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Bridging the Gap Between Barefoot Runners and Podiatrists

Posted by on May 13, 2012 | 23 Comments

Over the last few days, I’ve been engaging in a discussion on the Podiatry Arena, a forum for podiatrists and other health care professionals. I’ve been a lurker there for quite some time, but finally decided to post after a member took one of my posts out of context. After trading some barbs, we seem to have gotten to a point where we may be able to discuss some issues surrounding barefoot and minimalist running.

I’m excited about this prospect. Over the past few years, I’ve had the opportunity to engage various groups that are notorious for their barefoot running skepticism (shoe manufacturers and designers, running stores, coaches, etc.). The exchanges have been extremely valuable as a tool to refine my own understanding of barefoot and minimalist shoe running. More importantly, I think it has bridged the perceived gap in our ideologies. Without exception, we found we had more similarities than differences. Discussion about the differences usually lead to some sort of agreed middle ground. I’m hoping the discussions with the podiatrists leads to the same.

Having said that, the two groups seem to have an especially contentious relationship. This abrasiveness was apparent in our initial exchanges. This abrasiveness will also effectively kill any hope of productive conversations.

To that end, it is important to end the contentious relationship. We have to bridge the gap between barefoot runners and podiatrists. Since far more barefoot runners follow this blog, my focus will (mostly) be aimed at that group.

Idea #1: Reframe the issue. My own experiences and observations of others seems to suggest we don’t necessarily get benefits from barefoot running, rather we get benefits from improving running form. This still leaves a million unanswered questions (what IS better form, is there a universal good form or is it more of an individual thing, what’s the best method to teach better form, etc.). Barefoot running could be a component of better form, which should be part of the discussion. This reframing of the issue seems to result in much more productive conversations.

Idea #2: Understand we see the same world through two different lenses. Barefoot runners almost always see success stories. Podiatrists almost always see failures. I’ve been running and teaching about barefoot running for years. I’ve come in contact with thousands of runners. I can count the number of people that haven’t been able to run barefoot on one hand. Compare that to a typical podiatrist. They see nothing but people that have been injured while attempting to run barefoot. Think about it- when’s the last time you went to your doctor because you were feeling great?

This bias shapes our beliefs. Most barefoot runners believe everybody should run barefoot. Most podiatrists believe nobody should run barefoot. It’s sort of like men and women reporting their number of sexual partners… most men overstate; most women understate. The solution- accept there’s a middle ground.

Idea #3: Understand the nature of science in general and research in particular. I was originally trained as a researcher before teaching high school. My undergrad department happened to be obsessed with hammering home the idea of how science works. As a result, we clearly understood the limitations of the scientific method. It made us better potential researchers and skeptical consumers.

Most people (including barefoot runners and some medical professionals) treat research as if single studies unlock a particular secret to the universe. I blame the media. It’s not uncommon for the popular media to sensationalize a study. For example, let’s say a study is published that finds eating a Taco Bell Chalupa once per week increases your I.Q. by one point. Suddenly the local news is declaring that Chalupas are the next miracle brain food and hold the key to solving all of society’s problems.

In reality, the study was published in ‘The American Journal of Fast Food’, had a subject pool of six undergraduate subjects that lived in the same dorm room, consisted of a survey and a single game of Tetris as measurement tools, and was funded by Taco Bell. Worse, the authors clearly state all the limitations of the study, warn against generalizing the results to anyone beyond the six subjects, and outline the methods other researchers could use to increase the validity of the results.

This is precisely what happens when debates spring up about pretty much anything. In regards to running gait, there’s a ton of research out there. If you have an opinion, you can probably find a study that supports your opinion… and five that refute it.

