Holy Forefoot Flare, Batman!


Some sources say foot strike pattern does not matter. We disagree.

Look at this gal who midfoot/forefoot strikes. She also has a forefoot supinatus, a plastic condition where the forefoot is inverted with respect to the rearfoot. Take that combination and put it in a shoe with a forefoot flare and what do you get? Can you say AMPLIFICATION?

We’re not saying this is a bad shoe or even the wrong shoe. But, if she is going to run in this shoe, we will need to help her gain more ROM in her forefoot ( and some pelvic and hip stability) dodge doesn’t have to crash into eversion on each landing.

Help your patients with shoe selection. Something with less of a lateral flare in the forefoot would certainly make her life easier.

Need to know more? Consider taking our National Shoe Fit Program: link here:

Dr Ivo Waerlop, one of The Gait Guys

#badshoes #forefootflare #thegaitguys #forefootsupinatus #lateralflare #inversion

Barefoot vs Shoes...It's about the strike pattern


Footnotes 7 - Black and Red.jpg

“The influence of strike patterns on running is more significant than shoe conditions, which was observed in plantar pressure characteristics. Heel-toe running caused a significant impact force on the heel, but cushioned shoes significantly reduced the maximum loading rate. Meanwhile, although forefoot running can prevent impact, peak plantar pressure was centered at the forefoot for a long period, inducing a potential risk of injury in the metatarsus/phalanx. Plantar pressure on the forefoot with RFS was lesser and push-off force was greater when cushioned shoes were used than when running barefoot.”


takeaways from the study?

  • forefoot strike reduces heel impact

  • rear foot strike reduces forefoot impact

  • forefoot strike increases and prolongs pressures (in shoes) on the forefoot which could potentially cause forefoot problems

  • cushioned shoes do not really change impact force but change (reduce) the rate of loading

  • in a forefoot strike, pressures are shifted more to the mid foot

want to know more? Join us this Wednesday, December 19th on online.com: Biomechanics 303







Sun XYang YWang LZhang XFu W. Do Strike Patterns or Shoe Conditions have a Predominant Influence on Foot Loading? J Hum Kinet. 2018 Oct 15;64:13-23. doi: 10.1515/hukin-2017-0205. eCollection 2018 Sep.

link to FREE FULL TEXT: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6231350/





Podcast 138 (for real). Are you fighting your own gait/running neurology?

Topics:
1. Running with the extensors. Convergence and divergence of neurons.
2. Fighting your gait neurology. The lies about the Bird dog rehab exercise.
3. ACL and ACL rehab. Surgery or no sugery. Wise? Risks ? How social media discussions might just be getting it wrong.
4. Cross over gait and lateral heel strike and ensuing problems at great toe off. A failure to medial foot tripod high gear toe off ?
5. Are the hip flexors actually hip flexors in gait ? what are your high knee drills doing? Anything good?

Key words: acl, analysis, cross, extensor, flexors, gait, heel, hip, instability, knee, over, plri, pools, problems, running, strike, surgery

Links to find the podcast:

iTunes page: https://itunes.apple.com/us/podcast/the-gait-guys-podcast/id559864138?mt=2

Direct Download:http://traffic.libsyn.com/thegaitguys/pod_138_real_-_82818_2.12_PM.mp3

Permalink URL:http://thegaitguys.libsyn.com/podcast-138-for-real

Libsyn URL: http://directory.libsyn.com/episode/index/id/6978817

Our Websites:
www.thegaitguys.com

summitchiroandrehab.com

doctorallen.co

shawnallen.net

Our website is all you need to remember. Everything you want, need and wish for is right there on the site.
Interested in our stuff ? Want to buy some of our lectures or our National Shoe Fit program? Click here (thegaitguys.com or thegaitguys.tumblr.com) and you will come to our websites. In the tabs, you will find tabs for STORE, SEMINARS, BOOK etc. We also lecture every 3rd Wednesday of the month on onlineCE.com. We have an extensive catalogued library of our courses there, you can take them any time for a nominal fee (~$20).

Our podcast is on iTunes and just about every other podcast harbor site, just google "the gait guys podcast", you will find us.

So, what DOES cause a change in strike pattern with barefoot running?

We kinda thought so...

"CONCLUSION: Superficial cutaneous sensory receptors are not primarily responsible for the gait changes associated with barefoot running."

So what is? Most likely they play a part, but the joint and muscle mechanoreceptors that we had been talking about here on The Gait Guys for the last several years most likely play a larger role. The cutaneous receptors appear to play a role in general sensation, balance and coordination as well as coordination of upper extremity movements.

