So, what DOES cause a change in strike pattern with barefoot running?

We kinda thought so...

"CONCLUSION: Superficial cutaneous sensory receptors are not primarily responsible for the gait changes associated with barefoot running."

So what is? Most likely they play a part, but the joint and muscle mechanoreceptors that we had been talking about here on The Gait Guys for the last several years most likely play a larger role. The cutaneous receptors appear to play a role in general sensation, balance and coordination as well as coordination of upper extremity movements.

Thompson MA, Hoffman KM.Superficial plantar cutaneous sensation does not trigger barefoot running adaptations.Gait Posture. 2017 Jun 27;57:305-309. doi: 10.1016/j.gaitpost.2017.06.269. [Epub ahead of print]

https://www.ncbi.nlm.nih.gov/pubmed/28728130

More foot exercise studies to confuse you.

Don't necessarily believe all that you read. Please to not take away from this study that these 4 exercises: short-foot exercise, toes spread out, first-toe extension, second- to fifth-toes extension are golden goose exercises to rehab your athlete. On first glance if one is not thinking, that could be a mistake in translation.

"The intrinsic foot muscles maintain the medial longitudinal arch and aid in force distribution and postural control during gait."  That is a pretty bold statement by the study's authors. We would argue that a far less misleading statement would be that "the intrinsic foot muscles are a piece of the puzzle, just a piece, and to dismiss the powerhouse tibialis anterior, tibialis posterior, long and short toe flexors and particularly the extensors is a glaring oversight".  Yes, I know, the authors just wanted to study the intrinsics, I get it, -- one just has to be careful of the conclusions made when the study is so microscopic compared to the global perspective at hand.  Please, read on.

This study tried to correlate the effects of these 4 exercises: short-foot exercise, toes spread out, first-toe extension, second- to fifth-toes extension on activation of the foot intrinsics muscles they chose to observe (abductor hallucis, flexor digitorum brevis, abductor digiti minimi, quadratus plantae, flexor digiti minimi, adductor hallucis oblique, flexor hallucis brevis, the interossei, and lumbricals).

They looked at the activation before and after exercise in just 8 athletes. They did not look at non-athletes and yes, this is a terribly small N sampling and the study only used T2 weighted MRI to make these conclusions.

The study's conclusion was "Each of the 4 exercises was associated with increased activation in all of the plantar intrinsic foot muscles evaluated.".  

Here is my concern*. 
Did they consider the various foot typings ? (*Caveat, I have not read the entire study, I am trying to get it). There are many variables to consider including arch integrity, forefoot type, rearfoot type, foot flexibility, step width, step length, client weight amongst other things. Yes, that makes for a near impossible study, I get it. And, it does not appear they had a control study that looked at what happened right after walking. Wouldn't it be fair, and wise,  to see what the study showed after barefoot walking for 1-2 minutes ? I bet many of these muscles show significant activation there as well, after all, they were weight bearing and stepping down on the foot which requires the muscles to be activated and utilized.  So, does that then mean these 4 exercises are any better than walking ? Does that mean they will suffice for homework for your client ? Does that mean they will strengthen these muscles ? And, does activation mean proper pattern utilization of these muscles, meaning, is there functional translation over to functional use ? Yes, that is not what the study was looking at, but for darn sure that would have been nice info to know. Just take the study for what it found, and do not step beyond those tiny boundaries. We hope that is what they will go for in the next stage of study.  To be fair, they also concluded, "These results MAY have clinical implications for the prescription of specific exercises to target individual intrinsic foot muscles."  Safe words. Yes, I capitalized the word MAY.

- Dr. Shawn Allen, one of the gait guys.

Thomas M. Gooding, Mark A. Feger, Joseph M. Hart, and Jay Hertel (2016) Intrinsic Foot Muscle Activation During Specific Exercises: A T2 Time Magnetic Resonance Imaging Study. Journal of Athletic Training In-Press. 
http://natajournals.com/doi/abs/10.4085/1062-6050-51.10.07
http://dx.doi.org/10.4085/1062-6050-51.10.07

Podcast 97: Decomposition of human movement.

Topics: Decomposition of movement, sacrificing speed and efficiency for movement, gait efficiency, arm swing, more on injuries and unshod running and more !

