Plantar Fasciitis and the anti-orthosis, Minimalist Shoe Message

I have reached the following conclusion on careful review of this thread.

Arguing with somebody who has abandoned the use of reason is like playing chess against a chicken.

It doesn't matter how good a game you play, the chicken will merely knock over the pieces, S**t on the board then strut around crowing and declaring victory.

Best not to play chess with chickens really.

 

Brilliant summary Robert!!.. I wholeheartedly concur and I forwith disengage from any further games with "the chicken".

best
Simon

 

I will also disengage from "the French-Canadian chicken".

However, I am somewhat amazed that Mark Cucuzzella has refused to answer my repeated questions as to how he knows that plantar fasciitis is caused by weak foot muscles. After all, Dr. Cucuzzella is "one of the greatest educators on running" and he has already dropped the knowledge bomb on the nation about running shoes and running injuries.

From what I have observed over the past few years in this minimalist-barefoot fad, is that many of these "minimalist-barefoot gurus", when pinned down by someone who does know the scientific literature on the subject they are lecturing on, will suddenly change their story from claiming, for example, that ""The only way that you can actually fix plantar fasciitis is to address the root cause… weak foot muscles.", to "weak foot muscles may contribute to plantar fasciitis", which I totally agree with.

This type of behavior seems to be the case with many of them, saying one thing to their minimalist-barefoot disciples, who believe everything they say and place them high on their minimalist-barefoot pedestal, and then changing their tune and choosing their words much more carefully when speaking to more intelligent and informed people who are not afraid to question their opinions.

I believe the best way to stop these "minimalist-barefoot gurus" from changing their story, depending on their audience, is to publicly hold them accountable for what they say and make them back up their opinions with scientific research. Otherwise, they will continue to spread their anecdotal guesses as medical or scientific fact to their evagelical believers which, in the end, causes many individuals to question those of us who follow the scientific literature for best evidence in the treatments we provide to our patients.

It is time to stop this nonsense once and for all.:butcher::boxing::craig:

 

Robert:

This is another quote that will go on my list of "Best Quotes on Podiatry Arena in 2012".

That was a laugh-out-loud quote for me. Well done.:drinks

 

PA colleagues,

Although I said my prior was the last post there were a few direct questions I’ll respectfully answer.
On where my references are:
- Download the AMAA Shoes presentation from the yousendit link. The last 9 slides have close to 100 references and is supplemented by the “Natural Running Resource Sheet”. Read Jay Dicharry’s “Anatomy for Runners” and Larson/Katovsky “Tread Lightly” . http://www.yousendit.com/download/WUJhU2VpSWVwcFV3anNUQw

- Spend some time reading the works of Irene Davis and Casey Kerrigan. You could spend weeks here . http://www.ncbi.nlm.nih.gov/pubmed?term=davis is . http://www.ncbi.nlm.nih.gov/pubmed?term=kerrigan dc

Simon's comment that the Asics Natural Running video was not an Asics video is questionable. Here's the video posted by Asics Deutschland by the same guy wearing an Asics shirt...http://www.youtube.com/watch?v=eIlsHMTutpA. But really who cares.
Replying to a couple of other comments by Simon
- “I said Nature was the scietific version of Readers Digest!” ….you clearly stated it was NOT peer reviewed. Nature has the highest level of peer review
- “so at the end of this I can only conclude that your only qualification to sprout this nonsense is that you can run OK.. weird..” So my ONLY qualification is that I run. Interesting. I’ve been my own N of 1 before ever teaching this stuff. We all have to feel what we teach in our own bodies and be able to translate that and translate the literature from our experience. I like many was told not to run in 2000 after surgery for hallux rigidus on both feet. Guess what…. I have not missed a day from injury since. I went back to school. Here is my brief story http://zero-drop.com/?p=1485 . Another N or 1 is my good friend Mike
Wasson. He hit the rest button and just ran a 2:38 at age 46. A 4 minute PB. http://naturalrunningcenter.com/2012/09/23/flying-high-46/

To Kevin’s Comments on my take of PF. I have never said that weak muscles are the SOLE cause. Of course it contributes, as does structure, form, running volume, footwear, and maybe others. The PF is not a contractile tissue so muscles must be awake and active to control the foot. A big structural problem in my opinion is hallux valgus. This disrupts the front of the arch and the leafspring of the foot. Correct Toes are a great therapeutic option. They were mentioned in this month’s Running Times and we have placed 100s of walkers and runners in these from our store. I have 15 degrees hallux valgus and wear these with and without shoes to run. See Davis article on loading rates and PF from pubmed link….lots of variables. I am a clinician and assess the patient and take a history as you all do. For almost every weakness and injury (knee, ankle, back, hip, etc…) there is specific physical therapy. I find that often not the case for foot pain and the default is often treat the symptoms with support, injections, or prescription of footwear. Again read the refs.