Understanding how science works is a fabulous way to protect yourself against this problem. Here’s a quick and dirty primer:

  • Someone considers a question, like “Is breast size related to hair color in women?”
  • The researcher comes up with an educated guess based on observations and reviewing all the other studies that may be relevant. In this case, lets say their hypothesis is “Blonde women have bigger breasts.”
  • The researchers than test their hypothesis by designing an experiment. This is where it gets tricky. Ideally, you want a huge group of subjects that accurately represent an entire population. You need a method to measure your variables (hair color and breast size), then rule out all other possible variables. For example, you have to rule out wigs, occupation, geography, and any other variables that may be relevant. Some variables are difficult to eliminate, like the bias of the researcher. It can be done, but it makes the study more complex (and costly).
  • After collecting data (measuring air color and breast size), the researchers analyze the data with statistics. This mathematical voodoo gives an approximate likelihood that the study’s results aren’t just a function of chance.
  • The final step is interpreting the results. Good researchers are brutally critical here. They note the limitations of their research, the problems they faced, and they recommend what others can do to further test their hypothesis. In short, they’re telling other how to prove their hypothesis wrong.

Any single study, no matter how well designed, is more or less worthless. Several studies that show the same results are more valuable. If some studies refute the results, but many more replicate the results, that’s better yet. Finally, if someone studies all of the results of all of the studies, we end up with what’s known as a meta-analysis. THIS is the valuable research. At this point, we can be pretty confident in the results. There’s a very good chance all biases and experimental flaws have been eliminated.

HOWEVER, it is important to remember our ability to study anything is limited by our ability to measure it. Today’s awesome meta-analysis can be invalidated if we develop a better way to measure whatever we’re measuring (remember when scientists thought the Earth was the center of the universe?) Furthermore, every hypothesis must be disprovable. If we can’t prove our hypothesis is wrong, we cannot use science to answer the question.

The result is something the media never discusses- good scientists always understand that their beliefs can be wrong. Science is a method of systematic inquiry. Failure to admit “Hey, I might be wrong” isn’t science, it’s a belief.

What does that long-winded explanation mean?

WE NEED TO STOP USING SINGLE STUDIES TO MAKE SWEEPING STATEMENTS.

We cannot say “X study proves barefoot running is better than shod running. First, it’s not accurate. Second, it annoys those of us that actually understand the limitations of science. We need to understand there’s no research that shows barefoot running is superior to shod running, or vice versa. There’s a ton of research that investigates specific issues related to barefoot and shod running, but none of this is sufficient to to say “The research conclusively says we should be running [barefoot/in minimalist shoes/in non-minimalistshoes].” The research that’s available can be used to start a conversation, but that’s about it.

Idea #4: Remain open-minded. Good scientists have it right. They’re willing to abandon their model of how something works when empirical evidence calls for it. Unfortunately, not all scientists do this. Worse, us non-scientists are much less likely to do this. Our society champions those that “stick to their guns” and support an idea even if the contradictory evidence is overwhelming. If you’re in the business of helping others, this idea is flat out stupid.

All of us should remain open-minded to any ideas, even the ridiculous ones. We don’t have to implement the ideas, but we should strive to consider them. Ask questions like “How does this fit in my world view?” or “Is this idea as contradictory as I believe it is?”

I was a little surprised (though I shouldn’t have been) that the podiatrists from the forum ran in minimalist shoes. It was surprising because I bought into the stereotype we’ve created: podiatrists hate barefoot running and minimalist shoes. In my experience, this happens a lot. We are so closed-minded toward a particular group or idea, we fail to see that there’s a lot of common ground.

Idea #5 (specific to barefoot runners): Understand why medical professionals are hesitant to promote barefoot running. Kevin Kirby perfectly illustrated this point in the Podiatry Arena.

Let me give you an example. If you, as a blogger for Barefoot Running University, recommended that a runner try abandoning their running shoes and ran barefoot on your Barefoot Running University website, and that person stepped on a sharp object that cut into their foot, cut one of their plantar nerves and caused them permanent foot pain and disability, this poor person would have no legal recourse against you since you are just a lay person, who has no medical training and there is obviously no expectation that you are any sort of medical expert that knows anything about all the potentially harmful things that can occur with barefoot running.