Thompson MA, Hoffman KM.Superficial plantar cutaneous sensation does not trigger barefoot running adaptations.Gait Posture. 2017 Jun 27;57:305-309. doi: 10.1016/j.gaitpost.2017.06.269. [Epub ahead of print]

https://www.ncbi.nlm.nih.gov/pubmed/28728130

A blast from the past. Here’s one of our favorite posts, just in case you missed us a few years ago…

More Gait Guy Gait Gaffs: What it would look like if “The Flash”, ran with heel strike ? click here. Note the excellent anterior compartment use (nice ankle dorsiflexion and toe extension at terminal swing/ pre-impact) but heavy, nasty, heel strike. What is interesting here is that he has adopted a nice forward lean (ala. natural or chi running style) but when combining this with a heel strike gait you end up with an anterior pelvic tilt (which begins inhibition of the lower abdominals) and you then have to begin the power through phase in early-mid stance phase with the hamstrings. You need tremendous lower abdominal strength, and hamstring length and strength to run this way (go ahead, get up and try it running through your office ! let out a great “Yaulp” from the ensuing hamstring pull (ala Robin Willliams in Dead Poets Society) when you find out your abdominals are not strong enough to lean that far forward and still heel strike, without enough hamstring length (on second thought, just trust  us……although i know now we have challenged some of you). This is a medical disclaimer, dont do it !

The debate continues. More support for mid and forefoot strikers. … 
  “Forefoot and midfoot strikers had significantly shorter ground contact times than heel strikers. Forefoot and midfoot strikers had significantly faster average race speed than heel strikers.”  
 We are not saying “better”, but according to this study “faster”! 
 What is the ideal?  We wish we knew…Biomechanics seem to point to less impact is better, but what is actually best for the individual is probably due to genetics, training, practice, running surface and  t hat individuals neuromuscular competence and ability to compensate. 
  The Gait Guys. bringing you the facts, even if you or we don’t like them…  
                                                                                                                                           
  J Sports Sci.  2012;30(12):1275-83. doi: 10.1080/02640414.2012.707326. Epub 2012 Aug 2. 
 Foot strike patterns and ground contact times during high-calibre middle-distance races. 
  Hayes P ,  Caplan N . 
 
 Source 
 Department of Sport and Exercise Sciences, School of Life Sciences, Northumbria University, Newcastle-upon-Tyne NE1 8ST, UK. phil.hayes@northumbria.ac.uk 
 
 
 Abstract 
 The aims of this study were to examine ground contact characteristics, their relationship with race performance, and the time course of any changes in ground contact time during competitive 800 m and 1500 m races. Twenty-two seeded, single-sex middle-distance races totaling 181 runners were filmed at a competitive athletics meeting. Races were filmed at 100 Hz. Ground contact time was recorded one step for each athlete, on each lap of their race. Forefoot and midfoot strikers had significantly shorter ground contact times than heel strikers. Forefoot and midfoot strikers had significantly faster average race speed than heel strikers. There were strong large correlations between ground contact time and average race speed for the women’s events and men’s 1500 m (r = -0.521 to -0.623; P < 0.05), whereas the men’s 800 m displayed only a moderate relationship (r = -0.361; P = 0.002). For each event, ground contact time for the first lap was significantly shorter than for the last lap, which might reflect runners becoming fatigued. 
 
 PMID:22857152[PubMed - indexed for MEDLINE] 
  http://www.ncbi.nlm.nih.gov/pubmed/22857152

The debate continues. More support for mid and forefoot strikers.

“Forefoot and midfoot strikers had significantly shorter ground contact times than heel strikers. Forefoot and midfoot strikers had significantly faster average race speed than heel strikers.”

We are not saying “better”, but according to this study “faster”!

What is the ideal?  We wish we knew…Biomechanics seem to point to less impact is better, but what is actually best for the individual is probably due to genetics, training, practice, running surface and that individuals neuromuscular competence and ability to compensate.

The Gait Guys. bringing you the facts, even if you or we don’t like them…

                                                                                                                                     

J Sports Sci. 2012;30(12):1275-83. doi: 10.1080/02640414.2012.707326. Epub 2012 Aug 2.

Foot strike patterns and ground contact times during high-calibre middle-distance races.

