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Nick Campitelli, DPM, Member of Vibram Advisory Board, Writes New Blog on Plantar Fasciitis

Discussion in 'Biomechanics, Sports and Foot orthoses' started by Kevin Kirby, May 19, 2013.

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    Nick Campitelli, DPM, who is a member of the medical advisory board for Vibram Fivefingers, has just written an interesting article on plantar fasciitis on his blog.


    At the end of his rambling commentary, this was Campitelli's conclusion:


    Anyone care to comment on his ideas on his blog??
  2. Campitelli even has a book for sale on I-Tunes on "Running in a Minimalist Shoe".


    If minimalist shoes were so good for us, why should we need a book on how to run in them??

    Also, Campitelli and Vibram-funded, Dan Lieberman, PhD, both were consultants on a How to Run in Vibram FiveFingers Without Getting Injured 13 page "Step by Step Guide".


    Since when do runners need a 13 page manual on how to run in a running shoe without getting injured? Possibly when the same company is faced by two class-action lawsuits in regards to false health claims about their shoes??
  3. Paul Bowles

    Paul Bowles Well-Known Member

    I havent read the full article yet Kevin - does he allude to the real cause behind plantar fascitiis (or more appropriotely termed plantar fasciosis) and how we should be managing it?
  4. Craig Payne

    Craig Payne Moderator

    He must have missed the memo:

    The minimalism fad is over. The bubble has burst. The fat lady has sung.
    First Q sales figures in the US: minimal shoes sales down 10% to a marketshare of just 4% (it never went above 5-6%); motion control shoe sales up by 25%. Runners have voted with their feet.
    Of the dozen papers researching minimalism vs traditional shoes that are being presented at this weeks ACSM mtg; none of them found any advantages of minimalism in terms of running economy/efficiency or a reduction in injury rates.
    The number of people searching Google for things like 'barefoot running' or 'minimalism running is over half what is was a year ago - runners have lost interest in it.

    I even came across a comment that there are more people competing in unicycle races than there are running barefoot.
  5. toomoon

    toomoon Well-Known Member

    To be honest Kevin,

    This article was such a ramble, and so irrelevant to plantar heel pain, I do not think it worthy of anyone’s time and effort.
    Campitelli is flogging a dead horse, and as the train wreck unfolds for people who have gone “all in” with minimalism, these guys will get increasingly desperate.

    I think we have all contributed to a balanced discussion on the topic, and I for one no longer wish to engage the zealots. Better things to do with my time.. root canal treatment for example..

  6. Craig Payne

    Craig Payne Moderator

    Certainly been seeing a lot more of that in recent months; some of them are really lashing out with the ad hominem's as the science and evidence is not supporting them.
  7. Tuckersm

    Tuckersm Well-Known Member


    On my runs and rides, I have never seen a barefoot runner, (Except on the beach) but yesterday, I did see my first uni cyclist, on the bike track near Fairfield.
  8. Sicknote

    Sicknote Active Member

    Perfectly said.

    I know full well from a personal standpoint what effect poor dietary choices have on the feet, particularly in those suffering allergies & weak immune system.

    What I have discovered is that the feet are the first to be effected, for whatever reason I'm not sure. (It may be the body's self prevention mechanism of making the organs top priority & pushing "the invaders" into the extremities).

    My diet is centred around having clean blood, strong organs, de-calcified joints & when the body is constantly in a detoxed state, the tell tale signs of poor dietary choices are made even more apparent. From a detoxed state you have the advantage/awareness of being able to listen to your body better.
  9. Paul Bowles

    Paul Bowles Well-Known Member

    How did we get from plantar heel pain to poor dietary choices and the "detoxed state" :rolleyes: Are you the same Chiro who is also a Podiatrist who keeps telling my patients that foot levellers are far superior to their custom foot orthotics and that as a Chiro and Podiatrist you are much more qualified to treat their lower limb problems?

