Barefoot Running bad

Author: Craig

  • Do barefoot runners fly in aeroplanes?

    We have all seen one of the arguments that they love to make to support barefoot running. The argument goes something like: We were created to run barefoot. We are not born with running shoes. Because we were created that way then we should run barefoot. You know the story that they try to tell.

    We weren’t created to fly either, but we get in planes all the time. There are a lot of other things that we were not created to do, but still do. Are barefoot runners going to give up flying and all these other things?

    Do you see the absurdity of their argument? I bet that they won’t see it this way, as they like having it both ways (see: The lack of evidence for running shoes? – you can’t have it both ways!). They like being extremely critical of research that does not support their cause, but then do not apply the same standards of evaluation to research that supports their cause (see Intellectual Dishonesty). You can’t have it both ways.

    Either barefoot runners have to give up this nonsense argument that we were created to run barefoot or stop getting on planes. You can’t have it both ways.

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    Credit is due to this thread at Podiatry Arena for the idea for this post.

  • The lack of evidence for running shoes? – you can’t have it both ways!

    Who can remember the media flurry and hype on barefoot running sites when Craig Richards published his systematic review last year: Is your prescription of distance running shoes evidence-based in the British Journal of Sports Medicine? Here is the abstract:

    Objectives: To determine whether the current practice of prescribing distance running shoes featuring elevated cushioned heels and pronation control systems tailored to the individual’s foot type is evidence-based.
    Data sources: MEDLINE (1950–May 2007), CINAHL (1982–May 2007), EMBASE (1980–May 2007), PsychInfo (1806–May 2007), Cochrane Database of Systematic Reviews (2nd Quarter 2007), Cochrane Central Register of Controlled trials (2nd Quarter 2007), SPORTSDiscus (1985–May 2007) and AMED (1985–May 2007).
    Review methods: English language articles were identified via keyword and medical subject headings (MeSH) searches of the above electronic databases. With these searches and the subsequent review process, controlled trials or systematic reviews were sought in which the study population included adult recreational or competitive distance runners, the exposure was distance running, the intervention evaluated was a running shoe with an elevated cushioned heel and pronation control systems individualised to the wearer’s foot type, and the outcome measures included either running injury rates, distance running performance, osteoarthritis risk, physical activity levels, or overall health and wellbeing. The quality of these studies and their findings were then evaluated.
    Results: No original research that met the study criteria was identified either directly or via the findings of the six systematic reviews identified.
    Conclusion: The prescription of this shoe type to distance runners is not evidence-based.

    This was greeted with headlines in the news media, on running forums and on barefoot running websites as evidence that expensive running shoes are bad (do you remember the headlines?). Can anyone actually see anywhere in this study where they actually showed that? This is just further evidence of the intellectual dishonesty of the barefoot running community that they would interpret the research that way and promote it as saying that.

    All the study found was that there was no evidence to support the prescription of distance running shoes. They found no evidence because there is no evidence as no one has done any good research on it! Just because there is no evidence for it, does not mean that running shoes do not help. It does not mean that they don’t either. Why did the barefoot running community take this as evidence that running shoes are bad?

    I have no problems with the study and agree with the conclusion. I do have a slight problem with the way the article was written and its tone as it was obviously written by someone with an agenda (the author is a barefoot runner and has a financial interest in a barefoot running product). However, I will not dismiss the study because of that. The barefoot runners with their blinkers on will love the biased tone that the article was written with!

    If a study did come out and did show that running shoes helped and was funded by the running shoe industry, how would the barefoot running community react to that? Would they dismiss it because the running shoe industry funded it? Are they prepared to dismiss the study above because it was done by a barefoot runner? Are they prepared to dismiss the Liebermann et al research because it was done by a barefoot runner and funded by a barefoot running company? It will be interesting to see how the barefoot running community react, as that research is coming.

    Despite claims to the contrary by the barefoot community, there is NO evidence that barefoot running is better than running in running shoes. How should we interpet that lack of evidence? Should we do what the barefoot running community did and conclude that barefoot running is bad as there is no evidence to show that its good? Can you see the absurdity of that conclusion? Well, that is exactly what the barefoot running community did in the way they interpreted the Richards review above!