However, since I am a podiaitric physician, I must carry malpractice insurance for what I recommend to my runner-patients since I do have medical training in foot pathology, I do have extensive medical training and lecturing experience on shoe biomechanics, and do have training on surgery, I have treated thousands of injured runners over 27+ years, and I have been lecturing on running biomechanics for the past quarter century. Now, if I tell a patient that they should run barefoot as part of a treatment plan for their injury, and they stepped on a sharp object while running barefoot that cut into their foot, cut one of their plantar nerves and caused them permanent foot pain and disability, I would likely be successfully sued for medical malpractice by this patient since I would have been considered to have breached the standard of care for the medical community by recommending barefoot running. Why would I then want to potentially risk my patient’s health and my medical career by recommending barefoot running?

In short, it is far riskier for a doctor to recommend barefoot running than it is for a random blogger. The stakes aren’t quite as high, but this also why many running stores are hesitant to recommend barefoot running, too. It’s more or less the same reason you don’t hear lawyers tell their clients “Just lie to the cops.’ or teachers tell their students “Just cheat on the standardized test.”

Idea #6: Don’t play the superiority card. This comes up when podiatrists tout their degree, CV, or other such credentials or barefoot runners tout their own barefoot experiences. Yes, I do not have an advanced degree in biomechanics. Yes, you have never run an ultramarathon barefoot or in minimalist shoes. Instead of using our experiences as fuel for a pissing match to show which person has the more relevant experiences, think of your experiences as your own unique contribution to the conversation. Start conversations by thinking “What can I learn form this person” not “What can I teach this person.”

When I was a teacher, some of my colleagues bristled at the idea that I’d hold honest, open discussions in my classroom. They clearly viewed students as their inferiors. They were the experts, and it was their job to pass their knowledge down to their students. Coincidentally, this is probably why so many of us don’t understand the nature of science- we had teachers that insisted on teaching us irrefutable facts. I digress.

I found my students were fountains of knowledge. Most of their contributions were experiential… they would provide stories of how a particular concept or idea fit in their life. Sometimes they were confrontational. They questioned some theories and successfully pointed out the flaws. Other times they shared bits of knowledge I didn’t know existed. The lesson- don’t discount people because you think you know more than them.

Conclusion

Here are six ways we can help bridge the gap between barefoot runners and podiatrists. I think both groups could greatly benefit from honest, open dialogue. As it stands today, those conversations simply won’t happen. It’s not a hopeless cause, though. All that’s needed are a few tweaks in our way of thinking. We need to learn to listen more than talk. We need to learn that none of us have all the answers, and working together will likely give us better answers than we have right now.

What do you think?

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23 Comments

  1. The medical community and Functional Fitness. « Kemme Fitness
    May 21, 2012

    [...] engaging in dialog with his toughest critics in the medical community – podiatrists. See his post here. There is something quite important at the essence of that conversation. Actually there are many [...]

  2. The Fancy Lady
    May 18, 2012

    Funny I should read this post,, right after blogging about my injury and podiatrist visit today. The moment I told mentioned “barefoot running,” he concluded my stress-fractured metatarsal was clearly, clearly the culprit. As we looked at the x-ray, he explained it appeared to be from long-term, repetitive injuring. He blamed the barefoot running. I turned to him and explained I started running in March, barefoot running the next week, then injured myself a couple weeks after that. The sum total of my running time was 4 weeks, save a year in junior high track. You could actually see him calibrate the new information. He ordered a CT scan and next week will bring more answers.

    All this to say, I hated running until dropping the shoes and hitting the sidewalk unshod. Oh, wow! I cannot wait to get back to it – as soon as we figure out what on earth I actually did to myself and how to fix it.