The Carmichael Book? I posted this list before the Lance debacle but what Carmichael writes about aerobic development is true whether you are juiced or not. The juice is the icing on the cake for the pro unfortunately.
Thank you all for the thoughtful discussion….now out for a morning run. It’s cold so I’ll wear shoes 
Mark

 

Interesting conclusion on PA :

- Kevin never answer tons of questions I ask him on this blog ... BUT when he start to be more scientific and have no friends to back him he is turning minimalism defender on other blog like Podiatry Today and on his video with 'Coaches'... http://www.therunningclinic.ca/blog...la-chaussures-moderne-modern-shoes-defenders/

- Robert isaac : nice contribution to this post hahahahah

- David : he not just do cherry picking... he cut the conclusion of an article when it's not go in his way... so interesting ......................... tell a lot on this man

- Craig T : I'm teaching specific course on lower limb diagnoses in Medicine and physiotherapy at Laval University (a 40 000 students University). If you need help, ask me... especially if you need to know How relevant are your finding. You seem identified causes that are maybe not important... like many other in this arena you seems to over diagnose, over treat, over medicalized.......

- Craig P : still interested to you answer. I know this blog is too political. If you want you can write me a personnal email
C : Where have I ever claimed that BBS's should be used for plantar fasciitis?
B : So what do you prescribe? nothing? meaning barefoot? ... or any type of shoes... according to the patient preferences? colour preference?
C: ... they got so bad they could not continue...
B: Where did you pick-up that? I can write to Jack to know the reality. Is it an other interpretation of you church group?

Simon B : I never see a mammal so full of S***t. I don't understand also How and Why some people defend you... Just be from the some profession does't explain that. Money? Probaly. Like be a speaker in congress... Money? probably like be co-author of 4 paper... money? Probably. Supporting you is now associate to no credibility. you friends never defend you on this video http://www.youtube.com/watch?feature=player_embedded&v=k9pU1hMLP-E

Enjoyed you own debate (between 5 podiatrists) and let yourself think you have the truth about everything... during that time I will teach good practice to clinicians around the world. Last tips : don't be angry, it's not good for health
Blaise

 

Actually I commented on that video (if its the one I think it may be...can't check banned from Youtube). If it is half truths mate...you're getting quite a reputation.

Also you never answered my request to share some interesting papers on Strength and Conditioning, flexibility or any other phsyio info that may be of interest. I'd be very grateful.

Out from me too...bored

 

Been reading and lurking on the thread but as my running and running footwear knowledge is low, to comment on such is outside my remit.

Where I am a little confused (and not looking to be inflammatory or provocative) is the following:

"I am a clinician and assess the patient and take a history as you all do. For almost every weakness and injury (knee, ankle, back, hip, etc…) there is specific physical therapy. I find that often not the case for foot pain and the default is often treat the symptoms with support, injections, or prescription of footwear."

As almost all treatment I provide to the low leg, foot and ankle MSK injury (including the matter of plantar fascial problems), as a podiatrist, is physical therapy based and have learnt much of the skills in physical therapy contexts, I'm surprised at the above sweeping comment. But then I find the falling into either / or positions bewildering in most cases anyway. I tend to fall into a both/and purview.

Certainly, if there is need for alteration of forces through this part of the low limb, that is outside the capacity of physiotherapy rehabilitation, then I would provide that via footwear modification and/or orthosis supply, rarely any injection.

 

Blaise wins.

 

My personal email for request blaisedubois@me.com

 

Mark:

Thanks for answering my question. However, to quote you from your paper you wrote: ""The only way that you can actually fix plantar fasciitis is to address the root cause… weak foot muscles."