    The key point is, you can’t have it both ways.

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  • Do running shoes weaken muscles?


    That is what the barefoot running community and the anti-running shoe community would have you believe.  You see this claim being made all the time on barefoot running websites, books and on running forums. We know that the barefoot running community are really good at all sorts of intellectual dishonesty, should we believe them on this one as well?

    Given the strength of the claims being made, you would expect there would be at least some evidence to back it up wouldn’t you?, but there is none! They only want to believe it to be the case as it helps their agenda. Certainly many individuals who start barefoot running claim that their foot and leg muscles are stronger – but are they really stronger? Or do they just feel different as the barefoot running gait is different? Or do they deceptively feel stronger because they want them to feel stronger? (see this post on why individual experiences are flawed).

    In the context of the lack of evidence either way as to if running shoes weaken muscles or not, what other information do we have that could guide us to some sort of rational conclusion rather than some uniformed nonsense due to the wearing of blinkers. What about foot orthotics? Do they weaken the foot? You certainly see it claimed a lot by those who have not read the evidence. Two studies have looked at muscle strength and the use of foot orthotics. One by Mayer et al actually showed the opposite and foot orthotics increased muscle strength! The other study that looked at this showed after 4 weeks of orthotic use that there was a non-statistically significant increase in strength, so certainly no signs of a decrease in muscle strength which I would have thought would start to show by 4 weeks if it was going to happen. Now, obviously foot orthotics are not running shoes, but despite widespread claims that foot orthotics decrease muscle strength, all the research evidence is that either they do not or they increase strength!. Can this be extrapolated to running shoes? Maybe? Maybe not? What this research does do is calls into question the unsupported claims that running shoes do weaken the muscles.

    Then there is the one EMG (electromyography) study that compared running shoes to barefoot. They found no systematic differences between barefoot or running shoes. Some muscles activated earlier in barefoot and some activated earlier in the running shoe. If the running shoes were weakening muscles, then why are the EMG studies NOT showing a systematic decreases in timing and amplitude of muscle activation? Certainly no sign of any muscle weakening here!

    What about the Bruggeman et al study that looked at muscle strength after runners were randomised to their conventional shoe vs the Nike Free (which is not really barefoot, but is a minimalist shoe). They showed what appeared to be an increase in muscle strength in the Nike Free group. I have no problems with the study (except a few minor issues and it was funded by Nike). But consider these two points:

    1. The study was NOTHING to do with conventional running shoes weakening foot and leg muscles (which strangely has been interpreted as showing that by some!).
    2. Why did the Nike Free group of runners get an increase in leg muscle strength? Was it because being close to running barefoot is a good thing? (this is the interpretation that the barefoot running community would like to put on it). But what about the opposite conclusion? Could it be that the muscles got stronger because they had to work harder in the Nike Free shoe? Increased muscle activity is a bad thing as it is a sign of an inefficient gait. If the muscles are having to work harder, then performance will be affected. Surely that is a bad thing? Strange how the barefooted community with blinkers on can draw one conclusion when there are other possible conclusions that can be drawn.

    Conclusion: We actually have no idea if running shoes lead to weaker muscles or not. However, if we want to extrapolate the orthotics and the EMG evidence, then it could certainly be suggested that they do not. There is certainly more information pointing to running shoes not weakening muscles than the nonsenscial and unsupported claims by the barefoot running community.

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  • Where are all these impact injuries that runners are supposed be getting an epidemic of?


    Again, this is something that only exits in the minds of the anti-running shoe lobby. I have already shown how they have misused the research to scam us into believing that there is no decrease in the rate of injury from the alleged improvement in running shoes over the years. Some have even tried to claim there has been an increase. They are making this up as there is no data to support it.

    Libermann et al in the first sentence to his paper on barefoot running says “Running can be most injurious at the moment the foot collides with the ground”. I notice that they supplied no citation to back this claim up. In that work of semi-fiction, ‘Born to Run’, Chris McDougall makes numerous unsupported claims about impact injuries. Robbins et al in their editorialization of what is otherwise good research, talk about the sensory illusion that soft running shoes can cause alterations in impact behaviours and this makes running shoes increase the risk for impact injuries in runners. I could go on and cite many more examples and claims that get made about impact causing injury in runners.

