they're entirely lacking in any grounding in reality.

So, to the podiatrists, please stop making fools of yourselves.  This guy is a podiatrist, and he got it, so it's possible.  And he wrote this book in 1961.  You've got no excuse.

The Elderly and Bare Feet

Someone on BFT's Group asked about an "Article on bare feet helping the elderly?", and Laskey posted this:

This study seems to say the opposite

http://www.sciencedaily.com/releases/2010/06/100623085516.htm

"Going barefoot in the home, or wearing slippers or socks with no shoes, may contribute to falls among the elderly, according to a new study from the Institute for Aging Research of Hebrew SeniorLife"

Maybe going barefoot might be good for other reasons, but it seems maybe a smooth foot, or socks will lead to a greater chance of slipping and falling. VFFs then?

I replied:

That study doesn't tell you much, actually.

What would be useful to know is not what percentage of people were in their bare feet when they fell, it would be the inverse, what percentage of people who fell were in their bare feet.

So if 18% of people were in their bare feet, but they had 14% of falls, then there's an advantage to being in your bare feet, or the reverse could be true.

"Recommendations such as wearing well-fitting, low-heeled shoes with slip-resistant soles seem sensible," says Dr. Hannan, "but there is only limited data to support this advice."

In other words, "We think we know what we're talking about, but we have no proof." So to be safe, ignore them until they have proof.

Now, there are certain situations where barefoot is not best, primarily peripheral neuropathy (damage to the nerves in the feet, for instance), which is common in diabetes, which is common in older people, unfortunately.  (Especially common in older people who follow the medical profession's dietary advice.)  Also people with weak feet from wearing shoes may have difficulty transitioning, especially if they have balance issues in addition.

But that said, this study seems to be a glaring example of a medical "conclusion" in search of proof. 

Since pediatricians all recommend that children need to go barefoot for proper foot and leg development, I would like to hear a doctor give a clear-cut explanation of at what age all of our feet suddenly become incapable of supporting us, as they clearly evolved to do.

Many podiatrists would have us believe that once we leave the pediatricians' care, we must slap our feet into shoes and orthotics for the rest of our lives, and now the gerontologists would have us catch those few elderly rebels who have escaped the podiatrists' clutches and finally stuff their wriggling feet in shoes for the few sunset years of their lives.

A pretty grim prospect, if you ask me.

Given the above caveat, I think this "research" is ridiculous on its face.

Oh, I should have mentioned:

The study, which will [sic] be published in the summer issue of the journal Footwear Science.

No conflicts of interest here.  Please move along.

Barefoot Running and Podiatrists

Well, this is cool:

Background: Barefoot running is slowly gaining a dedicated following. Proponents of barefoot running claim many benefits, such as improved performance and reduced injuries, whereas detractors warn of the imminent risks involved.

Methods: Multiple publications were reviewed using key words.

Results: A review of the literature uncovered many studies that have looked at the barefoot condition and found notable differences in gait and other parameters. These findings, along with much anecdotal information, can lead one to extrapolate that barefoot runners should have fewer injuries, better performance, or both. Several athletic shoe companies have designed running shoes that attempt to mimic the barefoot condition and, thus, garner the purported benefits of barefoot running.

Conclusions: Although there is no evidence that either confirms or refutes improved performance and reduced injuries in barefoot runners, many of the claimed disadvantages to barefoot running are not supported by the literature. Nonetheless, it seems that barefoot running may be an acceptable training method for athletes and coaches who understand and can minimize the risks. (J Am Podiatr Med Assoc 101(3): 231–246, 2011)

Well, I'd say that this: "Barefoot Running More Efficient than Shod" could be considered "improved performance", but it also likely came out after this was submitted for publication.  That's a quibble.

I really couldn't ask for a better statement at this point.

What's coolest is that this appeared in the Journal of the American Podiatric Medical Association.

I'm always happy to write a post about podiatrists that does not include the word "dingbat".

The Barefoot Professor (Mark I) on Podiatrists

"My Scathing Analysis of Foot Experts Misinforming the Public":

"...Can you imagine a dentist who sincerely believes that candy for breakfast, lunch and dinner is the best thing you can do for your teeth? If the dentist was deceiving his patients merely to increase his own profits, I would merely despise him. If he were so ignorant of dental hygiene as to sincerely believe his prescription is best, then…. well, I would be truly afraid to be his patient. So is our situation, however, with many of today’s podiatrists. Crazy...."

