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

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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”

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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

More on EVA foam, impact loading behaviors, and adding shoe inserts.

A few weeks ago we wrote about some thoughts on the maximalist shoe foam trend and how it is possible that more foam could mean alterations in impact loading behaviors that could lead to problems (note we used the word could, and not will).  If there are pre-existing proprioceptive deficits in a limb these issues most likely will rise to the surface. 

The EVA foam in shoes is primarily used to absorb forces via air flow through interconnected air cells in the EVA during shoe deformation under body-weight. When the shoe has seen a finite number of compressive cycles the air cells collapse and the EVA can compact on itself leaving the shoe with an negatively impacting area of compression to fall into.  Shock absorption may be impacted and possibly lead to injury.

The Robbins study we discussed a few weeks ago (link) suggested that the reduction of impact moderating behaviour is 

Reduction of impact-moderating behavior is a response to loss of stability induced by soft-soled cushioned shoes: Humans reduce impact-moderating behavior in direct relation to increased instability.This is presumably an attempt to achieve equilibrium by obtaining a stable, rigid support base through compression of sole materials. Humans reduce impact-moderating behavior, thereby amplifying impact, when they are convinced that they are well protected by the footwear they are wearing. 

These were important points but we wanted to bring to your awareness of the component of the shoe you may have not thought of to this point, the foam foot bed that comes with the shoe, or ones you might add to the shoe  yourself post-purchase. With what we have just taught you in our last blog post and this blog post, we will let you make the connection we are suggesting you be aware of when it come to more foam, changes in foam as the shoes and inserts degrade and impaired impact loading behaviors.

There are just 3 brief study summaries here, take the time to read them and read between the lines now that we have educated you a little better in how to think about them.

Shawn and Ivo

J Appl Biomech. 2007 May;23(2):119-27.

Effects of insoles and additional shock absorption foam on the cushioning properties of sport shoes.

The purpose of this study was to investigate the effects of insoles and additional shock absorption foam on the cushioning properties of various sport shoes with an impact testing method. 

The results of this study seemed to show that the insole or additional shock absorption foam could perform its shock absorption effect well for the shoes with limited midsole cushioning. 

Further, our findings showed that insoles absorbed more, even up to 24-32% of impact energy under low impact energy. 

It seemed to indicate that insoles play a more important role in cushioning properties of sport shoes under a low impact energy condition.

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Biomed Mater Eng. 2006;16(5):289-99.

Role of EVA viscoelastic properties in the protective performance of a sport shoe: computational studies.

 Using lumped system and finite element models, we studied heel pad stresses and strains during heel-strike in running, considering the viscoelastic constitutive behavior of both the heel pad and EVA midsole. In particular, we simulated wear cases of the EVA, manifested in the modeling by reduced foam thickness, increased elastic stiffness, and shorter stress relaxation with respect to new shoe conditions. Simulations showed that heel pad stresses and strains were sensitive to viscous damping of the EVAWear of the EVA consistently increased heel pad stresses, and reduced EVA thickness was the most influential factor, e.g., for a 50% reduction in thickness, peak heel pad stress increased by 19%. We conclude that modeling of the heel-shoe interaction should consider the viscoelastic properties of the tissue and shoe components, and the age of the studied shoe.

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J Biomech. 2004 Sep;37(9):1379-86.

Heel-shoe interactions and the durability of EVA foam running-shoe midsoles.

A finite element analysis (FEA) was made of the stress distribution in the heelpad and a running shoe midsole, using heelpad properties deduced from published force-deflection data, and measured foam properties. The heelpad has a lower initial shear modulus than the foam (100 vs. 1050 kPa), but a higher bulk modulus. The heelpad is more non-linear, with a higher Ogden strain energy function exponent than the foam (30 vs. 4). Measurements of plantar pressure distribution in running shoes confirmed the FEA. The peak plantar pressure increased on average by 100% after 500 km run. Scanning electron microscopy shows that structural damage (wrinkling of faces and some holes) occurred in the foam after 750 km run. Fatigue of the foamreduces heelstrike cushioning, and is a possible cause of running injuries.

 

More shoe foam may mean more problems.
Last night we had a great online teleseminar (www.onlinece.com).  The talk was minimialism.  Here was 2 of our take home points:
More foam in the shoe is not always good. 
“Shoes with cushioning fail to a…

More shoe foam may mean more problems.

Last night we had a great online teleseminar (www.onlinece.com). The talk was minimialism. Here was 2 of our take home points:

More foam in the shoe is not always good.

“Shoes with cushioning fail to absorb impact when humans run and jump, and amplify force under certain conditions, because soft materials used as interfaces between the foot and support surface elicit a predictable reduction in impact-moderating behavior. ” -Robbins

Basically barefoot feet, and even shoes with thinner foam/soled shoes, tend to judge impact more precisely because there is less foam to dampen proprioceptive input. The more foam you stack under the foot, the more material that must be deformed before a sufficiently rigid surface can be detected by the foot. Think of this, what do we do in rehab ? We stand people on stacked foam to give them an unstable surface (if they have championed balance challenges on a stable surface first, this is an important first step). When the foot cannot find a firm platform it searches for stability and drowns in the instability. This can be what more foam under the foot provides, inability to reference stable ground surface can negatively impact proprioceptive joint and tissue receptors.

