Dear Dr. Lieberman : Some vital facts on forefoot running are not being discussed.

A clay pot sitting in the sun will always be a clay pot. It has to go through the white heat of the furnace to become porcelain. -Mildred Wite Stouven.

Today’s blog article is likely to bring flames to our feet, but we are not afraid of the heat.  At the very least we will settle for the heat this article may bring so that our work can get the recognition we feel it deserves and so the truth can be brought to light for the good of all mankind.

“Forefoot strike causes less impact force on the body,” says co-author Daniel Lieberman, Ph.D., a professor of human evolutionary biology at Harvard and scribe of a popular barefoot running manifesto in 2010. “People forget that running is a skill, and if you don’t run properly, you’ll get injured.”

Amen to that; we have been saying that for years before this all became popular talk …

We recently read this article in Men’s Health, yet another one supportive of minimalism running. And once again some of the most important facts are being left out. We just cannot sit here and watch the inaccuracies of minimalism and forefoot running continue to root themselves without policing. So, let us once again set foot into the raging battle.

According to the article (LINK) Sturtz says, “Landing on your forefoot, the way humans have run for thousands of years, produces almost zero impact on joints and bones, according to Lieberman’s 2010 study. But 75 percent of us now land heel first—cushioned running shoes made that possible (and comfortable)—which slams up to 3 times the body’s weight in impact force on your knees and legs.”

Our question is, “ Why is no one paying attention to foot types?” In every lecture we do, to clinicians or everyday runners, about “forefoot type” variants (valgus and varus to be precise) we comment that this is something that should be talked about during Running Form Clinics where forefoot landing is promoted. 

“… forefoot running is not the whole answer to injury prevention, just a component”, says Lieberman. “This is not a simple solution to a complex problem—you can’t change one thing and have everything be fine. You can still forefoot strike with poor form.”

And we would add to that quote that “you can get a resultant compensatory running form if you forefoot strike with a forefoot varus or forefoot valgus”. Not everyone has that pristine neutral forefoot bipod architecture that the internet articles are assuming exists in everyone, and thus there is no way that everyone has fully competent pristine forefoot biomechanics that will not eventually trigger injury. This is a fact, not our opinion. 

Dr Lieberman then goes on to say: “ If it ain’t broke, don’t fix it.”

We respectfully disagree. We do this on a daily basis (as do many of you).  If the check engine light on your dashboard is flashing at you every day for a week you would be remiss not to consider the repercussions.  “The car ain’t broken… YET” is a more precise comment. You would be wise not to go on a long distance car trip knowing this fact.  Translating this to forefoot load/strike running, ignoring a potential injury because of flawed forefoot anatomy and biomechanics is a recipe for injury.  Just because it isn’t broken YET doesn’t mean ignoring the issues will make them go away or make you immune. A few hundred or thousand miles on a forefoot variant can be an issue clinically and injury wise.

Just because the body isn’t broken YET doesn’t mean it cannot work better and prevent a problem down the road. Dr Lieberman then goes on to quote, “Remember, almost every distance runner gets injured".  Why is he batting from both sides of the plate here? If “Landing on your forefoot, the way humans have run for thousands of years, produces almost zero impact on joints and bones”, according to Lieberman’s 2010 study then why would he go on to say “Almost every distance runner gets injured”?  There has to be a reason !  Forefoot running is either the answer or it isn’t.  Our valid and ignored proposal above, and our repeated comments throughout our 500+ blog posts on this topic on foot types, is a valid answer to his injury assumption.  It is quite possible that these inevitable injuries occur because people take the advice of “if it ain’t broken, don’t fix it”.  It is also most likely that ignorance of the deeper facts is bliss for most people. .Had they spent the time to find out about their forefoot type and learn to modify subtle biomechanical flaws of forefoot loading strategies of their foot type, perhaps we wouldn’t hear “Remember, almost every distance runner gets injured".   Maybe that is why you SHOULD look into fixing things that are not YET broken and at the very least learn about foot types, particularly which one you have and the potential risks it exposes you to. Our blog here has done this in depth over the last year. 

“An ounce of prevention is worth a pound of cure” -Benjamin Franklin.  Anyone is medicine knows this is true (or should).

We prefer midfoot strike when possible, for many reasons but mainly because it takes into account a tripod contact loading response.  A tripod load is more stable than a rear foot unipod load and more stable than a forefoot bipod load, particularly when there are rear or forefoot variants (rearfoot valgus, rearfoot varus, forefoot valgus, forefoot varus) from the pristine normal that is always assumed in many articles.   A tripod loading response (midfoot strike) can dampen some of the mechanical flaws of either heel or forefoot strike patterns and of the foot type variants that are the norm, not the exception.

We see this stuff everyday in our practices. We are the guys that get the injury cases that are driven by the inaccuracies, or better put “overlooked facts”, of articles on the internet. To be fair, we have also written a fair number of articles for magazines and we know how they can get so chopped down that truth, honesty and full disclosure can be lost for the sake of publication limitations. None the less, our strong opinion, this article could have been far more complete had it talked about the issues we have brought to light here.  We love and respect the work of Lieberman and his colleagues.  He and his colleagues have done a huge service to the runners of the world and we have learned from them. Learning is a lifelong journey for us all and we just think that there is a huge information gap that is being missed and we feel it is time that the runners of the world hear the whole truth. We believe our work is filling that gap.

“First they ignore you, then they laugh at you, then they fight you, then you win.”

- Mahatma Gandhi

For the past year, we have been feeling a bit like Gandhi must have felt. We realize that some of our work is complicated, difficult to understand, and tough to digest. We know we are laughed at by some who prefer to seek the safety of ignorance. And yes, despite 600 blog posts on these very topics (yes, we have one of the most informative blogs and YouTube Channels on the web for runners and athletes looking for answers) we feel somewhat ignored. None the less, we continue to stick our necks out far and long to set the record straight to make sure that everyone knows the facts they deserve to know.   We hope you will forward, link, Facebook and tweet the hell out of our blog post today, for the good of every runner and athlete you know and for the whole of mankind.  We are in this for the long haul. Stick and stones … .       - Drs. Shawn and Ivo …  The Gait Guys

here is the article that spurred our post: