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In this F-Scan film we see increased pressure on the lateral column of the foot with forces traveling to the 2nd metatarsal as they come across the foot. This is most likely due to an uncompensated forefoot varus. Note the hot spots at the 2nd and 5th met heads. This patient also has a Morton’s toe which is a longer digit.

Rule #1…..never assume. Examine your clients even after F-Scans, pedographs, stop frame digital movie etc. What you see is often not the problem, rather their adaptive compensation around the parts that are working and those that are not. The problem can be local, where it appears the deficit is, or it can be elsewhere. Let the clinical examination draw the correct conclusions. For example, in this case, we could have metatarsus primus elevatus or a Rothbart Foot variant or a combination of all of the above with the FF varus.
There is nice engagement of the hallux flexors but when you see this in combination with a preceding insufficient 1st metatarsal grounding (as evidenced here of lack of “heat” under the 1st Metatarsal) a late supination attempt may be suspected to reduce a late midstance pronation vector. Again, let your clinical examination draw the correct conclusions.

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This is a case of internal tibial torsion. In particular, watch the right limb. We see a decreased progression angle of the feet, Right greater than the left, a “crossing over” gait; and bilateral toe off in supination, Right greater than the left. This can impair a persons ability to engage the lumbopelvic stabilizers adequately, impair patellofemoral tracking, and generate a host of compensatory motor patterns that are sub-optimal.

This individual’s shoe choice renders a degree of over-correction and is magnifying the problem to a degree.

The First Biodegradable Shoe→

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Same quality, less filling.

Ever think about what happens to that old pair of running shoes you retired or gave to the dog? It takes about 1000 years (yes, that’s 3 zeroes) for the EVA ( the midsole material in most running shoes) to break down. Brooks has come up with a nice alternative, that under the right conditions , takes 50 times less or about 20 years.

Brooks Trance 8: The First Biodegradable Running Shoe

Peter Weyand, PhD, SMU. Locomotor Performance Laboratory.

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From our new friend Peter Weyand, PhD, SMU, Dallas. Southern Methodist University, Locomotor Performance Laboratory.
In the study:
The biological limits to running speed are imposed from the ground up.
J. Appl Physiol (Jan 21, 2010).
Study concluded that the stance phase limit to running speed is imposed, not by the maximum forces that the limbs can apply to the ground, but rather by the minimum time needed to apply the large, mass-specific forces necessary. So, the faster the foot applies the max force into the ground and gets that foot off the ground to do the same on the other foot, the faster the person will be able to run.

Harvard: Lieberman Studies on heel strike

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Lieberman: …most experienced, habitually barefoot runners avoid heel landing & instead land forefoot or midfoot strike….most FF & some MF strikes (shod or barefoot) do not generate the sudden, large impact transients that occur with heel strike (shod or barefoot). Consequently, FF or MF strikers do not need shoes with elevated cushioned heels to cope with sudden, high transient forces that occur when you impact.

Shoes and Cushioning

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…and…Shoes with cushioning fail to absorb impact when humans run and jump, and amplify force under certain conditions, because soft materials used as interfaces between the foot and support surface elicit a predictable reduction in impact-moderating behavior. This behavior is not a response to sensations directly caused by impact because, ….
….whereas barefoot humans estimate impact precisely, humans judge it inaccurately when shod. Recent reports also indicate that humans reduce impact-moderating behavior, thereby amplifying impact, when they are convinced that they are well protected by the footwear they are wearing. …accounts for the 123% greater frequency of injuries with the most expensive shoes found by Marti.18

Saucony Kinvara

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(repeat posting from January2011)
Saucony has jumped on the minimalist running bandwagon with the Saucony Progrid Kinvara, a 7.7oz training shoe that has a heel-toe offset of only 4mm (heel height=18mm, forefoot height=14mm thus heel:forefoot ratio is 1.2 !). The upshot: with it’s relatively flat sole, its well suited to promote a midfoot/forefoot footstrike. IF your foot type is appropriate for the shoe ! Key point !