But par for the course, unfortunately.

A friend mentioned she had an issue while running, and asked if she should see a podiatrist.  "Oh, God no", was my response.  I sent her here instead.

Diabetes and Minimalist Shoes

One of the first thing I noticed after becoming a full-time minimalist during the summer of 2009 was the increase in "vascularity" in my feet.  The increased demands I was placing on my feet were met by increased blood flow (the veins got bigger, which my wife pointed out to me), and circulation got much better (warm feet all through the winter).

Now one group of folks who would seem at first blush to be bad candidates for barefoot-style shoes are diabetics.  Late-stage diabetes typically results in poor circulation to the feet, and in "peripheral neuropathy", that is, loss of feeling in the feet.

The loss of feeling means that diabetics are indeed poor candidates for barefooting.  You must have good feeling in your feet to avoid injury.  But increasing circulation should be a good thing.  Fortunately, there are a number of good options for diabetics looking to take advantage of the barefoot running movement.

It turns out that the production manager for one of the good options, Feelmax, is a diabetic.  Here's what he has to say about his experience:

"Well, I have diabetes as well and since 3 years I use Feelmax shoes (easy on me please :-) ) and my feelings in both feets have improved. Still can not run as I have wound on my foot (right - ball area) that is not healing well, but it is going in the right direction and looks that it is finally in the stage of closing up. Running is still out for me, but I wear my Feelmax as much as I can and my doctor told me that the blood circulation has improved in both of my feet.

"I do think that minimal footwear is the way to go in this case and also a large / covert toe box that protect the toes is needed. "

While I think that podiatrists are often way off base on their shoe recommendations, this is one case where if you're seeing a podiatrist for diabetic foot care, you should certainly consult with him.  His primary concern ought to be ensuring that your feet are protected, which is a valid concern.

New Frontiers in Wheat Poisoning

Alesio Fasano, mentioned the other day in this post, has released the results of his newest study: Study Sheds Light On Gluten Sensitivity (WSJ, subscription required):

"For the first time, we have scientific evidence that indeed, gluten sensitivity not only exists, but is very different from celiac disease," says lead author Alessio Fasano, medical director of the University of Maryland's Center for Celiac Research.

"The news will be welcome to people who have suspected a broad range of ailments may be linked to their gluten intake, but have failed to find doctors who agree.

"'Patients have been told if it wasn't celiac disease, it wasn't anything. It was all in their heads,' says Cynthia Kupper, executive director of the nonprofit Gluten Intolerance Group of North America...."

"...Although much remains unknown, it is clear that gluten—a staple of human diets for 10,000 years—triggers an immune response like an enemy invader in some modern humans."

There we go. Eating wheat is functionally equivalent to eating poison ivy: wheat contains proteins that trigger autoimmune responses. One type of response causes celiac disease, the other causes gluten sensitivity.  I'd wager there are more to come:

"'Imagine gluten ingestion on a spectrum', says Dr. Fasano. 'At one end, you have people with celiac disease, who cannot tolerate one crumb of gluten in their diet. At the other end, you have the lucky people who can eat pizza, beer, pasta and cookies—and have no ill effects whatsoever. In the middle, there is this murky area of gluten reactions, including gluten sensitivity. This is where we are looking for answers about how to best diagnose and treat this recently identified group of gluten-sensitive individuals,' says Dr. Fasano."

Dr. Davis' hypothesis seems to be getting some currency:

"'People aren't born with this. Something triggers it and with this dramatic rise in all ages, it must be something pervasive in the environment,' says Joseph A. Murray, a gastroenterologist at the Mayo Clinic in Rochester, Minn. One possible culprit: agricultural changes to wheat that have boosted its protein [gluten] content."

(Emphasis mine. Murray is wrong about people not being born with it. Gastroenterologists are moving up there with podiatrists in my estimation of the medical profession.)

If you're interested in hearing more, there's an interview with Fasano here, and the study is here.

One real pet peeve of mine:

"'There's a lot more that needs to be done for people with gluten sensitivity,' she says. 'But at least we now recognize that it's real and that these people aren't crazy.'"