Source

Department of Sport and Exercise Sciences, School of Life Sciences, Northumbria University, Newcastle-upon-Tyne NE1 8ST, UK. phil.hayes@northumbria.ac.uk

Abstract

The aims of this study were to examine ground contact characteristics, their relationship with race performance, and the time course of any changes in ground contact time during competitive 800 m and 1500 m races. Twenty-two seeded, single-sex middle-distance races totaling 181 runners were filmed at a competitive athletics meeting. Races were filmed at 100 Hz. Ground contact time was recorded one step for each athlete, on each lap of their race. Forefoot and midfoot strikers had significantly shorter ground contact times than heel strikers. Forefoot and midfoot strikers had significantly faster average race speed than heel strikers. There were strong large correlations between ground contact time and average race speed for the women’s events and men’s 1500 m (r = -0.521 to -0.623; P < 0.05), whereas the men’s 800 m displayed only a moderate relationship (r = -0.361; P = 0.002). For each event, ground contact time for the first lap was significantly shorter than for the last lap, which might reflect runners becoming fatigued.

PMID:22857152[PubMed - indexed for MEDLINE]

http://www.ncbi.nlm.nih.gov/pubmed/22857152

Support for a midfoot strike?  
 &ldquo; Running with a midfoot  strike  pattern resulted in a significant increase in gastrocnemius lateralis pre-activation (208 ± 97.4 %, P &lt; 0.05) and in a significant decrease in tibialis anterior EMG activity (56.2 ± 15.5 %, P &lt; 0.05) averaged over the entire stride cycle. The acute attenuation of  foot -ground impact seems to be mostly related to the use of a midfoot  strike  pattern and to a higher pre-activation of the gastrocnemius lateralis. &rdquo;  
 Do these results surprise you? They didn&rsquo;t really surprise us. 
  The lateral head of the gastroc is a midstance to preswing stabilizer and works synergistic with the medial head,  with the medial head firing earlier.  Sutherland  talks about these muscles not being propulsive in nature, but rather maintainers of forward progression, step length and gait symmetry. Thinking this through in a closed chain (foot up) fashion, this would counter the inversion moment created by the medial gastroc for supination in the second half of contact phase. If the foot is already partially supinated (as we believe it would be in a midfoot strike), it would have to pre activate. 
 A decrease in tibialis anterior activity? Sure. If the foot is striking more parallel to the ground, the anterior compartment (including the tibialis anterior, extensor hallucis longus, and extensor digitorum longus) would not have to eccentrically contract to decelerate the lowering of the foot to the ground. 
  Better?  Maybe, maybe not. We are seeing more and more literature about foot strike (if you missed our last few posts, click  here ,  here ,  here  and  here ), We still maintain that you need a competent lower kinetic chain, including the foot and an intact nervous system to drive the boat. 
  We remain, handsome, bald and nerdy&hellip;Ivo and Shawn  

                                                                                                                                  
   Eur J Appl Physiol.  2012 Aug 9. [Epub ahead of print]  
  Impact reduction during running: efficiency of simple acute interventions in  recreational  runners.  
   Giandolini M ,  Arnal PJ ,  Millet GY ,  Peyrot N ,  Samozino P ,  Dubois B ,  Morin JB .  
 
  Source  
  University of Lyon, 42023, Saint-Etienne, France.  
 
 
  Abstract  
  Running-related stress fractures have been associated with the overall impact intensity, which has recently been described through the loading rate (LR). Our purpose was to evaluate the effects of four acute interventions with specific focus on LR: wearing racing shoes (RACE), increasing step frequency by 10 % (FREQ), adopting a midfoot  strike  pattern (MIDFOOT) and combining these three interventions (COMBI). Nine rearfoot- strike  subjects performed five 5-min trials during which running kinetics, kinematics and spring-mass behavior were measured for ten consecutive steps on an instrumented treadmill. Electromyographic activity of gastrocnemius lateralis, tibialis anterior, biceps femoris and vastus lateralis muscles was quantified over different phases of the stride cycle. LR was significantly and similarly reduced in MIDFOOT (37.4 ± 7.20 BW s(-1), -56.9 ± 50.0 %) and COMBI (36.8 ± 7.15 BW s(-1), -55.6 ± 29.2 %) conditions compared to NORM (56.3 ± 11.5 BW s(-1), both P &lt; 0.001). RACE (51.1 ± 9.81 BW s(-1)) and FREQ (52.7 ± 11.0 BW s(-1)) conditions had no significant effects on LR. Running with a midfoot  strike  pattern resulted in a significant increase in gastrocnemius lateralis pre-activation (208 ± 97.4 %, P &lt; 0.05) and in a significant decrease in tibialis anterior EMG activity (56.2 ± 15.5 %, P &lt; 0.05) averaged over the entire stride cycle. The acute attenuation of  foot -ground impact seems to be mostly related to the use of a midfoot  strike  pattern and to a higher pre-activation of the gastrocnemius lateralis. Further studies are needed to test these results in prolonged running exercises and in the long term.  
 
