It is a condition that I often see from comments in forums that is frequently mismanaged. I do spend a lot of time on it at my Clinical Biomechanics Boot Camp course and like to tell the story about how I used to hate seeing it as my success rate used to be close to 100% failure; now its close to 100% success. The change was that dramatic once i realized what was going on with it; hence my reason for writing the blog post that I referred to above.
I have pretty much been running on and off my whole life. As of late, I have struggled a lot due to workload issues to find the time to do as much as I would like and an old injury with a bit of osteoarthritis now. I do plan on getting back and running another marathon within the next few years if I can, but let’s just wait and see.
I have had a lot to say about running (I obviously have a blog on running) and running shoes are no exception. Usually, I have run in what is the most traditional running shoe of the time. Lately, I have been mixing it up. The evidence does support having more than one different shoe in the rotation to mix things up to load different tissues differently. This does seem to have a protective effect for injury.
Recently I have tried a couple of unusual shoes and am aware of another in the mix.
I do some of my runs in the Airia One’s and have blogged about them. This is a shoe with a lateral slant in the forefoot, zero drop and a large toe spring. It certainly makes you run differently and use a different set of tissues.
I also recently got a pair of Enko’s which is spring loaded in the heel. Running in them is certainly a very different experience. I see a lot of anecdotes from people who had to give up running, now able to run because of these shoes. What I find intriguing in social media about these is the number of negative comments from those who have not tried them … go figure that one out.
The third shoe in the mix is the Ampla which has a spring loaded plate on the forefoot to help encourage you to run on the forefoot rather than heel strike. It came on to the market at a time that all the rhetoric and propaganda was that heel striking is evil and everyone should be forefoot striking. Turns out all that rhetoric and propaganda was wrong, but that has never stopped people in the past.
One thing I do find interesting about these “tech” shoes is the criticism of them in social media from those who have not even seen them, let alone tried them.
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.
This is something I find myself writing about a lot (here, here and here)
In a lot of those articles I refer to Kevin Kirby’s excellent video and you really can’t go past it for a description and an explanation:
It is a common finding, commonly associated with overpronation and also commonly confused with a medial heel whip. There is a lot of confusion between the abductory twist and the medial heel whip, especially in social media commentary. They are not the same thing. They are two very distinct and different phenomenon. The abductory twist is what is in the above video. A medial heel whip is something that occurs after the foot is off the ground.
I have actually given up responding in social media to those who are confused between the two. Move on.