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Foot Bone Marrow Edema after 10-week Transition to Minimalist Running Shoes

Discussion in 'Biomechanics, Sports and Foot orthoses' started by NewsBot, Feb 27, 2013.

  1. Dana Roueche

    Dana Roueche Well-Known Member

    Craig, that is great, issue solved.

    We are talking about a pair of slippers with uppers made of spandex type materials, rubber soles and individual toes, that is it. I find it totally amazing that an individual can be so out of touch with their physical being that they can put a pair of these slippers on and decide to just run themselves into injury. Why would someone do that? Your body has a way of telling you there is an issue long before it becomes serious. Obviously, these people ignore the warning signs and just continue to run until something breaks. The same people probably drive around in their car with the oil light on until the engine seizes. I suppose there will always be people who need to be protected from themselves. I hope none of them take up sky diving.

    The other thing I find totally amazing is that there are people out there that are so gullible as to believe a bunch of marketing claims about a given product and then go buy the product based solely on the manufacturers claims. Any responsible consumer understands better than that. Again, who cares? we are talking about a $90 pair of rubber soled slippers. If they don't work out, it's not the end of the world, go back and buy something else, but this time find an objective opinion about the product first.

    Unfortunately, no matter what Vibram puts out on their site, there will be people who abuse the product and will end up injured. There will also be people who buy the product because they believe it will turn them into an Olympic medalist. Both will ultimately realize that their own expectations are out of line with reality.

    If you feel it is your role or responsibility to help protect these people from their own stupidity, good luck.
  2. efuller

    efuller MVP

    Probably some heathcare proffesional told them it was better to run in minimalist shoes as opposed to big bulky shoes.

    Or, maybe she read a blog of barefoot runners that were saying it was more natural or that big bulky shoes would kill her.

    Really? So, you have no problem with the following scenario. You wak into an auto parts store and asking the guy behind the counter, with "Bob" stenciled on his shirt, and ask Bob what you should buy to help your care run better. Bob sells you some stuff to put in your gas tank. Then, your car stopps running. (or there is no change) Bob looked so objective. You really think this is not a problem?

    Well, it should be our responsibility to protect people from unrealistic marketing claims.

  3. CraigT

    CraigT Well-Known Member

    I am amazed that you find this amazing. People do terrible things to their bodies all the time with clear evidence that it is not good for you... this is certainly not that clear.
    As for believing marketing... have you seen Power Balance Bands??
  4. Dana Roueche

    Dana Roueche Well-Known Member

    Eric and Craig T,

    Vibram repeatedly states that the transition period is lengthy, that it could take some people over a year to fully transition. Vibram repeatedly states that if you have any indication of pain to STOP. Vibram also tells you that a gradual transition is critical to avoid overuse injuries. Vibram tells you to be patient and focus on connecting with your body.

    I'm not sure what more you think Vibram should do.

    In the past, Vibram made these claims which are no longer included on their website. The claims might be true, they might be false, we don't know because there is no supporting evidence available.

    1. Strengthens Muscles in the Feet and Lower Legs
    2. Improves Range of Motion in Ankles, Feet and Toes
    3. Stimulates Neural Function Important to Balance and Agility
    4. Eliminate Heel Lift to Align the Spine and Improve Posture alignment.
    5. Allow the Foot and Body to Move Naturally

    I just don't know how several people on this forum can make the leap that these claims will result in the runner injuring themselves. This is on top of all they comments Vibram has made about being patient, taking a long transition, not running through pain.

    I just don't get it.

    Simon B wrote in post "Vibram makes erroneous and dangerous claims and throws the punter to the wolves knowing full well many people will not even remotely follow their sketchy recommendations."

    The claims might be erroneous, they might be true. I know that Simon B can't prove they are erroneous any more than Vibram can prove they are true. I completely fail to see how they are dangerous. Simon, you might be overreacting a bit here.

    The mistake Vibram made is that they grossly underestimated the stupidity of their customers. If you give a runner what they believe to be a magic pill and caution the runner up and down to no take more than one pill a day. It can almost be guaranteed that there will be runners who will take the whole bottle at once and overdose.

    Regardless of what Vibram is selling, runners are going to injure themselves from over training.

    I do know for sure that FiveFingers are the wrong shoe for any runner that is incapable of receiving and safely interpreting the feedback that their body sending them.
  5. Isn't Podiatry Arena a forum for medical professionals?