    I just read the article - I wish I could have those 2 minutes of my life back! Alot of words to actually say - nothing: except his mate has plantar heel pain and he was going to give him orthotics if he wanted them. Sheesh!

    I'm with Simon - desperation.....I thought I was going to get some prophetic reason why plantar heel pain excists and some exciting theoretical rhetoric about evidenced based management of it. What did I actually get? A headache.....

    So is mine - problem is threads like this make me want to drink excessively taking me "out" of my detoxed state! ;)
  10. When I see a weed, I just pull it out so it won't go to seed....and cause more weeds......

    Moral of the story: Don't engage weeds...just pull them out by their roots....:cool:
  11. And for the latest of your many idiotic comments, Sicknote, you have now also been added to my ignore list.

  12. blinda

    blinda MVP

    Bet my list is longer than yours, Kevin ;)

    He`s been on mine for some time now, ever since he PM`d me `advice` on cancer treatment. Just not funny.

    I see from Paul`s quotes that Sicknote`s understanding of our innate and adaptive immune systems is just as indepth as his knowledge of carcinoma.
  13. Podiatry Arena's "Ignore List" has definitely reduced my blood pressure. It's like my own personal "mute button" for silencing those who don't add anything useful to our discussions here. What a great idea!
  14. David Wedemeyer

    David Wedemeyer Well-Known Member

    No and clinically it may well be the most impotent blog post of all time of the subject.

    :good: This says it all Craig, Excellent!

    Anyone else think this guy may be a certain sock less chiropractor allied with Campitelli & his ilk?

    Kevin from a non-podiatrist who came here to learn from your profession I appreciate having people like you and the contributors on PA who point out the weeds. Keep up the good work :D
  15. Dana Roueche

    Dana Roueche Well-Known Member

    Craig, as long as you and your peers continue to talk about minimal shoes, the concept will never die. It will live on in your discussion and continue to cause angst among your fraternity. Kind of entertaining to watch.

    When it comes to providing the only real piece of equipment for a sport that places a great premium on having low weight, I sincerely doubt that shoe companies will ever STOP designing and marketing ultra light running shoes. Shoe companies have made minimal shoes since they first started making running shoes. They will continue to make minimal shoes for as long as the concept of a running shoe exist. There will continue to people who prefer to run in minimal shoes and the market will continue to exist.

    All of the wishful thinking in the universe will not result in the disappearance of minimal shoes.

    10 years from now in 2023, let's compare notes to see if minimal running shoes are still being designed and marketed. Until then, lets watch and see how long the discussion of minimal running shoes remains active on the Podiatry Arena.
  16. Craig Payne

    Craig Payne Moderator

    I don't have to wish for it at all. What is happening is happening very independent of what I may or may not wish for. The numbers show that runners have voted with their feet and the science does not back all the claims that were made for it....the fad is over. Nothing to do with me; no skin off my nose. Only difference here, is that we weren't as gullible as others to fall for all the initial rhetoric and propaganda, that is not now being taken seriously by anyone except those who have so strongly 'hung their hat' on the fad.
  17. But it seemed so plausible... http://www.youtube.com/watch?v=JJX2uBp4HYw
  18. Dana Roueche

    Dana Roueche Well-Known Member

    Craig, maybe a little history lesson will help.

    "Joseph William Foster came from shoemaking pedigree. His grandfather, Sam, was a renowned cricket shoemaker and young Joseph, a keen runner, noticed the potential advantage that spiked footwear would provide on the running track.

    Working in a room above his father’s sweet shop, Foster created early versions of what would later become the lightweight Running Pump from around 1898. Completely handmade, the shoe matched the softest and strongest leather upper currently available with six one-inch spikes on the sole. Foreseeing the appeal of casual road running, Foster also created a flat version of the same shoe, with a rubber sole."

