Plantar Fasciitis and the anti-orthosis, Minimalist Shoe Message

Folks,

so Kevin "wishes me well" while showing a closed store front picture? Are you kidding me that he really wishes our store success?
I'm done with this thread and PA. I only responded to this thread as inaccuracies around a talk were put in public forum.

Maybe we'll meet on the trail or road someday.



Mark

 

The "Peacemaker"? my role model has no limits
couldn't understand anything Patti was saying/singing so i googled the lyrics and my worst subject was English, poety especially, what is she talking about? mark

 

Mark:

Sorry to see you go so soon since many questions that we posed to you still remain unanswered.

Maybe when you have some more time you can visit us again to explain to us how foot orthoses weaken feet and how plantar fasciitis is caused by weak feet. Since there is no known scientific research that shows these things that you claim in your blog articles to be true, we just wanted to know where you came up with these unusual ideas.....with not a shred of medical evidence to back them up.

We will keep the lights on for you.

Happy running.:drinks

 

It's about falling in love, Mark. Here's my favourite peacemaker courtesy of Sam Colt: http://en.wikipedia.org/wiki/Colt_Single_Action_Army

 

Sorry Mark, but I can't help but feel you are dodging the questions that are being asked of you...

For what it is worth, a good portion of what you say is relevant, but I feel you misunderstand some key components, and for this reason you are probably not nearly as effective as you could be with managing a problem like PF. You should engage Podiatry Arena more as most of the contributors are continually questioning current paradigms just as you do, and do so with the advantage of specific training and experience.

 

Kevin, : Meb was wearing a shoes with a big drop. it's a old picture. Now, with odrop shoes, he heel strikes a lot less, cure his knee tendon problem, did a PB on marathon and half at 37yo... and kick the A** to the asics athlete that refuse to train more with minimalism... and he is injured big time.

All the sale of the running shoes shop in the province of quebec increase a lot on minimalism (probably 30 to 40 % of runners run with minimalism shoes now)... the retailers that refuse see there numbers decrease.

CraigT : We just start to educate UK health professional (first course some month ago... next : next years)... BIG success. If you want open a shoes shop offering other stuff that just BBS, wait a little bit... in two years minimalism will be a big part of the market.

Already > 10%, every companies change their strategy and their shoes are more light, flexible, lower drop ... http://www.therunningclinic.ca/blog...-en-sommes-nous-minimalism-where-do-we-stand/

Love see some folks on this Arena working so hard to protect their 'market' and philosophy :drinks

 

Can you not see the irony in this??

Blaise perhaps you can answer for Mark seeing that it is a line that you have trotted out also-
Where is the evidence that foot orthoses weaken feet??

 

I tend to stay away from threads like this one. But i have read this one and thought carefully about this comment:

I don't see that at all. What I see is claims being made and both Mark and Blaise failing to answer the questions being asked of them. Mark has been repeatedly ask for the evidence and to explain the evidence that contradicts the claims being made and he does not respond to that. Blaise attempts to counter the evidence that says the opposite of what he is claiming but is unconvincing.

 

We debate on that on this Arena... seems that some don't understand the "adaptation concept"... so I will repeat for the xieme time.

My position (VERY clear)
* protective devices like shoes and orthotics decrease the tolerance to the mechanical stress (load x reps) on some protected structures
* applying more stress (load x reps) by minimalism or barefoot increase tolerance to stress and strengthens the foot and increases its muscle volume if it's done gradually

Ref (not so strong... but very interesting) : Sachithanandam 1995, Rao 1992, Robbins 1987, Bruggemann 2005 (UP), Bruggemann 2004 (P), Potthast 2005
Many observation of feet runners changes by starting more barefoot running.

Now provide me evidence that your protective devices are a good thing on LONG term ... and because you won't be able... tell me under which logic is a good treatment plan to do that.

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What Blaise is completely ignoring in his latest rant is the following factual information:

1. Flexible flatfoot is not a condition and does not require treatment in and of itself and does not correlate to a “weakened foot”. Blaise is trying to force the connection that the incidence of flatfoot equates to a “weakened foot” rather than normal development of the skeletally immature subject (you have a real paradox to explain with Charcot foot Blaise). That is simply not true, only the Church of the Barefoot makes this claim and it is UNSUPPORTED by the literature.
   
2. Children are born with what many term flatfoot, which resolves with skeletal development in very high numbers. Nothing like facts to stand in the way of the truth.
   
3. A flatfoot is not pathological, it is merely a finding of the relative height of the MLA
4. Foot “type” is not predictive of function, again childhood flatfoot resolves in high numbers with maturity – explain that please?
   
5. 3 factors affect arch height; age, gender and weight (uncorrected for in these studies).
   
6. Look closely at the Sachithanandam study, the incidence of flatfoot in those who began wearing shoes before age 6 was 3.24%, between the ages of 6 and 15 it was 3.27% and in those who first wore shoes at the age of 16 it was 1.75%. So the numbers were actually minimally higher in the age 6-15 group, and LOWER in the age 16 group! That doesn’t support Blaise or Mark or anyone else’s pet theories.
   