  PMID:  22875194   [PubMed - as supplied by publisher]   
     
  All material copyright 2013 The Gait Guys/The Homunculus Group, yada, yada, yada&hellip;

Support for a midfoot strike?

Running with a midfoot strike pattern resulted in a significant increase in gastrocnemius lateralis pre-activation (208 ± 97.4 %, P < 0.05) and in a significant decrease in tibialis anterior EMG activity (56.2 ± 15.5 %, P < 0.05) averaged over the entire stride cycle. The acute attenuation of foot-ground impact seems to be mostly related to the use of a midfoot strike pattern and to a higher pre-activation of the gastrocnemius lateralis. ”

Do these results surprise you? They didn’t really surprise us.

The lateral head of the gastroc is a midstance to preswing stabilizer and works synergistic with the medial head, with the medial head firing earlier. Sutherland talks about these muscles not being propulsive in nature, but rather maintainers of forward progression, step length and gait symmetry. Thinking this through in a closed chain (foot up) fashion, this would counter the inversion moment created by the medial gastroc for supination in the second half of contact phase. If the foot is already partially supinated (as we believe it would be in a midfoot strike), it would have to pre activate.

A decrease in tibialis anterior activity? Sure. If the foot is striking more parallel to the ground, the anterior compartment (including the tibialis anterior, extensor hallucis longus, and extensor digitorum longus) would not have to eccentrically contract to decelerate the lowering of the foot to the ground.

Better? Maybe, maybe not. We are seeing more and more literature about foot strike (if you missed our last few posts, click here, here, here and here), We still maintain that you need a competent lower kinetic chain, including the foot and an intact nervous system to drive the boat.

We remain, handsome, bald and nerdy…Ivo and Shawn

                                                                                                                                

Eur J Appl Physiol. 2012 Aug 9. [Epub ahead of print]

Impact reduction during running: efficiency of simple acute interventions in recreational runners.

Source

University of Lyon, 42023, Saint-Etienne, France.

Abstract

Running-related stress fractures have been associated with the overall impact intensity, which has recently been described through the loading rate (LR). Our purpose was to evaluate the effects of four acute interventions with specific focus on LR: wearing racing shoes (RACE), increasing step frequency by 10 % (FREQ), adopting a midfoot strike pattern (MIDFOOT) and combining these three interventions (COMBI). Nine rearfoot-strike subjects performed five 5-min trials during which running kinetics, kinematics and spring-mass behavior were measured for ten consecutive steps on an instrumented treadmill. Electromyographic activity of gastrocnemius lateralis, tibialis anterior, biceps femoris and vastus lateralis muscles was quantified over different phases of the stride cycle. LR was significantly and similarly reduced in MIDFOOT (37.4 ± 7.20 BW s(-1), -56.9 ± 50.0 %) and COMBI (36.8 ± 7.15 BW s(-1), -55.6 ± 29.2 %) conditions compared to NORM (56.3 ± 11.5 BW s(-1), both P < 0.001). RACE (51.1 ± 9.81 BW s(-1)) and FREQ (52.7 ± 11.0 BW s(-1)) conditions had no significant effects on LR. Running with a midfoot strike pattern resulted in a significant increase in gastrocnemius lateralis pre-activation (208 ± 97.4 %, P < 0.05) and in a significant decrease in tibialis anterior EMG activity (56.2 ± 15.5 %, P < 0.05) averaged over the entire stride cycle. The acute attenuation of foot-ground impact seems to be mostly related to the use of a midfoot strike pattern and to a higher pre-activation of the gastrocnemius lateralis. Further studies are needed to test these results in prolonged running exercises and in the long term.