A. Link to our server: http://traffic.libsyn.com/thegaitguys/pod_97final.mp3

Podcast Direct Download:  http://thegaitguys.libsyn.com/podcast-97

Other Gait Guys stuff

B. iTunes link:
https://itunes.apple.com/us/podcast/the-gait-guys-podcast/id559864138
C. Gait Guys online /download store (National Shoe Fit Certification & more !)
http://store.payloadz.com/results/results.aspx?m=80204
D. other web based Gait Guys lectures:
Monthly lectures at : www.onlinece.com type in Dr. Waerlop or Dr. Allen, ”Biomechanics”

-Our Book: Pedographs and Gait Analysis and Clinical Case Studies
Electronic copies available here:

-Amazon/Kindle:
http://www.amazon.com/Pedographs-Gait-Analysis-Clinical-Studies-ebook/dp/B00AC18M3E

-Barnes and Noble / Nook Reader:
http://www.barnesandnoble.com/w/pedographs-and-gait-analysis-ivo-waerlop-and-shawn-allen/1112754833?ean=9781466953895

https://itunes.apple.com/us/book/pedographs-and-gait-analysis/id554516085?mt=11

-Hardcopy available from our publisher:
http://bookstore.trafford.com/Products/SKU-000155825/Pedographs-and-Gait-Analysis.aspx

Show notes:

-Brain Friendly Interface Could Change the Way People with Spinal Cord Injuries Lead Their Lives
http://neurosciencenews.com/extracellular-matrix-brain-interface-2395/

-Barefoot vs Shoe debate
http://www.theglobeandmail.com/life/health-and-fitness/fitness/barefoot-vs-shod-running-its-a-dead-heat/article26180292/

-Sacrificing speed and efficiency for stability as we age (1) . Not a bad plan. Kind of like what we spoke about here below in this video: returning to a more primitive state as the system starts to break down.

1. Zurales K, DeMott TK, Kim H, et al. Gait efficiency on an uneven surface is associated with falls and injury in older subjects with a spectrum of lower limb neuromuscular function: A

prospective study. Am J Phys Med Rehabil 2015 Jun 5. [Epub ahead of print]

https://www.youtube.com/watch?v=_fBjyutWQvU  video link to our video on this

-http://lermagazine.com/news/in-the-moment-gait/speed-trap-slowest-seniors-have-increased-mortality

-Shoe:  the UnderArmor Fat Tire GTX Trail shoe.

https://www.underarmour.com/…/mens-ua-fat-tire-g…/pid1262064

- assessing the different genders: http://www.ncbi.nlm.nih.gov/pubmed/12689785

Ferber R, Davis IM, Williams DS 3rd. Gender differences in lower extremity mechanics during running. Clin Biomech 2003;18(4):350-357.

-Arm Swing
http://thegaitguys.tumblr.com/post/128715659449/unique-adaptations-to-arm-swing-challenges-the

Podcast 72: Neuroplasticity, EVA Shoe Foam, and Shoe Trends

Maximalist shoes and the death of Minimalism ? Could this be true ?

*Show sponsor: www.newbalancechicago.com

Lems Shoes.  www.lemsshoes.comMention GAIT15 at check out for a 15% discount through August 31st, 2014.

A. Link to our server: 

http://traffic.libsyn.com/thegaitguys/pod_73f.mp3

Direct Download: 

http://thegaitguys.libsyn.com/podcast-72

B. iTunes link:

https://itunes.apple.com/us/podcast/the-gait-guys-podcast/id559864138

C. Gait Guys online /download store (National Shoe Fit Certification and more !) :

http://store.payloadz.com/results/results.aspx?m=80204

D. other web based Gait Guys lectures:

www.onlinece.com   type in Dr. Waerlop or Dr. Allen,  ”Biomechanics”

______________

Today’s Show notes:

1. Neuroplasticity: Your Brain’s Amazing Ability to Form New Habits
new link (does not have the old photo ivo mentioned that he loved)
 
2. Last week we pounded the sand on EVA foam and maximalist shoes. There was alot of attention, emails and good social media discussion on the topic.  
LETS REVIEW IT
file:///Users/admin/Downloads/p142_Heel_shoe_interactions_and_EVA_foam_f_web_150dpi.pdf
 
3. Then there just last week there was an article in LER on “the death of minimalist shoes” ? 
READ THIS: 
The rise and fall of minimalist footwear | Lower Extremity Review Magazine
http://lermagazine.com/cover_story/the-rise-and-fall-of-minimalist-footwear
 

4.  Physical Therapy as Effective as Surgery for Meniscal Tear

Kathleen Louden

March 20, 2013
Torn Meniscus? Thinking about surgery? Think again…

5. Cast study: the broken foot tripod

Is Barefoot more economical ?

