and what have we been saying for the last several years?“The development of bone marrow edema after transitioning from traditional running shoes to minimalist footwear is associated with small intrinsic foot muscle size, according to research …

and what have we been saying for the last several years?

“The development of bone marrow edema after transitioning from traditional running shoes to minimalist footwear is associated with small intrinsic foot muscle size, according to research from Brigham Young University in Provo, UT.

The findings, epublished in late October by the International Journal of Sports Medicine, suggest that runners with small intrinsic foot muscles may benefit from strengthening exercises prior to attempting the transition to minimalist running.

Investigators randomized 37 habitually shod runners to 10 weeks of running in minimalist footwear or their own shoes, and performed magnetic resonance imaging at baseline and after the intervention to detect bone marrow edema and assess intrinsic foot muscle size.

Eight of the runners in the minimalist group had developed bone marrow edema at 10 weeks, as well as one in the control group. Those who developed bone marrow edema had significantly smaller intrinsic foot muscles than those who did not.

In addition, running in minimalist footwear was associated with a 10.6% increase in abductor hallucis cross-sectional area, a statistically significant change”.

Source:

Johnson AW, Myrer JW, Mitchell UH, et al. The effects of a transition to minimalist shoe running on intrinsic foot muscle size. Int J Sports Med 2015 Oct 28. [Epub ahead of print]

More on the Minimalist Debate“Nearly a third (29%) of those who had tried minimalist running shoes reported they had experienced an injury or pain while using the shoes. The most common body part involved was the foot. Most (61%) of those repo…

More on the Minimalist Debate

“Nearly a third (29%) of those who had tried minimalist running shoes reported they had experienced an injury or pain while using the shoes. The most common body part involved was the foot. Most (61%) of those reports involved a new injury or pain, 22% involved recurrences of old problems, and 18% were a combination of both old and new musculoskeletal problems.

More than two thirds (69%) of those who had tried minimally shod running said they were still using minimalist running shoes at the time of the survey, but nearly half of those who had stopped said they did so because of an injury or pain. The most common sites of pain or injury that caused survey participants to discontinue minimally shod running were the foot (56%) and the leg (44%).

While some runners who tried minimalist running shoes suffered some pain and discomfort, a greater percentage (54%) said they had pain that improved after making the switch. The anatomical area most often associated with improvement was the knee. The results were published in the August issue of PM&R.”

Tomorrow we lecture on Minimalistic Footwear and its impact on runners on onlinece.com and chirocredit.com. Join Us. Biomechaics 318; 8PM Eastern, 7 Central, 6 Mountain, 5 Pacific.
All the cool people will be there and if you attend, you will know w…

Tomorrow we lecture on Minimalistic Footwear and its impact on runners on onlinece.com and chirocredit.com. Join Us. Biomechaics 318; 8PM Eastern, 7 Central, 6 Mountain, 5 Pacific.

All the cool people will be there and if you attend, you will know why barefoot is not the same as minimal