Rearfoot : Forefoot Slope Ratio

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If you are like the Gait Guys you care about the heel:forefoot ratio of a shoe as the biomechanics change in the shoe. The closer you get the heel and forefoot to the same plane of contact the more natural the foot biomechanics. This is, in part, what the trend of the minimalistic / barefoot trend in shoes is all about. There are many other factors, but this is a big one.

Stress fracture factors guide orthotic choices→

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….well, some decent info here. But The Gait Guys are disappointed that there was no talk to dynamic evaluation of gait compensations and especially no talk of assessment for muscular inhibitions or weaknesses of foot controlling mechanics. Talked much about stability of the 1st MET, how about looking at the EHB, EHL, FHL, FHB function….to start !
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The Amazing “Persistence” Hunt.

Running all day to hunt for your dinner.
Barefoot running……minimalistic running shoes ? Do we really know all that the fad is telling us ? The Gait Guys are studying hard. Reading, watching, studying video. Asking the hard questions from the research Gods like Lieberman at Harvard. At 3:40 into the video, 8 hour hunt, in the African outback…..yes folks, he has shoes on ? The Gait Guys are looking into the hype, myths, and truth.
yes folks, at 3:40 into the video, HE HAS SHOES ON !

New changes around Mizuno's 2011 running footwear lineup→

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What the GAit Guys Say:     It is Time for Shoe Talk on The Gait Guys: breaking news…New Mizuno Wave Rider Shoe…..still the same Heel to Forefoot Ratio (RF:FF ratio)……still 2:1 (24mm : 12mm). The Precision is also 2:1 (22mm:10mm). Concern ? The heel is still raised, altered forefoot load, promotes heel strike, short posterior compartment ?

It is well documented in the literature that cushioned shoes increase impact forces. Increased impact forces often lead to injury and compensation… and the Wave rider 12 won an editors choice award from Runners World? What are they thinking? Increased comfort does not necessarily equate to better performance. How many athletes do you know who train in a recliner?


Orthotic Shoe Inserts May Work, but It's Not Clear Why→

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Leading orthotics researcher, professor of biomechanics@ Human Performance Lab @ Univ. of Calgary,Alberta. His conclusion: orthotics may be helpful as a short-term solution, preventing injuries in athletes. But it’s not clear how to make inserts that work. The idea that they are supposed to correct mechanical-alignment problems does not hold up. The work of THE GAIT GUYS, hopes to offer some insight.
Ivo Waerlop A potential riff in the article (Via Stu Currie):

1) Primates only have a transverse arch – they are flat in the longitudinal direction.

2) In primates the metatarsal bases are on the same plane as the metatarsal heads.
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3) The length of the phalanges is 18% of total foot length in humans, and 35% in chimps.

4) Australopithecus afarensis (Lucy) has the beginning features of a longitudinal arch, while retaining many characteristics of the ape foot. The same can be said for other hominid ancestors (H. Habilus)See MoreJanuary 20 at 7:51am · LikeUnlike

Ivo Waerlop We have always said that orthotics serve as a therapy, not a solution. Your prescription should be getting better (lessening) or more correction taken out with time, not becoming greater. They are an excellent tool, but not a substitue for good mechanics.

Shod landing provides enhanced energy dissipation at the knee joint relative to barefoot landing from different heights.→

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Its great to wear shoes if you are jumping, but not necessarily running. It is interesting that ground reactive forces were not significantly different for shod vs unshod conditions and that that knee flexion, angular velocity and power were higher for those “perceiving” that there would be more cushioning. It goes to show we are not smarter than our brain (we just think we are !).


 http://www.ncbi.nlm.nih.gov/pubmed?term=%22Yeow%20CH%22%5BAuthor%5D

Knee. 2010 Aug 24. [Epub ahead of print]

Shod landing provides enhanced energy dissipation at the knee joint relative to barefoot landing from different heights.

Yeow CH, Lee PV, Goh JC.

Department of Orthopaedic Surgery, National University of Singapore, Singapore; Division of Bioengineering, National University of Singapore, Singapore.