    Since when has it become a forum for runners with absolutely no medical training who have such an over-inflated opinion of their own knowledge that they feel it is their right and duty to advise well-trained medical professionals how they should think and how they should advise their patients on proper footwear for their athletic activities?:bang:
  6. Dana Roueche

    Dana Roueche Well-Known Member

    Kevin, this is an academic forum. When someone makes an unsupported statement, they should be prepared to defend their position. When I joined this forum, I don't recall reading that there is a list of qualifications required to join.

    Since my opinion differs from yours, I do not expect you to read what I write here, neither do I expect you to respond to it. Do us both a favor, save yourself some time and simply skip over the posts that have my name on it.
  7. blinda

    blinda MVP

    Nope, This is a forum for;
    Dana, I really don`t understand why you are still here. You are not a foot health professional and I, for one, am tired of reading your insulting posts and about your own running experinces and foot problems (or lack of, because you are such a great runner). I suppose you don`t recall reading this when you signed up;

    Actually, I am going to follow your suggestion and add you to my `ignore list`. I`d recommend it, Kevin.
  8. Dana Roueche

    Dana Roueche Well-Known Member

    Binda, oops Blinda, almost misspelled your misspelled name. I am still here because I frankly can't get over how I can so completely disagree with a group of people who are actually paid by runners for advice.

    I have never had a foot problem or any injury what so ever in the 40 yrs I have been running. So if you are reading about my foot problems, you must have me confused with someone else. I have never written about a foot problem.

    If you find what I have to say as having no value, then by all means, I fully encourage you to add me to your ignore list. I won't be offended in the least, for that matter, I don't care. I encourage Kevin to do the same.
  9. blinda

    blinda MVP

    Old 12th March 2013, 05:11 PM

  10. Vibram have no evidence to support these statements.

    Stop making claims they cannot evidence such as the ones you list above and below...

    What did the present study find? It found that running in Vibram five fingers and using a transitioning model described by Vibram increased the risk of injury when compared to running in traditional shoes. So, lets just think that one through: they wore Vibrams, did what Vibram suggested and got injured as a result....hmmm

    Perhaps Vibram should add:

    5. Increases bone marrow oedema to pathologic levels in a significant number of runners.

    At least we have some evidence for this. Unlike,

    There is no evidence to suggest that being patient and transitioning over a longer period will result in any differences to the results observed in the study under discussion.

    No, you probably won't.
    Last edited: Mar 12, 2013
  11. Dana Roueche

    Dana Roueche Well-Known Member

    So if someone quotes me in their post, does it hide that too?
  12. Craig Payne

    Craig Payne Moderator

    I often scan other blogs and forums to look at the response to research like this ... usually its hoot, but sometimes scary when you see how ill informed so many are ... and then you get gems like this blog comment on the NY Times story on this:
  13. Yep, there are those that can't read:
    Those that like to guess:
    Those that have minimal to zero understanding of the biomechanics of injury, yet proclaim to know all about "form"- whatever that is:

    Let me attempt to interpret the above:

    You need to pay to access the journal article, and I couldn't be bothered/ afford it.

    I haven't read the paper but I'm going to comment anyway.

    I'm completely guessing because I haven't read the paper.

    Because I haven't read the paper, I do not know what the other injuries were. My double "the the" shows that I am excited and eager to write this though and didn't bother to proof read.

    I have absolutely no idea of the running kinematics of this individual since I have not read the paper and even if I had, it was not reported in the paper. I do not understand the biomechanics of injury, but I'm egocentric and believe you all should listen to me, so I'll state something that I think makes me sound like I know what I'm talking about.

    I've already told you that I'm egocentric, what did you expect? But you are right, I really don't know what I'm talking about.


    Yep, it's impossible to get a stress reaction or even a stress fracture in a bone that doesn't "touch the ground"- Christ on a bike :bash:. Of course, no-one has ever had a fibula stress fracture. All you need is a "form" that prevents the 2nd metatarsal, 3rd metatarsal, navicular, calcaneus and talus from "touching the ground" when transitioning to Vibram five fingers in order to avoid pathological levels of bone marrow oedema. I'd be pretty concerned if several of those bones were ever touching the ground when running. When you've found that levitational "form", make sure you are not placing any of the above tissues or indeed, any other tissues outside of their zone of optimal stress won't you... :bang:

    Those that quite frankly don't understand research- the vast majority:
    And obviously the psychics like the one you listed above, Craig.
  14. Bel:

    Thanks for that reminder. Now I won't have to read that egotistical runner's bizarrre rantings any more.:drinks

  15. I posed this before, but no-one offered the punch-line:

    Q: How many people does it take to run in a pair of Vibram five fingers?