  3. Barefoot Running University » What Have You Learned About Barefoot Running?
    May 18, 2012

    [...] What Have You Learned About Barefoot Running? Posted by Jason on May 18, 2012 | No Comments Since I first took off my shoes and started seriously running barefoot, I’ve learned many lessons. In the beginning, I learned all the typical lessons new BFRs learn- elements of better form, the dangers of too much too soon, etc. Next I learned some of my own limitations as far as where and when I could run barefoot. After that, I started exploring the issue of shoes and barefoot running, which I’m still doing today (hence the recent discussions with podiatrists). [...]

  4. NickW
    May 14, 2012

    One thing I haven’t heard any of you bring up is some of the type of people that try barefooting and fail. We over at the BRS see these types of people every so often and they are the type that do not want to accept their part in their injury. They don’t want to let go of the mileage, speed, or amount of time that they were running shod and think they can do the same barefoot. They also will just turn around and blame barefoot as the problem, not their own impatience. Podiatrists see these people all the time. No wonder there is a disconnect. Not to mention the crap articles that you read in the newspaper (or online, or on t.v.), such as the Oregonian, that slam barefoot (and minshoes) and talk about how you’re going to get a stress fracture or just injure yourself, yet they never once talk that you have to slowly transition. Jason I’m glad you’re helping to break down the barriers so both sides can communicate.

  5. Brian G
    May 14, 2012

    I think there’s a good point to bring up regarding barefoot being the default recommendation vs. orthotics/structured shoes.

    Let’s assume that our species indeed evolved to endurance run. Does that mean everyone in our species are engineered at birth to run well if at all? In any biological population there is variety, some good or even great for a given task and some not so good or even really bad for the same given task. View it as a bell curve with the “good” encompassing the central bell, the “great” consisting of the left tail, and the “poor” consisting of the right tail. For Homo sapiens I have no clue as to the size and shape of this bell curve with respect to endurance running capabilities, but let’s assume it’s symmetric.

    Now, who sees on a regular basis those individuals fitting in a particular portion of the bell curve?

    I would argue that many of us posting on here, arguing for the value of barefoot/minimalist running, and practicing as trainers (e.g., Jason), see on a regular basis those capable of running good or great. And that is because those individuals are naturally bio mechanically engineered to run well sans shoe. So the default for that population would most often be barefoot.

    But what about those in the “poor” end of the bell curve, those who simply as a result of normal biological variation have crappy bio mechanics and structurally unsound feet? Who would most often see them? Podiatrists, I would guess (that is their profession, after all).

    For that “poor” population then what would/should the default be? I don’t think it would be running barefoot. Rather, it would be custom orthotics and/or structured shoes to provide the mechanical structural support that nature did not provide them. And if the patient is adamant that the doctor do whatever is necessary to help them to run (because swimming, say, just won’t do), given the medical ethics to help the patient what else could the podiatrist do in such cases than to prescribe custom orthotics?

    • Bare Lee
      May 14, 2012

      Brian, I take your point, but podiatrists don’t treat people who have grown up trying the default setting–barefooted–without success, so even if poor footwear, lack of previous exercise, or injury has brought sufferers of foot ailments to the foot doctors, it might still be worth trying resetting to the default first before trying interventions. Kind of like getting an asthmatic out of an enclosed, urban setting into the fresh air to see if that doesn’t clear things up first, before prescribing medication, provided that’s practical, etc.

      I’ve been around barefooted or minimalist populations for many years, and you just don’t see too many non-polio-affected people with foot ailments, any more than you see people with hand ailments.

  6. Bare Lee
    May 14, 2012

    Jason, I really like the exchange you’re having with Kevin Kirby. I suspect this will come to be viewed as a kind of a watershed moment in the debate. You’re both raising excellent points, But I look forward especially to Kevin’s reply to your latest set of questions (14th May 2012, 02:50 AM). You’re introducing Paul Wallis’s point here about what the default setting should be. It’s hard to believe any medical professional would recommend a raised heel, arch support, and a stiff sole as the default, although I can see why there’s room for debate about cushioning.

