All posts for the month June, 2013

I’m bumped out of concentration when watercolor-in-the-rain sleeveless plops down and tells her friend…

Overheard at cafe.

Overheard at cafe.

Yesterday, I took a class with Richard Simmons— himself. It was great! Lots of people, music, and fun. And afterwards…I sat and ate candy until I was sick. Why I bought it, I don’t know. (Waitress brings over menu.) Oh look, they have cottage cheese…

Taking a sip of coffee I ask myself, “If I offer, would she even accept my help?”

By the next sip I’m re-immersed in my Keynote project.

The New York Times occasionally publishes sound articles on fitness, but I’ve found their take on running to be routinely flawed. Tragically so— like their misguided pleas for gun control. In following suit, columnist Gretchen Reynolds asks Is Barefoot-Style Running Best? and reports that “If foot muscles become tauter and firmer, the scientists say, people’s arches should consequently grow higher.” Normally content to laugh and shrug off such errors, today I feel compelled to provide some perspective on running barefooted beyond pointing out that it’s ligaments— not muscles— that determine the height and integrity of the arch of a human foot. Since 140 Twitter characters just won’t cut it, here is “Runnin’ Nekkid,” a full chapter from my book Fitness, Straight-Up.

Bass Ackwards

Mark Twain said, “Civilization is the limitless multiplication of unnecessary necessities.”

Shoe companies and health care providers have traditionally put forth that various levels of biomechanical shortcomings are the root cause of our locomotive problems. We are inherently flawed, and only cleverly designed footwear is the solution. It’s no surprise then that the Brooks shoe company president, Jim Weber says, “We strongly believe most of our mileage should be logged in a performance running shoe, not barefoot.” He goes on, “Supportive, cushioned footwear is not only beneficial, it also plays an essential role in delivering a comfortable, injury-free running experience.” That perspective is not without precedent. Since the 1930s, corrective shoes have been designed and marketed as tools necessary for proper function.

Original Sin

Again, that we are inherently flawed is the presupposition, and indeed, physician R. Plato Schwartz plainly stated that humans need a heel under their shoe to throw their weight forward, step by step. Schwartz, an unseemly looking gent had eked out a niche for himself as an insurance company bloodhound sniffing out fake limps from genuine, injury-caused disabilities before he’d give himself fully to gait research. Later, he would claim that the horrors of flat feet could be mitigated with specialized heel-counters that prevent errant movement of the heel bone beneath the shin (pronation).

That Schwartz’s research and gait laboratory were directly funded by the Armstrong shoe company seemed to have escaped scrutiny by American physicians. Even his far-reaching claims that his Balance In Motion shoes, “when properly fitted, would correct flat feet, obliterate bunions, and callouses, alleviate sacroiliac pain, and,” in certain cases, “cure mental derangements by removing strains from the muscles and tendons of locomotion” weren’t sufficient to arch an eyebrow. Rather, it was Schwartz’s application of his methods to race horse performance that finally raised the ire of the medical community.

Fashion or Function

Historically, shoes and especially shoes with heels have served several functions, but none (save for, say, protective motorcycle boots) were functional, per se. On the acting stage heels and platforms were employed to distinguish rank and social status. Ancient Egyptian royalty was depicted in murals wearing heels while commoners were relegated to the lowly stature of bare feet. In Venice, Italy, platform shoes of 18” to even 30”— chopines— were worn by those who could afford such finery, along with the concomitant expense of hiring assistants to help them ambulate through street refuse and debris. Eventually, horseback riders found that a heel on their boots was useful for securing their feet in stirrups. The term well-heeled, by the way, derives from the association of the riding wear and the wealthy equestrians who wore them. However, in human locomotion and stance heels are necessarily problematic.

Consider the Leaning Tower of Pisa. This example of a columnar structure tilted slightly at its base leaves its crown hanging precariously farther afield. We’re similar, except our joints allow adjustment which provides a more visually vertical posture, but not without severely compromising our musculoskeletal alignment, our interface with the ground itself, and our very manner of movement, all so carefully arranged over eons by Mother Nature. I’d like to add that physician Victor Barker, in his book Posture Makes Perfect, describes any heel under a shoe as a “retrograde step…back towards the four-legged posture.” Such a pervasive artifice undermines some twenty million years of human evolution, and precipitates modern infirmity.

As a fashion accessory, shoes have their place. I appreciate a stylish pair of pumps on a shapely set of legs leading up to a short, short skirt as much as the next guy. But aside from the aesthetic, heels of any kind are bad news.

Nix the Kool-Aid

Now, incredibly, the problem of gait and shoe research is exacerbated by the presupposition, which is the assumption— and you know what happens when we assume things, right? — that the shod condition is somehow the baseline, the norm. Naturally, this skews all subsequent results. Conclusions are built on faulty premises. Of course, within that context, trying to talk sense to those invested in the medical / shoe-industry complex is akin to admonishing the ills of alcohol abuse to revelers at college fraternity bacchanalia. The intoxicated, you know, know no reason. Now, on the sober side there are podiatrists, MDs, and researchers who recognize some irrefutable facts.