This is what the medical profession does when people present with symptoms they don't understand: they don't investigate, they tell the people they're crazy.  If your doctor tells you this, tell him to go to hell and find a doctor who takes you seriously.  Yes, I know there are people who are crazy, and sometimes the doctor is right, but there just aren't that many crazy people running around.  Gluten-free is turning into an industry while the medical profession has got its head in the sand.

P.S. A gluten-free diet is a pain in the butt.  No one would do it just because it's "a trend".  It's worth it, certainly in my case, but it's a pain in the butt. 

Foot-Type Determines Running Shoe?

Another myth perpetrated by the podiatric profession.

P.S. If you think I'm being unfair to podiatrists, here's a podiatrist perpetrating the foot-type myth:

"I am Dennis Shavelson DPM, the doctor named in Dr. Kornfeld’s article.

"I am not against barefoot running (I am a Vivobarefoot Shoe dealer in practice in NYC),

"Feet are not made equal (The Foot Typing System that was mentioned). Some make excellent heel strikers, some excellent forefoot strikers, some neither, some both. I believe that’s what Dr. Kornfeld was alluding to.

"Once foot typed, advice, direction and mentoring can be given as to ways to walk, run, what shoes to wear including heel heights, what contact positions, what muscle engine training, the use of foot centering trainers (temporary orthotics weaned away as you strengthen, if you want to barefoot run (or backwards run, or walk sideways or forward..."

Here's my reply.

P.P.S.  I'm upstaged:

"With all due respect, reading statements like this on your FootHelpers website (http://www.foothelpers.com/index.html) is what makes people wary of those in your profession:

"'Simply send your Next Set of Casts (plaster, fiberglass or foam) and your Current Lab Rx to The FootHelpers Lab.

"'Dr. Shavelson will call you personally with your casts in hand to discuss and mentor you through the quick and profitable learning curve of Neoteric Biomechanics.'

"It's pitched as something not to be done for the good of the patient, but because it is 'profitable.'...

"Snake Oil: ...However, the most common usage of the phrase is as a derogatory term for quack medicine. The expression is also applied metaphorically to any product with exaggerated marketing but questionable and/or unverifiable quality or benefit."

Wow.  Hey, as they say, "If the shoe fits..."

VivoBarefoot Ultra: First Impression Review

Modular Ultra

This is one of the shoes I've been most eagerly awaiting.  Not just for me, but for my Croc-loving girls.  And not so much for running, but just to have a light, casual shoe for the summer.  Crocs are a mighty attractive package, which is why they've been so successful, but they're designed to please podiatrists, not my feet.

So I've been eagerly awaiting the Ultra's arrival, and here they are.

In the picture above, from left to right, you have: 1. An Ultra with the sock liner in; 2. two removable tongues, designed to be worn in the Ultra when the sock liner is removed; 3. the sock liner, removed; and 4. the other Ultra, with no liner and no tongue.  The bits pop together and seperate very easily.  I think most of the time I'll wear arrangement 4.

The only bummer about this arrangement is that the kevlar* liner that makes Vivo's soles puncture-proof is in the liner, not the sole.  This is due to a manufacturing problem with including the liner in the sole, but it means that if you're running in an area with cactus thorns, for instance, you're probably going to want to wear the liner.  Hopefully they'll be able to improve this at some point.

This morning turned out to be a good one for a first run in the Ultras.  It was in the low thirties when I set out for a short, three-mile run, so I started out with the sock liners in.  (Low thirties Fahrenheit: May in New England.  If you don't like the weather, wait a minute.)  My feet were plenty warm, and I continued for the first half of the run with the sock liners.  No abrasion or blisters, no real issues at all. 

At the halfway point, I stopped and took the liners out and stuffed them into my pockets.  I noted that there are little hexagonal nubs on the inside of the Ultras.  You don't notice these with the liners in, but they're quite noticable when they're out.  They're actually quite pleasant, and after a few minutes my feet got used to them.  They do provide some traction when running up or down hill: your feet don't slip around inside the shoe.

Standing there in my bare feet pulling the liners out reminded me that this would be a perfect morning for a barefoot run, but...  Sacrifices. :)

I did not use the tongues on this run, and frankly, I don't know why I ever would.  Again, there was no abrasion or blisters for the second half of the run.  I think the tongue would just get in the way, and, since the design of the Ultra is completely open, it would do nothing at all to keep debris out.