    Quoted from: http://www.oki-ni.com/daily/2013/04/history-of-running-shoes-part-2-fosters-running-pump

    The concept of a "minimal" running shoe was introduced by Joseph William Foster in 1898. Minimal running shoes have been around for and part of running culture for 115 years. If you really think that after 115 years, minimal running shoes are all of a sudden going to vanish, I would have to say that you are basing it on wishful thinking. There is a better chance that the minimal running shoe will be around for a 2nd 100 years than there is a chance of if going away in the short term.

    My assumption about the likelyhood of future of minimal running shoes is based on 115 year historical trend in the industry. What are you basing your claims on?
  19. Craig Payne

    Craig Payne Moderator

    Two things:
    1. The recent falling sales of minimalist running shoes
    2. The huge volume of recent research that is showing there are no advantages to it.
  20. Dana Roueche

    Dana Roueche Well-Known Member

    OK and I base my opinion on the fact that minimal running shoes were designed and have existed for the past 115 yrs.

    Since neither of us are fortune tellers, we will need to let the future determine whether minimal running shoes will disappear or if they will continue. Too bad we can't place a bet on what we think the outcome will be. I know I won't be wishing for something to all of a sudden disappear.
  21. Rmelendez

    Rmelendez Welcome New Poster

    Ianero states that plantar fasciatis is a condition related to biomechanics and the spur. If surgically treated the calcaneal bone has to be remodeled with heel spur rasping. Campitelli knows that. Advocators against this idea do not have the time experience to back up their theory
  22. Yeah! Because antihypertensives are a bad idea which will never catch on. They've never helped anybody...

    Wait, what?!?!

    There are no words.
  23. Well, thats certainly a view...
  24. Dananberg

    Dananberg Active Member


    Cigarette smoking has existed for centuries......but the fact that it continues to exist doesn't prove its
    value.......just its addictive nature. Crsig is right. The fad is over as is MBT and negative heeled footwear.


    STEVE LEVITZ Active Member

    plantar heel spurs are not the eitiology of plantar heel pain
  26. drdebrule

    drdebrule Active Member

    Here are my thoughts on the blog for plantar fasciitis from Campitelli:

    1. Yes, I want those 2 minutes back.
    2. His essay did not support the title. There was almost nothing on the cause of plantar fasciitis. Overuse, functional halllux limitus, training errors, pronation, poor biomechanics? No, just bad shoes. That's all you need to know. Perhaps it should have been titled my personal feelings about minimal shoe wear?
    3. If minimal shoe wear is so great than why do our patients need to buy such expensive minimal shoes? Why can't patients just take off their shoes and save the money?
    4. Seems like Dr. C. is taking a shot at Kevin Kirby. Kirby simply stands behind the evidence and is not for or against shoes.
    5. Let's design a randomized prospective study for plantar fasciitis looking at barefoot or minimal shoes as a treatment. Let's put in a control arm and see how this all adds up. Then there will be something to write about.
  27. Dana Roueche

    Dana Roueche Well-Known Member

    Shoes specifically made for running started to surface in the late 1800's, early 1900's. For the next 75 years, up until the early 1970's, the shoes designed and produced for running were essentially "minimal" running shoes. They didn't need to be categorized as "minimal" shoes. For that matter, there were essentially two categories of shoes, Track Spikes and Road Flats, both designed with minimalism as a key element of the design. The term road flat denotes within it's name the absence of an heel or at most a "minimal" heel. In addition to little or no heel, the shoes had little or no cushion, little or no support and were flexible. All characteristics of what is considered a minimal shoe today.

    In the early 1970's, it became popular for the shoe companies to add foam and later EVA to the midsoles of the shoe to provide cushioning. With this came a pronounced heel for even more cushioning in that area. Later, came design changes to add stability and motion control because of the issues that the cushioning was causing or at least believed to be causing.

    Moving forward for 35 yrs of added bells and 35 years of added whistles, the shoe companies continued to add more and more to their shoe designs. Finally, in the 2000's, people started to step back and look. After 35 years of EVA'd, Thermoplasticed, Nylon reinforced, super charged, super sized, whoopdy do, spectacular space aged running shoes it was recognized that these shoes did NOTHING to lower the alarming injury rate in runners. It didn't matter what runners were wearing on their feet, they were still getting injured at the same rate they were in 1970 before all of this nonsense began.

