Negativity from Podiatrists

[Paleo]

 I just wish that the

I just wish that the podiatrists (and the reporting) would differentiate between BFR as such and those people who do too much too soon (TMTS).

Perfect example is the recent article in the NY Times,

www.nytimes.com/2010/11/03/sports/03barefoot.html

which gives a generally good account of the new popularity of BRF (and a great mention of BRS). But, again it quotes the podiatrists talking about all the injuries from newbies to BFR. It should seem obvious as day that the patients started too fast. But the doctors don't really think about it.

I, for one, will never, ever see a podiatrist or orthopedist who is not him/herself an active athlete--preferably runner or cyclist (my sports). But, even my orthopedist--who was a cycling buddy and triathlete--was skeptical of my minimalist shoes (I hadn't started BFR yet). They challenged his medical training just a bit too much.

I think one of the most important messages we can get out is: go easy at first, really, really easy.

Cheers

Jamie

 

[The Ramzev]

  Maybe I didn't put it out

Maybe I didn't put it out there right, but the point of my original post was not to change the minds of current podiatrists, we know that wouldn't work so well and this topic has been hashed out plenty, of course the topic will turn to beer, Podiatrists are a worn out topic.

The point I was getting at with my original post, is therre anything that can be done to sway the minds of those in or just out of Med school? Is there a way to "infiltrate" the ranks of new Podiatrists? Maybe, like I had suggested, offering clinics or if there's already a clinic happening in close proximity to a Med school flyers could be posted. All it could take is a couple open minded students to possibly get the correct info out there. They all probably have to write a Thesis, right? Get a couple Barefoot running thesis' published and it'll change the conversation.

 

[Paleo]

 Since I ultimately believe

Since I ultimately believe in human curiosity and the power of honest science, I think that the younger podiatrists will get interested. Heck, there is probably a med student or two who has selected podiatry as his/her specialty because they read "Born to run" etc. But, it will take a while. After all a med student starting his/her residency in podiatry this year will first have an established reputation in say 10-15 years.

To infiltrate: grant money for research on BFR. This will get any budding podiatrist with the mildest inclinations to BFR to take up the subject.

As is clear from the NYT article I linked to, there isn't much research on it. But who would fund it?

• The big shoe companies: doubtful. I am sure they do their research. This resulted, for example, in the Nike free.
• Maybe a consortium of small "minimalist" shoe companies could find a bit in their budget.
• Government: maybe.
• A philanthropist: sure, if he/she is into the idea. (Anyone in the BRS with a couple hundred grand lying around?)

But, for BFR the problem is that there is no product to sell (the minimalists have it easier). So our best bets are on 3 and 4.

I remain optimistic.

Cheers

Paleo

 

[Barefoot TJ]

It's gonna take time.What I

It's gonna take time.

What I can't stand about these reports is that they don't bother to bring up the TMTS issue, sure, but they don't bother to differentiate a true barefoot running injury from a minimalist running injury.

 

[Barefoot TJ]

Only 'cause I know Ram is

Only 'cause I know Ram is following this thread I'm going to respond with a list of sentences:

Haaa. I remember when Ram brought this up... Oh so funny. You have gotten much better at your posting though, Board, no more line-by-lines.

 

[Barefoot TJ]

Most excellent insight there,

Most excellent insight there, Board. The truth is ugly, but it is the truth.

 

[The Ramzev]

I miss the list of sentences!

I miss the list of sentences! Thanks Board! Also thanks for the info, lots of it there. Maybe podiatrists aren't going to do much for us, but it gave me a day or two thinking I had a good idea.

I'll go have a good brew and come up with another idea. I got me some Dogfish Palo Santo, brewed in the largest wood brew tanks built some prohibition 12 % ABV so my posts this evening will be PWI so I'll apologize in advance.

 

[ajb422]

 I'm not sure that bringing

I'm not sure that bringing up the issue of injuries being caused by TMTS would really make a difference to most people. People don't want to be told they have to take things slowly (and I include myself in these "people"). Because obviously if something is good for you, then you should just be able to do it until you collapse without breaking things *catch the dripping sarcasm here*. Take for instance shod running. Most the time the first thing that stops you will be aerobic activity or muscles, not bones breaking. Of course a few months down the line comes all the injuries but by then they already have you hooked. Same thing with biking. You can just hop on and go without having to be super careful about when you stop.

I think the media should explain that the only reason we have to take it slow with bf running is because people put us in shoes as kids. Otherwise we would of acquired the skillset slowly and naturally and built the correct muscles to handle it from the time we started walking. The problem isn't in bfing the problem is putting 3 and 4 year olds in shoes.

 

[Longboard]

Paleo wrote:  Heck, there is

Heck, there is probably a med student or two who has selected podiatry as his/her specialty because they read "Born to run" etc.

Only 'cause I know Ram is following this thread I'm going to respond with a list of sentences:

Podiatry is not a medical specialty, and medical students do not select residencies in podiatry.

Instead, a student opts to attend a school of podiatric medicine without ever having attended a traditional medical school. Many countries do not even license podiatrists.

The profession was only invented in the 1960's, when American chiropodists decided to become surgeons and eliminate confusion with the similarly sounding profession of chiropractic.

There are less than half a dozen schools of podiatric medicine in the U.S.

The practice is primarily the care of feet that have been damaged by shoes, and there has not been an attempt to prevent these problems by recommending barefoot life despite the widespread acceptance in the field of this basic cause/effect relationship.

Podiatrists are not people that have chosen this area of the body to specialize in after having been exposed to the various medical specialties as are medical students before selecting their particular specialties.