Ground feel was better with the liners out, but they don't make much of a difference.  The Ultras were simultaneously firmer than I was expecting (a good thing) and had a bit less ground feel.  I'd say the Ultras have ground feel between a KSO and a Bikila or Trek.  You only feel the larger rocks.  This would make them ideal for running a race, although since you'd run the risk of aquiring a rock due to the open Ultra EVA construction, they might not be the best race shoes.  I'd be more likely to use my Speeds, frankly, which also have a bit more ground feel.  However, while getting rocks in the Ultra is the obvious thing to worry about, due to the open design, it didn't happen on my short run.

The issue that has plagued VivoBarefoot's primary running shoe, the Evo, has been creasing of the material over the toes, leading to abrasions and blistering.  My wife won't wear her Evos at all for that reason.

Happily, that issue is entirely absent in the Ultra.  Didn't notice anything unpleasant about them at all, in fact.

My only concern with the Ultra is that the elastic laces don't do much to prevent your foot from moving around, they don't have that dial-in feel that you get with a laced sneaker.  So running up or down steep hills might be problematic, and trail running would probably be very problematic, since they're so open.

I've been a fan of VivoBarefoot for quite a while, but none of their shoes have been my favorites.  The Russell Mocs and the Vibrams are the shoes I generally reach for first.

The Ultra could easily leap to the front of the pack as the warmer weather arrives, although I may save them for a casual shoe, as these would be best for running in conditions when I could as easily be barefoot.  This is not a criticism, just an observation.  I think they would be a fine running shoe for anyone who chooses to use them as such, and I'll probably do so from time-to-time myself.

I expect that my daughters, whose favorite shoes are the VivoBarefoot kids' shoes, will be wearing these everyday.  No more Crocs!  Hurrah!

* They use some compound that's not Kevlar, which is a trademark, but is the same chemical.

Ultra Toe Spring

P.S.  I'll note that the Ultra has a lot more toe spring than the Evo does.  It was always my theory that the Evo had so many problems with abrasion because there was not enough toe spring, which is to say, too much material over the toes.

P.P.S. Wore them for a run with Chris McDougall.  They were great.

My one concern with these is that they'd be too sweaty underfoot, but this has turned out not to be the case.  There's so much airflow around your foot that your foot stays quite dry.  The only time I had a problem with sweat in the Ultra was while doing leg presses in the gym.

Barefoot-friendly Podiatrists

Vibram is working with one, and he's taking questions from minimalist runners on Fridays on Facebook.

Eccentric Heel Drops for Achilles Tendinopathy

My first choice would be to walk or run uphill, and ensure your heel touches the ground at each step.  This is what I've used for Achilles' tendon issues in my bad leg.  (My bad leg is now my good leg, at least for the time being.)

If you can't for whatever reason do that, an eccentric heel drop is the exact same movement.

But, since it's come up, folks have asked for some decent videos.

I'd first suggest listening to this podcast by the (insane) Doctor Håkan Alfredson [P.S. podcast at new location] who invented the eccentric heel drop while trying to rupture his Achilles' tendon so his boss would have to operate on it and relieve him of his Achilles tendonopathy.  Instead, he cured it.  Whoops.

Having done that, and determining that you most definitely do not want Dr. Alfredson scraping your tendons to sever the nerves, you can try his exercises.

The videos below are the training for a study to evaluate the usefulness of orthotics for treating achilles tendinopathy.

"Achilles tendinopathy is a common condition that can cause marked pain and disability. Numerous non-surgical treatments have been proposed for the treatment of this condition, but many of these treatments have a poor or non-existent evidence base. The exception to this is eccentric calf muscle exercises, which have become a standard non-surgical intervention for Achilles tendinopathy."

The videos look useful, and are based on Alfredson's protocol. I'd skip the marshmallow shoes shown in the video, and do them barefoot. I'd also avoid orthotics... But that's just me. (I'd also avoid taking any medical advice from any doctor from Latrobe University, where this study is being conducted, as the quack Dr. Payne is a professor of podiatry there.  I'll not link to Dr. Payne's site again, but you can find it at the bottom of that link.)

I'll also note that Dr. Alfredson says that the bent-knee heel drops are crucial.  Did I mention that you should listen to his podcast before trying out these exercises?

