Is there minimized interest in barefoot running?
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Impact frequency data suggest unique risks for forefoot strikers -
Here is a picture, courtesy Ian G of Vivobarefoot flagship store in London. Karma?
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The beginning of the end.....or.....the end of the beginning???
If I don't have to hear any more nonsense from the minimalist-barefoot crowd with their idiotic, non-scientific anecdotal stories of how runners should never run in thicker heeled, more cushioned shoes and should never heel-strike, then I will be a very happy man.
From what I see here in Northern California now, the Vibram FiveFinger fad is falling off rapidly and runners are now left with an even more confusing array of running shoes to choose from, ranging from "minimalist" to the "maximalist" Hoka One One's. However, the "form clinics" are still popular here, including Chi, and Pose, so that the runners changing their running form are always a source of new patients for my busy practice. Too bad for them. Maybe some common sense will arrive at the end of all this turmoil and misinformation that Chris McDougall, and his many zealots, have brought upon the running community. -
Are we calling this propaganda? ... the church of the BBS?
Guys you are not serious...
http://www.therunningclinic.ca/blog...-en-sommes-nous-minimalism-where-do-we-stand/ -
Big thank you to Blaise and all your minimalist friends. A good friend and rival for AGC triathlon corp championship switched to minimalist last year and picked himself up a metatarsal fracture for his efforts. I did warn him. Now he's off for surgery and 6 months out so my main rival is out of the game. Hey I know this is just one case and there is no solid evidence to say that switching shoes was the cause but you chaps don't work off evidence anyway so i thought it may appeal. There is one runner you've lost and I'm sure he'll spread the word. I'll show you my trophy when I win it and dedicate it to Blaise.
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And this is where we are missing the boat with all the BS, we should be discussing why person x got injuries and why person Y got less. -
Every year one of the clinics I work at provide a 'Marathon preparation evening' around this time. Usual scenario is an audience of approx 30-50 city workers who are running the London marathon in 5/12 time all come in one evening and listen to a series of short lectures from a range of people on things which may help them (e.g. Nutritionist gives tips on eating regimes, Strength & Conditioning coach talks about gym based training to aid running etc). As part of this I often give a little talk on running shoes. Historically when the "any questions" bit at the end comes up the majority have been regarding "barefoot shoes" and the regular associated queries. This year there was barely a peep.
None of the elite runners I have spoken to about this 'craze' have ever seen the interest. As we know it is nothing new to them and most have incorporated it into their training for decades anyway.
Most of the amateur runners I speak to have pretty much made their minds up one way of the other already. They either tried it and it wasn't for them, tried it and it was for them, or never wanted to try it in the first place. -
How does someone land under their center of mass while running? This is one of the frquent claims I seem unable to grasp. Wouldn't you fall on your face right after landing under your CoM?
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tell him to run with a cast all the time... it's protect the foot better than the big bulky shoes you recommend.:drinks -
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1. Your feet are beforehand 'weaken' (in the sense of decrease tolerance to the mechanical stress -load x frequency-) by wearing protective device like BBS and orthotics (directly or indirectly by the running technic changes)
2. A too fast transition to more mechanical stress that not allow the foot to adapt to this new stress. (80% of the cause of the injured people come from training error -especially volume of intensity and degrees of intensity like sprinting and hills-... 20% from others... like the shoes.
And you what's your believe ? -
See how I do not mention anything about shoes or orthotics ;).
and the bending moments will come from an increase in Ground reaction force or frequency acting on the forefoot.
but to your post we come back to this stump - weakened foot anyways will leave that elephant alone.
by the way heard a great one about elephants in the room the other day- " I will leave the large pink elephant standing next to a huge pile of streaming sh!t alone " :D
But agree with your point training errors do cause most injuries, but this must be viewed n = 1 approach as we have no idea what is too much until it breaks. -
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I asked
do you agree with what I wrote ?
Bending moments acting on the metatarsals which push the bone outside of it´s physiological window, which leads to a stress reaction followed by fracture.
:snip
and the bending moments will come from an increase in Ground reaction force or frequency acting on the forefoot. -
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Above you said 2-4 weeks what would you do? -
2-4 weeks for a metatarsal fracure? Hell, let's get Blaise over here to sort out all the broken metatarsals the England football team get just before a major competition.
PS - surgery not my recommendation for him but he is in the army system and that's the route they have sent him. I did offer my assistance before and after the fracture... -
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Isn't that chart prevention and the symptoms diagnosis? Mike asked you how you TREAT it. Or did I miss something?