No, you didn't use the word "sole", you used the word "only", which means exactly the same thing. So again, do you have any scientific research that shows that plantar fasciitis is only caused by weak foot muscles?

I can tell you. There is no such research that says that weak foot muscles are a cause of plantar fasciitis. In addition, there is plenty of reserch that says that treating the foot with methods other than strengthening the foot will "fix" plantar fasciitis. Why did you fail to mention these other methods that are known to effectively treat plantar fasciitis, and at least have research backing them up, in your article on plantar fasciitis?

By the way, I have known Irene Davis personally for 15 years, know her research very well, and even she would never make such a statement as you did that ""The only way that you can actually fix plantar fasciitis is to address the root cause… weak foot muscles."

http://tao-fit.com/plantar-fasciitis-by-dr-mark-cucuzzella

Have a nice run.

 

Mark.. as stated previously.. I have no desire to argue with you.. actually I can't see how I can. As you stated from the beginning, we have different perspectives and on some things we agree.
My only point is that I am prepared to recommend barefoot and minimalism as well as traditional shoes on a case by case basis, and I have had excellent results with this over many years. It seems clear you believe only in barefoot or minimalism (and that is absolutely your prerogative) and you no doubt have had your own great experiences.
The argument is just a little too polarised for me now, and I have absolutely no desire to point score or send barbs your way. End of the day you and I are just a couple of guys with wives and children and lives to live and that is more important to me.The perception from you that I am an ASICS puppet is as accurate as any perception from my side that you work as a doctor only to sell minimalist product at your shoe store. I am certain that is not the case and that you have higher ethics than that. I would hope that you may be able to understand I am the same and that, as you observed last Saturday week, I never promote ASICS product, and infact am quite often critical of current concepts. You may choose to believe this or not.. it does not really matter, but I work hard within the framework of what I know and understand and what I can deduce from the available research. That is it, and that is the best I can do.
I wish you all the best Mark, in your professional and shoe and running endevours, and I look forward to seeing you in Ausstin, where we can once again challenge each other, and hopefully further our desire to help runners run better!

cheers
Simon

 

Blaise that's not the way anyone else is seeing it, in fact I received a number of emails thanking me for serving you up a huge slice of ST**. Your response to the overwhelming peer reviewed literature?

You had no response because there is no response and no evidence for you to present. You're the Brian Rothbart of PT Clucky.:dizzy:

 

Dear all.. I just discovered a fantastic feature on Podiatry Arena I did not know existed. If you click on Biase "the Chicken" DuBois's name, and go to personal details, there is a section there where you can "ignore" him.
Check this button and you never have to hear from him again. Not ever!!!!
Halleluyah! This is fantastic!

 

http://tao-fit.com/plantar-fasciitis-by-dr-mark-cucuzzella

The only way that you can actually fix plantar fasciitis is to address the root cause… weak foot muscles. (Thank you Lance from Barefoot Science for the insight).


I know a bit about this company Mark. Is this Lance Todd's expert opinion as a medically trained person or merely his opinion? BS produced some really poor evidence they promoted in their literature and even Patrick Malleret admitted that the science was flawed and over-hyped in a thread here.

Lance came on the scene of this company much later Mark, he is not the inventor or patent holder to my knowledge, he is merely the "CEO of a nasty legal battle over rights to the name and product. If I am incorrect, please correct me. How his opinion is relevant enough for you to put your name to it publicly is disconcerting.

http://www.investorsrealitycheck.net/documents/BestLifeRewardedLetter.pdf

 

Here is the link for the peer review policy for Nature.

Looks like some articles are peer-reviewed, and others are not in Nature. Very interesting.

I would hope that, in the future, people making claims about whether a journal was peer-reviewed "at the highest level" or "not peer-reviewed at all", would first do some basic fact checking about the journal's peer review policy before they started making innaccurate statements regarding that journal.

 

Simon:

I for one, do like dual density midsole running shoes. After the past thirty years of running in these shoes and recommending them for my runner and walker patients, I have found that they do work quite well. I recommend them frequently for my patients that have symptoms due to excessive subtalar joint pronation moments during running and/or walking.

The name "motion control" is probably not the best since these shoes obviously can't "control" abnormal kinematics of the foot. The name of these shoes should probably be changed to actually reflect what they actually do: modify the kinetics of ground reaction force acting on the plantar foot that may, or may not, alter the motion of the foot and lower extremity. Maybe the term "Pronation Moment Modifying Shoes" would be a more accurate term, but is probably too technical to catch on.

