Daniel Lieberman from Harvard has said it best, “How one runs probably is more important then what’s on their feet, but what is on ones feet may effect how they run”. This is my point exactly. Running shoes in my opinion are not much different in regards to preventing injury than the shirt on your back. The rate at which running injuries occur has not changed since the 1970s which is evidence that the current paradigm of treating these injuries or preventing is not working. This also includes the use of running shoes as we know them today (Yeung SS, Yeung EW, Gillespie LD. Interventions for preventing lower limbsoft-tissue running injuries. Cochrane Database Syst Rev. 2011 Jul6;(7)) If you are having issues with injuries etc, you may need to reset and go back to basics and learn how to run without relying in shoes and then find a shoe that “lets” you run.
In continuing on with this particular case, here are the X-rays that everyone was asking for in their comments. I drew lines to help demonstrate the structural changes which occurred and what we typically look at when reading an X-ray in regards to angles and arch height.
The blow images were shared with me by podiatrist Dr. Emily Splichal. They demonstrate the effect of how a strong abductor hallucis muscle can pull the big toe into more of a medial and anatomically correct position. So as one can see, if you strengthen the abductor hallucis muscle it will help to reduce a bunion deformity where there is angulation of the big toe occurring in the opposite direction of the muscle’s force. Anecdotally we see this in those who have had bunions and have then transitioned to barefoot activities as well as running in minimalist shoes. This is contrary to the prior belief that wearing orthotics will help to prevent the formation of a bunion deformity, which by the way is also anecdotal. The premise for preventing bunion formation with orthotics comes from the idea that reducing pronation with an orthotic device can prevent hypermobility to the first metatarsal. Studies that demonstrate this fail to exist.
In summary, I am not saying that barefoot running will fix an injury or prevent one. The point we are trying to emphasize is that relying on a shoe to fix or prevent an injury is not supported in literature. There is no evidence based medicine to use running shoes to prevent or fix injuries and this has been demonstrated more then once in peer reviewed literature.
Dr. Campitelli is a podiatrist in Akron, OH specializing in foot and ankle surgery with an interest and enthusiasm for running as well as helping runners with injuries. For the past several years he has been treating running injuries in patients by fixing their form and transitioning them to minimalist shoes. Having treated runners with all types of injuries through conservative measures with orthotics and shoe gear changes to reconstructive foot and ankle surgery, Dr. Campitelli has brought what works best and is most current to his practice as well as the Akron and Cleveland running communities.