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TREAT : 80% MSQ (rest... follow by gradual load by first of all increase volume... and careful integration of up hill, jump, intensity) ... YES GUYS, no best treatment to stimulate a bone to repair and become stronger that putting a CALCULATE stress on it.
Extra (the 20%) : US 0.05w/cm, supportive device like orthotics, circular taping to stabilized, taping, more rigid sole, elevated heel, BBS, medication sometime... SHORT TERM ONLY
PS hundreds of case like that, great success! -
I was quite happy to give you the benefit of the doubt - after all, I haven't met you and you may even be telling the truth some of the time.
But that last statement?
With no proof?
Here in the UK we think that a met stress fracture takes around five weeks to heal, minimum. That has been my experience too, in 40 years of practice. That has also been the experience of anyone treating soccer players, at every level.
Of course age and bone shape and density comes into the equation, as does foot-shape.
But four weeks - and hundreds of cases - wow! -
what you do is increase the bending moments acting on the metatarsals by getting the patient to run hills, jumping.
So the cause of the injury now becomes the treatment, ;)
Blaise I think we have an issue here because if the cause of the injury is the treatment we would not have an injury in the 1st place
Huston we have a problem ;)
care to explain ? -
OK guy, my last post... sorry very busy
Phil start with a 6 month and a surgery (I call this propaganda against minimalism or the church of the BBS)
Finally David speak about 5 weeks. not so far from 2-4weeks I was telling you. Thanks David
For the last time (I give you the example of a runner, like phil):
Treatment is a continuum of MSQ (mechanical stress quantification) between : no weight bearing, 50%WB, 100%WB, increase volume walking, then of light jogging, tempo, race pace half-marathon, RP10k, RP5k, speed training, hills, jumping, cutting, ...
The speed at which you move from one step to another is depending first of all of the capacity of the tissue to adapt to the 'increase new stress'... build bone
Yes there is exception
Yes there is influencing factors that help (US, some medication, ...) or hinder (NSAID, advance stage of the stress fracture, smoker, low metabolism and vascularization, ...)
Yes, 10% of stress fracture (tarsal bone, anterior crest of the tibia and all the knee and higher one) need a more careful attention and it's more difficult to just follow the symptom to progress (prognosis less clear, possibility of complication higher, ...)
About the last statement "hundreds of case like that, great success" : I'm in advance on traditional reflexions on many aberrant parts of our practice. It's the reason I teach and it's the reason why it's a success.
Just one thing for you all : dare to do different... stop to be paralyses by your conviction based on weak and old science... create changes and new science. Stop to focus on an little axe in the foot that mean nothing. Be able to refuse information coming from people that sale the product's information (even if their representative are podiatrist). Experience means nothing if you do the same thing based on nothing since 50 years. When the science is laking, experience is great... if it's enough vast to compare modality between them (when you will have prescribe correctly as much minimalist shoes as BBS, come back to me to discuss about your experience)
if you feel bad with what I just write, it's time to question yourself. Nothing personal :drinks
Need to retired for 3 weeks. -
so no you can not explain to my last question -
Yes the treatment is the cause : we call this Mechanical stress
- too much = injuries
- not enough = weakness and increase risk of injuries
- gradual application = adaptation, become stronger, prevention, treatment of EVERY "overuse" injuries
- rest and complete protection = good for short term
- stimulation and application of stress = good for long term
- key word for your database research : mechanotransduction, mechanobiology
By -
I understand how the body adapts
You stated that you would increase stress ie bending moments before healing is finished
In a healthy person gradual change in stress it this case will lead to bone adaption and increased resistance to bending moments to a point then fracture will occur:
A healing person ?
See you set the time frame of 2-4 weeks
We also know that the bending moments were too high and caused injury so how do you know how much is too much ?
So you see you still have not explained
General statements are not answering the questions re met stress fractures and I hope you do not deal wqith navicular stress fractures in this way, but thats for another day -
And you? did you try just one time to go faster? you can just tell us you have no experience with that time frame
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Mets 4-6 weeks
And yes I understand adaption and non adaption
I also wonder how many nonunions you have but of course you will state 0
This issue is timeframe stressing a healing bone -
I think Blaise got 6-months from my post. The chap I mentioned is a friend and (like I said) is untouched by podiatry. He has been advised up to 6-month recovery from his orthopaedic surgeon...not by a podiatrist. He is in the military so it's their system designing the treatment plan.
