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Evidence behind the 'barefoot running' headlines in the media - the Egg on Face Award

Discussion in 'Biomechanics, Sports and Foot orthoses' started by Craig Payne, Jan 27, 2013.

  1. Craig Payne

    Craig Payne Moderator

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    [rant warning on]

    We all recall the headlines in the mainstream media and on blogs from years ago about how great barefoot running was. The headlines were based on comments from research that did not actually show what the headline was saying. You know the ones I mean.... never let the facts get in the way of a good story. We raised red flags and alarms bells about that at the time, but those in the 'barefoot community' lapped it up.

    For example, there was all the headlines about barefoot running being better based on Lieberman study published in Nature. The media and barefoot community lapped it up .... but the Lieberman study did not even show that at all. This was pointed out in some quarters and even Lieberman himself put a disclaimer on his website to distance himself from these conclusions based on his work. But did, in general, anyone in the barefoot community even notice that? They were so swept up in the media hyped headlines.

    Another example was the barefoot websites and mainstream media outlets that claimed running shoes cause knee osteoarthritis. This was based on a press release put out on a flawed study of runners on a treadmill and was not even a study on osteoarthritis. The evidence is that running shoes do not cause knee osteoarthritis, but that did not stop the barefoot running websites claiming that. This was pointed out at the time. But did, in general, anyone in the barefoot community even notice that? They were so swept up in the media hyped headlines.

    Then there was the BS from Vivobarefoot, barefoot bloggers and the media with headlines that barefoot running was better based on a retrospective study of injury rates in forefoot vs rearfoot striking that was on a small number of almost elite runners who were actually wearing shoes! They ignored the two substantially larger studies on typical runners that showed that there was no difference!

    We all know the problem in the media of the headlines about getting facts right when they create headlines about research that do not quite match up. It just shows how gullible the public are to blindly accept the headlines.

    What happened, in general, in the barefoot and minimalist community when these inconsistencies between what the research actually showed versus what the headlines in the media and blogs said? The response was all the usually trope of argumentative fallacies and some of it was particularly vile. The vile responses just shows the true colors of some of these people. They are so incapable of litigating the issues, they resort to all the usual argumentative fallacies (...they probably don't even know what they are!). They did not want a bar of it and let the attack dogs loose.

    With the exception of a few isolated examples, there was a, in general, blind acceptance of the headlines generated from the research and an amazing lack of critical appraisal by advocates of the barefoot or minimalist approach.

    Now the tide is turning. Look at some of the recent headlines in the mainstream media:
    ‘Minimalist’ running style may be undermined by new findings from Kenya
    Some Barefoot Runners Tip Orthodoxy Back on Heels
    Barefoot running: The pace of dissent quickens
    (and there have been more, but do not have the links handy)

    I am the first to admit, that the research that these media reports are discussing does not support the headline of the article, just like all the previous ones mentioned above.

    What is amusing this time round is the whinging going on about these articles on barefoot and minimalist websites! They are right to whine about it as the actual research does not support the headline .... but where were these whingers a few years ago when the research did not support the headlines about barefoot running being better, when the research did not actually show that. You can't have it both ways ....so for that hypocrisy, I give them the coveted 'Egg on Face' Award:

    Attached Files:

  2. Paul Bowles

    Paul Bowles Well-Known Member

    LOL.....nice post!
  3. Blaise Dubois

    Blaise Dubois Active Member

    Hi Craig,
    When I read your post I feel you have something to protect or something against barefoot or minimalism. If you want to show that you know the literature and the facts around shoes (without emotivity, philosophy, ...) you need to tell that.
    - Close to 90% of the market are maximalist running shoes (TRC rating < 70) since many years and without any scientific justifications.
    - The only reason why 97% of the market was (up to 2008) maximalist big technologic bulky shoes ... is because marketing from companies and health professional recommendations. (nothing scientific)
    - We have presently NO GOOD evidence (good RCT with sufficient N and time of follow-up) showing that maximalist shoe (and any of the technology integrate in the shoe) or minimalist shoe or barefoot ARE BETTER THAN maximalist shoe (and any of the technology integrate in the shoe) or minimalist shoe or barefoot.
    - The best evidence presently linking injury and running shoes (correlation not causation) is the retrospective epidemiology survey of 2,509 runners (Goss 2012), showing that traditionally shod runners are 3.41 times more likely to report injuries than experienced minimalist shoe wearers.
    - Because our prescription and recommendation, actually, are based only on indirect evidences, it will probably change in the future. For the moment what's your chart of prescription? That's mine (you never comment) http://www.therunningclinic.com/medias/pdf/poster-2-english-4.pdf
  4. W J Liggins

    W J Liggins Well-Known Member

    I have no particular expertise in the mechanics of running, shod, unshod or (what seems more likely amongst so called barefoot runners) 'minimalist shoes'. However, as an individual with a scientific background (as are most of the posters on this site), I have to defend Craig here. It is a maxim of science that if you make a claim, it is for you to prove your hypothesis, NOT (emphasis) for anyone else to disprove it. That, it seems to me, is what the 'barefoot church' have notably failed to do, and Craig is simply pointing out that some evidence, however questionable, is now being produced to show that this is the case. So if you have conducted, or know of, RCTs to prove beyond doubt that 'barefoot is best', then please do reference it here. I have an open mind and will be very grateful, as, I am sure will our colleagues who spend the best part of their lives treating athletes.

    All the best

    Bill Liggins
  5. Blaise Dubois

    Blaise Dubois Active Member

    Shoe Companies MUST (emphasis) support scientifically their claim (or 'insinuation' about their technologies before putting their shoes on the market. Prove the safety first and the possible advantage second. But They didn't! (why after 30 years of promotion -by every body, Craig and me included- of high heel cushion and motion control shoes... there is no single RCT justifying those type of shoes).
    Professional that promote or prescribe these devices/treatments NEED to justify their actions. (I'm a health professional and I try to justify, to the best of my knowledge, all the treatment or prevention tips I give to my patients)

    For me, the 'barefoot church' failed like the 'big bulky shoe church' did. The problem here is not the word "barefoot" ... it's the word "church". I'm presently more aware about the 'big bulky shoes church'! (more money to promote -20billion business-, most part of the market -90%-, many members that want to protect they habit and business (that fit in the model) -physio and podiatrist-... and an history of >30years of promotion based on nothing)

    The best available evidence actually is the Goss study... to the side of minimalism.
    The pilot study on "Comparison of two types of running shoes for preventing injuries in recreational runners: a pilot study. CASEM Research Grant; Blaise Dubois, Jean-Francois Esculier, Pierre Frémont, Craig Richards" is done. soon the RCT.
    My opinion : If you have no RCTs to prove beyond doubt that 'big bulky shoes is best', and the available evidence seems to point to the the side of minimalism, why most of people recommend/prescribe big bulky shoes. Marketing influence? Habits? Philosophy? Market protection?
  6. Craig Payne

    Craig Payne Moderator


    The point I am making is about the "evidence" behind the headlines reported in the mainstream news media.

    There have been a lot of headlines and reports in the news media recently that are "anti"-barefoot or minimalism. However if you look at the research they are talking about, that research does not support the headline. (eg ‘Minimalist’ running style may be undermined by new findings from Kenya).

    I have come across a number of comments on barefoot and minimalist websites recently complaining (whinging) about those headlines and how the evidence does not support those headlines (and I agree, the research does not support what the headline says).

    What I am pointing out is that those very people complaining now were not complaining in the past when the headlines were not supported by the research that they were reporting on (eg the Running shoes cause knee osteoarthritis debacle).

