Hi
I had a pt yesterday on whom I had to remove 4 onycholytic nails
(toes 2,3 both feet).She also presented with a deep ulcer on the dorsum of her 3rd toe proximal to the nail. Pt is a female novice runner who has been running for a few months with a running club. Her running shoes fit well, but the problem is that she was taught by her running club to run on her forefoot. Thus the result that presented.
Now I know that this is common in the running community, forefoot striking, but am I the only one who thinks that this is wrong.
The argument
about forefoot striking reducing knee
problems can be corrected by gait correction- orthoses and correct running shoes, without the need for forefoot striking, and keeping with the natural heel -toe gait cycle.
Any comments?
Thanks
Hill
Forefoot striking running is quite uncommon.
Combining all the research studies done on footstrike patterns done within the worldwide scientific literature reveals that forefoot striking running actually accounts for only about 1% of all runners.
91% of all runners are rearfoot strikers and about 8% are midfoot strikers.
Tell your runner-patient that regardless of what the idiots at her running club told her, forefoot striking is not necessarily the best way to run. Unfortunately, there are still some coaches who are still teaching the "rearfoot-striking is bad, forefoot-striking is good" mantra, which has no scientific basis to it.
You may want to read the following article of mine where I review the research literature on footstrike patterns in running along with a few other articles I have authored or coauthored on similar subjects.
thanks
unfortunately i have come across quite a lot of runners/ coaches here that push for the forefoot running style. hard to understand them.
thanks for the links.
hill
There are advantages to midfoot/forefoot striking --> they load different tissues differently to heel striking --> that does not make it better, it makes it different.
For the knee, midfoot/forefoot striking does reduce loads at the knee (increases it at the ankle) and also tends to increase cadence that also helps the knee.
To change away from heel striking comes at a cost in that a different set of tissues get loaded and they need to be loaded slowly and progressively and they may not be able to take the load --> this is at least a medium term intervention if it is indicated.
For your patient the issue of developing the digital problems is one I have not really come across.
It sounds as though she was badly advised -- the process of changing the running technique needs good advice and supervision and most importantly a GOOD and COMPELLING reason to do it.
No one has ever shown that there is actually anything wrong with heel striking --> forefoot striking is being promoted by various running cults and fan boys based on propaganda and rhetoric and an misunderstanding and misuse of the actual research.