One more observation: I'm not a doctor, or a physical therapist, just a foot-deformed westerner trying to run the way I was born to.  Also, you should never believe anything you read on the internet, it's all crap.

OK, now that the caveats are out of the way, here are the videos.  I'll note that the videos are also available for download in the study (search for m4v in that page).

P.S. Lest you think I'm being too tough on Latrobe, and podiatrists, Dr. Munteanu, who is conducting the aforementioned study, has this advice:

"...If you are a runner, ensure that you have your footwear professionally fitted and replace your runners [sneakers] at least every 500km/6 months...."

I wonder if that's been shown to be effective?  Anyway...

Part 1:



Part 2:



Part 3:



Part 4:

Can Barefooting Cure Flat Feet?

Yes.  As we already know.

I complain a lot about podiatrists.  Dr. Nirenberg, however, is the very model of a modern podiatrist.  We should have a lot more like him.

Now you'd think that 100 years of evidence that barefoot-style shoes or barefooting can cure this condition would have some effect on medical practice, wouldn't you?

Thanks to Andy Southerland.

"Barefoot Running Phenomenon Hits White Plains"

This is right up the road from my office.  Excellent. 

I've not seen any other barefoot runners on the roads around where I live and work, although Vibram-clad runners are becoming more common.

It includes an obligatory dingbat podiatrist paraphrase: 

"Some podiatrists warn that the proactive could be harmful as the world is no longer filled with grassy fields, but with pavement that can be littered with glass and other items harmful to your feel."

Of course, as we know, the podiatrist profession is coming around.

Dr. Nirenberg Reviews The Altra Adam

From one of my favorite podiatrists: "The Eve Of The Next Phase In Minimalist Shoes":

"As a profound adherent of the minimalist footwear lifestyle, I looked forward to trying out Altra’s new Adam. I found it to be an extremely versatile, balanced, and comfortable shoe that is supremely well adapted to everything you can do with your feet: from walking, to running, to just loafing around. This shoe is so advanced that just like the Adam who launched the human race, it is sure to launch a new era in minimalist footwear."

"The Rise Of Barefoot Running"

In the Canadian Medical Association Journal, no less!

"Critics of barefoot running, including many podiatrists, note that there is no scientific evidence that indicates running barefoot is better than running in shoes, and say that even if running barefoot reduces some types of injuries it may cause other types of harm, such as puncture wounds on the soles and stress fractures in the metatarsals.

"Dr. Michael Nirenberg, a podiatrist who practises in Crown Point, Indiana, is not among those critics. Nirenberg has been a runner off and on throughout his life, and has suffered from plantar fasciitis, a painful inflammation of the main ligament in the foot's arch. This led him to conduct research on ways to strengthen the muscles in feet, which in turn led him to become a fan of going barefoot.

"'I started reading about our feet and shoes and supportive shoes. I became intrigued with the idea that once you support the arch of the foot, you don’t use your foot muscles as much,' says Nirenberg, who writes about barefoot running and other topics on his blog (http://www.americaspodiatrist.com/). 'If you start doing barefoot activity, be it running or walking, you start to build up the muscles in your feet.'

"His views aren't common in his profession, which tends to focus on using orthotics to correct foot problems. Orthotics do relieve pain quicker, Nirenberg acknowledges, but he recommends that people with foot problems transition over time to less-supportive footwear, and eventually incorporate some barefoot activity into their lives. As for barefoot running, Nirenberg agrees with the critics that there is no proof of its benefits ― at least, not yet.

"'Right now, there is no proof that running barefoot is better for you, but there is a lot of research that is leaning in that direction,' he says.

Nicely done.  Some of our other friends from the less-enlightened side of the podiatric profession are also present, including Dr. Kirby, who's moved atop the fence, and the idiotic Dr. Payne.

How Your Foot Ought To Work

"Unfortunately for shoe-wearing people, none of the above windlass foot mechanics happens in shoes, and this is one reason why shoes are so damaging to feet. Whether you’re wearing a wedge or a sneaker, the foot is immobilized inside the shoe."

But don't tell the podiatrists. ;)

A great post.  Also see Prof. Howell's first post on Foot Anatomy 101.

