Dr. Mark Cucuzzella’s Reply to Jeff Galloway’s Views on Minimalist Running Shoes and Injuries

Discussion in 'Front Page News' started by run_barefoot_az, Jul 23, 2011.

  1. run_barefoot_az

    run_barefoot_az Barefooters
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    Dr. Mark Cucuzzella’s Reply to Jeff Galloway’s Viewson Minimalist Running Shoes and Injuries
    With all his books, coaching experience, training methods, racing achievements, and Ironman-like durability with just over half-century of miles on his legs, Jeff Galloway is a respected fixture in the running community. And along with many other runners, I’m a subscriber to his email newsletter.

    But his take on minimalist running shoes in his most recent newsletter is not one I share. Here’s what he wrote:

    Many runners who own one of the minimal and exotic shoes that have popped up on today's market will tell you that these shoes have solved their running problems. I hear the other side of this issue, about every day, from those who have been injured (often severely) by using these products or by running barefooted. Many have to stop running for 4 to 6 months. Thousands have reported significant problems.

    I've seen this fad come and go 5 times during my 52 years of running. Something will come out in the media about minimal support/barefooted running, and thousands will try it. About a third of those who try it run for short distances and like the tingle of the feet so they run more. Without support, the distance or the surface of the run will often cause an injury--including a number of serious ones such as stress fractures. Each fad cycle ends when those injured tell other runners about their experience--so that very few want to put themselves at risk.

    Minimal shoe/barefooted running has its place if the foot can handle it: Short runs when running on a safe surface can give the foot a bit more strength and develop a lighter touch. Unfortunately, there are lots of risks on most running surfaces: pieces of glass, medal or rock--hidden below even the most groomed grass surfaces. There are also lots of surface irregularities that can produce serious trauma injuries in one step.

    Today's shoes have decades of orthopedic research behind them and can protect the foot from most of the problems due to running surface. Go to a store with trained and experienced staff members, like my Phidippides stores in Atlanta, and get the best advice.

    Here’s my reply to Jeff:

    I am curious about the runners who are showing up everyday claiming to have been injured as a result of minimalist shoes. Over a year ago in Shepherdstown, West Virginia, I opened the first footwear store in the nation purely devoted to minimalism and sold no shoes with traditional elevated heels. Two Rivers Treads was only the first store of its kind. There are now six new stores in the country who have embraced minimalism – and all are partners with the NaturalRunningCenter(http://naturalrunningcenter.com/), where I am also its executive director. All these stores are completely aligned with the education message of teaching good form, prescribing more functional footwear, and the progressive adaptation to more natural running.

    At Two Rivers Treads, we just don’t sell shoes; we have discussion with each and every customer regarding their running, injuries, goals, and some simple and clear instruction on how to reduce impact loads on their joints. We have sold over 3,000 pairs of shoes in a year and only five customers at most have returned with an injury and blamed the shoe. This is far less than Galloway’s daily experience. Are the injured runners just going to the doctors instead of back to us? I doubt it as we would be the first place they would return to if they felt it were the shoes. Do I have scientific data for all this….no, we are a small business.

    Maybe we are doing something different when we sell minimal shoes. So just what are we doing? The following educational information is included on our store wall sand handouts.

    Let’s first define how we interpret minimalism, a minimalist shoe, the risks, and the gradual progress.

    What is Minimalism?
    • Free the foot to develop naturallyLook for the least amount of shoe you can safely wear nowWork toward reducing the amount of shoe necessary through strengthening the foot and improving your strideRunning is a natural movement of the body, rather than an unnatural act that requires artificial support to perform safelyEmbraces the notion that the beefier the shoe, the more a runner's natural stride is inhibited
    What is a Minimalist Shoe?
    • Complements natural foot functionHeel to toe drop is very lowMaterial under the foot is thin….allowing maximum ground feelUpper Soft and FlexibleLight Weight and Flexible
    Effects of a Modern Running Shoe?
    • Impairs your natural bouncePromotes heel strikingAlters your natural lever (heel lift)Creates unstable baseCauses loss of sensory inputCauses skin atrophyCreates unhelpful movement memory
    What are the Risks of Minimalism?
    • Foot is NOT guided into running strideFeet need to do some of the work and need to get strongIf form is incorrect and you are not strong in the right places you may develop soreness….so listen to your body and progress gradually
    How to go Minimal?
    • Take it slow at firstAdd distance graduallyThe more minimal the shoe the more adaptation it will takeProgress through the stages of Shoes from Neutral/Transition to Minimalist to Barefoot StyleDo some barefoot running and walking
    For early adapters who are weak in their foot and hip stabilizers a minimal shoe may be what we call a “neutral –transition shoe”, such as a Newton Isaac or Altra Intuition.

