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Deconstructing ‘Five-Finger Running’ From an Injury Standpoint

The latest craze in running is Vibram’s new “Five-Finger” types of shoe ware. Although these products may be appropriate for a very select subset of the running population, the recent explosion of hype regarding this new craze has exposed many runners to a significant risk of injury . The premise of this style of running is that it will make the muscles around the lower leg and foot strengthen, subsequently restoring the runner’s function back to its evolutionary pre-shoe “normal state.” The untested theory behind this new fad can lead to two very serious problems. First, it requires the runner to adopt a new midfoot striking running pattern. Ninety-eight percent of all runners are heel-strikers. Without the proper coaching into how to transform from a heel-striking pattern to a midfoot striking pattern, the runner is left in the dark concerning this crucial modification. In fact, Ross Tucker, PhD “The Runner’s Body has found that 83% of all runners who make the switch to Vibrams continue their heel-strike pattern. Dr. Tucker’s research has concluded that since there is no cushioning in the Five-Finger shoe ware, heel pressures are seven times greater than running in a normal running shoe, markedly increasing the chance of injury. Here is the second problem of Vibram’s theory: Muscles and tendons by definition are meant to create motion across joints. Ligaments on the other hand, are meant to connect bones together and are responsible for giving the body structural integrity. In the foot they are responsible for holding your arch in a high position. When a person over pronates, the ligaments fail to do their job. Five-Finger systems would have you attempt to train muscles to do the ligaments job. This creates abnormal stress on the muscle/tendon unit and leads to inflammation, pain and eventual loss of function. This breakdown, in its early stages will present as small areas of inflammation and minor tendinitis. If left untreated, it can proceed into chronic tendinitis (which is much harder to treat), plantar fasciitis, Achilles tendinitis and other problems of the ankle, shin, knee, hip and low back pain. Additionally, all the muscles throughout this “kinetic chain” may be forced into performing stabilizing work which is not their primary function. This too may lead to overuse injuries which are not directly associated with the movement dysfunction down the kinetic chain.

As Running Events Increase in Number, So Do Overuse Injuries

As the number of available running events are on the rise, so too are those overuse injuriesassociated with increased training volumes. In fact, in a study published by Dr .D. Cosca, MD,University of California Davis Sports Medicine Program (Common problems in endurance athletes), he finds that “… intensive training and inadequate recovery leads to the breakdown in tissues reparative mechanisms and eventually to overuse injuries.” The real problem is the creation of the condition called “tendinosis.” Normal “tendinitis” is a common injury condition which, if treated correctly, leads to a healing response and ultimate restoration of that tissues integrity. Tendinosis, on the other hand, is a function of inadequate resting of a tendinitis. If the injured tissue is not allowed to go through its normal healing process, it enters into a vicious cycle of repeated micro trauma while disallowing the reparative properties of its blood supply. As the degenerative properties of the tissue progresses, it becomes more difficult to treat. The finality of this deleterious process may ultimately lead to tissue rupture. Major areas of diagnostic concern are plantar fasciitis, Achilles tendinitis, medial tibial stress syndrome, patellofemoral syndrome, iliotibial band friction syndrome, stress reactions, stress fractures, and other problems up the kinetic chain. The best way to prevent one of these injuries from limiting your training is to attack it early. Early intervention includes following the acronym “RICE:” Rest, Ice, Compression and Elevation. Unfortunately, it is ingrained in the marathoner’s mindset to ignore early symptoms and power through their regimented training programs. What he or she fails to recognize is that losing 1-2 weeks of their training programs is better than the alternative- losing 1-2 months. By following the correct treatment regimen, a visit to the local physician or physical therapist would be the next step. A custom biomechanical assessment and even custom foot orthotics may be appropriate, depending on such factors as over-pronation, leg length discrepancies or muscle imbalances.