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Monday, December 5, 2011

D1 Bham's Doc Connor Blogs on Vibram 5 Finger Silliness

Check out the blog below on the Vibram 5 Finger shoes from D1's orthopedic doctor down at D1 Birmingham, Dr. Geoffrey Connor MD.

Today: The Vibram 5 fingers.
Where to begin with this silliness? If you haven’t seen them here is a pic (to be fair, this example of the many versions looks more like a water sock others are a bit more sturdy) . . .

In my opinion the five fingers is really the visionary design (along with well-noted publications referenced below) that have given rise to the current minimalist shoe fad (many variations and manufacturers have since caught on as well). The idea here is that the shoe simply gives a minimal amount of protective padding to your God given natural foot. Beautiful. Simple. Elegant. It’s God’s design after all, right?
Fine. I think these things are neat, if a little weird looking.

What bothers me about them, however, is the somewhat fanatical following they have created among a sub-set of runners and others, and the erroneous logic applied to their use in multiple sports or everyday life. The publication that most minimalists refer to as their bible is Born to Run by Christopher McDougal.

In a nutshell, the book tells the remarkable story of a pre-historic tribe in which the men are known for their amazing running capabilities using little more than a thin strip of protection strung to the bottom of their bare feet. Interestingly, in order to accomplish such prowess and durability, the runner must shorten their stride and strike the ground with equal force applied to the forefoot and hindfoot, and then push off with the forefoot. This is not a natural stride for the uninitiated.

Despite anecdotal evidence that certain groups of tribesmen have a shortened stride and strike and push off on the balls of their feet, this is actually a mechanically and energetically disadvantageous maneuever which eliminates the God-given lever arms created by the calcanues bone and the Achilles and Extensor hallucis longus tendons. The biomechanics of the human gait are complex, but it boils down to this: countless and age-old studies confirm man is made to heel strike as first contact with the ground in a normal stride. Much of this research was done in the early 20th Century at the dawn of the motion picture era by Etienne Jules Marey. You can see much of it here.

I would also submit, that the average Central American or African, pre-historic tribesman is a smaller person with a substantially lower daily protein and caloric intake, subjecting the foot to far less per stride stress than a 21st century North American. Meaning, if you are a lithe, fit, distance runner, minimalism may be the way to go. If you are an American Football linebacker it is not.

It is also my opinion that the independent sleeves for each toe are meaningless. “Barefoot” running can be accomplished without this feature. To be clear, this is my opinion only, not based on any particular evidence. There are runners who tell me that this design gives them a better “feel” for the surface.

I have already seen anecdotal evidence in my clinic a disproportionate increase in peroneal tendon and tibialis anterior tendon issues as a result of using in the 5 fingers for both running and other sports. There could be a number of reasons for this, but it is likely that running in these “shoes” without adequately adopting the shortened, padding gait could be a significant factor. It is also, as noted, likely that endo and mesomorphic individuals have no business wearing these shoes. Based on some reading that this is being attempted, I am a surprised that I need to add that minimalist shoes and bare feet have absolutely no place in a weight room or contact sports. For accomplished distance runners, ectomorphs, running for speed (let’s say under 7 minute milers) minimalist shoes may indeed be a great idea, but, in the final analysis, for the majority of those running for cardiovascular fitness, it is unlikely that minimalist “shoes” are the way to go. For the guy shopping in Wal-Mart in these things, I think you just like attention; try a rainbow afro-wig, it’s much safer.

At the end of the day, humans are built to be highly efficient, unparalleled walkers. Distance running is something that comes a bit unnaturally – we force it. We are built to be decent at running in short bursts, but most mammals built for prolonged speedy running have hooves. I tell my marathoner patients frequently (usually when treating stress fractures), “You do realize that the greek runner at the end of his run from Olympus to Marathon died, right?” (I can hear the minimalists now, “Those stress fractures are created by those clunky hunks of rubber and plastic on your feet!”)

If you’ve never tried minimalist shoes before, I suggest you start slowly. Work on the stride pattern in your usual shoes. Wear the minimals for short runs at first. Do not try to go out for your usual multi-mile run and try to incorporate this all at once. Also, please make no mistake, I have always been, and will continue to be an advocate of running for the sake of cardiovascular fitness. I think it has no equal in this regard. But, for most neophytes and novices, wearing well-fitted traditional running shoes with appropriate orthotic supports for foot type will be the best method to avoid injury.

CLICK HERE to also check out Doctor Connor's website.

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