This is something I have a lot to say about and talk about a lot during the Clinical Biomechanics Boot Camps. The main reason I like talking about it is that it is something I used to hate seeing. The % of successful outcomes with conservative treatment was almost always pretty close to 100% failure. Surgery was always a good option to send these people of to. That was until this study and discussion here. Transitioning a runner from a heel strike to more of a forefoot strike and shortening the stride length to increase cadence now has a pretty close to 100% success rate! I like talking about that.
However, what makes it interesting is considering this in the context of how much evidence is needed to change clinical practice. As all we have is that one small study, which has no control group (but the results were dramatic) and a biologically plausible and theoretically coherent mechanism. I like to ask people is that sufficient to change clinical practice? Theoretically it should not be. In a perfect world, clinical practice does not change until there is enough randomized controlled studies to be combined into a meta-analysis to show that we should change practice. Unfortunately, the real world and clinical practice does not work that way. This study on anterior compartment syndrome makes for an interesting discussion point on my courses.
I have been talking about this as part of the Clinical Biomechanics Boot Camps for many years now. What is really flattering is when a participant in one of those courses contacts me down the track to say they tried what I suggested and it works. I like talking about that.