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.

On and on goes the barefoot debate. 
There is no single right answer, so use your head.
article link, click here
We have been saying what this article talks about all along, even years before the Vibram 5’s hit the market, back when Vibram cam…

On and on goes the barefoot debate. 

There is no single right answer, so use your head.

article link, click here

We have been saying what this article talks about all along, even years before the Vibram 5’s hit the market, back when Vibram came to us to ask us for our thoughts on the early versions.  You will see our soapbox rant on this topic over and over again in our blog posts and it is the modus operandi behind our new 2012 Shoe Fit program that will likely launch February 1st in several forms for several professions to meet everyone’s needs.

That modus operandi being that not everyone has a foot type, anatomy or biomechanics to get into minimalist shoes, without a possible cost that is.

In this nicely written article by Cynthia Billhartz Gregorian “Barefoot running: Sales grow, but so does debate about benefits, safety” at the link above she lightly covers some of the aspects of the debate.  We have read just about every piece that has come out on the barefoot-minimalist trend. Sadly, some of the blogs are mere opinion and it is rare that the honest truth comes out.  That truth being our mention above that some folks just do not have the skill, endurance, strength or anatomy to delve into footwear that does not support or protect their physical limitations.  Lets be honest, at 5'9’’ I have to come to the realization that no matter how much i practice to be in the NBA I am not going to make it. I just do not have the physical anatomy to be an NBA star.  And some people, no matter how much they want to run barefoot or minimalist, just do not have the anatomy to allow it. Someone with a history of foot pain who has a rigid forefoot varus really is not going to do well in minimalist shoes. There are articles written out there that just tell people to bite the bullet and go 100% into their new minimalist shoes, into the natural way they were supposed to run from the very start and force the body to adapt, that the new form they adopt will take care of any problems. Well, in our experienced and educated opinion, that is just not smart. Someone who has a shortened posterior compartment (calf-achilles) after being in heel shoes for years is going to have several flaws biomechanically going to minimalist shoes right off the bat. One example, just one for now, is that the person is going to have premature heel rise and thus premature forefoot loading response around a compromised ankle rocker mechanism. And there are many others of course.

Here is the bottom line as we see it. No shoe company is going to run a commercial or add on their product with the warnings on the cover or in the fine print. We are not talking about cigarettes here.  Admitting that some people should not be in their product would be admitting that the product has limitations and risks.  What kind of advertising add would that be ? Besides, admitting to limitations or mentioning warnings is a mere step away from liability cases.  We are pretty sure of this, after all, look what happened to the Shape Up Shoe in the courts.

Here is what we say to the naysayers, look at the research and use logic.  If you are new to the game, leave the extremist blog sites for those that are looking for radical opinions. Because we do not have any openings in our clinics for the next several weeks if you throw caution to the wind.

Good running to you all in 2012, use your head, for the sake of your feet.

Shawn and Ivo

Our new friend, Dr. Mark Cucuzzella. An inspiring story.

OK, now you have read the article in the NYTimes.  Here was Dr Cucuzella’s blog post following the article.

