Ask the Doc - Michael Nirenberg, DPM - What's the deal with podiatrists?

Discussion in 'Front Page News' started by C. Beth Run., Sep 30, 2010.

  1. C. Beth Run.

    C. Beth Run.
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    1. Texas - Dallas
    2. Texas - Austin

    Jul 6, 2010
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    Ask the Doc
    Michael Nirenberg, DPM
    What's the deal with podiatrists?

    The short version: So what's the deal with podiatrists?
    The long version: When I was recently reviewing press about barefoot running, I saw some trends in the kinds of "expert sources" used and the kind of things they said. A typical story would have two sources, one pro- and one anti-barefoot running. A better story would have three or four expert sources to give more perspective, perhaps mixing in somebody like a coach or an orthopedic surgeon.
    But the "anti" source was almost always a podiatrist, and, more interestingly, it was unfailingly podiatrists who said the most ignorant things about barefoot running. It was as if they had never tried it or observed it. For example, one said that running in a racing flat was just like running barefoot, which anyone who's ever run an inch barefoot could tell you is not true.
    Curious, I spent a while perusing a long podiatry forum thread about barefoot running. While the attitudes among the podiatrists there were a bit more nuanced, the general theme I got was that there was a persistent belief that bodies could not change. Only people who had gone shoeless since birth or were blessed with perfect biomechanics should attempt running in bare feet; everyone else was doomed to need shoes because they had always been wearing shoes. Again, this is something that anyone who has ever spent a week at the beach barefoot, or done a martial arts class, could disprove; such people know that their feet and their bodies can change, indeed, within a scale of weeks.
    From this very small sample, I am getting a poor impression of the profession as somewhat disconnected from reality.
    Is this impression accurate? And if so, why are things this way?
    Cheers, stomper

    Hi Stomper,
    Barefoot running is not new. Most experts agree that humans have been walking upright on two feet (bipedal) for at least three and a half million years, and presumably for most of that time we have been running barefoot or in minimalist footwear. There is even a "running hypothesis" that suggests that in order for humans to have survived in our "caveman" days, we depended on our ability to run long distances, to literally outrun prey to catch it.
    Recently, most podiatrists and many shoe companies have advocated that feet generally need support, especially when running. The American Podiatric Medical Association released a press release advocating against barefoot running due to a lack of solid research showing its benefits. Oddly, I have not found one scientific paper proving that barefoot running is harmful or worse than shoes. Yet, there is scientific research that shows a correlation between footwear and foot problems.
    Generally, the podiatrists who advocate that feet need support are doing what they have been taught and what they believe to be best for people. Some doctors though may be taking this stance because of they have a financial interest in keeping feet in orthotics or supportive running shoes.
    Interestingly, one website's sole purpose is to advocate that barefoot running is bad for you. Officially, the owner of the site prefers to remain anonymous, and I have no intention of pulling him out of the closet, but unofficially I can tell you that the site is run by a podiatrist with an interest in promoting running shoes (and who even has a running shoe website). This podiatrist also makes money teaching podiatrists the biomechanics necessary to make patients orthotics.
    There are many good, open-minded, independent-thinking podiatrists who believe the human foot can make it on its own -- without supportive shoes and/or orthotics! But these doctors are but a tiny voice against the billion dollar supportive footwear/orthotic industry.
    Michael Nirenberg, DPM

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  2. owl

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    Oct 1, 2010
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    Most podiatrists seem to have a very low opinion of the human masses, and don't believe that anyone would have the brains/will power/persistence/patience to transition to a barefoot-mode of running properly. Perhaps this view is accurate. However, it does not apply to the typical independent-minded, rugged individual that you find running in VFFs or bare feet.

    So I conclude that the mass of podiatrists have nothing intelligent to add to the barefoot conversation.
  3. pbarker

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    1. Canada

    Sep 19, 2010
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    I am sure there are changes occuring in the training of pediatrists as we speak. It is absolutely fascinating times we live in. Thank you Dr Nirenberg for your input.

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