Many podiatrists do take up surgical residencies these days after completing podiatry school because they no longer would be granted hospital privelages nor insurence coverage without that additional training.

The paradigm shift will not come from within the ranks of podiatrists, but instead from primary care physicians that can recommend the best known way to avoid the podiatrist.

Many medical doctors never refer patients to podiatrists. There are medical specialties that treat all podiatric problems without the need ever to refer to a podiatrist. Usualy either a dermatologist, an orthopedic surgeon, wound care specialist, infectous disease specialist, or vascular surgeon will fill the need.

In my opinion, the podiatrist will always recommend footwear and orthotics no matter how much evidence there is to the contrary. The nature of their profession is based on how to survive in a shoe wearing culture.

I believe that well informed rheumatologists may soon advise patients to try barefoot walking for relief of knee pain, because they are being taught that in their specialty journals. The orthopedic surgeon will lose out on the referal, but the arthritis doc will have done his/her job. Soon orthopedic surgeons may recommend barefoot exercise instead of physical therepy......unless they own the PT clinic.

Podiatrists function for the most part as primary foot care doctors, treating the whole family for what ails their "feets".

Podiatrists have always accepted that barefoot populations do not need their services, and they will not deliberatly try to shrink their patient pool.

As people slowly start to adopt barefoot exercise and lifestyle, the need for podiatrists will diminish and a smaller number of college students will choose to enter podiatry school. It really hasn't been a first-choice for most to begin with, but rather an alternative to an off-shore medical school when acceptance to a U.S. based medical school has started to appear unlikely.

Not that there's anything wrong with that, many dentists, osteopathic physicians, chiropractors, and optometrists ended up in their fields via similar default, but when it no longer looks as if a podiatrist can make a buck or two in a new millenium barefoot culture, it will no longer seem to be an attractive option to students who have given up on gaining a shot at other medical careers.

 

[Longboard]

barefoot ramzev wrote: I got

I got me some Dogfish Palo Santo, brewed in the largest wood brew tanks built some prohibition 12 % ABV so my posts this evening will be PWI so I'll apologize in advance.

We get an extra hour tonight. Yeah baby! I think this calls for at least 1 extra % ABV, if not more.

12%? I thought Scotch Ale at 10.5% was pushing the limits of what we can still call beer.

I tried a Bell's "Hell Hath No Fury" ale ( http://beeradvocate.com/beer/profile/287/20604 ) a few days ago. At 7.5% ABV I thought that kicked butt.

I'm dying to try it with some wings dipped in "Scorned Woman" (http://www.vitafoodproducts.com/m-70-scorned-woman.aspx) hot sauce.

 

[pbarker]

I'll have another Guinness

I'll have another Guinness and some potatoes fries please.

My MD is a marathoner. Last time I went for an annual check up I told the Dr I was a barefoot runner.

You could hear the crickets. I'll bring it up again next time, maybe if I'm lucky I'll get a referral to podiatrist and go in fully armed with data.

 

[jschwab]

I have talked to a few sports

I have talked to a few sports physiology students who had to write papers in school about barefoot running - it was assigned. There is some hope.

 

[Paleo]

I appreciate the correction,

I appreciate the correction, Longboard. I was not aware of that (I had never really thought about it). I lumped Podiatrists in as a med. specialty--like a funny mix between an orthopedist and a dermatologist.

Way back when, I was referred to one by an orthopedist, as I was fighting some chronic achilles tendinitis. Well, the podiatrist did proscribe orthotics. They provided relief immediately. I wore them for several years, but realized eventually that I could never get a good fit in any shoe--a problem I had never had. The fact was the orthotics made me dependent on them. At some point in a fit of frustration about ill-fitting shoes, I figured this can't be right. So, I ditched them, and got along just fine.

Well, all in all that partly explains why podiatrists will be so skeptical of BFR. It's not in their professional interest. But, orthopedists are another matter. I still think that serious grant money is the best way to get younger docs to get interested in the subject. Where's our local philanthropist?


ajb422 makes a good point. People don't want to be told what to do in any circumstance. I, myself, have learned the lesson the hard way. Either way you slice it, it is a matter of TMTS. I tell people that they have to think of BFR as a new sport. They should pretend they have never ever run before, and take it appropriately slow. They should get there workout from some other sport until they've built up their foot structure.

 

[Longboard]

Paleo wrote:..... the

..... the podiatrist did proscribe orthotics. They provided relief immediately. I wore them for several years, but realized eventually .... The fact was the orthotics made me dependent on them.

Podiatrists as well as patients love them for the in-many-cases almost instantanious pain relief, never once thinking about the addictive potential.

Back pain victims are warned by their physicians to only wear a "cinch belt" occasionaly during their recovery period, lest their muscles atrophy furthering their problems.

Orthotics may indeed have a legitimate purpose, temporarily relieving pain until health can be restored to the structures that are ailing.

 

[jschwab]

Longboard wrotealeo

..... the podiatrist did proscribe orthotics. They provided relief immediately. I wore them for several years, but realized eventually .... The fact was the orthotics made me dependent on them.

Podiatrists as well as patients love them for the in-many-cases almost instantanious pain relief, never once thinking about the addictive potential.

Back pain victims are warned by their physicians to only wear a "cinch belt" occasionaly during their recovery period, lest their muscles atrophy furthering their problems.

Orthotics may indeed have a legitimate purpose, temporarily relieving pain until health can be restored to the structures that are ailing.

I was someone who wore orthotics for a very short period of time (less than six months). My feet corrected, and my gait went from bad to perfect. But I was like a rock star in the office - hardly anyone has that kind of improvement because they are not motivated to fix what's wrong.