    Why were they blinding accepting one set of headlines and complaining about another set of headlines - when the evidence being reported on did not actually support either set of headlines?
  7. Blaise Dubois

    Blaise Dubois Active Member

    I fully agree with you. If it's not about an agenda, it's about a philosophy... people agree with the headline they believe whatever the evidence. I think a good example is here. Most of people writing on PA will argue against barefoot and minimalism because it's not fitting in their practice philosophy...
  8. I think you are talking crap. Most people that write here on a regular basis are regularly reading and interpreting cutting edge research to inform their philosophy and clinical practice, they are more than willing to be proven wrong and to change their practice on the basis of good quality, published research evidence.
  9. Blaise Dubois

    Blaise Dubois Active Member

    You speak about Simon bare told?
  10. Forget Simon Bartold for a minute, Blaise; you seem to be obsessed with the man- which is just weird. What's important is how you as an individual clinician respond to the research evidence presented to you; that's what differentiates a good clinician from an average one and from someone pushing a personal agenda. At the moment, you come across to me as someone pushing a personal agenda with a grudge against Simon Bartold. Is that really how you want your contemporaries to see and remember you when you've gone?
  11. Blaise Dubois

    Blaise Dubois Active Member

    I thought Simon was in your super team. So you speak about Kevin? Who are you speaking about when you say "most people that write here on a regular basis are regularly reading and interpreting cutting edge research".
  12. W J Liggins

    W J Liggins Well-Known Member

    This is (once again) turning into a circular argument. I do not recollect any contributor to this site 'plugging' particular shoes or defaming others. However, it is reasonable, is it not, to accept that the likes of Payne, Kirby and Spooner who are acknowledged experts in their field are going to possess a great deal more knowledge on this subject than a news hack who has just scraped the surface, and more so, a benighted individual who has credulously accepted the news hack's say so. To claim that after a hypothesis is formed and failed to be supported by the evidence, then by inventing an alternative area of research you somehow discredit those who have legitimately questioned the former is, to say the least, naive.

    Are you a pod?

    All the best

    Bill Liggins
  13. Do grow up, Blaise; for you own sake.
  14. Blaise Dubois

    Blaise Dubois Active Member

    I don't know you, and I don't who you speak about. Do you speak about Simon B? I agree about one thing : this is turning into a circular argument... and like ever finish with personal attack. :drinks
  15. Blaise Dubois

    Blaise Dubois Active Member

    What's my agenda Simon?

    I'm teaching in 2 university, I'm teaching around the word a post graduate course about evidence based on running injury prevention, I'm a clinician, I'm a runner, I'm a father of 4, I'm working with the national team, ...

    I was prescribing big bulky shoes and motion control in the past... I change 10 years ago
    The course I give will follow the evidence and won't be less or more popular if I promote minimalism or maximalism...

    What my agenda?
  16. Your agenda seems to be a personal angst against Simon Bartold; you're other personal agenda, judging by your last post and several previously, appears to be in promoting yourself. You really don't get it, do you?
  17. W J Liggins

    W J Liggins Well-Known Member

    It's not surprising that you don't know me and that I don't know you since I am in England and you are in Canada. That is the huge value of sites such as this and why it is worth the time that Craig Payne puts into it.
    I'm sorry that I did not make myself clear. I speak of Craig Payne (Australia and internationally recognised expert on the mechanics of running), Kevin Kirby (USA and internationally recognised expert on the mechanics of running), Simon Spooner (UK and internationally recognised expert on the mechanics of running).

    I'm glad that you agree that this is turning into a circular argument; however, you did not answer my question,; are you a pod? (This is not a personal attack).

    All the best

    Bill Liggins
  18. That's very kind of you, but I'm sure others might beg to differ; myself included.
  19. Paul Bowles

    Paul Bowles Well-Known Member

    If what you recomend follows the evidence - can you please link me to the evidence behind barefoot running or minamilist running which you seem to be arguing in the affirmative for?
  20. Blaise Dubois

    Blaise Dubois Active Member

    No I'm not
  21. Blaise Dubois

    Blaise Dubois Active Member

    The best evidence about shoe prescription (even if flimsy for most), now, is that one. http://www.therunningclinic.com/medias/pdf/5390-cdc-affiche-organigramme-.pdf
    Explain many time. The Goss study is one of the piece of the puzzle.