Barefoot Shoe Companies please take note. Barefoot-Natural Running: Fad or Trend

One question still remains, is this whole barefoot “thing” a fad or is it truly a trend that is here to stay ? The Gait Guys believe it has become entrenched enough now, in reputable research journals, that this is a firm trend that will not be going anywhere anytime soon.  The studies are just too convincing that there are benefits. However, Dr. Waerlop and I feel that there are risks for some folks.  Those mainly being that some foot types do not, and never will, have business being in such minimalistic shoes. We remained concerned about the misleading advertising, that these types of shoes will make everyone’s feet stronger. For some, they will, but most of the time strength education must be directed, so why would it be any different here ?  For example, there is a right way to do a squat, and a wrong way and merely doing more of them without guidance does not guarantee that the intended and proper motor patterns will be achieved. We all need direction when it comes to difficult things, like proper foot function.  Thus, merely putting on a minimalistic shoe does not mean that the correct patterns and strategies for foot strengthening are being automatically instituted. We see plenty of folks who are in minimalist shoes and yet still display toe hammering and clenching behaviors which are clearly not seen in strong feet, to the claims that these shoes will do it all are just not true.  And, for those that have challenged foot types and lower limb torsional issues (ie. FF varus, Rothbart Foot, cavovarus foot, excessive tibial varum and/or tibial torsion etc) these folks will likely trend towards local foot problems or injuries or issues further up the kinetic chain (hip, knee, low back etc).  Understandably, these are heavy medical terms and conditions that are very much out there in the running public. We know, we see them daily.  The problem could be that those providing the education do not have enough clinical background to know what these issues are let alone recognize them.  So how can they then draw these issues to the surface in educating the public ?  As I say in my lectures, “You first have to know what a platypus is in order to identify it.  Otherwise it is just a hedge hog with flippers and a duck bill."  These underlying anatomic issues are the elephants in the room that everyone is missing, everyone except us.  We get the folks who are running in these minimalist devices and we get to see who never should have been in them in the first place.

The good thing is that many companies are setting up educational programs to help folks drop down into "minimalism 2.0” but still, to date, no one is talking about the elephants in the room, those being those foot types that are too risky to be in the shoes and even more specifically, how to strengthen the foot.  Merely putting the shoes on and wearing them does not mean the end user who already has challenged feet will begin to engage the correct muscular motor patterns.  But who would admit to those risks, that would be stupid advertising and product risk.  With 36+ clinical years we feel this is where we have some pull and can help.

Someone needed to be talking about the elephants in the room.  We finally decided that we had enough experience clinically, and with runners and shoes, to be that person. Agreeably, there is a danger in doing too much barefoot running too soon. We made this clear over the past few years as Biomechanics Advisory Board members for one of the big players in this game.  For us it is about “keeping them honest” as we like to say now. We are trying to make the calls on the products that have questionable statements and applaud those that stick their neck out but whom take our critique well.  We do not know everything, but we seem to know much more than most when it comes to the biomechanics of what is going in these products.  If you put 10 different feet in a product, you will get 10 different biomechanical presentations from the shoe. So, much of what is being missed is the education of what is going on with the parts that are in the shoe, and that is our world.  A major part of the barefoot or natural running trend are the problems that exist with the thing you are putting into all of these products, a person. A person who likely does not have the classic middle of the road, ‘Average Foot’ these shoes were designed around; that foot that all these companies base their research and dialogue upon.  To us, the most important thing for us to do is to raise the knowledge and awareness to the public, shoe companies and shoe stores that there is likely a ~10-15% standard deviation off of that average foot where their products will work as they claim.  Those other 70%, well…….they need us and they deserve to have us help them see the elephants in the room that no one is talking about.

If the collective goal of the natural running movement is to reduce injuries then the education MUST continue into educating the fabricators and running public of all of the issues at hand (or “foot” in this case) which should include talking about the elephants in the room.

Please help us get the message out. Wouldn’t it be great if this message went viral ? Send this to your friend who just bought a pair of “barefoot or minimalistic shoes”. Send it to your shoe store owner, your coach, your trainer, your doctor, therapist, your running club colleagues, your brother etc.

Lets educate everyone so this positive trend does not have a dark undercurrent that no one speaks of.


Shawn Allen, Ivo Waerlop………with almost 4 decades of clinical experience…..we are,  The Gait Guys

Fabricating a Shoe Last: The LAST word

A few words about lasts (but not the last)

Dr. Ivo Waerlop & Dr Shawn Allen

A last is the mold or template for creating the shoe. It defines the shape of a shoe. The last can create a high, medium or low volume shoe. They can also be relatively straight or curved (this refers to the shape of the “sole” of the shoe). If you turn the shoe over and stare at the sole, mentally bisect the heel with a line going to the front of the shoe. If the line bisects it, it is a straight lasted shoe (this corresponds to the axis of the 2nd metatarsal, or slightly lateral to it). If more of the shoe falls medial to this (more of the sole on the big toe side) it has a curved last. Curved last shoes can vary in the degree of curvature. Curved last shoes are designed to help control pronation, as they provide medial support and slow its rate by causing a relative supination of the foot after heel strike (it weights the lateral border of the shoe for a longer period of time, theoretically allowing less pronation). Curved last shoes can put more motion into a foot, especially one with limited rearfoot motion (it still must pronate, but due to the lack of rearfoot motion, the forefoot must compensate and now must do so in a shorter period of time).