PMID:22875194 [PubMed - as supplied by publisher]


All material copyright 2013 The Gait Guys/The Homunculus Group, yada, yada, yada…

Looks like Newbies are heel strikers   
  &ldquo;Nearly all novice runners utilize a rearfoot strike when taking up running in a conventional running shoe. Hereby, the footstrike patterns among novice runners deviate from footstrike patterns among elite and sub-elite runners.&rdquo;  
     
   please take some time to explore the links we put in, as they are germane to the post   
       
 The question begs, &ldquo;Why?&rdquo; 
  do they believe running is merely an extension of walking, and just &ldquo;speed up&rdquo; the process? 
 are they afraid of going too fast and are using the heel strike to &ldquo;brake&rdquo;? 
 do they learn to strike differently with more experience? at least  one paper  eludes to &ldquo;yes&rdquo; 
 is it &ldquo;more comfortable&rdquo; as  this paper  says it may be? 
 If there is a rear foot strike, the foot is poised to be able to pronate to a greater degree. This theoretically means it (ie, the foot) can absorb more shock through this mechanism, although this seemingly contradicts the  Lieberman study  
  This paper certainly had a nice cohort size (&gt; 900 runners) so we can state, at least for this group, that this is not by chance.  When there is a fore foot strike, the foot is more supinated and makes a seemingly &ldquo;rigid lever&rdquo;, does this mean there is less shock (perceived or actual) with this foot posture? 
   Lots of questions. This is only 1 part of the puzzle.   
  The Gait Guys. Sifting through the literature and giving you the beef  
                    
  Gait Posture. 2012 Dec 29. pii: S0966-6362(12)00448-1. doi: 10.1016/j.gaitpost.2012.11.022. [Epub ahead of print]  
   Footstrike patterns among novice runners wearing a conventional, neutral running shoe.   
   Bertelsen ML ,  Jensen JF ,  Nielsen MH ,  Nielsen RO ,  Rasmussen S .  
 
  Aarhus University Hospital, Aalborg Hospital, Orthopaedic Surgery Research Unit, Science and Innovation Center, Aalborg DK-9000, Denmark. Electronic address:  miclejber@gmail.com .  
 
 
  Abstract  
  INTRODUCTION:  
  It has been suggested that striking on the midfoot or forefoot, rather than the rearfoot, may lessen injury risk in the feet and lower limb. In previous studies, a disparity in distribution in footstrike patterns was found among elite-, sub-elite, and recreational runners.  
  PURPOSE:  
  The purpose of this study was to investigate the footstrike patterns among novice runners.  
  METHODS:  
  All runners were equipped with the same conventional running shoe. Participants were video filmed at 300 frames per second and the footstrike patterns were evaluated by two observers. The footstrike was classified as rearfoot, midfoot, forefoot, or asymmetrical.  
  RESULTS:  
  A total of 903 persons were evaluated. The percentages of rearfoot-, midfoot-, forefoot-, and asymmetrical footstrike among men were 96.9%, 0.4%, 0.9%, and 1.8%, respectively. Among women the percentages were 99.3%, 0%, 0%, and 0.7%, respectively.  
  CONCLUSION:  
  Nearly all novice runners utilize a rearfoot strike when taking up running in a conventional running shoe. Hereby, the footstrike patterns among novice runners deviate from footstrike patterns among elite and sub-elite runners.  
  Copyright © 2012 Elsevier B.V. All rights reserved.  
 
   PMID: 23280125 [PubMed - as supplied by publisher]  
     
   all material copyright 2013 The Gait Guys/The Homunculus group. Please don&rsquo;t lift our stuff without asking and giving credit.

Looks like Newbies are heel strikers

“Nearly all novice runners utilize a rearfoot strike when taking up running in a conventional running shoe. Hereby, the footstrike patterns among novice runners deviate from footstrike patterns among elite and sub-elite runners.”


please take some time to explore the links we put in, as they are germane to the post


The question begs, “Why?”

  • do they believe running is merely an extension of walking, and just “speed up” the process?
  • are they afraid of going too fast and are using the heel strike to “brake”?
  • do they learn to strike differently with more experience? at least one paper eludes to “yes”
  • is it “more comfortable” as this paper says it may be?
  • If there is a rear foot strike, the foot is poised to be able to pronate to a greater degree. This theoretically means it (ie, the foot) can absorb more shock through this mechanism, although this seemingly contradicts the Lieberman study

This paper certainly had a nice cohort size (> 900 runners) so we can state, at least for this group, that this is not by chance.  When there is a fore foot strike, the foot is more supinated and makes a seemingly “rigid lever”, does this mean there is less shock (perceived or actual) with this foot posture?

Lots of questions. This is only 1 part of the puzzle.