    What do all these claims and the many more numerous ones have in common? They don’t even tell us what an impact injury is. They provide no evidence of impact even causing overuse injuries in runners. The reason is because there is no such thing as impact causing overuse injuries in runners! They are all making it up and perpetuating the myth! Why would they do that for?

    There is not one study that has shown higher impacts cause an increased risk for injury! (Obviously I am not talking about the extreme high impacts that might cause an acute fracture).

    What are the common injuries that runners get:

    Patellofemoral pain syndrome/anterior knee pain (Runners Knee) – none of the studies done on this have linked it to impact.

    Medial tibial stress syndrome (shin splints) – not one of the prospective risk factors studies done on this has linked it to impacts.

    Plantar fasciitis (heel pain) – not one of the risk factor studies have linked this to impacts.

    Stress fractures – none of the studies done on this have linked it to impact.

    I should not need to cite any more examples, as these make up most of the overuse running injuries. If you do not believe me, do this: Pick any injury. Do a literature search on the studies that have looked at what increases the risk for that injury. Notice how none of them find impact as a problem?

    In fact the opposite is the case. We need higher impacts from weight bearing activity to prevent osteoporosis and make the bones stronger! (The research evidence on this is unequivocal).

    Where are all these people getting their information from about the myth of impacts causing overuse injuries in runners and it reaching epidemic proportions? Why are they perpetuating the myth? Why are they making this into a problem? Why are they making up this epidemic? Is it because they have an agenda to promote and the myth suits their purposes? High impacts being a problem in runners only exists in the minds of those with an agenda.

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  • Why does the barefoot running community continually fall for this nonsense?


    I have already gone over how the barefoot running community generally misrepresented and misreported the Liebermann research and how they misrepresented and even lied about the Kerrigan research, so now let’s take a closer look at the online article that they all seem to quote as ‘evidence’ (and we all know that the barefoot running community does not even really know what evidence is).

    The article I am referring to this one by Michael Warburton that was published online as part of the online journal, Sports Science.

    Lets look at it. The article starts off with:

    “Well-known international athletes have successfully competed barefoot, most notably Zola Budd-Pieterse from South Africa and the late Abebe Bikila from Ethiopia”

    Off to a really bad start there, as we know that Abebe Bikila could run faster and break a world record when he started wearing running shoes and Zola Budd is now running in shoes!

    “in this review I will show that wearing running shoes probably reduces performance and increases the risk of injury”

    You will soon see that the author failed miserably in achieving what he claimed.

    “Where barefoot and shod populations co-exist, as in Haiti, injury rates of the lower extremity are substantially higher in the shod population (Robbins and Hanna, 1987).”

    This study on injury rates in Haiti does not actually exist. It was made up. Surely the fact that Robbins and Hanna did not cite a reference for it should have been a give away? Never let a little thing like this stand in the way of those who have an agenda.

    “This association between injury and wearing shoes is consistent with the possibility that wearing shoes increases the risk of injury”

    There is NOT one study that shows that. The ones cited by the author did not show that. Anyone reading those studies with the blinkers off can see that.

    “However, there have been several studies implicating footwear in the etiology of injuries in runners”

    Again, there is not one study that shows that. The author is being dishonest. He does present some studies that he claims support that, but they do not. Let’s look at them:

    “It is claimed that footwear increases the risk of such sprains, either by decreasing awareness of foot position provided by feedback from plantar cutaneous mechanoreceptors in direct contact with the ground (Robbins et al., 1995)”.

    Robbins et al never showed that, they just CLAIMED that in the editorial like conclusion to their research which not even on ankle sprains!

    “or by increasing the leverage arm and consequently the twisting torque around the sub-talar joint during a stumble (Stacoff et al., 1996). “

    That was a good study, but did not actualy show an increased risk for ankle sprains (it wasn’t even about ankle sprains!) and shoe design in the heel has changed significantly since the late 90’s, so this study is irrelevant to the authors argument.

