Forefoot balance and forefoot variants. Are you a forefoot strike runner ? You had better read this.
So, what about the attached video ?
What do you see as this gentleman loads onto the forefoot. Watch the left hallux (big toe) and watch the long flexor strategy for the lesser toes. It is plain to see that this subject has flawed forefoot stability. The big toe does not even engage during forefoot loading ! The metatarsal head it taking it all, and that can mean risk to the metatarsal shaft, ligaments, sesamoids and soft tissues. Can you imagine this person running ? Without proper toe function, one of which is to help add stability and to offset metatarsal loading pressures, this person is at risk for pathologic loading responses in the forefoot. We see flawed patterns like this all the time in our runners, of all ages. Think this kind of educational information needs to be part of the form running classes and natural running courses being offered around the country ? We think so. Education does not mean you cannot do something, it merely helps the end user to be more aware of their limitations and risks. Education can lead to the adjustment of a behavior. But you often have to bring the behavior to a persons recognition.
The next time you decide to lace up your shoes, before you do it slip off your socks and do a double and a single leg forefoot heel risk like this fella in the video. What is your strategy? Do you clench the toes or do you PRESS them like you should with a balanced strategy with the long and short toe flexors and long and short extensors ? Do you load the big toe nicely? Do you have hammer toes ? How is your forefoot bipod stability ? Are you wobbling all over the place ? Remember, running is a single leg strategy. You are merely alternating one legged balancing when you run. You never have both feet on the ground. So, what is that single leg stability like? You may say that a static assessment like we have suggested is not reality. But we say that is incorrect. Sure it is different. But one main difference is that the forward speed of running allows momentum to blur the pathologies you might see in a quieter slower assessment. The forward momentum will surely blur frontal plane stabilities but we assure you, they are still there. One of our favorite lines is “speed kills”. But in this case speed will hide the tiny instabilities and flaws that exist. Just because you cannot see them or feel them when you run doesn’t mean they are not there. Kinda like the “Boogey Man”.
Work on your forefoot loading response every day. Get to the point that you can get to a single leg stance with good posture and stability with reduced sway. Then see if you can get to a clean quiet forefoot load on that leg as you lean forward into a wall.
The smallest of things can make the biggest difference. Especially if you are doing sometihng (like walking or running) thousands of times a day.
Don’t be a casualty. Do the work you need to do.
Here is some research to support or views.
Everyone is on the barefoot and minimalist running kick these days. Much of the time, justifiably so. But, if you have been reading our work here on our blog you will know that there are many issues that these same folks are just not talking about. We have tried to share our concerns about the forefoot load when there is a forefoot varus or forefoot valgus and the implications of faulty mechanics and injury resulting from asymmetrical forefeet. Not everyone can forefoot strike without heightened injury risk. This is why many times we suggest a midfoot strike since it dampens some of these risk factors when present. Manufacturers who promote a forefoot landing loading event need to be talking about these risks.
Today we share a research article giving a little more rooting to some of these concerns but from a slightly different angle. In this article,
Mickle et al discuss toe deformities such as hallux valgus and very likely hammer toes and their effects on balance and stability. In their abstract they focus more on older folks with hallux valgus and lesser toe deformities who displayed different gait, balance and plantar pressure characteristics compared to individuals without toe deformities.
Spatiotemporal gait parameters were measured as well as postural sway. Their results indicated that, although there were no effects of toe deformities on spatiotemporal gait characteristics or postural sway, older people with hallux valgus and lesser toe deformities were found to display altered forefoot plantar pressure patterns. These findings suggest that toe deformities alter weight distribution under the foot when walking, but that the relationship between toe deformities and falls may be mediated by factors other than changes in spatiotemporal gait parameters or impaired postural sway.
Make of this research what you will, but in our opinion you just cannot ignore the fact that faulty forefoot function will impact stability and performance. It may even be a predictor for injury, in this case falls from instability, but in our opinion other musculoskeletal injuries in the lower limbs. It is clear that altered biomechanics result in compensations and we all know that compensations are alternative strategies from the norm. And if you add enough miles to alternative strategies, injuries are not likely to be far behind.
Here is another article:
Foot Ankle Int. 2005 Jun;26(6):483-9. Gait instability in older people with hallux valgus. Menz HB, Lord SR. Musculoskeletal Research Centre, L Trobe University, Bundoora, Victoria.
In their study they determined that “subjects with moderate to severe hallux valgus were found to exhibit significantly reduced velocity and step length on both walking surfaces and less rhythmic acceleration patterns in the vertical plane when walking on the irregular surface compared to subjects with no or mild hallux valgus.”
They thus concluded that “hallux valgus has a significant detrimental impact on gait patterns that may contribute to instability and risk of falling in older people, particularly when walking on irregular terrain.”
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The smallest of things can make the biggest difference. Especially if you are doing something (like walking or running) thousands of times a day.
Don’t be a casualty. Do the work you need to do.
Shawn and Ivo