Podiatrists and Barefoot Running

Love to be a fly on the wall for this one:

"The Great Shoe Flap" Arrives in Boston: Is Barefoot Running Better?

"...Dr. Jenkins, a professor at Midwestern University's Arizona Podiatric Medicine Program, recently compiled extensive research from more than 120 external sources -- including Christopher McDougall's 'barefoot bible,' Born to Run. 'There has been a lot of focus on the biomechanics of barefoot running, and not as much on the perceived hazards that can cause injury,' he said. 'Our presentation is neutral from a scientific approach and aims to address all of the important angles.'

"Although many consider barefoot running a 'craze,' Dr. Langer believes it has longevity...."

And this is not the same doctor who did this study.  Times, they are a'changin...

"Take Off Your Shoes And Walk"

Take Off Your Shoes And Walk: Steps To Better Foot Health is the book all podiatrists ought to be reading.  Simon Wikler, DSC* was the rare doctor who wasn't willing to stick to the status quo when told by an older colleague:

"'Foot troubles are chronic conditions people have had for a long time,' he advised.  'You'll waste your time trying to find their cause and cure.  Be content just to give people all the relief you possibly can'"

Dr. Wikler noted during his practice and travels that barefooted people had none of the problems that plagued his shod patients.  Using this knowledge, he began to treat his patients by advising them to strengthen their feet.  He prescribed exercises, walking, properly fitted shoes, and, especially in the case of children, barefoot activity.  His cure for fallen arches in children was quite simple.  Take off their shoes.

His advice for children was a little more radical than his advice for adults, who could also have benefitted from going about in their bare feet.  In this, I suppose, he was a victim of his profession, which seems to believe that at some point we become unsuited for walking in our bare feet.  Or maybe he was just bowing to the practicalities of America in 1961.

The one criticism I do have is that he didn't seem to realize that bunions could be cured simply by going barefoot or at least wearing properly-fitted shoes.  My sister-in-law, who took her sister's advice for alleviating her back pain and bought a pair of VivoBarefoot shoes, reported to me the other day that her bunions had nearly healed since she'd been wearing her new shoes every day.

In a touching anecdote, he reports on his attempts to bring to market a non-deforming shoe for America's children.  He found a man with feet deformed from improper shoes who might help him manufacture these shoes.  The man told Wikler he was crazy.

Wikler was forced to abandon the enterprise as losses mounted, observing:

"The difficulty was, it seemed, that nine out of ten mothers were more interested in style and appearance than in the non-deforming character of their babies' shoes."

I can only hope that the customers of the modern minimalist shoe companies prove that our mothers have learned something since Wikler's day.

Wikler also notes that shoes made on the fabled Munson last, the only shoes made in the last 100 years which were designed to allow your foot to work naturally, were going out of style as "old man's shoes."

Take Off Your Shoes and Walk is unfortunately long out of print.  Amazon lists two used copies available, and that's where I got mine.  Luckily Unshod.org has made a good portion of this book available online.

Read the introduction, and the excellent history of foot problems, and, especially if you have kids, the sections on foot health.  It's well worth your time, and will probably save you quite a bit in podiatrist bills, especially if you're a runner.

Interestingly, the one ailment that Wikler never mentions is that favorite of the runner in sneakers: plantar fasciitis.  I guess folks didn't get it prior to the sneaker.  But we know what the solution is: Take Off Your Shoes and Walk!

*Doctor of Surgical Chiropody (Chiropody is now known as podiatry.)

Running In The Military

Pose, Chi, and Evolution are making inroads in the military, to help cut down the injury rate.  (Running related injuries are now the number one training injury in the military.)

"Meanwhile, a slew of recent studies are overturning long-held running maxims as researchers struggle to more clearly define the emerging doctrines.

"'The answer to decreasing running injuries is not to limit running, it is to develop the runner,' says Maj. Charles Blake, a 3rd Special Forces Group doctor serving as physical therapist for special ops units in Afghanistan.

"Blake insists the key to reversing injuries and improving running is simply a matter of technique.

"'I have taken four minutes off a person’s two-mile run time in a week. That can only be related to technique in movement,' he says.

"Change can’t come soon enough. More than a million troops suffer serious sprains, strains and other injuries every year, with running as the leading cause, according to Defense Department research....