It is also interesting that there is a growing body of research showing the kinematic and kinetic effects of "motion control shoes" with dual density midsoles in the scientific literature. Dual density midsoles are probably the single most important feature in current running shoe construction that reduces external subtalar joint pronation moments during running and walking.

You should reconsider your opinions about "motion control shoes" with "dual density midsoles".



R T H Cheung, G Y F Ng:Motion control shoe affects temporal activity of quadriceps in runners.British Journal of Sports Medicine 2009;43:943-947.

Alice Rose, Ivan Birch, Raija Kuisma:Effect of motion control running shoes compared with neutral shoes on tibial rotation during running. Physiotherapy, Volume 97, Issue 3 , Pages 250-255, September 2011.

Roy T. H. Cheung and Gabriel Y. F. Ng: Motion Control Shoe Delays Fatigue of Shank Muscles in Runners With Overpronating Feet. Am J Sports Med, March 2010 38:486-491.

Kim Lilley, Vicky Stiles, Sharon Dixon:The influence of motion control shoes on the running gait of mature and young females. Gait & Posture; Article in Press.

 

Kevin.. the context of my comments on dual density EVA are that it is very heavy, and very old technology. That does not mean there are some circumstances it does not work for, but for me it always adds an unaceptable weight penalty, and this will definitely not benefit the athlete. My comments are also made in the context that whilst dual density may well work, there are better ways to achieve positive kinetic and kinematic advantages for the running athlete. Whilst some of these techniques are available right now, even more will be available in the very near future. Manipulation of midsole/outsole geometry is one such technique that many are exploring.
I for one will be glad to see the eventual demise of manufacturing techniques that may well be beyond their use-by date...
Having said that.. there will probably be some athletes (in my opinion a very few), who will continue to benefit from the "motion control" concept of footwear design for a few more years until we have come up with a better, lighter way..:dizzy:
cheers
Simon

 

Simon:

OK, Bartold, you are now forgiven since you have now explained yourself to my satisfaction. However, always remember who all the girls run to after our many Tarsal Coalition concerts...it's not the guitar player(s). I do, however, like the Australian guitar player's smoking jacket......I think it may conveniently come up missing after our next concert.

 

Nah.. that smoking jacket looks better on me and you know it.. I am more than happy to be Keif Richards to your Mick Jagger anytime my friend. I am now off to lecture to a whole bunch of physios, pod, docs and chiropractors in Portland Oregon on the evils of minimalism .. haha..should be fun!

 

Watch out for Dr. Correct Toes himself, Ray McClanahan, DPM, who practices in Portland. He may be coming after you especially if you say something like minimalist shoes are a fad, or something foolish like that.

Also, did you know, Simon, that Correct Toes can do the following for the world's population if they would only send in their $65.00 to Ray McClanahan's website?! Amazing....and to think that it can cure hallux rigidus and improve your performance by 4-5% also!!

 

Great explanation Simon, and very close to my own thoughts, which is basically - When the dual density midsole was created and became common practice, the construction of the shoe itself was inadequate, and hence the dual density worked well to help. However, in the past few years the shoe construction has improved in a lot of other areas, and it is my opinion that the dual density midsole is not necessary in majority of cases.

 

Here's some more spin from him regarding minimal shoes and 'natural' running: http://correcttoes.wordpress.com/

 

Just going off topic for a minute but I thought maybe Tarsal Coalition could work on covering this little ditty by a band called Half Man Half Biscuit a favourite of mine growing up. It's a slow start but keep listening. I think it's off their album Trouble over Bridgewater.

http://www.youtube.com/watch?v=HhhlfS3IyZc&feature=youtube_gdata_player

 

PA colleagues,
I’m enjoying all the comments on the post…it helps us discuss and think.
Funny as all the pundits align and wait for more research to tell us whether to run more efficiently and with better mechanics....Al Salazar is moving forward teaching it and his runners are winning gold medals and Ritz healthy and setting PBs. Form is important!
http://www.runnerspace.com/video.php?video_id=6588
The real work happens on the track when we take all the stuff we know and think and see what works. I encourage Simon and others to continue research to help injury prevention and performance. Nike and Salazar have stealth projects too but he has gone public on good form.