    But the most important is the lack of evidence about promotion and prescription of traditional, maximalist shoes. Hope you are not prescribing this to the majority of your patient... if yes, please explain to me, I want to learn. (Even KK admit on Podiaty Today that his prescription was just based on his believe... and not evidence based.)

    We present a poster of our systematic review at the IFOMPT (this year) about shoe prescription. Will be release soon on our WS

  22. Blaise Dubois

    Blaise Dubois Active Member

    Simon seems to be a good guy... and funny. Nothing personal against him.
    He is just demagogic and bias.

    Promoting myself? So debating here is promote ourself... Is it the number of tread? the number of 'like'? If you speak about 'ego'... I need to work harder to be at the level of some writing here.
  23. Paul Bowles

    Paul Bowles Well-Known Member

    Blaise you are missing the point - I asked you for your evidence for what you believe and practice, it wasn't about what I believe.

    I have printed that link you sent - now for those who know me, they know that I don't print lightly. I print for nearly nobody. There has to be a catastrophic world ending phenomonen for me to print anything - I just hate wasting paper. But I printed this. Primarily because I just had to read it for myself....on real paper.

    I'm still tryng to get my head around it (so forgive me) but its the first chart of its kind that has told me as a patient what sort of shoe to wear specific to an injury.....in the short time I have spent with my piece of paper I can honestly say I am quite gobsmacked! But let me digest it and I will get back to you!
  24. CraigT

    CraigT Well-Known Member

    In your shoe selection chart you recommend minimalist shoes or racing flats for muscle and tendon, fascia and bone injuries (in the foot and posterior leg) and any anterior leg and more proximal injuries that are over 6 weeks old?

    What is your evidence based justification for this?
  25. Blaise Dubois

    Blaise Dubois Active Member

    Hi Craig,
    I will be brief,
    Please don't do like everybody here. I provide the evidences and if yo don't agree challenge me with other and better evidences that go against mine. The goal with a chart is to oriented the clinician (with the best evidence available) to a better practice. These guidelines will maybe change in the future according to new evidences.

    Also I explain that in another post... I feel you (all debater here) will never be satisfy with my explanations and in the same time you will never provide better explanations and counter argument. So I will retire if we, AGAIN, turning into a circular argument.

    Note that there is a time frame for each condition (because most of people come from BBS -TRC rating less than 65)... that's maybe different for your barefoot clients?

    * We have an idea of the biomechanical effect AND on the body tissue stress/load that different shoes have (majority of people... not all). To give example the best treatment for an Achilles persistent tendinopathy is 1. good mechanical stress quantification and 2. stimulate the tissue (eccentric exercise ... or just exercise... depending of the believes). that's the reason why if someone have a persistent tendinopathy, I recommend to stress if gradually with a shoes that increase the stress on it. Another exemple is the link between a pathologie and the way you run. decrease heel strike will decrease ant compartment syndrome (Diebal 2012)... and increase the TRC rating -ex:decrease the drop- is one way to decrease heel striking.

    *Running shoes (TRC rating less than 65) promote heel strike (2012-Williams, 2011-Lohman, 2011-Vincent, Wegener 2011, Jenkins(R)-2011, Hamill 2011, Jungle 2010, Chen 2010, Jungers 2010, Lieberman 2010, Squadrone 2009, Kurz 2004, Bishop 2006, Divert 2004, Aguinaldo 2003, Dewit 2000)

    * Running shoes (TRC rating less than 65) increases the stress on the anterior part of the leg, knee and higher... (Diebal 2012, Rethnam 2011, Hamill 2011, Lieberman 2010, Bergmann 2010, Braunstein 2010, Kerrigan 2009, Shakoor 2006, Divert 2004, Shorten 2002, 1996 Hennig, Bergmann 1995) or doesn’t decrease it (Hardin 2002, Cole 1995, McNaire 1994, Nigg 1987)