    Since these huge over designed running shoes weren't helping, why not consider wearing something that will at least produce an efficiency gain? Why not look back at where the running shoe started? Holy flip flops Batman, we've had minimal shoes all along! Maybe those will work just as well and we don't have to run in Big Bulky Shoes after all.

    What is really unfortunate, is because of the nature of running and it's participants in their unending quest to find the Holy Grail, the magic pill that will turn them into a world class athlete over night simply by purchasing a piece of equipment, the Minimal shoe fell victim. The minimal shoe isn't going to solve any more problems than the big bulky shoe. It is simply a matter of what works best for the individual runner, nothing more, nothing less.

    The good that has come out of all of this is that the shoe companies jumped on the bandwagon and produced a bigger bandwagon full of different models of minimal shoes to pick from. Great news for the runner who can actually benefit from these shoes.

    Minimal shoes are priced like all other running shoes. All running shoes are expensive, minimal shoes aren't any more or any less expensive than traditional running shoes. The reason "patients" or runners who aren't "patients" can't just take off their shoes and save money is because it is not practical. Shoes, whether they are minimal or traditional, protect the sole of the foot from rocks, sharp things and friction from the surface of the ground. They protect from burning and from freezing. They protect from stubbing toes, etc. It just isn't practical to run in all climates and surface conditions without some sort of protection to the foot.

    What this whole discussion or debate boils down to is a matter of level of protection. From a 4 OZ minimal shoe up to a 15 OZ motion control shoe, we are really talking about a continuum of the level of protection the shoe provides. Different runners need different levels, that will never change. What is really important is not whether a style of running shoe is dead or not, what is important is that someone will some day hopefully figure out how to help the person who is struggling to find the running shoe that offers the right level of protection so that they can optimize their running potential and their running experience. I suppose until then, we can sit around and argue about what style of running shoe is best.
  28. toomoon

    toomoon Well-Known Member

    Quote Dana Rouche: "Since these huge over designed running shoes weren't helping".

    How do you know this Dana.. can you provide us with any evidence that they did not 'help'? And "help" what exactly?
  29. CraigT

    CraigT Well-Known Member

    Dana- Do you think Runners from the early 70's are the same as they are today???
  30. Dana Roueche

    Dana Roueche Well-Known Member

    Simon, I can't provide evidence that they "helped" any more than they didn't. Since running shoe companies go out of their way to avoid making any claims about what their shoes do or don't do, "helped" is left up to the interpretation of the consumer.

    Simon, do you know what "tradiditional" (defined as not minimal) running shoes that have been marketed over the past 40 years were and are intended to do? Have they accomplished that intention? Can it be demonstrated?

    Simon, can it be proven or demonstrated that tradional running shoes have reduced injury rates? Should runners who aren't prone to injury wear traditional shoes? What should they wear? Should runners prone to injury wear traditional shoes? What should they wear?
  31. Dana Roueche

    Dana Roueche Well-Known Member

    The runners from the early 70's are now 40 years older.
  32. toomoon

    toomoon Well-Known Member

  33. Dana Roueche

    Dana Roueche Well-Known Member

    Simon, here is the point I made taken in context from my original post:

    "What this whole discussion or debate boils down to is a matter of level of protection. From a 4 OZ minimal shoe up to a 15 OZ motion control shoe, we are really talking about a continuum of the level of protection the shoe provides. Different runners need different levels, that will never change. What is really important is not whether a style of running shoe is dead or not, what is important is that someone will some day hopefully figure out how to help the person who is struggling to find the running shoe that offers the right level of protection so that they can optimize their running potential and their running experience. I suppose until then, we can sit around and argue about what style of running shoe is best."