    Whatever the conclusion though, what will always be outside of this particular debate are the aesthetics, pleasures, and ideologies of bare feet. I like barefooting because I experience a lot of enjoyment though it. BFR has led me to SBL, which has in turn made me more bold and even mildly militant about my right to this pleasure and ‘lifestyle.’ My feet get ‘itchy’ for stimulation when I sit at my desk (barefoot on a smooth wood floor). Meanwhile, others are truly revolted by bare feet. No amount of research into gait or injuries will change this.

    Whatever you and Keven work out, I would ignore Spooner. He seems incapable of decent reading comprehension. He’s a good example of the insipid arrogance one finds in those who are merely above-average in intelligence and education.

    • Paul Wallis
      May 14, 2012

      I’m particularly impressed with the way you’re handling yourself. I can see how I must have made them upset. They attempted to try and get you to admit to “barefoot is better”, as soon as you do you admit to the burder of proof, when in fact it falls on the shoulders of their claim that running in shoes is better. I wasn’t willing to shift the burden of proof onto my shoulders. I wanted evidence that running in shoes was better than what has been used for millions of years.

      Although I still adamantly believe that there is no evidence to support that shoes are a default position. I admire Jason’s tact in listening and engaging in a conversation, rather than arguing over logical fallacies. Logical fallacies, and especially being acused of using them drives me over the edge. You’re a bigger man then me Jason.

      • Bare Lee
        May 14, 2012

        Paul, perhaps you softened them up, and so they’re now more receptive to Jason …

  7. dmitri
    May 14, 2012

    Hi all, thanks for the discussion. I’m learning a lot. I’m a BF runner myself (since 6 months only)… running in Italy, where NO ONE is running Barefoot yet. My idea is to introduce it in my direct neighborhood, and I’m trying to experiment with practice and theory. You guys in the US are way ahead in all this… and the scepticism here is huge, and trying to introduce BF running here in Italy has to be based on open-mindedness and respect for every runner or running related person. We’ll see, I’m gonna give it a try to spread the word and action, although I still lack a lot of experience and knowledge to be confident on it. Open-mindedness is the start of all learning and “confrontation” is only constructive, for every one. ciao and thanks

  8. Steve
    May 14, 2012

    Wow! What an excellent post! It’s easy to forget that there is no burden of evidence either way on barefoot versus shod (away from dangerous environments and extreme temperatures). I have been guilty of viewing the world through barefoot paradigm blinkers and hope that I am a little more reasonable these days. You know how it is: it feels so good, you want everybody to see things the same way. I have come to understand that form is the main issue; presumably there’s still insufficient evidence on this too?

  9. HeatherW
    May 13, 2012

    I ran barefoot once with a podiatrist (who was also running barefoot). While he claimed to have never seen a patient that had injured himself or herself running barefoot, he mentioned that he sees the “worst of the worst” when it comes to feet. A lot of his patients, he mentioned, have serious problems with their foot anatomy, and he thought that seeing truly dysfunctional feet all day could really color some practicioners’ viewpoints.

    I think WE need to realize that for many of the podiatrists’ patients, it’s not “orthotic versus barefoot”, but “orthotic versus wheelchair”.

    • Curt
      May 14, 2012

      Good point. I’ve been seeing a podiatrist for about 18 months to deal with some foot issues resulting from several decades of living shod. The doc has never treated another barefoot runner, and although I’ve been running BF for only 2 years, he quickly admits that I have the best looking feet of any of his patients. He says that 80% have diabetes and that many of the amputations he performs are because people wait until it’s too late to seek medical treatment.

      My podiatrist has been good at helping to diagnose and treat my comparatively minor problems, but as soon as he mentions orthotics or steroid injections I put my foot down.