Salazar and his group were highly influenced by running science guru Steve Magness. Here are Steve’s thoughts:
“Looking at elite athletes, when racing and training, they generally have higher turnover, minimal ground contact time, and a landing that occurs closer to their Center of Gravity. Since the majority of elites exhibit these same characteristics while racing, it makes sense that this is the optimal way to run fast. So, why are we wearing footwear that is designed to increase ground contact, decrease turnover, and promote footstrike out in front of the center of gravity? I have no idea.”
http://www.scienceofrunning.com/2010/01/why-running-shoes-do-not-work-looking.html
Steve’s in depth research report is worth the read
http://www.scienceofrunning.com/p/get-science-of-running-literature.html
If any of you are at The Running Event in Austin lets all go for a run and a beer 
Mark

 

You mean this Shmokin` jacket? It IS cool.



Talking of clothing, funny thing; I was looking for the above pic by searching on the Summer School threads. Came across this. Spot the similarity in dress?



BTW, Kevin. It was YOU who asked me to dance, remember?

 

Look in the OED under "cool", it'll say "see Spooner".

I've got a pair of strides like Bartolds' too which I procured in Montreal when I was invited to speak at PFOLA out there: my first overseas gig.

 

I couldn't resist the temptation.......

 

Mark I'm getting that you really don't care to or cannot answer either Kevin's nor my questions. I am attempting to have a civil discussion with you of the claims that you have made regarding plantar fasciitis and barefoot/minimalsim.

This thread is not about running shoes, elite athletes, optimal running styles. ground contact etc. and while all of that is important, it is really off topic. I hope that you can see my point and we can continue. If not and you just cannot answer, that is acceptable and just say so please. Here are the questions again:


*Please show us the research evidence that supports that people with plantar fasciitis have weak foot muscles.

• Mark, how do you resolve that as James and Jay, who are both contributors to your website, give very conflicting explanations of proper foot joint function? Jay is saying that this is good and James is saying that this is bad. Any thoughts on these apparent contradictions Mark?
• What is your position on “locking of the midtarsal joints”?
• How is the 2nd metatarsal cuneiform like a spring please, in your own words?
• What structures do you feel modulate forces in running, walking and jumping?

Regards,

 

Two of my favorite things, so I am in!
The problem may be Mark.. that we are talking at cross purposes in relation to track athletes and marathoners who have completely different requirements, but seem to be lumped in wih the 10 k guys. In my view, it is not possible to compare the 2 groups..

S

 

I'll have you know that those "strides" are a pair of the extremely difficult to procure Betabrand " Sons of Britches"... please Dr. Spooner.. a bit of respect..

 

I did like this photo of us in Belgium this year....cool duds, Dr. Spooner....

 

I agree, we should all try to emulate the best runners. Who was the best American olympic marathon runner this year? Why of course, it was, Meb Keflezighi, heel striking all the way to a 2:11:06 marathon, taking 4th place. Therefore, using your logic, Mark, all runners should be heel striking to emulate Meb? Right?

Really, Mark, let's talk about science, not about what some has-been runners are guessing about what the best running form is for the every single one of the millions of runners in the world. Using quotes from running coaches, Mark, is like using anecdotes in science...they are basically personal opinions that are useless in scientific debate and can easily be discredited with other expert opinions from other running coaches who totally disagree with the point you are trying to make.

When you made that statement in your article on plantar fasciitis, "The only way that you can actually fix plantar fasciitis is to address the root cause… weak foot muscles." you used an unreliable source to make a statement, as a physician, that is false, misleading and potentially injurious to people who need expert medical care for their plantar fasciitis. By making such a statement, you are promoting an unsubstantiated method of treating plantar fasciitis as the only way to cure plantar fasciitis. You, as a physician, need to rethink your position on this to one that is backed by scientific research and fact.

Let's take a step back and look at what someone from your family practice specialty would think of a podiatrist making the following statement, in bold type, in an article "Treating Hypertension": "The only way that you can actually fix hypertension is to address the root cause....too much blood pressure...therefore you must bleed the patient to fix hypertension." What would most family practice physicians think of such a bizarre statement coming from a podiatrist?