The Gait Guys. Sifting through the literature and giving you the beef

            

Gait Posture. 2012 Dec 29. pii: S0966-6362(12)00448-1. doi: 10.1016/j.gaitpost.2012.11.022. [Epub ahead of print]

Footstrike patterns among novice runners wearing a conventional, neutral running shoe.

Bertelsen ML, Jensen JF, Nielsen MH, Nielsen RO, Rasmussen S.

Aarhus University Hospital, Aalborg Hospital, Orthopaedic Surgery Research Unit, Science and Innovation Center, Aalborg DK-9000, Denmark. Electronic address: miclejber@gmail.com.

Abstract

INTRODUCTION:

It has been suggested that striking on the midfoot or forefoot, rather than the rearfoot, may lessen injury risk in the feet and lower limb. In previous studies, a disparity in distribution in footstrike patterns was found among elite-, sub-elite, and recreational runners.

PURPOSE:

The purpose of this study was to investigate the footstrike patterns among novice runners.

METHODS:

All runners were equipped with the same conventional running shoe. Participants were video filmed at 300 frames per second and the footstrike patterns were evaluated by two observers. The footstrike was classified as rearfoot, midfoot, forefoot, or asymmetrical.

RESULTS:

A total of 903 persons were evaluated. The percentages of rearfoot-, midfoot-, forefoot-, and asymmetrical footstrike among men were 96.9%, 0.4%, 0.9%, and 1.8%, respectively. Among women the percentages were 99.3%, 0%, 0%, and 0.7%, respectively.

CONCLUSION:

Nearly all novice runners utilize a rearfoot strike when taking up running in a conventional running shoe. Hereby, the footstrike patterns among novice runners deviate from footstrike patterns among elite and sub-elite runners.

Copyright © 2012 Elsevier B.V. All rights reserved.


PMID: 23280125 [PubMed - as supplied by publisher]



all material copyright 2013 The Gait Guys/The Homunculus group. Please don’t lift our stuff without asking and giving credit.

New Study Finds Group of Heel Striking Barefoot Kenyan Runners.    
   Not all that is barefoot is necessarily forefoot&hellip;   
 You may have seen our tweet yesterday and have read this article. Or maybe, because you are a foot geek, you have seen it already. 
 Here&rsquo;s the summary:   &ldquo;Jan. 9, 2013  — A recently published paper by two George Washington University researchers shows that the running foot strike patterns vary among habitually barefoot people in Kenya due to speed and other factors such as running habits and the hardness of the ground. These results are counter to the belief that barefoot people prefer one specific style of running.&rdquo;  
  The study reported a 72 percent rearfoot landing when running barefoot at endurance pace speeds supporting the notion that speed affects landing choice (faster speeds transitioned  the runners into more midfoot / forefoot landing).  Lieberman&rsquo;s Harvard study which brought much of the forefoot strike principle to the western world was often based off of sub 5 mile paced runs.    
  It raises the question  &ldquo; If barefoot IS better, and forefoot impact IS BETTER, then, what gives?&rdquo;   
 We think the better response is: 
  there are many variables (genetics, surface, speed, etc) that can influence foot strike patterns and this paper exemplifies that. 
 Fore foot striking in runners does lessen impact forces. 
 Forefoot striking does appear to accentuate any forefoot abnormality (ie: varus/valgus) that may be present (something we will continue to say until someone proves it otherwise). 
 forefoot striking loads the posterior compartment of the lower leg (tricep surae (gastroc soleus complex)) to a greater degree 
  We like a mid foot strike, not because it is the middle road, but because it supports the notion in distance running that the entire foot tripod (which is more stable) engages the ground reducing solitary forefoot and rearfoot loading issues which each have their risks and challenges and allows for a more stable contact point for the body to negotiate over.  We have pounded sand on forefoot types, and the inherent risks of forefoot strike running with each of them, from our inception.  But, when it comes to midfoot strike there doesn&rsquo;t appear to be much, if any literature out there to support our opinion.  Maybe now that the forefoot and rearfoot studies are out there maybe someone will find a tribe of midfoot strikers to support our rants. 
 We think the key is not necessarily strike position, but rather where the foot is hitting the ground relative to the body AND MORE IMPORTANTLY, having a competent foot and lower kinetic chain and core, along with the body&rsquo;s ABILITY to absorb or attenuate those forces, no matter where the foot is striking the ground. 
 This is no doubt the 1st in a series of papers looking at this. It will be interesting to see where it goes from here. 
 Ivo and Shawn&hellip;  The Gait Guys 
 here is the link:  http://www.sciencedaily.com/releases/2013/01/130109185856.htm  
  all material copyright 2013 The Homunculus Group/ The Gait Guys. Please ask to use our stuff and reference it appropriately. We know a guy named BamBam who helps people play nice.