  10. Tim
    May 13, 2012

    I’m logging in if for nothing else than to add myself to the list of people you’ve met (if not already on it) that can’t run barefoot. That fact makes this exchange and post highly interesting to me, as I can really see both sides of the coin. I loved running barefoot, and still love the idea of it; but, for my particular foot, every time I try again to run bare (no matter how short a run) I have up to a week of pain in my metatarsal area. I’ve given into the fact that shoes are tools that I will need and have worked instead on building the best form I can, thinking like a barefoot runner,even when shod.

    I totally support the idea of zero/low drop running though. I do notice a distinct difference when running in “traditional trainers” and the low drop options.

  11. Phil
    May 13, 2012

    Jason,
    I’m about to start my 4th year of podiatric medical school. I’ve been competitively running ultramarathons for 10 years. I’ve run 13 hundred-milers, even won a few. I’ve also run competitively in reduced and minimal shoes. Sometimes I run barefoot. It brought a huge smile to my face to read this post. Of course there is common ground, at least for people with open minds. We all tend to congregate with like-minded people and adhere to a stereotypical party line: orthopedists prefer surgery; podiatrists prefer orthotic therapy; massage therapists prefer massage; barefoot runners prefer, well, barefoot running. Then, we villainize those who disagree. We all seem to have our special interests to protect.

    I’ve been reading your blog for a while, as I feel it’s fairly representative of barefoot enthusiasts, and it’s important to know what runners of every shoe-choice and ability think. I must say, it’s been a struggle to read your blog for the past year or two, at least when posts concerned the medical community. “That’s me he’s talking about,” I would think. Frankly, some of the posts angered me. Why are you questioning my credentials and touting your own? My classmates and I have strong backgrounds in science, we did undergrad research, we’re just as qualified, frequently more so. There are more knowledgeable doctors, more talented runners. We read the same papers, so why are you claiming that you’re right or better informed? It was a classic case of shaking my fist at the computer and yelling, “Someone is wrong on the internet!”

    But it’s your blog, diversity of opinion is healthy, and most of the time I agree with you. So I keep reading. I think part of the apparent barefoot runner-podiatrist divide stems from exactly what you described: physicians tend to see unhealthy people, while you coach fundamentally healthy people who are already receptive to changes in form and footwear. A typical podiatric patient may be obese, diabetic, aging, difficult to educate and unwilling to change. See enough of these patients (i.e. for 20 years), and your perspective will change from prevention to disaster-aversion. This is why it’s important that we not only learn from each other, but rely on each other. Everyone who deals professionally with runners, from doctors to coaches, has something important to contribute.

    To end this long reply with an encouraging note, many of my fellow podiatric medical students are very interested in barefoot running as tool to teach proper form. Though some attending physicians frown on it (invariably they aren’t runners themselves), I have yet to meet a podiatrist who doesn’t agree that strong intrinsic foot musculature and decent form are fundamental to healthy running. The question is, how best do we encourage sustained physical activity, especially in people who don’t want to exercise? Some prefer barefoot. Others find it uncomfortable. My goal as a physician in training is to keep my patients active, and sometimes shoes help with this. Sometimes surgery helps. I’ve seen lives change for the better with orthotics. In the future, perhaps we’ll be able to identify exactly who will benefit most from taking off their shoes. We don’t have an accurate predictive tool yet, and as Dr. Kirby wrote, physicians can’t take that risk. Personally, I’d prefer if barefoot was the default position and all modifications proceeded from there, but we live in a shod culture

    Good luck at the Bighorn 100. I’ve run it twice, ’07 and ’09. Long climbs. Lots of mud and rutted trail from the wildlife. Sunset in the clouds at Porcupine aid station (the turnaround point) is otherworldy. Have a blast.

    Phil S

    • Peter Larson
      May 14, 2012

      Great comment Phil – always important to keep our varying perspectives in mind in these discussions. I’ve sent two of my undergrads on to Podiatry school in the past three years, and if there is one thing I hope for them it’s that they keep an open mind. Same goes for barefoot and minimalist advocates when it comes to thinking about things like orthotic intervention.

