New Barefoot Running Study Did Not Follow Proposed Transition Recommendations.
A recent study published ahead of print in Medicine & Science in Sports & Exercise suggests that “Vibram FiveFingers Lead to Greater Risk of Foot Bone Injury”. The problem with this is that the guidelines the authors established did not follow the recommended slow transition they proposed is needed to prevent injury.
To begin with, starting with 1-2 miles is way too much too soon. Regardless of a runners experience if they’re wearing traditional running shoes. Anyone familiar with the 10% rule of increasing exercise amount and intensity would clearly understand this. If you normally run 3-6 miles then its .3-.6 miles for you first 1-2 weeks of running. Not 1-2 miles. So I would expect edema from stress reaction.
Secondly, this line sums it all up.
After the third week of running, subjects were advised to add mileage in the Vibram FiveFingers as they felt comfortable, with the goal of replacing one short run per week in traditional shoes with a short run in the Vibram FiveFingers.
You could be feeling comfortable but injury could be occurring. Remember, overuse is the number one cause of running injuries. Short is subjective. And 3 miles is LONG for someone who has never ran this way before. It should take 6-8 weeks to hit three miles NOT THREE WEEKS.
The runners clearly did not follow the recommendations I gave to Vibram USA who prospered a running brochure 2 years ago. Anyone who has read my text will see this study did not follow the proposed protocol that I have implemented. At the Kent State University College of Podiatric Medicine, we put 12 runners through 6 months of running in FiveFingers and none of them were injured in our recent study with data yet to be revealed.
The methods these runners followed in my opinion would without a doubt put a runner at risk for injury and would not need any imaging studies to support this.
The other thing to consider is that we don’t frequently MR foot pain unless we suspect stress fractures so this could be adaptive changes. This means that we don’t consider edema normal as we simply have enough asymptomatic changes to compare this to. So basically there could be a lot of individuals with edema that could considered normal but we call a stress fracture.
Further more, anyone who is familiar with Wolff’s Law would understand that bone responds to stress. In order to surmount this stress you need increase blood flow. With increased blood flow you see edema -medullary edema. This study should be titled, “Objective Findings in Runners Offer Further support for Wolff’s Law”.
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About The Author
Dr. Nick Campitelli
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.
Thanks for sharing a more cautious and realistic transition process. I’ve been slowly transitioning to a Merrell Barefoot shoe from a heel striking pattern and standard shoe and this will be a good tool to use to pace myself. Enjoy the blog!!
Thanks for sharing a more cautious and realistic transition process. I’ve been slowly transitioning to a Merrell Barefoot shoe from a heel striking pattern and standard shoe and this will be a good tool to use to pace myself. Enjoy the blog!!
Keep working ,terrific job!
Hello Dr Nick and thanks very much for your informative work! I have purchased your text and understand the transitioning game-plan to Five Fingers, but have a question.
My achilles started hurting months ago when I started to transition to five fingers and I definitely tried to do too much to fast. I hadn’t read your book yet and that was a mistake. I took a lot of time off to get better and life got in the way as well and I haven’t ran for 8 months. I’m ready to get started again and since I do not have any routine at the moment, should I still try and transition out of old running shoes or can I just start fresh, slowly with my Five Fingers exclusively? I’ve been doing calf drops to strengthen my calves and am jumping rope as well.
If I can start exclusively with my Bikila’s, would it be ok to start with your Sample Program 20 Miles/Week schedule and only run the “Miles in Minimalist Shoe” mileage and stop? Would that be a good schedule to start? Attempting to get to 2 miles in 8 weeks and then follow the 10% rule forward? My goal is to get to race a 10k eventually but not until I’ve transitioned properly.
Thanks very much for your help as I’m eager to get back to running but want to have the right schedule to do it right this time.
Jess
Thanks for following Jess!!
I’m glad your eager to get back to running, and I think that by focusing on your form you will love running even more!
I would advise running a bit more then just the miles outlined with your minimalist shoes, but would do so in a pair of shoes with so e cushion and support (Cushion more important then support). Basically follow the program but not to the extent of total mileage since your not used to running 20 miles a week. Maybe cut in half. But not all in minimalist shoes! Put your older shoes back on for rest of mileage. If you feel good after a week or so, you can ad miles, but most likely miles in traditional shoes. Always adhere to the outline of minimalist shoe miles.
Listen to your body and worry more about form then shoes.
Good luck!!