7. The gradual decline in numbers as the subjects reached age 16 support what others have said all along, which is that flatfoot decreases as we mature skeletally. The incidence of flatfoot is no higher in the general adult population. Well, there’s a problem isn’t there? Also, none of these studies find these subjects feet were “weakened”, they only measure arch height. Doh!

At any rate this has nothing to do with the questions asked, it is just more of Blaise’s now famous deflection and transferrence. Blaise and Mark’s abject failure to thrive intellectually in a forum rife with intelligent individuals bores me. I could have a go at his other references but why bother, same result. No need to respond Mark, I had hoped you had something to contribute but as with all conversations that I've had with bf/min facts are not your strongest suits.

Adaptation my arse. Who is blind and cannot see the truth here? Who is protecting their pocketbook while boo-hooing everyone else? No brainer, like Blaise.

 

I agree with all 7 points of your list... What your point?
Blaise

 

That none of your references have anything to do with the subject as usual and that these references actually counter what you are saying. Jesus do I even have to explain your own responses to you?

Shoes don't weaken feet. orthotics don't weaken feet. Ejaculating articles on flatfoot doesn't support the above. Those studies are long term!
craig:

 

Actually shoes/ orthoses alter the stresses that go through a range of structures. If chosen/designed well (this is where assessing the individual comes into it)- this should have a positive effect on pathology/ pain and allow the person to perform their chosen activity.
I am pretty certain that an active uninjured person is getting stronger than someone who is injured and unable to exercise.

The fundamental flaw in your argument is that you assume everyone has the same ability to handle this stress.
If what you are saying is true, then you don't ever need to actually treat or manage a person apart from saying 'make changes gradually'. If this was the case, of course shoes or orthoses are not really needed but by this rationale you also don't need someone telling you that you need to learn to run differently- they just need to decrease the load a little and then slowly increase again... hell they can wear gumboots to run if 'they just take the time to adapt'
Oh- and that would mean that obese people must have the strongest feet and don't have any problems related to the forces going through their feet... they would have progressively got stronger as they increased their GRFs, and in your world they can do this without any upper limit

My experience is that everyone is different, and to be succinct, not everyone can adapt to the 21st century. Ignoring the positives of what traditional footwear and foot orthoses can do is doing your patients a disservice.

Obviously this varies case by case.
Clearly if someone has morphology that creates load on certain tissues and this cannot be reversed, then the orthoses are likely to be long term.

Other times the orthosis may be useful to help develop movement patterns which can be self maintained. These people are more likely to be able to stop wearing the orthoses or at least decrease the necessity to wear them. Better to keep them in your cupboard than throw them away though... you can fall back to them if you so desire.

We often have cases here where our athletes have successfully used orthoses to overcome injury, and stopped using them, only to find that the injury returns despite regular physio and conditioning management. Do you think they are better off doing this than just continuing to wear orthoses??



.

 

There's five minutes of my life gone that I won't ever get back.

Seriously, why are we even debating any of this?
Low/zero heels in running shoes are nothing new. I wore them in 1972 0r 1973 (didn't like them). In the 50's and 60's they were all that was available.
Running footwear started to become more padded and bulky along with the running boom, as an answer to all the injuries.

My take is most of those new runners weren't built to run - they had the wrong geometry.
That's why old, established clubs with about 50 hardcore runners were able to field the same people event after event. Those runners had been at it for a while, they didn't get injured, and natural selection had persuaded those who weren't built for running to try another sport.
Now (around 1975 on my patch of the UK) thanks to Jim Fixx all of a sudden running is the greatest thing since sliced bread, and club memberships went up almost overnight by 200 or 300%.

Running shoe manufacturers were persuaded that shock attenuation was the answer, hence the padding, or in Adidas's case, the Dellinger Web. When that didn't work for everyone they moved right along onto motion control. Three types of shoes - anti-pronation, anti-supination, and neutral. Of course you have to run on a treadmill to make sure you have the right shoes - and pay the premium shop price of course (the treadmill cuts out mail-order). Actually, thinking about it NIKE had a low-bulk shoe with a cobra pad in it in 1974 called the Equator. Quite expensive for the time, and I think they only lasted a couple of years in that particular incarnation. I liked mine once I'd taken the cobra pad out.

Running shoe manufacturers will push anything which they think will sell (hence Vibram 5-fingers - at any other time in history those would simply have been a bad joke, or a sex-aid, or maybe both).

Remember you are arguing with someone who claims he cures met stress fractures in four weeks - he also claims he's treated 100's of cases.

Blaise, you do realise that you may be in your ascendancy, right now? It could be all downhill from here \.

 

I know I closed this thread, but here is some data on this I just got.

So far have tested 6 people with unilateral plantar fasciitis to measure plantarflexor strength of toes using a force platform (assume that this measures the strength of the intrinsic muscles and the long flexors). In all 6 there was not even a close hint of a difference between the painful and the unaffected side - they were exactly the same.

Obviously 6 is inadequate for a formal study and this was me just doing some testing based on what has been said in this thread.

HOWEVER, if muscle strength was an issue in plantar fasciitis, then I would have expected to at least see a difference in at least some of the 6 (ie weaker on the painful side/stronger on the unaffected side), but that was not the case.