Michael Warburton, an Australian physiotherapist, says…

Running related chronic injuries to bone and connective tissue in the legs are rare in developing countries where most of the people are habitually barefooted.

Canadian researchers, Robbins and Hanna say…

Where barefoot and shod populations exist, as in Haiti, injury rates of the lower extremity are substantially higher in the shoe wearing population.

Lynn Staheli, MD, renowned pediatric orthopedist says…

If you look at a place like China, and you compare the feet of those who don’t wear shoes with those who do you find that the non-shoe-wearers have better flexibility and mobility. Their feet are stronger, they have fewer deformities, and less complaints that the shoe-wearing population.

Further, the late podiatrist and author, William Rossi (who grew up in Boston, living above his parents’ shoe store) points out that…

From infancy on, most of the hundreds of millions of shoeless people of the world habitually stand and walk, not on soft, yielding turf (a persistent myth among the medical practitioners) but mostly on unyielding ground surfaces. Most shoeless children are raised in such environments in cities like Bombay, Manila, Mexico City, Calcutta, Jakarta, Bogota, etc., where the streets are either cobble-stoned or paved or hard packed turf. Those uncovered, unsupported feet grow with strong, normal arches.

Rossi continues…

A century ago, the rickshaw, which originated in Japan, was the common means of transportation in many Asian cities. In 1910, some 18,000 rickshaws and 27,000 rickshaw men were registered in Shanghai alone. The rickshaw men, most of whom began their occupations in their late teens, averaged 20 to 25 miles daily, trotting barefoot, mostly on cobbled or paved streets and roads. Many stayed at this occupation for 40 or 50 years. The feet and arches of almost all were healthy and exceptionally strong.

Consider too that researcher Adam Daoud of Harvard University references the 2004 work of Harvard professor, Dan Lieberman and University of Utah professor, Dennis Bramble, when he says that…

…evolutionary pressure selected for endurance running ability for around 2 million years before the development of the modern running shoe,” and, that “one would then predict barefoot running to be both efficient and safe.

What About Injury?

Over the last 40 or 50 years, as recreational running has enjoyed immense popularity in America, foot and leg ailments have become increasingly prevalent. Despite the claimed advances in running shoe technology, rehabilitation techniques, and training methods, there is still no real consensus on the actual cause of these injuries, and thus there has been no real remedy offered in the mainstream.

There is, however, the business model that treating the symptom is preferable to finding a cure because the revenue stream stops right there, with the cure. But, who would really believe such tacit collusion could exist in the modern, civilized, medical / shoe-industry complex? It can’t happen here, right?

In any event, about half of runners will be injured by their sport this year, next year, and the year after, and it will continue like that indefinitely. This necessarily indicates that the running shoe, and any other external fix has proven to be— based on evidence— an overall, abject failure. Instead solving problems, our trusted shoes could very well be causing problems.

The running shoe has been shown to materially alter sensory perception, making it more difficult to respond in correct context to variations in surface firmness. Moreover, cushioning makes it near impossible to sense the additional impact transient of a heel strike, which tends to accompany shod running, but is normally absent in barefoot running. You don’t feel the shock, but it’s still there! Compounding this, shoes, because they insulate and “support” the foot, necessarily weaken it in the same way that helping a chick peck its way out of its shell prevents initial, natural strengthening.

I know some might bristle at such a conclusion in large part because it’s unlikely many of us know a world without shoes. Most of us were forced into shoes before we were walking! So, such knee-jerk defensiveness of convention can be expected. The tenacious grip of belief can be hard to shake even in the face of irrefutable fact.

I might point out that through all the research that has sought the cause or causes of injury, running technique has taken a back seat. That’s because running, unlike other sports, is considered to be a natural activity. It’s argued humans already know how to run, which is true— up to a certain point.

As a species we’re more similar than we are different. We’re hard-wired for (endurance) running. As children, before we know anything, most of us experience our three dimensional world viscerally. From this most primal level, we begin running with a technique as fluid and efficient as that of any wild beast. Prescriptions of society— restrictive shoes, and fearful or irritated early parental admonitions, “Stop! Don’t run into the street.” — negatively affect gait, and create a cognitive dissonance that can be recognized in the body language of most runners. A heel-strike, common to about three-quarters of the running population is a startling example of the conscious mind saying, “Go!” and the subconscious mind saying, “No!” Every step slams on the brakes. This running style is a gestalt that reveals just how far we’ve veered from our natural alignment with those physical forces that originally modeled our form to suit our function. Understand that running speed is irrelevant in this equation, and that endemic injury is the smoking gun. That leads right to running technique, because it’s only through egregious misuse that we could so consistently be injuring the most resilient structures of our bodies, our feet, and legs.