2. Impact loading behaviors.

if we know the surface (the shoe or the actual surface/ground) is unstable, we will modify the pending impact loading behavior. In other words, you will jump differently onto a frozen puddle than you would dry ground. Studies have shown that the more foam a shoe has (ie. the more the potential instability from the example above) the greater the reduction of impact moderating behavior.

Humans reduce impact-moderating behavior in direct relation to increased instability.- Robbins

hope to see you in the next online teleseminar in 4 weeks !

shawn and ivo

reference:

BioMechanics April 1998

Materials: Do soft soles improve running shoes?
Most athletic shoes advertise injury protection through “cushioning,” but real world studies have not shown impact moderation.
By Steven Robbins, MD, Edward Waked, PhD, and Gad Saad, PhD

tumblr_mun4vkY4vF1qhko2so1_1280.jpg
tumblr_mun4vkY4vF1qhko2so2_1280.jpg

You create your own gait problems.

Just a simple reminder. Most shoes have EVA foam between the hard outsole rubber. EVA foam compresses but it also has memory. If you have a running form issue or a foot type that drives abnormal biomechanics into the shoe then over time the shoe’s EVA foam will break down into that pattern. Not only does this then support the problem, but it enables you to engrain the pattern (which means you are not engraining a cleaner pattern) meaining that every other joint and muscle then assumes that this is the norm and begins to alter their function based on the premise. A sign issue can drive many issues and many other complaints.  This client had a rigid rear foot varus , obviously as you can see by the wear pattern (yes, we gently and lovingly flogged this running for wearing the shoes this long into this pattern) but it was made worse by letting the shoe entrench this pattern so deeply. You see, their rear foot varus was no where nearly as bad as the wear into this shoe. But they continued to wear it and the foam continued to break down further and deeper into this varus wedged pattern. They came into see us for lateral knee pain and a tight IT band that was not responding to foam rolling (we immediately began to whimper and then proceeded to thump our forehead into our desk, repeatedly).  Some things should be obvious, but even we are far from perfect or wise at times.  

Key point, you have heard this here over and over again from us, have 2 or 3 pairs of shoes. Introduce the new shoe into your running repertoire at the 200 mile mark. At that point start rotating your shoes so that you are only a day away from a newer shoe that his not broken down into a faulty pattern and thus deformed EVA foam.  Even by the time the one shoe is dead and done, you have not been in it every run.  You should never kill a shoe to the 500 mile mark and then buy a new shoe. The pattern you have worn into your shoe will suddenly disappear when you put on the new shoe. Injuries occur from repeated events or sudden changes. Reduce your risk and rotated at least 2 pairs of shoes, one newer and one older.  

We talk about alot of these issues, and so much more, in the National Shoe Fit Certification Program. Email us if you think you might be interested.   thegaitguys@gmail.com

And ……when it comes to your feet and shoes, use your head.

Shawn and Ivo, The Gait Guys

Gait Guys, can I wear my racing flats during regular weekly base runs ?

Perhaps the better question is “should you wear your racing flats for regular base building runs ?"  Most injuries are based on a volume of impact miles across anatomy structures that are not appropriately protected or which have been encouraged into biomechanically challenged positions because of surrounding weakness or functional asymmetry.

In previous blog posts we have talked about the theory that more EVA foam is not always better and supported these ideas with research.  However, the pendulum can swing to the opposite as well. It is also plausible that a tipping point of less foam also increases risk because of a lack of shock attenuation.  The results of the study below demonstrated significant differences in peak pressure, maximum force, and contact area between the two shoe conditions of racing flat and regular training shoes (see study for specifics). There was a significantly higher maximum force measured in the lateral midfoot in the racing flats while an increased maximum force was observed beneath the rearfoot in the training shoe, 

What the study did not go into was the foot type and the running form from what we could tell. Heck, it is even possible that the small "n” of the study could have included a bolus of cross over runners with forefoot varus for all we know. the study did not delve that deep. We have all learned that often it is not what you do but how you do it and additionally, although not entirely pertinent here, that what we see is often not the problem (translation: just because the peak pressures measured high in an area does not necessarily mean that the adjacent anatomical structure to the peak pressure will suffer the impact and trauma of said pressures. This is a dynamic load sharing organism, where things break down is rarely where the problem exists)

Bottom line from our standpoint, and this does not hold true for everyone but it is a fairly safe statement, if your foot type is not pristine and your running form could stand some perfecting then perhaps running flats for anything than race day is not the most sane and cerebral decision.  This may be especially true if you are milking some subtle injuries or asymmetries that speak to you from time to time on a run.  But to each his own.  Human’s are inherently risk takers and subject to cognitive dissonance, especially when things are going well. And who knows, runners may fall even deeper into this profile for all we know.

Here is the study for your perusal. 

If you want to get better at this game of assessment, shoe fitting and foot type matching you might want to consider our National Shoe Fit Program.  Email us at  thegaitguys@gmail.com if you want us to send you some information on our program.