Mark Cucuzzella MD
Shepherdstown, WV
November 5th, 2011
9:58 pm

NYT Readers,
I’ve been flattered by the emails from around the globe of runners sharing their stories of recovery and discovery. Here is my story.
“A man’s errors are his portals of discovery” – James Joyce
Twice in the past two years, my running shoe store, Two Rivers Treads, which is in the small town of Shepherdstown, West Virginia, was honored to host and gain wisdom from best-selling author and force of nature Christopher McDougall. Locals came to hear from Chris aka “Mr. Born to Run.”
Chris and I both share a similar pathway in the discovery of better fitness and health through natural running. He is now a world-famous author, and in addition to owning a minimalist shoe store, I am a family physician in a town of 3,000. We both are in our mid 40s, and have trashed our feet and legs along the way, the result of a lifelong addiction to running.
Chris’s bestseller “Born to Run” follows several narrative threads, but it is also his own personal story of “why does my foot hurt?” He discussed the regular trips to the doctors, shoe stores, and orthotic makers. With each escalation in care there was more pain, that is, until he found a different route in the remote Copper Canyon of Mexico where the Tarahumara Indians run in flat-sole tire-tread sandals happily into their 80’s. He also met barefoot runners during his research for the book. He eventually arrived at the conclusion that most conventional running shoes are the cause of running injuries.
I began running barefoot on the beach as a pre-teen and easily covered distances of 10 or more miles. My personal path of pain began in high school and then into a college and post-collegiate running career. I had successes that were often tempered by injury, setbacks, surgery. I had acquired a closet full of arch supports, orthotics, various shoe types. This was always in search of the holy grail of pain- free running.
I pushed through the pain in pursuit of the Olympic Marathon Trials 2:22 standard and came within two minutes on two occasions. When I hit 34 years of age, my first toe joints were fused with arthritis, and I was forced to have surgical procedures to reduce the pain. The prognosis looked bleak for a future in running.
And a lot like Chris’s own trip to Copper Canyon, my journey of discovery began afar: while watching Kenyan runners go barefoot. I applied this natural way of running to my own jogging. I learned how to run softly. Seven months after surgery and with a new efficient and painless running stride, I ran a 2:28 for third place in the 2001 Marine Corps Marathon, only four minutes shy of my best time ever for the distance.
A decade has passed and the learning I gained about natural running only became deeper and broader. You might say that I was being “home-schooled” on all aspects of movement and how the foot interacts with the ground. For example, the Tarahumara Indians run in a style reflective of how we all ran as children; they land lightly on their mid-foot (not the heel), have a slight forward lean, and are completely relaxed and happy. Also, the best shoe was less shoe.
My self-enlightenment about footwear and running was not as immediate as Chris, who experienced it by cultural immersion. Chris and I both agree that it is not about the shoes (or lack thereof), but more about understanding how your body stands and moves, improving strength and function, and then figure out what shoe (if any) to wear. Ten years after the foot surgery and being told not to run, I feel that I’m finally putting all the pieces of the puzzle together. I finished the Boston marathon in 2011 in 2:37:00, practically smiling the whole way. Several months later, I won the Air Force Marathon outright; and back running the day after the race. I love light and flat shoes for road races, trails, casual, and at work to get me secretly close to barefoot at my day job as a physician.
We all have to follow our own path of what works or doesn’t work. Our bodies and past running histories are different. View the resources Natural Running Center, you will have a practical way to make injury-free running a permanent fixture in your own life.
I especially want to thank colleagues for sharing knowledge: Danny Dreyer, Jay Dicharry, Lee Saxby, Danny Abshire, Dr. Ray McClanahan, Dr. Daniel Lieberman, Ian Adamson, Dr. Phil Maffetone, Blaise Dubois, Pete Larson, Dr. Irene Davis, Lorraine Moller, and Nobby Hashizume. And especially Bill Katovsky and Nicholas Pang for helping me create the Natural Running Center.
–Mark Cucuzzella, M.D. mark@freedomsrun.org
http://naturalrunningcenter.com/
https://www.tworiverstreads.com/
For our movie on Barefoot Running Style - enjoy
http://youtu.be/kpnhKcvbsMM

Here is a decent video on how to do the “100 up” and age old running practice technique developed as discussed in a three-page essay from 1908 titled “W. G. George’s Own Account From the 100-Up Exercise.” According to legend, this single drill turned a 16-year-old with almost no running experience into the foremost racer of his day.

In George’s words: “By its constant practice and regular use alone, I have myself established many records on the running path and won more amateur track-championships than any other individual.” And it was safe, George said: the 100-Up is “incapable of harm when practiced discreetly.”

The Once and Future way to run. NewYorkTimes

excerpt from the article……….

“Martyn Shorten, the former director of the Nike Sports Research Lab who now conducts tests on shoes up for review in Runner’s World, followed him (Cucuzzella) to the microphone. “A physician talking about biomechanics — I guess I should talk about how to perform an appendectomy,” Shorten said. He then challenged Cucuzzella’s belief that cushioned shoes do more harm than good.

________________________________

As Steve Jobs might say to this………. "yes, there are bozos amongst us”

We know Dr. Mark Cucuzzella. We talk with him often over long conference calls. Dr Ivo was on the discussion panel with him at the Newton Running Retail Conference this year. We are becoming pretty good friends.  We feel quite comfortable in saying that Mark has every right to talk about biomechanics, he has earned our respect.

