Finally! Here's the Roundtable discussion from UKSEM as heard from the Front Row at the Excel in London on Friday 25th November.
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(from left) Ross Tucker, Dan Lieberman, Matthias Marquardt,
Benno Nigg, Simon Bartold, Dan Howell |
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| Simon Bartold & Dan Howell in deep discussion |
This is a faithful transcription of what was heard. All three and a half thousand words of it.
The Experts involved in this discussion were:
(DH) Professor Daniel Lieberman, Evolutionary Biologst, Harvard University
(BN) Professor Benno Nigg, Biomechanics Professor, University of Calgary
(MM) Matthias Marquardt, Natural Running Coach & Physician
(SB) Simon Bartold, Australian Podiatrist & ASICS Global Research Consultant
(DH) Professor Dan Howell, the ‘barefoot professor’ of Anatomy, Liberty University
(RT) Ross Tucker, PhD, Self-Employed Consultant in Sport Science including SA Rugby & adidas
Other abbreviations:
BF = Barefoot
FF = Forefoot
RF = Rearfoot
GRF = Ground Reaction Force
TA = Tendo Achilles
Tib Ant = Tibialis Anterior
Tib Post = Tibialis Posterior
Opening Question:
"If a runner picks up a magazine or newspaper, they are seeing the following statement: 'Shoes are evil. They do not help, they may even cause injury. Barefoot running is natural, and will help prevent injury, and therefore everyone should be encouraged to run barefoot'. Do you buy or sell this concept?"
Discussion on Advantages & Disadvantages
Advantages of:
BF –
We don’t wear gloves on the hands all the time (DH)
SHOD –
Protection & Performance (SB)
NEITHER –
We don’t know – no evidence for either (BN)
BOTH –
Protection is advantage for SHOD running on streets (MM) but natural surfaces like grass, golf courses useful as advantage for BF for strengthening feet (MM)
CHANGE THE QUESTON –
BF running as natural as breastfeeding (DL) & this debate demos how out of touch with our bodies we are & we have done some things what we are not evolved to do (cereal in cardboard box/air travel/antibiotics) so the question should be about being human?
How will the debate evolve in the future?
(SB)
· How do we do the research is the key issue? (SB)
· "If I were to design an experiment to test barefoot running, where a group of runners will do 45 minutes of barefoot running, would my University's Ethics Committee approve that research?".
(RT) Response: The answer of course, is no, unless they didn't know any better, because we know that 45 minutes of barefoot running in a population of shod runners is guaranteed to cause injury!
· If Protocol going to be previously SHOD runners 45/60 x3 week BF for 6/52 –will not get through ethics commitees
· Simon Russell study had exclusions that make it shaky data
(BN)
· 2 Questions
- FF landing & RF landing
- BF running & shod running
· Internal forces are important – Internal Forces for FF landing & RF landing are THE SAME
· FF loading TA but RF landing Tib Ant loaded
· Difference internal active impact forces during landing & midstance are 4-5x bigger
· If forces are the reason for injury in running then the active phase of the ground contact is important rather than landing forces
(DL)
· Injuries are multifactorial
· We still don’t understand what causes most running injuries.
· What happens on impact for BR is that it hurts! Therefore some mechanism possibly stopping the runner from hurting may be present but not proven even literature is divided
· Running Form may not land on heel as this form of running is seen by the body as having different signal to rear foot landing which may intuitively not be
· Bone becomes stiffer at higher rates of loading (Hysteresis) therefore when energy is lost as light, heat or movement during fast rate of loading it may be more injurious as the movement that occurs as result of this may be an aspect of injury in running
· It is a complex area! No one solution. But it is more than how you land, and running involves posture, cadence and form-this needs to be addressed as to how you use the body when running not just landing
· We have learned about diet, and just as we have applied this evolutionary logic , then the current null hypothesis *that everyone in the world wears shoes and this is the normal situation disprove the use of shoes* may need to be addressed for the right study question to be asked
(MM)
· The researchers have the job to find the solution for running injury problems
· Never going to be the one solution
· Always the same Question: Does it help, will it not help?
· Evolution of the debate has gone through three phases:
- 30 years ago: cushioning was the hot topic
- 20 years ago: medial posts
- Now: Natural running?