Let's also now look at our roles as medical practitioners so we can have another viewpoint of what others may think about our comments on these blogs. Let's look, together, at a very common problem in today's world where we have many physicians making bizarre, misleading and potentially injurious comments on blogs. That common problem is quackery.

How is quackery defined? Stephen Barrett, MD, from Quackwatch, defines quackery as follows:
the promotion of unsubstantiated methods that lack a scientifically plausible rationale.

Can you, Mark, substantiate with medical or scientific research your promotion of the idea that weak foot muscles are the cause of plantar fasciitis? Does your promotion, Mark, of the idea that weak foot muscles causes plantar fasciitis have any scientific plausible rationale?

You may want to consider these things very carefully before you make any more statements, like the one you made in your article on plantar fasciitis about foot strengthening being the only way to fix plantar fasciitis, about a medical subject you obviously know very little about.

Have a nice run.:drinks

 

Kevin,

Is it almost pointless to argue or debate as you mention things that as not my direct statements. The statement you make reference too is by Lance Todd. I quoted him in article. My article was written for a blog and Washington Running Report was like many articles for the media, an opinion from my experience. I did NOT submit for scientific review nor had intention too. This was written 2 years ago. We are all learning. Dissecting this is like peer reviewing you email.
From the article I made it clear we not know all the answers but gave these suggestions to try. Folks with PF have tried everything it seems and we lack true evidence based approaches.
Here is what I wrote on the complexity of the problem. See the last and most important point on seeing a provider.

Several Structural Causes can Contribute to the Problem
■Weak intrinsic muscles of the foot
■A misaligned and weak first toe
■Tight shortened calf muscles
■Tight plantar fascia

Other Important Contributors
■Increased mechanical stress from the amount of running or activity
■Obesity
■Adapting too fast from supportive footwear which inhibits intrinsic muscles to flat shoes or barefoot (i.e. summer if going quickly into flip flops or barefoot)
■Poor walking and running mechanics
■Overly supportive footwear leading to instability. This is a paradox as shoes that over support will weaken the foot which in turn leads to the foot’s instability.
What Can You Do to Correct Plantar Fasciitis?
There are a few basic principles but they will vary depending on the cause:
■Any support from an orthotic, arch support, or taping should be a temporary modality while you strengthen and lengthen the tissues. Using one of these forever is akin to breaking your arm and leaving the cast on forever (in one week muscles begin to atrophy from disuse).
■Doing eccentric drop down exercises from a stair can help. Place your foot on stair and drop your heels down. It is OK to have a little pain doing this as long as it is getting progressively better.
■Dorsiflex the big toe to lengthen PF if it is tight
■Get out of heels – gradually – in ALL activities
■Work on foot intrinsics… pick things up with your foot. Walk barefoot.
■Practice a technique of running encouraging more natural form, lighter ground contact and loading rates, and more proprioceptive cueing.
■Strengthen your big toe by pushing it into the ground as often as you can whenever you are standing throughout the day. This will wake up the foot muscles and help recreate the arch.
■If you first toe is bent in consider a product to straighten it like Correct toes from Dr. Ray McClanahan.
■Use the principle of gradual progression and body sensing when making any changes
■Avoid NSAIDS (Motrin, Ibuprofen, etc). These drugs interfere with natural healthy healing processes.
■See a good health provider who understands natural running and walking

On couple other points in the thread:
David asks me to differentiate opinions of others? I gave a short talk at the Marine Corps Marathon on my thoughts on running form and footwear. I make no claim to have exact answers to these specific questions. Runners can read Jay and James pieces, strentghten their feet and train the springs progressively, and see what result they have.

On Meb. What a ridiculous picture and assumption from one frame. Plus this is 2004! Med cracked and went back to rebuild himself like Ritz and is at his best now nearing 40.
Watch this video. He runs beautifully and does not overstride. He has mastered form and runs wiuth the Sketchers MFS (midfoot strike) shoe
http://youtu.be/_P1Y6b1RXM0
it is not about heel, forefoot, midfoot but rather how you engage the ground. Reaching out is overstriding, even with forefoot strike. One can land perfect with foot closer to center, bent knee, no overstride and engage the heel first. Watch our video….we explain it in 8 minutes.
http://youtu.be/zSIDRHUWlVo

Also i take offense that i am somehow being referenced to quackery. I am a Professor of Family Medicine and take care of ill patients daily, many critical, at our small critical access hospital in West Virginia. Running injuries are not that important in my life.