    *Running shoes (TRC rating less than 65) decreases the stress (peak pressure) on the foot. (Rethnam 2011, Tessutti 2010, Wiegering 2009, Wegener 2008, House 2002, Windle 1999, Nyska 1995)

    * On long term the only evidence we have is : Retrospective epidemiology survey of 2,509 runners :: Traditionally shod runners were 3.41 times more likely to report injuries than experienced minimalist shoe wearers (46.7% shod vs 13.7% minimalist) (Goss-2012)

    * Important also to remember the lack of evidence about promotion and prescription of traditional, maximalist shoes.

  26. W J Liggins

    W J Liggins Well-Known Member

    Thanks Blaise for confirming that you are not a pod. (nothing wrong with that). However, can you please state your profession so that we are all aware of your background.

    I find difficulty in accepting your arguments, because, once again you seem to be attacking existing running shoes. These may or may not be worthy of attack; however, your proposition (as I understand it) is that you recommend minimalist shoes. The question which I (and it seems, others) want an answer to is, since your hypothesis is that minimalist shoes are better, where is the evidence (other than the slightly questionable study to which you refer)? I have no bias; I'm not an expert in this field, but I will need a great deal more to convince me than the thin evidence that you have this far posited.

    All the best

  27. Blaise Dubois

    Blaise Dubois Active Member

  28. drdebrule

    drdebrule Active Member

    I haven't read the Goss study but have read the abstract. This study was just an anonymous self-reported online survey, but is a good starting point.

    Perhaps we can all agree to disagree in a respectful manner. It is nice to see some people truly have a great passion for what they do. I do enjoy reading these posts and know that future research will solve the problem. Maybe the focus should be developing a consensus on what the best study would be.
  29. Athol Thomson

    Athol Thomson Active Member

  30. Paul Bowles

    Paul Bowles Well-Known Member

    Im trying to remain respectful here - but I think not answering the questions gets people frustrated. Looking at that chart that Blaise posted I still cant seem to get my head around it. Musculoskeletal injuries in the lower limb are force related - the question is still begging to be answered - how does prescription of a minimalist shoe for a force related injury (regardless of what it is) assist? Why according to the chart do acute injuires get PECH shoes but chronic > 6 weeks get minimalist in all cases but neuroma and OA? Considering there is sufficient crossover in abnormal pathomechanics for several of the pathologies requiring different types of shoe how does that work?

    Considering ALL of the PEER REVIEWED evidence on sub talar joint function, COP mechanics, sagittal plane function, kinematic analysis, dynamic analysis - how does that chart address the force related issues pertaining to the above research?

    Again let me re-iterate Blaise I am not attacking you - i'm asking legitimate questions which the "barefoot" believers avoid answering. They constantly run people around in circular straw man type arguments providing lots of charts and colours and fancy words which at the end of the day really amount to nothing but hot air - i'm hoping you can steer me/us away from that and provide some clarity.

    Blaise does your clinic sell or is it affiliated with the sale of running shoes?

    For a person who states they follow the evidence when I look at your website the word is "Barefoot" is very prominant....again no disrespect I am simply trying to understand this. As someone who works with elite runners daily I just don't get it - I wish I did though!
  31. Craig Payne

    Craig Payne Moderator

  32. Paul Bowles

    Paul Bowles Well-Known Member

  33. Paul:

    It is really no use trying to reason with Blaise. He has an agenda and refuses to acknowledge anyone or any evidence that is against his agenda. No one knows about Blaise or cares about his ideas outside his little world of barefoot-running groupies. If you want to bang your head against the wall trying to reason with him, don't blame me if you end up with a headache as a result.:bang::bang::bang:
  34. Paul Bowles

    Paul Bowles Well-Known Member

    Hi Kevin, I have a hard head. I'll respect his point of view but if he wants to debate it then show me the evidence. Every post that someone posts on here "arguing" semi pseudo science without evidence makes them look fairly ordinary. Im open to discussion on certain points but "hidden agenda's" are becoming the norm on these forums.