    Now how do we define shoes? This too is on our store walls, and the shoes are displayed this way in the NaturalRunningCenterShoe review section http://naturalrunningcenter.com/naturalrunningcenter-shoereviews/

    Barefoot-Style Shoe
    • Your feet “feel” the groundTh
      innest layer of protection between foot and groundHeel and toes are levelLand on the midfoot/forefootLightweight
    Minimalist Running
    • Some cushiony comfortLittle to no heel-to-toe area dropEnhanced ground feel with feetSoft, flexible shoe moves with feetIdeal for all surfaces– road, trail, track
    Neutral/Transition
    • Similar protection to most running shoes but without elevated heelLittle to no heel-to-toe area dropFoot is in natural positionEncourages midfoot/forefoot landingIdeal “starter” shoe for transitioning runners to minimalist/barefoot-style


    The real folks making this happen in a small community such as Shepherdstown are my lead employees, aka the Shoe Guys, Tom Shantz and James Munnis who lend some practical and philosophical advice on the topic

    Here’s Tom: “We give verbal warnings to all minimalist shoe buyers. I have been adapting for a little over a year now. It is a slow process. What I have found what works best is to have two pair of shoes. One that is ‘flat’, zero drop, and one that has a drop of 5mm. One should transition into the 5mm shoe first. It should take approximately 2 weeks. The zero-drop shoe should take you approx three months to transition into. Once you have transitioned into both shoes you should continue to slowly increase your distance in the zero-drop shoe. The 10% week rule is out the window. Try 1% increase in the zero-drop shoe. For a younger runner who has been in racing flats the transition is much shorter.”



    Now here’s James: “It’s still funny to me how three million years of evolution is still considered a fad by some folks. Nobody who has ever followed our advice on gradual transition has ever been injured from the act of running completely barefoot, or in minimalist shoes. Many do have the usual fatigue and discomfort over a period of up to a year or so trying to undo the weakness and atrophy of the most excellent foot that has been caused by horrible traditional footwear for everyday wear and for running. Mother Nature has a result that is very endurable and survivable, despite our very recent efforts to screw it up with the many ridiculous features of a traditional running shoe. Would anyone please tell me one single reason to elevate a human heel above the forefoot for anything, or to interfere with our natural suspension system with arch support, and especially for running?”

    So there you have it: Two Rivers Treads’ Shoe Guys have spoken. And as their informal comments reflect, it is not about the shoe, but the education. An example of one of the fun educational sessions hosted by our store is the recent Natural Running Roundup with Chris McDougall on the home page of the NaturalRunningCenter.

    Here’s to healthier running,

    Dr. Mark Cucuzzella
     
  2. JosephTree

    JosephTree Barefooters
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    There just seem to be an awful lot of people who are out there running BF / Minimalist and staying healthy and happy. I'm one of 'em. If it didn't work for me over the last 16 months I'd probably have stopped. We don't hear from many folks who give up and revert to conventional shoes once they've acclimated, either.

    I also believe that the key is education. The ones getting hurt are the ones treating it as the fad and not giving the transition its due. I was lucky in that respect. I didn't transition at all, except from non-runner to barefoot runner.

    Maybe Jeff galloway will live to revise his opinion. It's happened.
     
  3. twinkletoes

    twinkletoes Barefooters
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    It's alwaysaggravating to mewhen people who don't support our running style trot out "severe injuries" as the main argument against running without the Highly Engineered Running Shoes. As if podiatrists and orthopaedic surgeons had no steadybusiness everfrom severely injuredrunners before this so-called fad? That's just silly. We get hurt because we move. A year to transition is about right and the first months were definitely tough for me, but I would do it again, absolutely. Wish I had taken off my shoes years ago when I first heard of barefoot running. Also,glass is very sparkly in the sunshine and easy to avoid. That one always puzzles me.
     
  4. Neil_D

    Neil_D Chapter Presidents
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    Ha ha.

    IT's a shame that all the years of running haven't taught Jeff that much about the the sport he loves if that is the kind of uneducated belief he holds.

    Ok, so as far he sees it the fad ends when all the injured runners tell their friends about the injuries and not to buy minimalist shoes or run barefoot. Well, considering the numbers of people that are being injured by conventional running shoes it may be about time that 'fad' should have ended but it hasn't so that argument has been debunked.

    If he is meaning to say that runnners in conventional shoes never get injured then there would obviously be no need for all the podiatrists and sports doctors out there manufacturing orthotics, because, after all, the running shoe companies spend millions on their 'research'.