      • Bare Lee
        May 14, 2012

        I agree, I appreciate your comment Phil. We need more podiatrists participating on barefoot forums, and more barefooters participating on podiatry forums. And I’m glad to hear a physician in training state that he’d prefer “if barefoot was the default position and all modifications proceeded from there,” while recognizing the ideological bias involved in living in “a shod culture.”

  12. Ken
    May 13, 2012

    For anyone who is interested, here is a link to Jason’s exchange. – http://www.podiatry-arena.com/podiatry-forum/showthread.php?t=64746&page=11&highlight=Robillard.

    Jason, I hope this is the exchange you were talking about. In any case, you did miss a calling as a diplomat. Nice job!

  13. Rick
    May 13, 2012

    This is a great post and topic.

    You also brought up some great points Jason. I agree, it is very important to be open to learning new things everyday. I also think it is great to see things from a different perspective which reminds me of this quote from Stephen Covey, “We see the world, not as it is but as we are.” However, at the end of the day, it is still about the money that “custom” orthotics bring in annually.

    I realize that some people are only looking for the “quick fix” or the Bandaid. And in their mind, the orthotic is providing them with a long-term solution to their problem. But the principles of human function still remain: an orthotic does not improve the mechanics in any way, and I think many (most!) professionals are aware of that.

    A “custom” orthotic only addresses the symptoms, and when you truly understand the biomechanics it is obvious. I’m not only referring to the mechanics of the foot which is the only region a podiatrist is trained in, so therefore it is the only thing that they think about (and look at!).

    It is extremely important to think globally because that is what running is. Running is a reaction from the foot to the jaw, and believe it or not, the function/stability of the temporomandibular joint improves the overall neurological stiffness throughout the human chain.

    Therefore, the pebble in the shoe does not allow the foot to interface with the ground in a way that allows for normal/natural function. An orthotic only reinforces the compensations and over-time, the weakest link between the foot and the jaw will rear its ugly head.

    The truth is: podiatrists (and other professionals!) will continue to sell/market orthotics because at the end of the day, that revenue helps to pay the rent (and cushion the bottom line!).

    I can educate a professional on the principles of biomechanics until the cows come home, but that doesn’t mean they will listen or change how they practice. I can also show them that it is possible to restore/improve the mechanics by addressing the muscular system. But the facts don’t matter because the professional makes a living selling orthotics and cortisone injections. So, they are not willing to refer, or educate the consumer on a different option because that would mean money is walking out the door. Many consumers/athletes are open to the options, but they are never presented with them.

  14. Ken
    May 13, 2012

    It sounds like you turned a shouting match into a meaningful exchange. If that’s the case, congratulations! If you can do on Podiatry Area, then you can do it anywhere. Maybe you missed your calling as a diplomat?

    Would it be possible to post a link to the exchange? Finding anything on Podiatry Area is really painful. Between the interface from 1993, and the constant server timeout I can’t seem to get to it.

  15. Peter Larson
    May 13, 2012

    Jason,

    Nice post. When you get down to it, everyone is after the same goal: to help people enjoy running without getting hurt. Whether you’re a barefoot runner, a podiatrist, a PT, or any other interested party, this is what we are all after. And from a scientific standpoint, we are all essentially using different methods to achieve the same end. Injuries happen because forces stress tissues beyond their ability to repair. Running barefoot, wearing orthotics, doing strengthening work all work by altering the way forces are applied to our tissues to alleviate stress to the tissue that is injured. So, ultimately, all we are doing is arguing about the best method to alter how force is applied to the body. All of these methods can work, and success of each is going to vary by individual and by the expertise of the person providing diagnosis/advice.

    Pete

    • Jason
      May 13, 2012

      Thanks Pete. Your initial skepticism a few years back was a major influence in my quest to seek more evidence that supported barefoot running, which led me to a much more open-minded approach to all that we do. Thanks for reminding me about the nature of science. ;-)