(DH)
· Null Hypothesis is key-natural versus ‘normal’, nobody is ‘normal’
· 2 people in the panel said : “we need shoes” (& they were wearing shoes) – this is the ‘World View’ opinion
· DH however has been spending 95% of past 6 years without shoes
· DH does not believe those speakers need shoes
Is natural always better?
If you have an infection you need (unnatural) antibiotics, so is the ‘natural’ viewpoint about barefoot walking valid?
DH
· does not walk with hands & does not listen with his eyes therefore some of these comparisons made by panellists are spurious
(DL)
· Humans are adapted to walking BF.
· Calluses are basically all you need – these are the form of adaptation required
· 30-40000 years old shoes have been found but archaeological records alas don’t always have shoes which don’t survive
· Hunter Gatherers will often make simple sandals out of animal skin
· The Tarahumara Indians were the tribe of runners described by Chris MacDougall in ‘Born to Run’ but they would wear simple shoes
· Shoes are therefore ‘normal’ as well as being BF!
On what individual basis would Podiatrists prescribe footwear?
(SB)
· Motion control or Cushioning main difference between running shoes
· This does not recognise the individual variability in runners
· Prescription however takes away the individual as it is an imposition by the practitioner
· The reason that runners get injured us the same repetitive load pattern
· 60% of runners get injured
BUT 85 % of badminton players get injured
Therefore humans get injured!
· Irene Davis demonstrated greater acceleration forces on FF strikers
Did we evolve to be Barefoot?
(Dh) yes
(SB) no
(DL) yes
Discuss the Biomechanics of running
(DL)
· HS involves far higher effective mass with exchange of momentum (although not the entire body coming to dead stop)and data since the 80s shows a higher effective ass on RF strike, although some RF strikers have a higher effective mass than some others, and some of the body comes to a stop, but not all
(BN)
· Effective Mass is our baby (University of Calgary) & something you can measure-it can be calculated
· Quantify the GRF when we cannot measure it
· Effected mass multiplied by the acceleration of the tibia you get the effective mass – nothing to do with the loading of the joints
· The joint loading needs the wobbling mass model (published in the Journal of Biomechanics) and has the wobbling masses move out of phase with the bone and can be calculated to estimate forces
· What is the benefit to discuss effective mass in the running debate - there is none?
· The GRF has been measured – use inverse dynamics and calculate up the body
(DL)
· Effective Mass is about GRF and nothing less (just base physics)
· But what is the effect of this? We have much to earn. From Newton’s third law that for every force there is an equal and opposite force this is important.
· Also the wobbling mass question is around what will occur as this happens?
(BN)
· The impact peak in GRF was not present anymore in experiments at hip in running
(DL)
· Strong studies with tibial acceleration forces & GRF
· GRF and forces in the head have also been published demo different data sets with some asking of the shockwave to GRF
(SB)
· Concerned that people can access the website and get an unfair analogy of a static model that is communicated to the public (from the Dan Lieberman website)
(DL)
Honest faith effort to make open an analogy to help people understand complex mechanics
(MM)
· Tried to sort some of his own problems by running BF, which sorted some problems out.
· Also damaging to feet is when there are stones on the pathway, or concrete or rocks lying around, or getting cold in the snow!
1. More of the debate could be about what is in the shoes that makes BF runners not want to use them
Cushioning
2. Medial Support
3. Thick midsole & unflexible – or deep flex groove instead that brings the shod runner closer to natural?
4. Heel RAISE – the higher the raise, the greater the pelvis tilt & the biomechanical effect on the bend of the knee on hitting the ground
(DH)
· Agree that walking & running is complicated from biomechanical perspective.
· If walking & running is so complicated then why add an alteration device to the shoe to make unnatural (and generally negative) changes –all day and every day – this widens the debate
· Why run BF for 30-40 minutes but you walk around in shoes which you have spent the recent past in?
· What about the daily routine?
· AT least 50 miles walk as a form of rehabilitation
· Toe springs/arch supports should not be used.
· There ARE times for shoes –like running in certain terrains and conditions,
· How can we build a shoe that assists and segments the natural foot/form?
(BN)
From the start:
· Impact forces are dangerous – cushioning required to cushion these forces.
· Went out to prove that.
· Impact force peaks are always about the same. Irrelevant whether shod or BF.
