We have moved!

As you have probably noticed, this blog has been sadly neglected! I now have a bit more time on my hands and will be reviving it on my new website www.huntergait.com.au. I look forward to debating with you there!

cheers

Craig

Is the modern distance running shoe evidence based?

A scientific mind should challenge my statement that there is no evidence that modern running shoes either prevent injuries or improve performance. To fail to do so merely replaces one unfounded dogmatic belief with yet another.

How then can I back up my claim there there is no evidence that modern distance running shoes provide any benefit to the wearer?

To do so requires a systematic examination of the published scientific literature. This is done by searching electronic databases which catalogue all the studies published on particular topics. If no studies are identified via this process then you can confidently make the claim that no evidence has been published.

With two colleagues from the University of Newcastle, I have recently published such a systematic review in the British Journal of Sports Medicine.

We searched for studies which compared adult runners running in modern running shoes (elevated cushioned heel and pronation control features tailored to foot type) with those running in either bare feet or other running shoe types. We restricted our searches to studies which measured the impact of wearing these shoes on a real world outcome such as distance running performance, musculoskeletal injury rates, osteoarthritis risk, enjoyment of running or overall health and quality of life.

We failed to find a single published study.

This means that either 1)the studies have not been done or 2)their results have been suppressed because they show that modern running shoes are either of no benefit or are in fact harmful. Only the shoe manufacturers know which of these is true.

We can only hope that an entire generation of runners have not been the unwitting victims of unethical corporate behaviour.

We have consistently seen how large corporations behave when their profits are threatened by the truth. Big Tobacco, the pharmaceutical industry and asbestos manufacturers come to mind as poignant examples.

Will the multinationals who perpetuate and feed on the myth of the modern running shoe be next?

The running shoe renaissance

After 25 years of stagnation, there have been a number of innovative new running shoe designs enter the marketplace over the past few years which are well worthwhile examining. These designs can be broadly classified into barefoot running shoes and midfoot/forefoot strike running shoes.

Just like heel strike running shoes, these designs remain untested solutions to unproven theoretical assumptions. As such, it remains to be demonstrated whether a barefoot, midfoot, forefoot or heel strike shoe design is more desirable. However the very existence of these shoes gives us the tools we need to begin to test answer these questions.

The two barefoot designs to enter the market have been the Vibram Fivefingers and the Feelmax range. Both appear to successfully achieve their design objectives, the Fivefingers providing a thin rubber sole shaped to the wearers foot and Feelmax a soft flexible kevlar sole reminiscent of a moccasin.

In the forefoot strike market, Newton have released what looks like a heel strike running shoe with an energy storage and return unit under the forefoot. Unlike the barefoot shoes described above, I suspect that the wearer does not naturally adopt a mid or forefoot strike in this shoe, instead having to consciously learn this technique. The forefoot energy storage device is interesting but like many shoe technologies is really compensating for a loss of natural function caused by the shoe rather then adding any true benefit. In this case it is loss of the foots natural spring as a result of disruption to arch function.

Out of all these new designs, I think that Velocy have made the most interesting contribution. This shoe is not designed to achieve a mid/forefoot strike per se, rather its design objective is to allow the wearer to lean significantly forward when they run without overbalancing. This is based on the belief that our lack of a means to counterbalance this forward lean means that we cannot fully utilise our capacity to generate forward momentum. I love the originality behind this design but would have thought that having big feet would achieve the same objective!

Dunlop Volleys- Still the gold standard?

I had a great day today, participating in a community triathlon. It also gave me a chance to road test a pair of Dunlop Volleys.

If you are not familiar with these shoes, they are a basic canvas plimsoll with a thin PVC sole which have been sold in their millions over the past 50 years in Australia. They sell for $20, have a thin foam inner sole, no arch support and a very slight heel elevation (my only complaint). Until recent times they were the sports shoe worn by every school student in Australia and by many sports people.

I really enjoyed the run. I felt very fluid and noticed no increase in impact forces despite not having run on the road for some time. My gait felt natural and very similar to barefoot, which begs the question- do we really require new 'barefoot' designs or should we first revisit successful designs of the past?

Clearly this shoe is very different in its design intent and function from a modern running shoe. As such, there needs to be a clear justification for why it has been effectively discarded from the runner's arsenal.

Is the modern running shoe any better than this 1950s design?

No one really knows.

How could we go about answering this question? Contrary to popular belief, it is a simple matter to measure the impact of running shoe designs on injury rates and perfromance. Any argument that a $10 billion dollar industry can't afford to undertake these trials is farcical.

Two testing methods come to mind. The first is a real world trial where manufacturers compete to demonstrate their superiority such as occurs in motor sport via competitions such as Formula 1.