I address this in lectures and in other, more running-specific writings, but let me just offer a quick aside. There could hardly be a greater voluntary insult to the body, to the lungs especially, than smoking cigarettes. Anyone who can recall their first smoke probably remembers the physical effect: quite a bit of coughing, burning, watery eyes; and, probably dizziness and nausea, too. That smoking provokes physiological responses akin to poisoning, or allergic reactions, would clearly seem to demonstrate that inhaling cigarette smoke, which contains carbon monoxide, among other toxins, presents a clear and present danger to the physical health of the human organism. Yet, Memorial Sloan-Kettering Cancer Center, and the Fred Hutchinson Cancer Research Center determined that the likelihood of getting lung cancer from smoking, which is said to kill about 130,000 people each year, can be accurately predicted by age, sex, and smoking history. For instance…

A 68 year-old man who smoked two packs a day for the past 50 years and continued to smoke had a 15% (less than 1 out of 7) chance of developing the disease in…the next ten years.

That 15% is at the high end of the scale. Compare that with the certainty that this year about half of all runners will be injured by their sport— running! — which is as natural to human beings as breathing fresh air. The issue here is not the severity of the ailments, say, lung cancer versus shin splints, but their respective prevalence. How could the odds possibly favor smoking forty cigarettes a day (more than two per waking hour), every day, for half a century? Let me say again: only through egregious misuse are we able to so consistently injure the most resilient structures of our bodies!

Because the running shoe materially alters natural gait and simultaneously robs us of the feedback necessary to correct and adjust our faulty stride, this protective, supportive device creates, and becomes itself a threatening environment. Sadly, with cushioned shoes, we don’t even get the initial red flag that a drag on a cigarette provides.

What’s the Fix?

In our consumerist society, according to the author of the best-selling book Born to Run, Christopher McDougall says, “We’re told to just buy something, instead of to just learn something.” Then, after purchased pain killers, hi-tech shoes, and orthotics fail, we still seek other passive remedies, dismissing learning how to run differently as too much bother. Lack of consensus confounds the issue. McDougall, in his book, queries Irene Davis, MD, then head of the Running Injury Clinic at the University of Delaware, “So, what’s the right way to run?” She replies, “That’s the eternal question.” And, it gets worse. “There is no correct running form— and you can’t learn it. Form is God-given…If you systematize it, you destroy it,” says Olympian, Kip Keino in Roy Wallack’s book, Run For Life.

I say, however, that there must be one correct running form because Nature is parsimonious. Her process painstakingly fashions function and filters out the faulty. Correct running form is defined by that technique that allows each of us, with our functionally identical musculoskeletal systems to run in harmony with Nature. That means to run comfortably within the framework of the same physics (including gravity and ground reaction) that determined our morphology and physiology, and to do so without shims, splints, or crutches. If you cannot run barefooted with a particular running style— heel striking, paw back, foot drag, what-have-you— then that style is necessarily invalid. By the way, McDougall learned how to run barefooted, and in so doing he cured an injury that stymied two MDs, and a marathon-running podiatrist. Barefoot is potent medicine! Well, more accurately, let’s just say that running barefoot removes one cause of injury.

While running form itself is fully detailed and annotated in Correct Running Form and Running Form: Simplified, the following briefly describes how running really works.

As a Pose Method running coach I consider running in a novel way, but one that’s as natural to humans as are the undulations of flying to sparrows, and swimming to elephant seals. That means regardless of medium, on this planet, horizontal locomotion requires us to hitch a ride with gravity. In running it’s like this:

From the moment our (fore) foot touches the ground until mid-stance, aka the running pose, our bodies hinge from that support on the ground. As they do this gravity is accelerating our center of mass as it falls to the earth. At the same time our natural biomechanical spring— that musculoskeletal system so carefully arranged through eons of evolutionary processes, and which includes the arch of the foot, the ankle, knee, and hip joints, and all their elastic tissues— is being compressed, not unlike a pogo stick. From mid-stance, this spring quickly recoils and pushes us up to where we can again give ourselves to gravity.

Following this rebound, as our stride continues, the hip, knee, and ankle extend further, but not to push us forward. This extension serves only to keep the foot in contact with the ground so the body can fall through a longer arc, pivoting about its support like a tree felled in the forest. This increases the horizontal displacement of the center of mass. Beyond a certain point foot traction begins giving way to slippage.

All this occurs in about a quarter second and between -6 and 22.5 degrees from the vertical, depending on speed. In faster runners it happens more quickly, there is less knee flexion, and vertical oscillation is reduced.

The last step is to change support. That is, to lift or pull the foot from the ground. The center of mass and the body then begin free falling more downward than forward, right into the next stride.

