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”.