· When you run faster the impact forces increase.
· When you run a certain speed they are about the same:
· Therefore impact forces are not necessarily the issue-otherwise faster runners would have injuries as a result of the impact forces being higher.
BUT
· The marketing argument of cushioning is flawed and there have been no studies published : these demonstrate impact forces and higher loading rates do not show conclusively that there are more injuries due to impact forces
· If you know where you land you adjust immediately and adjust resonance and are less injured than if you don’t know where you land
(MM)
Would anyone take a shoe for marathon without concrete?
(DL)
If there is no impact peak then it does after what the surface is made of but how rough it is?
I there a cost to running softly n hard ground?
(BN)(DL)
Yes there is –particularly under fatigue.
Cirque de Soleil
30% of actors not able to participate in their productions.
Surface was built with a very compliant surface –land on beam the suface was hard, between the beams it would deform by about 2cm.
The young actors were being injured-they did not where they woud land and preacivate their muscle therefore not prepared to dampen high vibrations so they had high vibrations and had injuries at the insertions.
Smooth and hard surface was created-three weeks later the injury rate was down to 2 to 2.5 % (which was more normal rate) and the actors had employed muscle tuning to dampen down the vibration
(SB)
· 1981 first questioned study on the cushioning yet footwear companies still putting these into their shoes & still putting anti-pronation devices into footwear(which don’t work anyway)
· Alchemy for shoe company: These minimalist shoes would be a lighter shoe in a protective package
Where’s the research into supporting SHOD or BF running or minimalist footwear reducing injury?
(BN)
· Effect in principle were same for minimalist shoes
· Concept was different for the three shoes with some study data into reduction of injury:
- MBT bulky shoe
- Adidas feet you wear inside of shoe
- Nike Free mimics the foot
· Many different strategies and concepts
· 2 tear study double blind with basketball players had a reduction of 30% injuries
(SB)
· Clincians NOW could be well advised to look at:
- Minimalist footwear
- Change running form
- Some BF running
- Change your training plans
· Question for clinicians is “what is the problem with the runner in front of them-higher up the body what is occurring?”
(DL)
· The form is much more important than the foot?
· How do you run?
· How does the shoe affect the foot when you run?
· Running should be seen as a skill.
· Forget the foot & shoe, what about the form and how it’s taught?
· Some of the proprioception from the foot is blocked even in minimalist footwear-this may be an advantage of BF running even as a useful way of ‘relearning’ how to run even if it is not all the time
(MM)
Leaving the shoe behind as a tiny part of the debate – other aspects of the debate are:
· Athleticism
· Training Regime
· Running Technique
· Motion Analysis
· What happens in the pelvis & spine & the shank?
BUT
· Same discussion again as there is no evidence either!
· Difficulty when faced with runners as to what advice could be proffered?
Questions from the Audience?
Overstriding
(DL)
· BF runners will not FF strike the whole time but the key detail is high moments around the ankle hypothesising TA & calf strains, therefore the advice that landing with less of an overstride & with the foot more under the knee and hip may be more beneficial but there is less understanding of this form of running
Any research into non-natural running styles?
(DH)
· If you want to graduate into minimalist shoe then start with BF natural running.
· Are injuries from people who don’t land the way they feel most comfortable and instead get injured by
· Don’t start on grass
· Start on pavement BF doing what you feel is natural! What your body feels is natural.
· DH feels that in the transition from trainer to minimal you are still not striking the ground. If BF, the skin is tender and will make you slow down which gives you information on the strike and the skin then adapts quickly over weeks, muscles adapting over months & bones adapt over years. This is a better form of natural running.
Vibrams as a progressive move towards BF running?
(SB)
· There is no definition of form for minimalist or even transition.
· Congratulates DL on the transition advice on the previously critised website!
· There is some risk as no one knows how long the transition will take.
· Also some care required from a manufacturing perspective as material response has made certain thing much more possible with a lighter more minimalist shoe by SH’s definition of function
(MM)
· Experience in Germany with many years of running and coaching experiences
· Start transition through walking then 10/60 running maximum to start with
· Commence on the grass then move onto asphalt/concrete
What about starting on uneven ground for NM adaptation as means for transition?