Have a good weekend and get out for a run 
Mark

 

Mark:

Thanks for your reply.

Looks like we will have to agree to disagree since, from my experience of being a competitive distance runner for decades and a sports podiatrist for over 27 years, your opinion piece on plantar fasciitis was not only innaccurate but misleading. Even though you did mention you got the idea from Lance Todd that the only way you can fix plantar fasciitis is addressing the root cause, weak foot muscles, you did bold it in your article and did not use quotes around the statement. Therefore, in doing so, you obviously wanted to emphasize that this was very definitely your opinion also. Is it still??

We, (and I mean nearly all the sports podiatrists in the United States, except those that are medical advisors for Vibram Fivefingers), very commonly get great results from treating people with foot orthoses for years and years with plantar fasciitis. Your notion that

is ludicrous.

I have never seen one of my runners who habitually wear foot orthoses have "weak feet". In fact, because they wear foot orthoses, they become stronger since they can train more often, train faster and train longer distances since they avoid injury by wearing their orthoses and can run more with their orthoses. Your continued insistence that foot orthoses somehow weaken feet over time is not only baseless, and without scientific evidence, but is also contrary to what us sports podiatrists see on a daily basis in our practices. Do you ever ask any podiatrist's opinions that aren't minimalist-barefoot shoe advocates? I tend to doubt it.

Since you are a Professor of Family Medicine and obviously are a caring physician for your patients in the hospital, you must also realize that I have been Professor of Biomechanics at the California School/College of Podiatric Medicine now for 27 years and I also care greatly about the health and welfare of all my patients, whether they are runners or not. When I see a physician whose expertise is not foot and lower extremity biomechanics, such as yourself, write such misleading and poorly referenced blog articles on how to properly treat running injuries such as plantar fasciitis, then I believe it is my duty to point out these problems since, ultimately, runners get hurt by listening to this bad medical advice.

Next time, when you write an article on plantar fasciitis, please take the time to read some research on the biomechanics and treatment of plantar fasciitis so you can produce a more objective and fair article on this very common disorder that sports podiatrists see daily in their practices. It does not help your credibility in promoting yourself as some kind of running biomechanics expert or foot injury treatment expert when you write such articles that are obviously biased toward promoting the "Born to Run Party Line" of "barefoot-minimalist shoes are great for everyone - orthoses weaken all feet over time - heel striking is bad for everyone". It makes you look bad to the rest of us that are professors in foot and lower extremity biomechanics and experienced sports podiatrists.

Hope your minimalist only running shoe store continues to do well financially for you.:drinks

 

By the way, Mark, hope your minimalist running shoe store in West Virginia doesn't go the way of this minimalist running shoe store in London, UK......

 

Kevin,
I have never met you and it is clear we have differences of opinion. You wishing me, my store, my community, and my employees demise will not change my mind. Funding a store in a rural town of 3000 and helping keep a downtown alive is not about shoes.
We opened the store to support the work of race organization and community grants on trail building and physical activity. I direct 3 races which give back more than anything shoes can. The store supports 20 races.
http://freedomsrun.org/Partners.aspx
Not sure about the picture but yes a Terra Plana shop closed to open a VivoBarefoot flagship store which is open
http://www.vivobarefoot.com/us/our-shops/
Mark

 

Mark:

Please show me where I "wished your store demise". All I did was to show a minimalist running store that went out of business and said, and I quote:

"By the way, Mark, hope your minimalist running shoe store in West Virginia doesn't go the way of this minimalist running shoe store in London, UK......"

Like all businesses in this day and age, there is a chance this could happen. Hopefully this won't happen to your running shoe store also.

Read my comments more carefully next time, Mark, before you wrongfully conclude that I said something that I actually didn't say.


By the way, Mark, where is your scientific evidence that foot orthoses weaken the feet? All of us podiatrists here on Podiatry Arena are wondering where you came up with that unusual piece of information that foot orthoses weaken feet. Was this scientific research you got this information from? Or, Mark, did you get this information from a minimalist-barefoot blog or by reading "Born to Run", that book that is full of mistruths and biased, cherry-picking journalism.