    And besides, since when has ankle sprains been an issue for runners? It makes up less than 1% of injuries that runners get and I bet in the vast majority of those the shoe would not have been a factor, so the author really is barking up the wrong tree here.

    “One of the most common chronic injuries in runners is planter fasciitis, or an inflammation of the ligament running along the sole of the foot. There is some evidence that the normally unyielding plantar fascia acts as the support for the medial longitudinal arch, and that strain on the proximal fascial attachment during foot strike leads to plantar fasciitis (Robbins and Hanna, 1987). Barefoot running may induce an adaptation that transfers the impact to the yielding musculature, thus sparing the fascia and accounting for the low incidence of plantar fasciitis in barefoot populations (Robbins and Hanna, 1987).”

    Robbins and Hanna did NOT do a study on plantar fasciitis and there is NO evidence that there is less plantar fasciitis in barefoot populations, so I have no idea what the author is talking about here. If you look at all the prospective studies on what causes or increases the risk for plantar fasciitis, NONE of them have shown that this is a factor! The author is barking up the wrong tree again.

    The rest of the section on chronic injuries is equally nonsensical as it all focuses on the changes in impact moderating behaviour allegedly induced by running shoes and impact related injuries. The flaw is that there are NO injuries caused by impact. Not one study has shown that high levels of impact increase the risk for any overuse injury in runners (see this for more). So who cares if the shoes induce some sort of sensory illusion and affects impact moderating behaviour or not? Its not an issue, except in the minds of those with an agenda.

    The next section looks at performance:

    “Wearing shoes increases the energy cost of running”… “Flaherty (1994) found that oxygen consumption during running at 12 km/h was 4.7% higher in shoes of mass ~700 g per pair than in bare feet”

    Anyone see a problem with this? Running shoes now weigh half that amount, so the performance argument can’t be used anymore. Why do the barefoot running community continually trot this one out? Again, barking up the wrong tree on this one as well.

    So now lets look at the conclusions:

    Running in shoes appears to increase the risk of ankle sprains, either by decreasing awareness of foot position or by increasing the twisting torque on the ankle during a stumble.

    Wrong (see above).

    Running in shoes appears to increase the risk of plantar fasciitis and other chronic injuries of the lower limb by modifying the transfer of shock to muscles and supporting structures.

    Wrong (see above).

    Running in bare feet reduces oxygen consumption by a few percent.  Competitive running performance should therefore improve by a similar amount, but there has been no published research comparing the effect of barefoot and shod running on simulated or real competitive running performance.

    Wrong (see above). However, I agree with the bit I put in itallics, but we do know that no elite runners choose to run barefoot.

    Research is needed to establish why runners choose not to run barefoot. Concern about puncture wounds, bruising, thermal injury, and overuse injury during the adaptation period are possibilities.

    Surely research into why the barefoot running community continually promote bad research and get it wrong so often is more important?

    In the introduction to his review, the author claimed:

    “in this review I will show that wearing running shoes probably reduces performance and increases the risk of injury”

    Did they achieve that aim? Of course they didn’t!

    Why is it that the barefoot running community are so gullible that they continue to repeatedly fall for this kind of intellectually dishonest nonsense?

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  • Why do no elite runners run barefoot?

    What Mary thinks of barefoot runners

    If barefoot running was so great, then why are there no elite runners doing it? Why have no world records been broken when running barefoot? Don’t you think that every elite runner and their ‘staff’ have looked at everything that could possibily give them a competitive edge? Why have they chosen not to run barefoot? Even the elite runners from African nations who grew up barefoot choose to run in running shoes – why is that?

    The only elite runners that have run barefoot were Abebe Bakila (and we all know that he could only break the world record when he started wearing running shoes)  and then there was Zola Budd, but thats one out of how many over how many years? And even she has stopped running barefoot and gone back to running shoes, so I guess the barefoot running community can scratch her off their list of barefoot running pin-ups as well (that leaves them with no one!). As she told the Guardian:

    “I no longer run barefoot,” she said. “As I got older I had injuries to my hamstring. I found that wearing shoes gives me more support and protection from injuries.”