The second is a randomised controlled trial where athletes are randomised to train and race in different shoe types. This is the study type used to evaluate the efficacy and safety of new medications and is ideal when there are multiple other factors which could affect the outcome which must be controlled for.

Ideally the two methods would be combined so that such a Formula 1 style race series truly tests the shoes rather than the capacity of each company to hire the best athletes. This could be achieved by randomly allocating each team athletes from a common pool of elite runners

The take home message is that we have the capacity to transparently monitor running shoe design. Can vested interests be overcome to allow this to occur?

Time will tell.

A deafening silence?

A quick update regarding running shoe manufacturers and the apparently very uncomfortable issue of evidence.

Number of major running shoe manufacturers contacted= 18
Number who have responded= 11
Number who have provided evidence that their running shoes decrease injury rates= 0
(Number of legal threats= 0)

This is all very laissez-faire (let the buyer beware), but I think we can do better.

I think it is time to harness the power of numbers. I will post an online poll on this blog. If you want to see a straight answer from your cherished shoe brand posted on this blog then vote now!

Is there a running shoe mafia?

I have been busily contacting all the major shoe companies asking them to direct me to the evidence that their distance running shoes either prevent injuries or improve performance.
The most entertaining responses so far have been from Mizuno and Puma who both claimed that whether or not their running shoes prevent injuries or improve performance was a trade secret.

Refusing to tell consumers whether or not your product works is certainly a unique marketing ploy!

They are not alone. I have received a similar response from ASICS in the past.

I received a preliminary reply from Brooks in which it was clear that they did not appreciate the question. Hopefully their next installment is a little more enlightening.

New Balance referred me to a website where the use of their shoes is justified on the basis of the opinion of their podiatrists.

Saucony were a breath of fresh air, their representative laying out it clearly that there is no direct evidence that their shoes either prevent injury or improve performance.

I will keep you updated as more replies come to hand!

Running dyslexia : Heel vs mid-foot strike

People get awfully fired up about when talking about whether heel striking or a mid-foot strike is a better running technique. Foot strike is obviously important, but there is a danger is being too prescriptive how it should occur.

What is more important is that each runner find the running style which is most beneficial for them. There is never one formula which can be universally applied to all body types, running shoes, speeds and surfaces.

How do you find your ideal running style? Your body is preprogrammed to find the most efficient way of doing things. Running is no different. If you focus on the training task rather than your form, you will naturally adapt your gait pattern to that which is most efficient for you.

So why do so many people run so badly? And why do we have to teach people how to run?

I suspect that a major component will turn out to be that modern running shoes not only disrupt our biomechanics, but also stop us from learning how to run efficiently. By blocking the precise sesnory information usually gathered by the foot, they appear to give us a kind of running dyslexia. If you can't feel your feet properly, how can you learn to run efficiently? Running in a pair of Nike Air Max is surely akin to trying to play piano with astronaught gloves on.

When viewed from this perspective, the solution is not to teach runners how to run, it is remove those factors which are preventing them from learning this for themselves. Coaches need to get their athletes either into bare feet for part of their training or to find them a shoe which does not block their capacity to learn. Once this is achieved, then the coach can stand back and focus on distance and intensity whilst style takes care of itself.

So what is the end result of this unimpaired learning process? Everyone is different, but most distance runners will end up landing on the mid foot or with the foot flat to the ground. I am yet to see a natural heel striker whilst running in bare feet, but have heard of a few people who maintain that this is their natural gait.

So get out there and find your style! You don't need a coach and you don't need a fancy pair of shoes. Just find a grass track and introduce it to your bare feet. If you take it slowly and give yourself plenty of time to adapt you will find it very rewarding.

So what do you do if you then want to go back to running in shoes? The challenge is to find a pair of shoes which allow you to maintain your barefoot style. Unfortunately, you will find that most shoes will dramatically change the way you run and many have been deliberately designed this way. To avoid this, a shoe with a thin, flat, highly flexible sole is a good start. Think Dunlop Volleys, think track shoes with waffle soles.

Unfortunately, even these shoes alter gait. It was this frustration that led Dr Scott Nightingale and I to begin developing barefoot running shoes for our own use. Our current favourite is the "Barefoot on Grass". As well as minimising mechanical disruption to the foot, we also specifically designed it to optimise sensory feedback. To achieve this, we constructed the sole from a series of overlapping scales. Each scale is independently mobile, thus allowing your foot to detect precisely localised changes in pressure.

I wear this shoe when I am not training barefoot and it is the only shoe I have tried in which I still feel 'barefoot' and don't have to consciously work to maintain my natural barefoot gait. Check it out at http://www.barefootongrass.com/.