Saying something like "orthoses weaken feet, seems to be a very unusual comment from a Family Practice physician since I assume you have probably:

1) never casted a patient for a custom foot orthosis,
2) never dispensed a custom foot orthoses,
3) never adjusted a custom foot orthosis, and
4) never followed a patient with custom foot orthoses for any significant length of time to see if foot orthoses actually weakened the feet.

By the way, Mark, for your information, I have made over 15,000 pairs of custom foot orthoses for runners, other athletes and just everyday non-athletes from all over the western United States over the last 27+ years, and never, not even once, have I seen my foot orthoses cause a weakness in my patients' feet. In addition, I have been lecturing on foot orthosis therapy both nationally and internationally (in nine different countries) for the past quarter century and have written three books on the subject. Maybe you should spend some time reading one or all of my books so you can begin to learn more about current theory and research on foot orthosis biomechanics and foot orthosis therapy.

 

Mark,
Kevin did not wish any ill to you or your store or community...

Rather than commenting on what Kevin didn't say, how about commenting on what he did say...

I want to see some evidence that suggests that orthoses weaken feet!

 

You mean like the peer-reviewed evidence that I offered previously in this thread?

Mark you mentioned the "springs" of the feet and now you are evading an explanation? I feel my questions are fair, they were made by your counterparts who contribute to your blog. Am I to opine that it is ok to say something on a blog and then gloss over it later on when called on it? We expect a lot more from a physician influencing patients in his care and the general public Mark. Sorry, you won't get a pass from me or many others being a health care professional.

The problem is you are making the unsubstantiated claims 1) Plantar Fasciitis is due to weak foot muscles and 2) that foot orthoses weaken feet. You are making the claim former claim based on Lance Todd’s insight as referenced in that article on tao-fit.com.

Lance’s partner at BS Patrick Malleret, another non medically trained salesman makes some very interesting and fantastic unsupported statements that ignore the evidence as well on Twitter via a LinkedIn group:

http://twitter.com/pmalleret
Patrick M. • In no other field of medicine is bracing, cushioning or supporting the
recommended long term solution for muscular skeletal issues that can be
rehabilitated. The foot is an engineering masterpiece. 20 muscles (some miniscule) support our weight daily and we have the Chiropractic and I believe certain fractions of the Podiatric community that state in their "old world" teachings that foot muscles cannot be rehabilitated over the age of 18yrs old. Hogwash! I have seen this proved wrong thousands of times and will gladly send anyone interested a study done at Huddersfield University in the UK that states unequivicolly that footprint can be reduced by an average of 36% in 100% of participants in simply 4 weeks by exercising foot muscles. Yes that means Steven Bentley, that your wife could have reversed her flat footedness, if she had had the right tools! If muscles exist they can be trained, surely no one argues with that comment? Thus my absolute confusion as to why someone would train in VFFs for X minutes per day and then slip into a pair of shoes with an orthotic insole. One step forward, three steps backwards! Did you know that the US military have a clinical study that proves that orthotics (by Superfeet I believe), actually produced ZERO benefits and actually created more issues than they solved. I can hunt out the study if anyone is interested.

Patrick M. • 70% of your brain’s information for movement comes from the nerves on the soles of your feet. The more you can feel the ground, the greater your body’s understanding of its surroundings and natural movement.

Patrick M. • We manufacture an insole that acts like an artificial pump for someone who is suffering from diabetic issues relating to their feet (google venous pooling). In addition to that the wearing of our product reduces dramatically the occurence of calluses. People suffering from diabetic foot issues always suffer from being flat footed.Being flat footed and wearing "any" type of shoe will result in friction within the shoe which results in calluses, which then become ulcerous, which then become gangrenous, which then results in amputation. All of this can be avoided by wearing our insoles.

These are the people that you are crediting for your “insight” Mark. His comments are all to familiar to many made by the barefoot/minimalists and neither have any science on their side. Anyone with any knowledge of diabetic foot care should be alarmed at the last tweet. Care to comment?

Let’s not forget Patrick wrote this right here on PA:

And,

You won’t address the conflicting statements of two of the professional contributors to your blog Mark, so be it. To the rest of us who have put some time and effort into understanding lower extremity function though, it is glaringly apparent that their comments conflict and that you could drive trucks through the holes in their accuracy and logic. If you want to stake your professional name on pseudoscience and hyperbole you couldn’t find better colleagues to align yourself with.