    I do know that a few elite runners do some drills barefoot, but do distance themselves from the exaggerated and nonsensical claims made by the barefoot running community, as well as the intellectual dishonesty.

    I did come across this message posted on Podiatry Arena by a barefoot runner trying to explain why elite runners do not run barefoot:

    “Why do most non-elite runners wear running shoes? It’s because of (1) multi-million dollar marketing budgets from running shoe companies – they had me for 20 years, and (2) Fear. Fear stoked by podiatrists such as yourself.”

    See how deluded these people are? Do you really think that elite runners and their staff are that stupid that that would fall for running shoe company marketing hype and fear stoked by podiatrists? These sorts of statement are insults to the intelligence of elite runners. Who would you rather want to believe: The eilte runners who go to great lengths to find every edge that they can or those nutters who make statements like that? Who do you think is more intelligent? Who do you think has deluded themselves because the ‘want to believe‘? Do you think they also wear tinfoil hats?

    If barefoot running is any good, then the elite runners would be doing it. Ever wonder why they are not? Surely this says something?

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  • The problem with n=1 and ‘evidence’


    You often see barefoot runners responding to comments about the lack of evidence for barefoot running by doing one of two things:

    1. They point to evidence. However, when you look at it, it’s not evidence (they are really good at doing this intellectual dishonesty. For example, see how they fell for some of the research: Hook, line and sinker).
    2. They claim that they have all the evidence they need as they can run barefoot and they know some others that have successfully transitioned to barefoot. If they think this is ‘evidence’, then it is really further evidence of how they delude themselves. They need to go back to school to learn what the word ‘evidence’ means.

    Within medical and health research, there is what is known as a hierarchy of evidence. At the top of the hierarchy are the meta-analyses that combine data from several prospective randomized controlled trials. At the very bottom of the hierarchy is the individual experiences. The n=1 (ie research involving one person individual experience) is not research. It is just one persons individual experiences. These experiences can be flawed or misinterpreted. Let’s look at examples and analogies:

    I think everyone is clear on the evidence of the risk of harm of smoking during pregnancy, yet a number of women still smoke during pregnancy. Often when asked why they are doing it, they respond with something like, ‘My friend smoked during pregnancy and she had no problems’. That is pretty much the sort of argument that barefoot runners like to make. They have a friend that can run barefoot, therefore it must be OK, despite all the scientific evidence. Well, this kind of argument is not acceptable in the context of smoking and pregnancy, why is acceptable in the barefoot running community? I will concede that there is NO evidence that barefoot running is harmful, but there is NO evidence that it is beneficial either, despite the claim that the barefoot runners like to make – in this pregnancy and smoking analogy, the evidence for barefoot running is knowing some others that do it! That is NOT evidence.

    Would you like to be operated on by a surgeon that has only done one of a particular type of procedure before? Would you be happier about it if the surgeon had a couple of other surgeons they knew who had also done the procedure? What kind of evidence is this? I assume you can see where this analogy is going…

    Any number of medical and health treatments that people swear work have been shown not to work by good clinical trials. There are no good trials on if barefoot running is beneficial or not, yet the barefoot running community constantly talk about the evidence of the n=1. This kind of evidence is not acceptable elsewhere, so why is it acceptable to the barefoot running community?

    How often do you see comments that go something like “I used to get all these injuries and now that I run barefoot, I don’t”. Lets dissect that kind of comment. How do you know that the injuries are less because of the barefoot running?:

    • most runners tend to go through phases of getting more injuries and then not getting injuries. It is just the way it happens. So, how do we know that a particular individual that transitions to barefoot running was not just due to enter a phase of less or no injuries. The reduction in injury could be due to this and NOT the barefoot running (but then again it may not be).
    • now that they are running barefoot, there is a good chance that they are now running on a softer surface. Maybe the lack of injuries is due to surface and nothing to do with the barefoot running (but then again it may not be).
    • maybe at the same time they transitioned to barefoot running, they also started doing more stretching exercises. The reduction in injury could be due to that and nothing to do with the barefoot running (but then again it may not be).
    • maybe they changed how many sugars that they have in a cup of coffee in the morning at the same time they started barefoot running.  Maybe that is the reason for the no injuires (but then again it incredibly unlikely to be the reason, but we can not rule it out).