    It's something of an irony that Jeff calls his stores Phidippides I bet that the real Phidippides wasn't sporting heavily enginneered running shoes, raised heels, springy cushioning etc, in fact I would hazzard a guess and say, if he wasn't barefoot then he would have been wearing something similar to a minimalist shoe.

    Enough said.

    Neil
     
  5. Dr. Mark

    Dr. Mark Barefooters
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    BF Runners,



    Want to leave you with a great piece and video that sums this up.....I think?

    Rememeber the child and marshmellow experiment?

    http://zero-drop.com/?p=3068

    Enjoy and just go run!

    Mark
     
  6. Angie Bee

    Angie Bee Barefooters
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    This was a great post! I reposted it to facebook and laughed out loud at the marshmallow test!

    I don't think I could have resisted the temptation of instant gratification back then. Different story with my barefoot running though.

    Thanks Mark :)
     
  7. casatucson

    casatucson Chapter Presidents
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    I made the switch to barefoot/minimalist about a year and a half ago.My first transition footwear were Vibram Five Fingers and an old pair of Converse shoes. I currentlywear Luna Sandals and also do one or two total barefoot runs per week and run a total of about 50 miles per week. My prior chronic knee pain is now completely gone.



    I have seen two cases of people injuring themselves while using Vibram Five Fingers:



    The first is a 50-something year old male who was really jazzed about the idea but when we ran together I noticed that he continued heel striking in the VFFsjust as if he were wearing shoes. He went back to shoes.



    The second is a 20-something female who is overweight and attempted to do mega-miles too soon before dropping the extra weight.



    These injuries had more to dowith improper technique than the barefoot style itself.
     
  8. BarefootDad

    BarefootDad Barefooters

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    Barefoot Friends,

    I've been running sans shoes for about 10 months and usually run 4.5 milesevery other day. While on business in West Virginia, I greatly enjoyed running barefoot through the beautiful historic towns.In Shepherdstown, WV, Ihad the opportunity to visit Two Rivers Treads and truly enjoyed the family atmosphere andgenuine runners who work there! Dr. Mark Cucuzzella offers free clinics on running 101, injury prevention, and barefoot running. I highly recommend them!

    Some of the towns have older roads, red brick sidewalks, and occasional glass shards (no explanation there)that can turn the soles of bare feet into hamburger.Recent 100+ degree daysmade the black top roads very toasty, so I went back to Two Rivers Treads to buy my first pair of KSO's. I put the shoes on, paid for them,and literally ran out.They were filming a Newton Running Commercial outside, which was far more fun to be in than listening to a marathon runner/chi running instructorexplain the importance of proper fit.

    I later explained to Tom Shantz, one of the Shoe Guys, that I had a blister and may need to return the shoes. Tom refunded the money andthen refused to sell me a different pair of shoes until afterthe blister heals."It is the only way to ensure a proper fit when we put you in another pair of shoes," Tom told me. Tom then spent close to an hour, 20 minutes of which was after the store was closed, to share the benefits of a number of different minimalist running shoes. Wow! I learned more in that hour with Tom and during the barefoot running clinic withMark than I have in 10 months.Theytruly believe in what they are doing.



    Run lightly,

    Barefoot Dad
     
  9. stomper

    stomper Guest

    Galloway is (in a way) describing something we've often discussed on this site, that the experience of wearing minimal shoes can get people too excited and lead to TMTS injuries. I think that most people at the BRS wouldn't disagree with that observation, but they would disagree with dismissing minimal shoes outright as he seems to be suggesting.

    As for actual BF running, it doesn't sound like Galloway really knows what he's talking about. The whole comment about the dangers of rocks and glass and etc. is frequently trotted out by "experts" (usually podiatrists) who discourage barefoot running, but anyone who has actually run BF knows how overblown those fears are. Accordingly, I get the impression that Galloway has observed very very few true BF runners.

    The whole thing about "decades of orthopedic research" behind shoes is irrelevant. In all of that research, there is simply no evidence demonstrating any difference in injury rates between shod and barefoot runners. Every runner should know that, whether they choose to wear shoes or not.
     
  10. mageomatic

    mageomatic Barefooters
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    My expreiance, I start running in VFF KSO, at frist I could not even make it 15 mins, after 3 months, I was able to complete a 1/2 marathon . last fall I complete my 8th 1/2 marathon and second one with my VFF. All I can say is Im running faster, stronger, and feel great at the end of the run. Also I have been injury free. Im now training for a full marathon.
     

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