I’d like to mention that an erroneous concept in running— the push-off— endures perhaps because of a visual illusion. An extended lower limb appearing to powerfully drive an archetypal running stride reinforces the impression of strong muscular effort in fast running. Yet, for the push-off to work as described the posterior ground reaction force (PGRF) would have to be greater than bodyweight to provide acceleration. This, according to Newton’s Third Law of Motion— for every action there is an equal and opposite reaction. The problem is, it isn’t. PGRF is always below bodyweight, so push-off cannot accelerate the runner.

What’s more, ground reaction forces are the same between faster and slower runners at the same lean angles meaning faster runners are not pushing themselves any harder. You see, both speed and PGRF increase with lean angle because of angular velocity (of the body rotating about its contact with the ground). Posterior ground reaction, instead of being the seat of propulsion assumed by conventional wisdom, since it remains below bodyweight, turns out to be merely supportive. PGRF is a frictional force that allows a longer horizontal resultant vector.

So, running correctly and naturally is elegantly simple— just Pose, Fall, Pull! I advocate and teach this running technique because I’ve researched running enough to understand the Pose Method to be precisely that singular correct form that necessarily allows safe and efficient running. (If there were something better, I’d be using it instead.) The system of Pose Method drills ingrains proper mechanics and that all-important perception that allows runners to know, by feel, when they are running correctly, and more important, when they are not. While having such a blueprint dramatically shortens the learning curve, just by barefootin’ we tend to move closer and closer to the natural ideal anyway, each time we run. Our success becomes a matter of awareness, practice, and patience.

In the Long Run

Whether or not you will choose to learn Pose Method running, my recommendation for now is that by taking off your shoes and running you will immediately begin to reconnect with the natural function of your body. Injurious and inefficient heel-striking will soon give way to springy forefoot landings, a quicker cadence (foot turnover), and a much greater proprioceptive sense, which over time will allow you to run across a variety of terrain, lightly and comfortably, with or without shoes.

So, barefoot running is best learned during the preseason when fitness is a lesser concern. Unless you are already regularly barefooted the progression toward appreciable distance takes weeks for some, and months for others. Avoid rushing this! Should you be able to get through two miles on your first time out, prematurely exposing your tender feet to the harsh world, you could be rewarded with deep blood blisters, surface abrasions, and aching and burning sensations that can last for more than a week. That’s hardly encouraging. You might erroneously conclude that barefoot is not for you. Frequency, not duration, is your key to successfully adding barefoot to your training. Rx: Run a city block every day for a week. Then run two blocks for two weeks. Run three blocks for three weeks, and so on. Get the feel for barefoot running, step by step and give your bones, muscles, and soles of your feet the months of time required to sufficiently develop and strengthen. Your body will adapt at its own pace.

By the way, Andrew Weil, MD, in his audio book Breathing: The Master Key To Self-Healing, describes one of his patients who, suffering terribly from stress and anxiety, was prescribed specific breathing exercise to elicit his desired calm and relaxation. Though it took several years of practice before the patient would realize the full internal peace he sought, he did eventually succeed in taking charge of his own state of mind instead of turning himself over to passive, anesthetic treatments. My point is, however long it takes, it’s worth your time and effort if you can learn to more comfortably run without restrictive, numbing, and gait-altering shoes.

Choosing Your Path

As you weigh the evidence on both sides of the argument, and perhaps apply Occam’s razor— the simplest solution is probably correct— you could very well determine for yourself that shoes are an unnecessary necessity. Or not.

I don’t really expect that you will throw away your shoes for good and now only run barefooted. Indeed, because of additional traction, protection from ground-surface heat, the occasional bottle-cap, or piece of broken glass, or the unknowns of nighttime running, a light, flat pair of shoes is probably a good idea. (So is looking where you’re going.) Nonetheless, the compelling reason for you to include unshod sessions in your training is that barefoot supports and generally strengthens your feet, and therefore your fitness, overall.

Without admitting they got it wrong all along some shoe companies have hopped aboard the barefoot bandwagon with various iterations of minimalist footwear. Some are vast improvements over ordinary running shoes while others are just more of the typical bells and whistles. Remember, less is more.

For what it’s worth, when I run barefooted I prefer to run without shoes. When I do wear shoes for running I’ll use the Vibram Five Fingers, Classic. Their new EL-X model looks like a promising model, too. In triathlon, for speed of transition, I’d choose a racing flat that would just quickly slip over bare feet. Besides consuming precious race time, putting feet into socks is doubly confining and restrictive. When I do wear socks I choose Injinji five-toe socks to keep my digits free inside of motorcycle boots and dress shoes. So to sum it up, instead of cultivating fragility and weakness by wearing shoes, my aim in runnin’ nekkid is to celebrate what Leonardo Da Vinci called a masterpiece of engineering: that is, the human foot.