    Can you see where this is heading? It is often easy to blame the most obvious factor and not consider other possible intervening factors. It does not mean that the barefoot running was the reason or not the reason, it is just you cannot jump to that conclusion based on individual experiences (or are you happy for a surgeon to operate on you who has done something once and knows a few others that have also done it?).

    Why are individual experiences so flawed? For those who want to explore this further, I suggest you read: Why do ineffective treatments seem helpful?. While this is written in the context of medical and health interventions, and about how an individual’s own clinical experiences can be flawed, the principle can be applied here to an individual’s experiences with what they perceive as the benefits to themselves of barefoot running. If you want to make claims about your experiences, that’s fine, but convince me first that you understand what this article is talking about. Otherwise stop making the silly claims about what you think is evidence.

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  • What has happened to injury rates? Are running shoes to blame?

    You can often read comments or statements to the effect that running shoe technology has allegedly improved massively over the last 20-30-40 years, yet when you look at the epidemiological studies of running overuse injuries, there has been no change. The barefoot running community tend to use such statements as evidence that running shoes are bad. You also see many claims in barefoot running books and websites, that the injury rate is actually going up. But like other bits of intellectual dishonesty, they just do not seem to get it and repeatedly twist things to suit their agenda.

    Yes, if you look at the marketing of running shoes and the technological development of running shoes, there is an apparent improvement in the features that are claimed to help reduce running injuries.

    Yes, if you look at the old and more recent prevalence and incidence of running overuse injury studies, the rates of injury are pretty similar (as an aside, most comments I have seen in running barefoot books, on running forums and barefoot running websites on this, show that they do not even know the difference between the words ‘incidence’ and ‘prevalence’, so how can you trust any interpretation they make of the research of they can’t get the basics right?).

    But, if you dig a little deeper, the comparisons between then and now do not stack up to scrutiny. You will not be able to find a single epidemiologist (the specialists who do these sorts of studies for a living) who would agree that the comparisons between the older studies and the newer studies are valid. If they are adamant you can’t do this, then why do the anti-running shoe community think they can do it?

    Why can’t you compare them? Because:

    • The populations used are different in different studies
    • The selection of the populations are different in different studies
    • The definition of an injury was different in different studies
    • The collection of the data was different in different studies
    • Running has changed over time (I came across a comment recently that the average marathon time in the 80’s was 3hr 8min and these days its around 4hr 20mins – how can you compare these two different populations?)

    On the surface, it does appear the injury rate across studies over time has not changed, but dig below the surface and you cannot make that comparison. It’s simply not valid. If you want to beat up on running shoes, you are going to have to find something else rather than dig a bigger hole for yourself using this data.

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  • Do barefoot runners wear tin foil hats?

    When you look at many of the websites and blogs that promote barefoot running you cannot help but be left with the impression that running shoes are close to being the source of all evil on this planet. “Global warming can be reversed and world peace achieved if we just stop wearing those damn running shoes“.

    Seriously, folks, do you honestly believe that the running shoe industry would deliberately make and sell running shoes that they know will actually cause harm (let alone global warming and wars). That is what many barefoot running commentators would want to have you believe.

    Yet, I can find no evidence of running shoes doing any harm. I do see many comments on barefoot running websites, but like a lot on these sites, it not backed up with any evidence. The evidence that they help is also lacking, but the lack of that evidence does not mean that they don’t. However, the illogical rationale of some barefoot runners is that they do cause injury because there is no evidence that they help – I assume you can see the illogical argument they put forward.

    If you check out some of the characteristics of what constitutes a conspiracy theory, then the barefoot running community (in general) meet all or almost all of the criteria in their belief of a big conspiracy by the running shoe companies. Seriously, folks, do you honestly believe that the running shoe industry would deliberately make and sell running shoes that they know will actually cause injury.