PS - This guy recieved first class coaching on how to change his stride pattern so it wasn't anything he was doing wrong. That's the blanket answer you offer when injury occurs... -
So to conclude :
phil 6 months
you 4-6 week
david 5 weeks
me 2-4 weeks
So you can debate with phil one that. Do your own experience and come to me with your next NEW guideline on that.
nonunion : remember some (rare)... not runners I follow from the beginning... people I see after +/- 2 months, referred by other health professional because a bad evolution... and YES it was because the patient start too early to apply too much stress on the bone... MSQ... MSQ... MSQ... MSQ... MSQ... MSQ... MSQ... MSQ... MSQ... MSQ... MSQ... MSQ... MSQ... MSQ... MSQ... MSQ... MSQ... MSQ... MSQ... MSQ... MSQ... MSQ... MSQ... MSQ... MSQ... MSQ... MSQ... MSQ... MSQ... MSQ... MSQ... MSQ... MSQ... MSQ... MSQ... MSQ... MSQ... MSQ... MSQ... MSQ... MSQ... MSQ... MSQ... MSQ... MSQ... MSQ... MSQ... MSQ... MSQ... MSQ... MSQ... MSQ... MSQ... MSQ... MSQ... MSQ... MSQ... MSQ... MSQ... MSQ... MSQ... MSQ... MSQ... MSQ... MSQ... MSQ... MSQ... MSQ... MSQ... MSQ... MSQ... MSQ... MSQ... MSQ... MSQ... MSQ... MSQ... MSQ... MSQ... MSQ... MSQ... MSQ... MSQ... MSQ... MSQ... MSQ... MSQ... MSQ... MSQ... MSQ... MSQ... MSQ... MSQ... MSQ... MSQ... MSQ... MSQ... MSQ... MSQ... MSQ... MSQ... MSQ... MSQ... MSQ... MSQ... MSQ... MSQ... MSQ... MSQ... MSQ... MSQ... MSQ... MSQ... MSQ... MSQ... ;) -
I think we may have just seen how Blaise gets his information.
You are actually cherry picking this thread in front of our eyes. Please go back and read what people are posting. -
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if it's a GOOD friends, hope you will tell him to cut his rest to maximum 6 weeks... ...........
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Read on....complete the picture.
Actually don't bother I'll repeat it for you or we're going to be here all day else and you've got to go away for 3 weeks (please don't be the UK). Orthopaedic surgeon said 6-months not a podiatrist. He's never seen a podiatrist in a clinical setting. podiatrist never recommended surgery. Here is what I wrote amongst other things;
Surgery not my recommendation for him but he is in the army system.....Oh b*llocks go read it yourself it's 5pm on a Friday and I'm off for a beer. -
So we have a stressed tissue - metatarsal which due to said stress has fractured, the body is well aware of this and has started the healing process, increased blood supply .
literature stats callous formation is at it´s biggest 2-3 weeks after fracture, so the point at which the body is working the hardest to stabilize the fracture Blaise you increase the stress on the area with the, which most likely will lead to increased callous formation due to the bending moments at the fracture site and according to the lit I have reviewed increasing the time of healing and reducing the strength of the fracture site once healed.
So it makes no sense to be stressing the area.
FWIW 4-6 weeks post fracture slowly increase stress, while wearing an orthotic designed to reduce the bending moments on the affected metatarsal, 6 weeks walk run programs for those wanting to return to running and then depending reduce the amount of walking increase running then look at speed and distance
this way you have allowed the bone to heal correctly for long term health and slowly increased stress, while always reducing the stress on the that met due the biomechanical predisposition for bending moments to cause a fracture at a certain training load or change.
ps studies have also shown that army personal get less stress fractures of the metatarsal when wearing traditional running shoes that army boots in training -
did you try a cast... for ever... that's very efficient to decrease the stress on the MTT -
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Ok- let's see Blaise...
2-4 weeks to heal a MT stress fracture?
How do you define 'heal'?
I would expect that it mean being able to perform at least at the same level before injury.
Your treatment-
And as you start loading this stress fracture too early and it flares up? Back to square one...
How are you doing your diagnosis?
And seeing that you are such a fan of evidence based medicine, care to share your references that this is based on??
Considering a Jones fracture is a type of MT stress fracture, your blanket statement of
You know nothing about the case, so are in no position to make any comment.
However I have come to expect this from you Blaise...
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