"Termain says Pose did what numerous sports medicine docs, podiatrists and expensive orthotic inserts never could — put an end to what seemed like an endless string of running injuries."

Via Runblogger on Facebook.

Vibram's New Shoe Testing Center

Here's the Wall Street Journal story, for those who have a subscription, and here's an excerpt, for those who don't:

"...Mr. Mendl says manufacturing soles for other shoe retailers remains the primary business of Vibram. But the VFFs now account for 30% of the firm's global sales. And while sales of the unusual-looking shoe were slow at first, the company sold 400,000 pairs in 2009, and 2.5 million pairs last year, Mr. Mendl says. In 2011, Vibram's global sales target is more than four million pairs. "We can't make them fast enough," says Mr. Mendl, who, along with 100 other mostly Chinese employees, lives on campus.

"The genesis of the shoe is partly due to the barefoot-running trend that has taken off in recent years in cities like New York and London, and which gathered pace following the success of Christopher McDougall's 2009 best-selling book "Born to Run."

"Proponents argue that the cushioning and structure of regular shoes lead to an intense heel strike that doesn't allow the wearer's feet to absorb shock well, potentially causing injuries. Barefoot runners—there are now dedicated websites, clubs and numerous books backing the trend—say running au naturale happens with a less-intense strike of the forefoot that rocks to the heel, putting less strain on the knees and spine.

"While debate still rages among running groups, podiatrists and fitness experts about the merits of barefoot running, several running-shoe manufacturers have looked to get in on the trend developing shoes that mimic the barefoot style. Nike and New Balance both have minimalist shoes that are lighter and encourage a midfoot strike. With the help of Vibram, North Face and Merrell too are due to release near-barefoot, minimalist models soon...."

Why You Shouldn't Wear Crocs

I looked long and hard at Crocs.  My daughters love them and they're light.  Ultimately I decided they're too supportive.  One daughter went without them this summer, and the other wore them.  The Croc-less daughter's feet are strong and tough after a summer spent barefoot.  The Croc-ed daughters feet are weak, narrow, and soft.  She used to love to run, until she started wearing Crocs all the time. We threw out the Crocs a week ago.  Crocs are crack for your feet.  They feel great, and they make them weak.

Today I find this article:

"Not Such A Croc: Might a Fad Shoe's Health Claims Stand?"

"You've tried to ignore them, but they've spread like vermin. Crocs are everywhere. That's often the way with shoe crazes -- think Birkenstocks, Earth shoes, Dr. Scholl's. Crocs wearers are practically evangelical about the shoes' supposed comfort, but really, how can you trust people who go out in public wearing goofy rubbery clogs with vent holes in them? Might as well ascribe health benefits to chopped-off garden galoshes or jelly shoes.

"Time to call in the foot experts and expose the things for the frauds they are. Except -- surprise -- that turns out to be more difficult than you might imagine.

"Crocs, made of a resin foam called Croslite and listing for $29.99, are featured prominently on the Web site of the Bethesda-based American Podiatric Medical Association ... as one healthy alternative to flip-flops; two Crocs models -- both in the Crocs Rx line, designed for people with diabetes and others with circulatory and foot ailments -- recently have been awarded the APMA Seal of Acceptance. The APMA takes special note of the fact that Croslite 'warms and softens with body heat and molds to the users' feet, while remaining extremely lightweight.'

"Harold Glickman, chief of podiatric surgery at Sibley Memorial Hospital, praises Crocs for their ample toe room, deep and supportive heel cup and secure rear strap. Their loose fit, he said, means no pressure points or rubbing spots, and their nonporous material gives them antibacterial properties that makes them 'a huge asset to those susceptible to infection -- those with diabetic ulcerations, wounds or poor circulation.'

"Glickman, who isn't among the physicians who have partnered with the makers of Crocs to stock the shoes in their offices, began recommending them to patients after he began wearing them himself. 'I found them myself to be so comfortable, a bell went off.' Now he suggests them to people with plantar fasciitis, a painful stretching of the tissue along the bottom of the foot, and to those undergoing bunionectomies or other foot surgery. 'The patient can go right into them post-operatively, bandage and all.'"

Here's a rule of thumb for you: if conventional podiatrists approve of a shoe, it's bad for your feet.

VivoBarefoot's new shoe the Ultra, on the other hand, is the anti-Croc.  I can't wait for it.