(DL)
· The risk is repetition of exactly the same running on a consistent surface such as asphalt or concrete
· It is possible for Trail Running in a city = running along the Thames this am by DL!
· Treadmill - Every step is exactly the same which is likely to be injurious?
Best runners in the world? Should we look at these runners as the poster boys for long distance running and do they do mostly midfoot or forefoot stance?
(SB)
· Statement is untrue. Mixture of runners are in world’s elite!
· If speed is the key then then a FF or MF contact but land under your COG is more likely to be beneficial.
· If injuries are the key then need to look at the indivisual and their athleticism and form.
· (BN)
· 83% is the number of Mid or FF who land in a marathon group of 10000 in a typical marathon.
(debated by MM & host)
· Pete Larsson has suggested this is not the case (runblogger.com)
· Japanese study has determined the back of the heel is advantageous.
· Optimal strike is different for different styles-can be measured on treadmill
(DL)
· Don’t be too concerned about the elite runners-analogy, would eb watching what the supermodels.
· We have evolved to make animals gallop
· Elite just distorts the issue – why would we worry about efficiency? Many people are running (for fitness) to lose energy & NOT be too energy efficient
· Elite end is just 1% of all runners
(SB)
· Not everyone wants to be an elite runner
· Cyclists don’t overanalyse unlike the running community
The ABC Of Running – can you explain to (MM)?
(MM)
· This is a traditional part of the German training process and the traditional name for technical moves
· Co-ordination training
· Core Stability
· Flexibility
· Stretching
· Technical Training (the ‘ABC’)
Is it just a question of function as to whether some people function better in BF environment or Shod one?
(BN)
· In process of measuring different muscles around ankle to join to strengthen them
· BF running or Shod running uses ‘about the same muscles’
· Running with lateral side shuffling –double muscle activity and double training effect of these muscles – so need forward actions AS WELL as lateral motions
(DL)
· We evolved to be hunter-gatherers rather than sitting all day long then exercising in the gym!
· Just doing running as our only form of exercise is also abnormal
· Evolution gives us a balanced perspective
· We have grown up in an abnormal environment
· “Mismatch hypothesis”
· 25% pes planus
· 33% myopoic
Aren’t your feet just always cold when BF?
(DH)
· Adatation.
· Your feet adapt to different temperatures.
· Shoe is a tool ( for deep cold) and personally DH choose a moccasin with no insole as his footwear of choice for protection
· BF studies could be seen like a study of piano players habitually wearing gloves to play piano having a small section removing these gloves to play
(MM)
· 15 years ago attempted to be BF but could not adapt fully to cold
· Also felt cycling without shoes difficult to manage
(DL)
· Evolved to walk BF in tropical conditions, not to run BF in New England or Winter in England
(DH)
· If he (DH) is to get people to be BF 50% of the time he appreciates that he needs to be BF 90% of the time
(SB)
· 50% of the population of Western Society with Diabetes Mellitus – this is a risk for BF running
(DH)
· Warning about Late stage Diabetes Mellitus when unable to feel the surface
· Going BF if they can feel the ground it improves the circulation
(MM)
· Stressed that in Diabetes Mellitus then BF running should not be recommended recognising that with 1st contact with ground there a sensory function about that ground reaction moment
(SB)
· In agreement with that statement
(DH)
· Perhaps this might be a situation where shoes are used, but the BF population has examples where Diabetes Mellitus has been ‘improved’ with BF
(DL)
· Adult onset Diabetes Mellitus should not be happening today but occurs with diets we are not adapted to & with too little exercise is the problem: running & exercise should be encouraged
RT thanked all of the speakers as he brought the Roundtable Discussion to a close & directed them to the media lounge.
The main rationale is enhancing trade links with their principle partners of Asia and Australasia rather than North America - which was the reason for bringing themselves into the time zone with the US at the end of the 19th Century in the first place.
He is the strongest link between the two great countries of Scotland & Samoa. 
He died of a cerebral haemorrhage aged 44. The local Samoans surrounded his body with a watch-guard during the night and carried it upon their shoulders to nearby Mount Vaea where he was buried overlooking the sea.
He died of a cerebral haemorrhage aged 44. The local Samoans surrounded his body with a watch-guard during the night and carried it upon their shoulders to nearby Mount Vaea where he was buried overlooking the sea.