    A: At least a thousand: one to wear the Vibram's and do the running, the other 999 for the runner to share their experiences with via blog-sites, man (whether or not they are interested in the runners opinion is irrelevant to the runner).

    Peace, y'all.
  16. Craig Payne

    Craig Payne Moderator

    This comment made me laugh:
    People are going to extraordinary lengths to discredit this study! .... why do they not hold all studies to that same standard?
  17. toomoon

    toomoon Well-Known Member

    the following is an excerpt from an essay I am preparing for my website:it will be up tomorrow with a bit of luck! www.bartoldbiomechanics.com

    Trauma can arise from an acute injury (acute fracture, bone marrow contusion) or be second*ary to repetitive injury (fatigue and insufficiency fractures as well as stress reaction). The com*mon underlying MRI finding is bone marrow edema. In addition to trauma, marrow edema can be seen in a broad spectrum of entities, including infection, transient osteoporosis of the hip, and neoplasm, but the clinical history of injury typically allows the correct diagnosis to be made.
    Acute Fracture
    MRI is exquisitely sensitive for detecting fractures and is especially valuable in assessing radiographically occult fractures of the hip. The MRI findings are usually focal. On T1*weight*ed imaging, the fracture is visualized as a line of low signal intensity. On T2*weighted fat* saturated and STIR imaging, the fracture line can be hyperintense and surrounded by a variable amount of edema.
    Stress Fractures
    Stress fractures occur secondary to repetitive injury. They can be further characterized into fatigue fractures, in which normal bones are subjected to increased loads, or insufficiency frac*tures, in which abnormal bones are subjected to normal stress. Stress fractures are usually focal.
    The most common finding is marrow edema, which is best seen on T2*weighted fat*saturated and STIR imaging. On T1*weighted imaging, the linear low* signal fracture line runs perpendicular to the major trabeculae. Commonly affected sites include the proximal femoral head and neck (both fatigue and insufficiency), basicervical femoral neck (insufficiency), distal fibular shaft (both), anterior tibial midshaft (fatigue), and proximal posterior tibial cortex (fatigue).
    Stress Reaction
    Stress reaction occurs secondary to repetitive injury and is often seen in the mid and distal tibia (medial tibial stress syndrome). Stress reaction usually appears as a focal lesion which shows increased signal due to edema on T2*weighted and STIR imaging. The continuum of findings ranges from periosteal edema (grade I), to both periosteal edema and marrow edema seen on T2*weighted imaging (grade II), to marrow edema visualized on both T1*weighted and PD imaging (grade III), to visualization of a discrete fracture line (grade IV).

    The moral is that MRI is superb at imaging soft tissues and bone marrow and that bone marrow edema is always abnormal. Bone marrow edema is very different to imaging of the normal progression in which hematopoietic marrow converts to fatty marrow. Suck on that Vibram!
  18. Then you get the experts in neuroscience:

    How does the wearing of shoes block neural feedback? One minute I was fine, then I put on a pair of shoes, now I have peripheral neuropathy. :dizzy:
  19. Dana Roueche

    Dana Roueche Well-Known Member

    Finally Kevin has put me on his ignore list! For years I've watched Kevin chase people away from this forum who have an opinion or idea that conflicts with his own belief system. Kevin has learned that I am not intimidated easily and he has failed to discourage me from posting on this forum. My hope going forward is that I'll no longer need to deal with him.

    Kevin, even though you can't read this, I wish you the best and may your mind continue to be closed.
  20. Connie D

    Connie D Member

    Really? Go on then, with Kevin `out of the way`, teach us more of your scientific evidenced based beliefs. We`re all ears....The stage is all yours, Dana.
  21. Give us a break!! Here's a tip Danny - take a minimalist approach to your opinions in future - apply a light touch, better still, none at all. You have nothing worthwhile to add to any discussion on these topics.
  22. Dana Roueche

    Dana Roueche Well-Known Member

    I have commented on the pastor of the Church of Podiatry and his followers are coming to the rescue.
  23. No Mr Roueche that is not the case. I do not get the impression that Dr Kirby spends his time writing on this forum for some self-serving purpose, rather he gives his opinions and advice primarily for the benefit of his colleagues and their patients - much in the same way as the majority of health professionals do on this forum. Rather a collective contribution to the body of knowledge for subjects within our scope of practice. As with others, I get the sense that Dr Kirby contributes altruistically and for the greater good - which is rather different from the self-serving and frankly embarrassing whinging that permeates from your quarter on a regular basis. Your lack of knowledge and ignorance know no bounds Mr Roueche, do us all a favour and find another place to peddle your insecurities. You have become a bore.

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