The mind is like a parachute…It works best when open….

Shawn & Ivo, we are…….The Gait Guys  (and hoping that we are someday challenged by guys like Shorten…we like bozos : ) ).

Oxygen cost of running barefoot vs. running Shod.

This study concluded that at 70% of vVO (2)max pace, barefoot running is more economical than running shod, both overground and on a treadmill.  So, if you have a competent enough foot to run barefoot or in minimalistic footwear, and it is important to note that some people are not purely from an anatomical perspective, you can improve your economy of running and use your energy sources efficiently. But if you are one of those unfortunate ones that has excessive pronation or other functional foot challenges, you will have to settle for the less economical shod running.  That does not mean you will not have as good a workout, it just means that you will be protecting your foot doing so.  Sure, you might not be the fastest one on the track, but you will be able to show up every day having not compromised  your feet.

____________________________

Int J Sports Med. 2011 Jun;32(6):401-6. Epub 2011 Apr 6.

Oxygen cost of running barefoot vs. running Shod.

Hanson NJ, Berg K, Deka P, Meendering JR, Ryan C.

Source

Health, Physical Education and Recreation, University of Nebraska at Omaha, United States. njhanson@gmail.com

Abstract

The purpose of this study was to investigate the oxygen cost of running barefoot vs. running shod on the treadmill as well as overground. 10 healthy recreational runners, 5 male and 5 female, whose mean age was 23.8±3.39 volunteered to participate in the study. Subjects participated in 4 experimental conditions: 1) barefoot on treadmill, 2) shod on treadmill, 3) barefoot overground, and 4) shod overground. For each condition, subjects ran for 6 min at 70% vVO (2)max pace while VO (2), heart rate (HR), and rating of perceived exertion (RPE) were assessed. A 2 × 2 (shoe condition x surface) repeated measures ANOVA revealed that running with shoes showed significantly higher VO (2) values on both the treadmill and the overground track (p<0.05). HR and RPE were significantly higher in the shod condition as well (p<0.02 and p<0.01, respectively). For the overground and treadmill conditions, recorded VO (2) while running shod was 5.7% and 2.0% higher than running barefoot. It was concluded that at 70% of vVO (2)max pace, barefoot running is more economical than running shod, both overground and on a treadmill.

Well, in some ways, Barefoot IS better!
In those famous words: Res ipsa loquitur (The thing speaks for itself)…Well sort of…

Though some research is conflicting regarding barefoot running as being better, or more injury preventative, chalk one up for the efficiency of barefoot.

Glossary:

vVO is percentage of maximal velocity of graded exercise test. in this case 70%.
VO(2) is the maximal amount of O2 the body utilizes for an exercise
RPE: is how hard you perceive you are working for a given exercise or task

video provided courtesy of Two Rivers Treads and Newton Running

Int J Sports Med. 2011 Jun;32(6):401-6. Epub 2011 Apr 6. Oxygen cost of running barefoot vs. running Shod. Hanson NJ, Berg K, Deka P, Meendering JR, Ryan C. Source

Health, Physical Education and Recreation, University of Nebraska at Omaha, United States. njhanson@gmail.com

Abstract

The purpose of this study was to investigate the oxygen cost of running barefoot vs. running shod on the treadmill as well as overground. 10 healthy recreational runners, 5 male and 5 female, whose mean age was 23.8±3.39 volunteered to participate in the study. Subjects participated in 4 experimental conditions: 1) barefoot on treadmill, 2) shod on treadmill, 3) barefoot overground, and 4) shod overground. For each condition, subjects ran for 6 min at 70% vVO (2)max pace while VO (2), heart rate (HR), and rating of perceived exertion (RPE) were assessed. A 2 × 2 (shoe condition x surface) repeated measures ANOVA revealed that running with shoes showed significantly higher VO (2) values on both the treadmill and the overground track (p<0.05). HR and RPE were significantly higher in the shod condition as well (p<0.02 and p<0.01, respectively). For the overground and treadmill conditions, recorded VO (2) while running shod was 5.7% and 2.0% higher than running barefoot. It was concluded that at 70% of vVO (2)max pace, barefoot running is more economical than running shod, both overground and on a treadmill.

Pretty cool, eh?

Ivo and Shawn, 2 geeks making a difference