Hi Natch, welcome to the
Hi Natch, welcome to the forum!
I am so glad more medical professionals, including podiatrists, are venturing on to this site. Thanks for laying your perspective out for us. I've trained and worked as a scientist and I too am looking forward to a wider body of evidence about BFR and MR (I suspect, actually, that research will find a difference between those two activities). I edit the "Library" section of the site including its summary of the current state of scientific evidence and popular press coverage.
For better or worse, in the past podiatrists (with notable exceptions) have been the butt of a lot of jokes and dismissals here on this site. That's because many of the podiatrists quoted in the popular press and in online sources in 2009-2010 were (to make an unfortunate generalization) rather ignorant about the actual practice of barefoot running or the ability of bodies and minds to adjust to that practice. The party line you speak of-- i.e. "there's not enough data yet" -- was not really evident in the popular press until 2011. Before that the podiatrists in the press and in online sources mostly made objections to BFR based on hypothetical scenarios--lacerations, infection by viruses, repetitive forces, etc.
Like so much of medical advice (for better or worse), these objections were not made on the basis of evidence in journals. There simply was not that much published evidence out there about barefoot running. So instead the advice came out of some other font of "knowledge" -- tradition, perhaps, or "first principles" that sound reasonable but actual practice shows may not make sense.
One example is the whole fear about lacerations and puncture wounds. In reality, it's so overblown. Anyone who had actually met five real barefoot runners would know that. Another is the whole concept of BFR only being suited to "non-overweight people with perfect biomechanics." This was the most common critique by podiatrists and running coaches in the popular press toward the end of 2010 and the beginning of 2011. Yet there's no evidence I know of showing that the effect of BFR differs between weight classes, and "perfect biomechanics" is what my professor in the philosophy of science would have dismissed as a piece of pseudo-scientific jargon instead of an actual working scientific classification. "Perfect biomechanics" has no objective, widely agreed upon definition and matching basis of measurement and therefore works better to cow plebes than to actually play part in any research study.
Of course I follow this kind of stuff with a skeptical eye. But even people who don't share this hobby of mine know when a medical practictioner is making a broad generalization that doesn't match their experience. Sometimes I think medical practictioners make such generalizations because they feel they're supposed to be "authorities" on everything. But when the receiver of the advice has good reason to doubt that generalization, the medical practictioner loses a lot of credibility.
Unfortunately this has happened between barefoot runners and podiatrists. I hope it's all because of a few loudmouths who got quoted in the press a lot, and aren't really representative of the profession. If that's true some of us owe podiatrists an apology.
This is a tempest in a teacup for sure; very few people in the West actually run barefoot; many won't ever see a podiatrist. But the BFR movement does reflect on bigger cultural trends -- the increasing (and, to me, distressing) isolation of the human body from the range of natural conditions, for example. So understanding what feet can really do isn't just about feet; it's not trivial.
Anyway, I never even considered that podiatrists might get to the point where they would recommend barefoot running to their patients. I'm pleased any medical practictioner is even thinking about it.
I agree, there's not much evidence for it now, at least if the goal is preventing injuries. But by the same token there's not much evidence for recommending running shoes. Mostly there is the weight of tradition. And given the pretty shocking rate of injuries to recreational runners in shoes, I'd say it's not a great tradition we must strive to keep, like, say, mistletoe at the holiday party. Where someday diehard BFR's and podiatrists will hopefully make up.
Again, welcome. !