    If you believe that, then I think it’s time you took off your tin foil hat    *.

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    * If you do not know what this means, then check the Wikipedia entry.

  • Are Podiatrists snake oil salespersons?

    One thing you quickly learn about the barefoot running community, in general, is that they are very sensitive to criticism and cannot engage in rational discussion about the issues (more on that later). Instead they resort to name calling and use other diversion tactics, which is a classic sign of people arguing from a position of weakness. One classic line I came across recently was a barefoot runner trying to defend barefoot running from a criticism by calling Podiatrists the biggest snake oil salesmen of all time (they should have said salespersons!). Typically, they could not defend the criticism and had to introduce this attack rather than deal with the actual issue. See the Wikipedia entry if you do not know what is meant by snake oil.

    What intrigues me is that what if Podiatrists are snake oil salespersons or not, what has that got to do with barefoot running?

    There are podiatrists who are even barefoot runners and even promote barefoot running! (see this). Are they also snake oil salespersons? A look at some of the discussion on podiatry forums will show that podiatrists are not opposed to barefoot running. However, most podiatrists seem to take the position I take here and that is they have a problem with the intellectual dishonesty in the barefoot running community, the misrepresentation of research by the barefoot running community and the non-scientific nonsense that they espouse. Just becuse a Podiatrist (or for that matter, any other type of health professional) point this out, rather than deal with the issue raised, they come out with a criticism of Podiatrists.

    Podiatrists are really good at critical self analysis of the underpinnings of their professional work. For more see these discussions on snake oil and their criticisms of their own. I do not see the barefoot running community doing the same self critical analysis. For example, is the barefoot running community going to hold accountable the two barefoot running websites that blatantly lied about the Kerrigan research? (see Hook, line and sinker).

    However, I still do not see what all this has to do if barefoot running is good or bad and why some in the barefoot running community try to defend barefoot running by attacking podiatrists. It’s really a nonsensical argument.

    But anyway, lets address the concept of Podiatrist’s being snake oil salespersons. I assume they are saying this as Podiatrists use foot orthotics as one tool of many in their armamentarium used to treat overuse injuries in runners. Physical therapists, orthopaedic surgeons, chiropractors, pedorthists, etc also use foot orthotics for the same reason. Are they also snake oil salespersons?

    Do foot orthotics work? I challenge anyone to find me one (just one will do) study that shows foot orthotics do not work (I know they cannot, as there are none!). Every single study that has looked at this (and there are over 200) has shown foot orthotics work. Most of those studies were not even done by Podiatrists! Even the ones with bad methods and flaws still showed they work. The ones with good methods and minimal or no flaws still showed they work. Have those who choose to call podiatrists snake oil salespersons read any of these? I doubt it.

    The patient satisfaction studies show people are satisfied with their foot orthotics; the outcome studies show people get better with foot orthotics; even the well designed randomised controlled trials show that those in the foot orthotics treatment group get better. Most of the results of these studies show that there are 70-80-90% satisfaction, improvement in outcomes etc with foot orthotics. Where does anyone ever get the impression that foot orthotics do not work? There is certainly more evidence accumulated for the use of foot orthotics than there is evidence for the benefits of barefoot running.

    As the numbers show 70-80-90%, that’s still 10-20-30% of the time that they were not helpful. But those figures are pretty consistent with most medical interventions. For example, surgical procedures do not work all the time; antibiotics do not work all the time. Are surgeons and family practitioners snake oil salespersons because their surgery or antibiotics did not work 100% of the time?

    Why do foot orthotics not work in those 10-20-30% of the time? Could be they were the wrong prescription; could be due to biological variation (i.e. antibiotics do not work all the time); could be that they should not have been used in the first place; could be a failure of the runner to follow instructions; could be any number of reasons. At the end of the day, there is a failure rate for every medical, surgical, pharmaceutical, mechanical or physical therapy. Should they not be used because of that reason?

    My advice to the barefoot running community: Stick to the issues; discuss and debate the issues and stop throwing up nonsensical oneliners when you feel you are backed into a corner. You are only showing the weakness of your position when you resort to those tactics.

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