New Study Finds Group of Heel Striking Barefoot Kenyan Runners.

Not all that is barefoot is necessarily forefoot…

You may have seen our tweet yesterday and have read this article. Or maybe, because you are a foot geek, you have seen it already.

Here’s the summary: “Jan. 9, 2013 — A recently published paper by two George Washington University researchers shows that the running foot strike patterns vary among habitually barefoot people in Kenya due to speed and other factors such as running habits and the hardness of the ground. These results are counter to the belief that barefoot people prefer one specific style of running.”

The study reported a 72 percent rearfoot landing when running barefoot at endurance pace speeds supporting the notion that speed affects landing choice (faster speeds transitioned  the runners into more midfoot / forefoot landing).  Lieberman’s Harvard study which brought much of the forefoot strike principle to the western world was often based off of sub 5 mile paced runs.

It raises the question “ If barefoot IS better, and forefoot impact IS BETTER, then, what gives?”

We think the better response is:

  • there are many variables (genetics, surface, speed, etc) that can influence foot strike patterns and this paper exemplifies that.
  • Fore foot striking in runners does lessen impact forces.
  • Forefoot striking does appear to accentuate any forefoot abnormality (ie: varus/valgus) that may be present (something we will continue to say until someone proves it otherwise).
  • forefoot striking loads the posterior compartment of the lower leg (tricep surae (gastroc soleus complex)) to a greater degree

We like a mid foot strike, not because it is the middle road, but because it supports the notion in distance running that the entire foot tripod (which is more stable) engages the ground reducing solitary forefoot and rearfoot loading issues which each have their risks and challenges and allows for a more stable contact point for the body to negotiate over.  We have pounded sand on forefoot types, and the inherent risks of forefoot strike running with each of them, from our inception.  But, when it comes to midfoot strike there doesn’t appear to be much, if any literature out there to support our opinion.  Maybe now that the forefoot and rearfoot studies are out there maybe someone will find a tribe of midfoot strikers to support our rants.

We think the key is not necessarily strike position, but rather where the foot is hitting the ground relative to the body AND MORE IMPORTANTLY, having a competent foot and lower kinetic chain and core, along with the body’s ABILITY to absorb or attenuate those forces, no matter where the foot is striking the ground.

This is no doubt the 1st in a series of papers looking at this. It will be interesting to see where it goes from here.

Ivo and Shawn…  The Gait Guys

here is the link: http://www.sciencedaily.com/releases/2013/01/130109185856.htm

all material copyright 2013 The Homunculus Group/ The Gait Guys. Please ask to use our stuff and reference it appropriately. We know a guy named BamBam who helps people play nice.

Video Gait Case: A troubled Youth.

This is a video of a teenage girl with chronic posterior knee pain. What do you see in her gait. Don’t cheat yourself. Before you read below see what you can see first and then drop your eyes down to our work below.

  1. Heavy rear foot lateral strike. This is rearfoot inversion at its worst. This is considered rearfoot varus. Hyperpronators will often display the opposite, a rearfoot valgus. In this case, a heavy lateral strike leads to sustained lateral foot weightbearing which will mean she stays on the outside or lateral aspect of her foot too long and thus stays in supination.
  2. The heavy lateral foot strike will often lead to knee hyperextension during initial contact and often continues throughout stance phase, as this is a position of stability for the joint. At the end of the video as her knees come into view you can see the degree of knee hyperextension (somewhat). This may remind you of our blog post months ago on anterior knee pain (Anterior Meniscofemoral Impingement Syndrome). Such an anterior pitch of the pelvis and lumbar extension can obviously lead to shortness and shortness-weakness of the psoas and rectus femoris to name just a few.
  3. This type of gait will often lead to an accentuated lumbar spine lordosis curve (functional usually) with an accentuation of the anterior pelvic tilt and resultant inhibition of the lower abdominals. This furthers the knee hyperextension and thus the cycle continues (the knee hyperextenion perpetuating the anterior pelvis and weak abdominals which then drive continued knee extension). Bringing these topics and blending them with items in #2 will naturally limit the degree of hip extension (since the extension of the limb is occurring in the lumbar spine) and lead to inhibition and weakness of the gluteus maximus.
  4. Quite frequently a heavy lateral rear foot strike results in a heavy pronation event at the forefoot loading period (forefoot pronation) particularly when the foot progression angle (turn out) of the feet is large. We DO NOT see this here. However, in these cases one had better have exceptional medial foot tripod skill, endurance and strength (S.E.S once again) as well as great strength in the long and short big toe flexors (FHL, FHB) to help anchor that medial tripod because the forces that are coming into the forefoot in those case are like a rhino at feeding time. However, in this case, there is a plantar flexed 1st ray posturing of the forefoot. A trained eye can see some of the functional characteristics of this forefoot type, but you really must confirm its presence on a clinical examination mainly because you want to know if it is a rigid or flexible forefoot variant. A plantarflexed 1st ray is sometimes found paired with a rearfoot varus, as the foot is trying to find the medial tripod. A forefoot valgus is also possible, but this usually results in the medial foprefoot striking the groung 1st, as opposed to the lateral, as we see here. These people often have great difficulties getting off of the outside of the foot and onto the medial foot to adequately toe off the big toe. This is sometimes referred to as an apropulsive gait.

