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There is no barefoot running debate

Discussion in 'Biomechanics, Sports and Foot orthoses' started by Craig Payne, May 10, 2011.

  1. Craig Payne

    Craig Payne Moderator

    I too question the value of any prospective study. It would be interesting, but no more. I have seen many statements in the barefoot community, things like “we need a prospective study to prove barefoot is better” .. well duh! … that is a really bad approach to science to start with and is just showing the preconceived biases to whatever results might happen. How will they respond if the results do not show that?

    In the previous big thread on barefoot running debate there was some discussion surrounding the issues of prospective studies and its design (eg biggest problem is the intention to treat analysis of those who cannot transition to barefoot; the selection vs self-selection of participants; etc). At best all a perfectly designed prospective study can tell us is the global injury rates between the groups under study.

    Of what use is that information? Bragging rights? What impact will it have on clinical practice?

    For example, let’s assume that the injury rate is lower in those who run barefoot. Let’s assume that we have a runner in front of us with PTTD, what do you do? Just tell them to start running barefoot and they will be fine? ….. of course not. They probably should NEVER barefoot run or forefoot strike, as the joint moments involved with PTTD already high and will be even higher with forefoot striking and to do so is a recipe for disaster (not to mention litigation for malpractice). We already have a number of anecdotal reports where runners who got PTTD and tried the barefoot advice and ended up with reconstructive rearfoot surgery, never to run again due to the disability. How will the results of any prospective study change the clinical decision making in these situations?

    Example two: What if they have anterior compartment syndrome? Should forefoot striking/minimalism/barefoot be considered as part of the treatment plan? It will not matter what the results of some global prospective study on injury rates show, but based on this thread, the answer is probably yes.

    My question is, how would a global injury rate prospective study be any use in informing the clinical decision process in those two examples?
  2. Admin2

    Admin2 Administrator Staff Member

  3. BEN-HUR

    BEN-HUR Well-Known Member

    That is a very good point Craig. Believe your premise (i.e. "preconceived biases") to be true & set up research in an attempt to confirm this premise could potentially affect ones perception of the results/data... & subsequent interpretation/conclusion. Even setting up research based around an incorrect premise will potentially lead to false/incomplete/swayed results (subconsciously... or worse, consciously). It can certainly affect objectivity in science research & potentially influence the following of where the evidence is leading - should be directing us. There has been some history of this type of "bad approach to science" (i.e. premises/"preconceived biases" based on a philosophical world view or to support one's agenda) for some time within some fields of science... with some more heavily influenced/affected than others.

    With critics/analysers on both sides of the fence (so to speak)... & various perspectives/viewpoints allowed to be assessed within discussion/research; honesty & true enlightenment should prevail on the issue of the more appropriate foot attire &/or foot strike for various individuals. It will be good then to have confidence in some degree of established evidence/criteria for clinical advice to our patients. There is much to be done in this area of which fields such as Podiatry have a strong future in. It may require (in part) unlearning what we have learned... & starting from the ground up.
  4. stickleyc

    stickleyc Active Member

    Regrettably, I had to miss ACSM this year. Had I known Kevin and Irene were going to debate, I would have made more of an point of going.

    I am curious though, from anyone who was there, if there was any noteworthy advancement in the discussion in the debate between Irene and Kevin.

    Specifically, in a post prior to the meeting, Kevin was mentioning the gait retraining research Irene is doing. While this is interesting, I am still struck by the fact that the thesis of Irene and others seems to weigh so heavily on tibial acceleration as the "end-all" factor. While I see the value of controlling tibial accelerations, I have also read gait retraining studies aimed at controlling knee adduction moment and yes (for Simon), leg stiffness and these approaches seem to have as much merit for controlling injuries.

    So, any new highlights from the recent debate, especially as it relates to the gait retraining of tibial accelerations?

  5. Admin2

    Admin2 Administrator Staff Member

    Not sure it was exactly noteworthy!: Running economy in shoes vs barefoot
  6. Cris:

    I learned more from talking to Joe Hamill in Manchester a few weeks ago than by debating with Irene. Joe wasn't so sure that this "gait retraining" is actually a long-lasting treatment. He thought that most studies point toward the fact that people will tend to always go back to what makes them more metabolically more efficient during running, regardless of how they are "retrained".

    Irene said herself during our debate that it takes approximately 8 sessions at $80.00/session to successfully gait retrain a runner ($640.00). Just imagine the amount of time off work and transportation costs that all those visits would require and what the additional effective cost would be. Certainly, custom foot orthoses seem like a bargain to treat running injuries considering their lower cost, their long-term effects, their short adjustment period and absence of hours of time to "retrain" and the volume of research data that show they are very effective forms of treatment for running injuries.

    Irene did say that her goal was to get all of her runners out of orthoses. Don't think that many of my runner-patients would be too happy with that prospect, especially not for $640.00, especially with almost no research to back up the theory of gait retraining and the especially with the great success most of my runner-patients and thousands of other runners over the past quarter century have had with their custom foot orthoses.

    Actually, it is a little odd for me to hear any well-respected clinical researcher state that their goal is to get runners out of orthoses. What is so bad about custom foot orthoses? Are they any worse than eye-glasses? What would we think of a researcher that had a goal of wanting to get everyone out of glasses by doing "eye-retraining exercises"?
  7. efuller

    efuller MVP

    I have some acquaintances who are big fans of the book "28 Days to Reading Without Glasses: A Natural Method for Improving Your Vision by Lisette Scholl". Basically, you do eye exercises to strengthen your focusing muscles. Sound familiar. Using that example, I would rather rest my eyes by using the glasses. I would also rather "rest" my posterior tibial muscle with a medial heel skive orthosis. I just hope that people who get this "natural" is better advice are smart enough to listen to their bodies.

  8. toomoon

    toomoon Well-Known Member

    All of Irene's examples in relation to gait retraining are completely anecdotal if the last presentations I heard her give in Melbourne are anything to go by.that said, gait retraining in the correct setting can be extremely useful.
    I also had the chance to debate her in relation to barefoot running at this meeting, and it is like talking to a brick wall. All the usual stuff is trotted out with no real science.
    I have to admit I am completely puzzled by this given her excellent academic track record.
    Maybe she has some gun research up her sleeve we shall soon be exposed to? But.. I somehow doubt it
  9. NewsBot

    NewsBot The Admin that posts the news.

    Is There Evidence to Support a Forefoot Strike Pattern in Barefoot Runners? A Review
    Daniel S. Lorenz and Marisa Pontillo
    Sports Health: A Multidisciplinary Approach November/December 2012 vol. 4 no. 6 480-484
  10. Craig Payne

    Craig Payne Moderator

    After 368 posts in this thread (and whole lot of other threads) and all the claims about all the alleged "science" that supports barefoot running, we still have none and what I said in the first post of this thread stands:

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