Last also refers to the material (or way that the material) overlays the midsole of the shoe. The last (look inside the shoe on top of the shank) is the surface that the insole of the shoe lays on, where the sole and upper are attached).    Shoes are board lasted, slip lasted or combination lasted. A board lasted shoe is very stiff and has a piece of cardboard or fiber overlying the shank and sole (sometimes the shank is incorporated into the midsole or last).  It is very effective for motion control (pronation) but can be uncomfortable for somebody who does not have this problem.  A slip lasted shoe is made like a slipper and is sewn up the middle.  It allows great amounts of flexibility, which is better for people with more rigid feet.  A combination lasted shoe has a board lasted heel and slip lasted front portion, giving you the best of both worlds (theoretically).

A general rule of thumb is: You really can’t go wrong with a straight last. It will work for all feet, especially if you are using an orthotic. This is especially important with people with forefoot abductus, moderate to severe pronators and rigid feet (rear or forefoot). A forefoot abductus and severe pronator’s feet will move laterally in the shoe, often causing crushing, rubbing, cramping and blistering of the little toe against the side of the shoe. A rigid foot, because the foot needs to be able to pronate at the mid and forefoot, will have a similar problem. You can use a curved last with people with mobile or hypermobile feet, provided their pronation is not too severe (clinical judgment, trial and error).

I hope this clarifies some of the issues surrounding lasts, their shape, and usage. This will probably not be the last word on lasts, but hopefully will suffice some of the burning curiosities surrounding the subject.

* important addendum to the youtube video: please note that the last that was created has a raised heel (if you look closely). This will put the shoe and foot in relative plantarflexion. This is likely for a traditional trainer running shoe or daily dress shoe where there is a 20+mm heal lift in comparison to the forefoot platform. Beware, this is not how the foot was designed, ie. rearfoot and forefoot are supposed to be on the same plane for anatomically designed biomechanics. This plays into the mechanical features of the minimalistic shoe trend of Newtons, Vibrams, NB minimus, Atra Adam and EVE, TEraPlana etc. 

We hope this was helpful,…….Ivo and Shawn……..we are, The Gait Guys

The Gait Guys: Some strategies in Controlling the Foot Arches and Big Toe

As promised. We fixed the volume.  Less hiss next time. Enjoy

Dr. Shawn Allen of The Gait Guys speaks about proper stabilization of the medial foot and arch. Muscle specifically discussed are a team: FHB (flexor hallucis brevis), AbDuctor hallucis, and tibialis posterior. He discusses the functional anatomy, normal and pathologic movement patterns of the arch and first ray complex and big toe (hallux). His foot’s ability to show the optimal patterns for the arch and hallux are excellent examples. Follow up videos and DVDs will show more details you need to know, and some of the exercises he and Dr. Ivo Waerlop use to restore a foot that has lost these abilities. The DVDs are in the works. Take their lectures and CME on www.onlineCE.com. Visit them at www.thegaitguys.com and on their facebook PAGE & Twitter of the same name for daily feeds of unique things.

Barefoot Winter Footwear: The mukluk.

In this, the latest of The Gait Guys videos, Dr. Shawn Allen talks about a neat product, the Steger Mukluk. It is about as close as you can get to a Minimalist Winter boot (in case you are chasing caribou in the north, or shoveling out from the Chicago Blizzard of 2011, or just working outside in the bitter cold). Some interesting principles of minimalist shoes apply here. Where do these guys come up with their ideas !