Wow, all this from some bad gait skills and some minor foot variances huh ?! Yup.

Which brings us to shoes. Wouldn’t it be nice to be well versed on all these issues before you slap her into a neutral shoe ? Because she clearly does not need a stability shoe; pronation is absent in these feet. So, do you pick a neutral shoe with a soft lateral heel crash zone ? How about one with a lateral rearfoot cut out (or “entry” as it is often called? What about no cut out ? Would she do better in a straight lasted shoe or curved ? There are plenty of questions, more than just these. But for this case…….lets stop here and answer just these few for now.

  1. no soft lateral heel impact crash zone with this type of rear foot
  2. use a shoe with no cut out (the beveled cut out at the lateral heel will promote more sustained lateral foot weightbearing). Shoes without a cut out (or entry) will help to drive that heel into eversion and pronation but you had better make sure you have changed their gait and ensured adequate medial foot tripod strength, because remember those types of feet will be driving into that medial forefoot in a major hurry with aggression…… but, thankfully this is not the case here.
  3. Choose a Straight lasted shoe in this case. A more curve lasted shoe will promote more and faster pronation into that forefoot, there is already enough !

There is so much more to this game that simply promoting natural running form or natural walking form. So much more than simply dropping someone to a zero drop or minimal shoe. As we say, it is often not the shoe but the thing you put in the shoe……. but you have to know what shoe you put on the foot and how it is going to react to the foots abilities and its challenges.

Our Shoe Fit program is getting closer and closer to a release date. Those that have been through our program, formally or informally will have the knowledge and skills to dissect a case like this and make some good assessments and choices.

Shawn and Ivo. Gait Geeks, Shoe nerds, Running form teachers, …….. and halfway decent doctors too.

So, does the angle your foot strikes the ground really matter?  With all the talk about minimalistic training and striking  under the body  being less stress on the human frame and more efficient, you would  think so. Here is one study that seems to support that premise. 
  f rom the studies conclusion:  “Our results indicate that  individuals with a larger knee angle (i.e.,  greater extension) 50 ms  prior to initial contact (IC) experience a  higher ROL  (Rate of  loading) during gait and have poorer proprioceptive scores.”  
 Proprioception, gait kinematics, and rate of loading during walking:  are they related? Riskowski JL, Mikesky AE, Bahamonde RE, Alvey TV 3rd,  Burr DB. 
 J Musculoskelet Neuronal Interact. 2005 Oct-Dec;5(4):379-87. 
  http://www.ncbi.nlm.nih.gov/pubmed/16340143  
   Helping to promote gait literacy…We are…The Gait guys

So, does the angle your foot strikes the ground really matter? With all the talk about minimalistic training and striking under the body being less stress on the human frame and more efficient, you would think so. Here is one study that seems to support that premise.

from the studies conclusion: “Our results indicate that individuals with a larger knee angle (i.e., greater extension) 50 ms prior to initial contact (IC) experience a higher ROL  (Rate of loading) during gait and have poorer proprioceptive scores.”

Proprioception, gait kinematics, and rate of loading during walking: are they related? Riskowski JL, Mikesky AE, Bahamonde RE, Alvey TV 3rd, Burr DB.

J Musculoskelet Neuronal Interact. 2005 Oct-Dec;5(4):379-87.

http://www.ncbi.nlm.nih.gov/pubmed/16340143

Helping to promote gait literacy…We are…The Gait guys