Shawn and Ivo, The Gait Guys

Differences in plantar loading between training shoes and racing flats at a self-selected running speed.

 Wiegerinck JI et al.  Gait Posture. 2009 Apr;29(3):514-9. Epub 2009 Jan 14.

Summarized Abstract:

The purpose of this study was to examine the difference in plantar loading between two different running shoe types. We hypothesized that a higher maximum force, peak pressure, and contact area would exist beneath the entire foot while running in a racing flat when compared to a training shoe. Peak pressure, maximum force, and contact area beneath eight different anatomical regions of the foot as well as beneath the total foot were obtained. The results of this study demonstrated a significant difference between training shoes and racing flats in terms of peak pressure, maximum force, and contact area. The significant differences measured between the two shoes can be of importance when examining the influence of shoe type on the occurrence of stress fractures in runners.

Gait Guys, What is the truth when it comes time to buying/rotating new shoes ?

A few moons ago an awesome Facebook reader asked us about changing shoes and the validity of the “press test”.  Here was Eve’s link to the press test and here is what it said:
 Do the Press Test

“To determine if the midsoles of your shoes are compressed and are no longer providing cushioning, do the press test. Using your thumb, push on the outsole upward into the midsole. With new shoes, it should be easy to see the midsole compress into lines or wrinkles. As the shoe wears down, the midsole compresses less with the same amount of pressure. When the midsole shows heavy compression lines and the press test reveals a minimal amount of compression, there is little or no cushioning left.”

There is a valid point to this test, but it might be considered too rudimentary by many purists.  But most purists rarely can offer us a better solution.  Here is the issue, EVA foam has a lifespan in terms of maintaining its initial shock absorption. EVA foam cells compress and deform over time, most foam in this world does whether it is your Tempurpedic mattress, the foam base for your rugs or your car seat. And with areas of greater wear and compression the foam accelerates its deformation. This is why certain areas of your car seats, your rugs and your bed get softer.  The same thing goes with your shoes. But they really do not get softer, the areas get compressed and the foam changes its density and its integrity. It no longer performs.  Resistance, compressibility and resilience changes.  This is the problem with shoe foam as well, no matter what foam a company is using.  However, the bigger problem if you really think about it is that the foot type you have and the biomechanics (good or bad) that you drive your foam into will be the direction future foot loadings deviate into.  Can this be good ? Rarely. Can this be bad ? Usually.  EVA simply has a given number of cycles, and that number is variable with many factors in place such as weight, running form, foot strike, foot type, weathering of the foam, wet foam, dry foam, outer sole glue, foot bed components and attachment, number of miles.  So, degrading shoe foam is a fact of life for a walker or runner. 
The “press test” gives the user some idea of how much the foam is compressed and how much resilience it has left. But it is a test limited very much by the subjective assessment.  We wouldn’t hold a torch to the test and make it a solitary assessment factor, in fact we rarely do it ourselves. But every little test and assessment has some perks and information that can be gleaned from it.
For the record, we like to play it cautious because injuries cost money and time to a runner. So we error on the side of caution always and go for lower numbers for the life span of shoes.  Each shoe is different and we will  not leave you with actual numbers here because the algorithm gets a bit large and convoluted but the bottom line is that cheaper shoes usually use cheaper materials and more expensive shoes usually use better materials (yes, this does not always line up as truth, we know this).  But shoes like Newtons and Altras from our experience seem to survive the trials of running a bit better (at least in our athletes) and so we allow more miles in them.  But for those looking for some harder numbers here are our loose rules:
400-500 miles per pair of shoes.  At 200 miles begin a second pair of shoes and start alternating the shoes every run (old shoe one day, next day use the new shoe).  This will reduce the successive days in a shoe in which the foam is driving deeper and deeper into deformity and thus you are only a day away from a reprieve from the deforming shoe. This will reduce injury risk.  This will also give you a dry shoe on a run the day after a shoe got soaked or caked with mud.  Water and mud add shoe weight and change biomechanics. Once the older shoe his the end lifespan mark you have the second shoe at 200-250 and you are ready for a new shoe. So you are never in a shoe until its death, when it is completely deformed and driving pathomechanics and possible injury only to the very next day step into a new shoe with entirely different (albeit neutral and unbiased) mechanics in the foam.  Injuries occur much of the time with change. Be smarter with your shoe rotation and reduce change.
VITAL NOTE:
Running and walking use different biomechanics and loading styles. Walking has heel strike as a norm, running for the most part shouldn’t include heavy or any heel strike depending on the athlete and who’s “pulpit of running form” that athlete chooses to pray at the foot of. Like religion, there is no one right way …  we each need to find what is best for us. And thus, since running and walking biomechanics are so different you should keep your running shoes for running and have another pair for walking and your other workouts.  Remember though, running shoes are build mostly for sagittal (forward) movement and not for lateral sports. This is why you should never, never ever, use your running shoes for tennis, racquet ball, basketball or many forms of cross fit.  Get a court shoe that is build for lateral movement. Not only will the shoe last longer but it is built on a platform that is more suited for such activity.

Shawn and Ivo

The Gait Guys…….