    The more we find out about people on these forums the more we realise thay have vested interests in the snake oil they are pushing!

    Again don't get me wrong, I have no problems with people selling snake oil - just don't come into a medical forum pushing your wares! Keep it to www.iloverunningnaked.com or www.gunsdon'tpeoplekillrunningshoesdo.com
  35. Blaise Dubois

    Blaise Dubois Active Member

    It's sad but it's the only one we have comparing minimalism and Maximalism vs injuries. It's flimsy... it's week... it's not a RCT... it's retrospective ... it's a questionnaire... but it's publish in a peer review journal, the N = 2500, it's coming from someone with no agenda and no expectation.

    So, please, be faire and accept that the study is not in the side of the BBS.

    There is no better study supporting the prescription of BBS.
  36. Blaise Dubois

    Blaise Dubois Active Member

  37. Blaise Dubois

    Blaise Dubois Active Member

    I remember one smart discussion with you and it was not here. On podiatry today you said :
    You asked: "Is there science supporting the prescription of "modern" shoes with characteristics like (more than 9O z, stack more than 20 mm and drop more than 7mm: large majority of the running shoe on the market presently) for a BEGINNER or a CHILD."
    Not to my knowledge.

    I don't generally recommend traditional training flats (TTFs) for children (...)

    As for your second question why a 200 lb, flat footed, beginner runner that will be running on hard surfaces could not use a racing flat to run in, I would personally recommend a TTF rather than a minimalist shoe for this runner due to the runner's body weight and the runner's presumably pronated feet. There is no good scientific evidence for this choice other than treating 1,000s of runners over the past 27+ years with similar size and foot structure. In other words, my personal experience would lead me to recommend the TTF style of shoe, probably a "motion control" or "stability" shoe, but I have no research evidence to back up my personal recommendation.

  38. Craig Payne

    Craig Payne Moderator

  39. Paul Bowles

    Paul Bowles Well-Known Member

    Blaise I think you are conveniently forgetting one thing. There may be a lack of evidence pertinent to motion control footwear that satisfies your tastes, however you cannot refute the massive amounts of peer reviewed high quality data/evidence on the causes of lower limb related injuries, force transmission and ortho-mechanical principals - a large part of which Kevin has contributed to. You are saying the same thing over and over - and I still don't get it. Simply put an answer to the question. How does a minimalist running shoe address the force related pathomechanics of lower limb injuries? Answer that and we are getting somewhere. Keep avoiding the question and it keeps looking like you are peddling your snake oil!
  40. Craig Payne

    Craig Payne Moderator

    The authors deliberately targeted forums and websites frequented by minimalist runners to recruit them for the online survey. You could not get a more biased population, especially those with no injury history in responding! (ie those who had an injury and are now back in BBS's would not likely be on a minimalist/barefoot forum or website to see the link to take part in the study; etc etc)

    It was not n=2500. They eliminated 1605 runners from that 2500 and the data was presented on the remaining.

    No epidemiologist would come close to taking this study seriously; and they have no agenda on this either.

    Its like the proposed study that was published on clinicaltrials.gov (and has been removed and I can no longer find it). We discussed it in another thread a couple of yrs ago - it was going to compare injury rates in barefoot vs shod runners. The only problem was that the inclusion criteria for the barefoot runners was a >6 month history of running barefoot with NO injury. There was no such inclusion criteria for the shoe group. So of course the results are going to be biased toward the barefoot group - if you have not had an injury for 6 months, the chances of having one in the next 6 months are low. Hopefully its been removed from clinicaltrials.gov as the study never happened, as it would have just been another piece of useless research because of the inclusion criteria.
    And there is still no study supporting the prescription of minimalist shoes either!

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