Barefoot Shoe Companies please take note. Barefoot-Natural Running: Fad or Trend

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One question still remains, is this whole barefoot “thing” a fad or is it truly a trend that is here to stay ? The Gait Guys believe it has become entrenched enough now, in reputable research journals, that this is a firm trend that will not be going anywhere anytime soon.  The studies are just too convincing that there are benefits. However, Dr. Waerlop and I feel that there are risks for some folks.  Those mainly being that some foot types do not, and never will, have business being in such minimalistic shoes. We remained concerned about the misleading advertising, that these types of shoes will make everyone’s feet stronger. For some, they will, but most of the time strength education must be directed, so why would it be any different here ?  For example, there is a right way to do a squat, and a wrong way and merely doing more of them without guidance does not guarantee that the intended and proper motor patterns will be achieved. We all need direction when it comes to difficult things, like proper foot function.  Thus, merely putting on a minimalistic shoe does not mean that the correct patterns and strategies for foot strengthening are being automatically instituted. We see plenty of folks who are in minimalist shoes and yet still display toe hammering and clenching behaviors which are clearly not seen in strong feet, to the claims that these shoes will do it all are just not true.  And, for those that have challenged foot types and lower limb torsional issues (ie. FF varus, Rothbart Foot, cavovarus foot, excessive tibial varum and/or tibial torsion etc) these folks will likely trend towards local foot problems or injuries or issues further up the kinetic chain (hip, knee, low back etc).  Understandably, these are heavy medical terms and conditions that are very much out there in the running public. We know, we see them daily.  The problem could be that those providing the education do not have enough clinical background to know what these issues are let alone recognize them.  So how can they then draw these issues to the surface in educating the public ?  As I say in my lectures, “You first have to know what a platypus is in order to identify it.  Otherwise it is just a hedge hog with flippers and a duck bill."  These underlying anatomic issues are the elephants in the room that everyone is missing, everyone except us.  We get the folks who are running in these minimalist devices and we get to see who never should have been in them in the first place.

The good thing is that many companies are setting up educational programs to help folks drop down into "minimalism 2.0” but still, to date, no one is talking about the elephants in the room, those being those foot types that are too risky to be in the shoes and even more specifically, how to strengthen the foot.  Merely putting the shoes on and wearing them does not mean the end user who already has challenged feet will begin to engage the correct muscular motor patterns.  But who would admit to those risks, that would be stupid advertising and product risk.  With 36+ clinical years we feel this is where we have some pull and can help.

Someone needed to be talking about the elephants in the room.  We finally decided that we had enough experience clinically, and with runners and shoes, to be that person. Agreeably, there is a danger in doing too much barefoot running too soon. We made this clear over the past few years as Biomechanics Advisory Board members for one of the big players in this game.  For us it is about “keeping them honest” as we like to say now. We are trying to make the calls on the products that have questionable statements and applaud those that stick their neck out but whom take our critique well.  We do not know everything, but we seem to know much more than most when it comes to the biomechanics of what is going in these products.  If you put 10 different feet in a product, you will get 10 different biomechanical presentations from the shoe. So, much of what is being missed is the education of what is going on with the parts that are in the shoe, and that is our world.  A major part of the barefoot or natural running trend are the problems that exist with the thing you are putting into all of these products, a person. A person who likely does not have the classic middle of the road, ‘Average Foot’ these shoes were designed around; that foot that all these companies base their research and dialogue upon.  To us, the most important thing for us to do is to raise the knowledge and awareness to the public, shoe companies and shoe stores that there is likely a ~10-15% standard deviation off of that average foot where their products will work as they claim.  Those other 70%, well…….they need us and they deserve to have us help them see the elephants in the room that no one is talking about.

If the collective goal of the natural running movement is to reduce injuries then the education MUST continue into educating the fabricators and running public of all of the issues at hand (or “foot” in this case) which should include talking about the elephants in the room.

Please help us get the message out. Wouldn’t it be great if this message went viral ? Send this to your friend who just bought a pair of “barefoot or minimalistic shoes”. Send it to your shoe store owner, your coach, your trainer, your doctor, therapist, your running club colleagues, your brother etc.

Lets educate everyone so this positive trend does not have a dark undercurrent that no one speaks of.


Shawn Allen, Ivo Waerlop………with almost 4 decades of clinical experience…..we are,  The Gait Guys