    I would sincerely encourage you to share your opinion about what you believe the purpose of a running shoe is and to follow that with what you think is important regarding the different categories of running shoes being marketed and how that relates to the actual runner.
  34. Even though I can't see Dana's comments here since I have ignored him...for good reason....my mental image now of this discussion is one of a rooster on a chess board knocking over chess pieces and then claiming he has won the game...ala Robert Isaacs....

    Am I very far off, Simon??:rolleyes:
  35. Dana Roueche

    Dana Roueche Well-Known Member

    Simon, I would ask you to share with Kevin that I have acted only as a professional and a gentleman who is simply trying to have a productive discussion. I have not taken anyone's words out of context, twisted, misinterpreted or misunderstood them. Most importantly, I have not attempted to discredit anyone on this forum.


  36. efuller

    efuller MVP

    So, in the absence of evidence you pose the question what should people wear. People should wear what feels good on their feet. I had som Nike cross trainers with the air midsole and they gave me sinus tarsi pain. When I wear motion control shoes with features that tend to shift the center of pressure under the heel more medially, I do not get sinus tarsi pain. I have a more medial that average STJ axis and I would have no problem recommending motion control shoes to people who also have a medially positioned STJ axis. There is a very logical explanation of why this should help.

    When I run, I'm much more comfortable in traditional running shoes as opposed Aqua socks (which are great when I go canoeing) or combat boots. I'll bet that if you did a survey of runners they will know which shoes are more comfortable to run in. They might not know which brand or model of runnig shoe is more comfortable to them, but I'd bet most of them would choose a running shoe. There are probably a small percentage who choose running shoes because that is what they are supposed to do.

  37. Dana Roueche

    Dana Roueche Well-Known Member

    Eric, well said and thank you. You are getting at the point I've been trying to make all along.

    In my initial post, I wrote: "What is really important is not whether a style of running shoe is dead or not, what is important is that someone will some day hopefully figure out how to help the person who is struggling to find the running shoe that offers the right level of protection so that they can optimize their running potential and their running experience."

    In addition to your comments about wearing what feels good on your feet, not only should physical factors be considered but a combination of multiple factors. This brings to mind the Nike Vomero, an extraordinarily cushioned shoe. They feel wonderful when you use them to wear around the house. Yet wearing them on a long run of 20 or 30 miles and they become absolute torture, at least they do for me. The softness of the shoe cause my feet and legs to compensate and become totally exhausted which I believe can be explained by the concept of ZOOLS. The negative effect of these shoes is exaggerated when wearing on trails that are softer than pavement. On the other hand, a pair of firm shoes with minimal cushioning that might not feel as comfortable around the house, allow my feet and lower legs to feel fantastic after 30 miles of running. My point here is that shoes that feel comfortable in one situation might not be the end all shoe for every situation.

    When you mix varying situations across many runners it begins to become obvious as to why there are many different categories and types of running shoes. Hopefully, everyone can find the right shoe to fit their physical requirements and situation. For someone with a lot of experience, selecting the right shoe typically is not a problem. For someone new to running, the possible combinations can be overwhelming and the likelyhood that the wrong shoe will be picked is probable. Reading popular running books combined with poor marketing practices doesn't help.

    In the mid 1990's, long before any of this discussion became common, I ran a 100 mile trail run at 10,000 feet altitude in a pair of Rockport casual oxford shoes. They were something you would wear to a backyard picnic and would never consider running in. There were several reasons I did this. One was that even 20 yrs ago, I believed that what the running shoe companies were marketing was probably more financially driven than altruistic on behalf of the runner. I was curious to see how my feet and legs feel after running 100 miles in a simple pair of casual shoes vs an overpriced, over promoted pair of running shoes. What I found out is that while I always needed to change running shoes after 60 miles to give my feet and legs a break, in the casual shoes, I had no need to change them because my feet felt great the entire 100 miles. The results also showed me something, I clocked a personal record for a 100 mile mountain run which I have never able to match in traditional running shoes.

    There is plenty of room in the running shoe industry for all categories of shoes that exist today and for new categories that will be created and probably become popular tomorrow.

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