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Wednesday, January 18, 2012

Lies, Damn Lies, and Barefoot Statistics



I just got an email from VIVOBAREFOOT in my inbox with the following title: "It's Official: Barefoot is Best!" Oh goodie! It's official! When is the victory parade? I love parades!



BTW, I think our parade would look a lot like this too.

So I opened the email to see if us barefooters had won anything. Nope. Not even a trophy. The email was actually an article about some sciency stuff. It talked about the latest study by Harvard professor Daniel Lieberman regarding footstrike patterns and injury rates. Dr. Lieberman looked at the injury rate of 52 NCAA cross-country runners over several years. He found that during the course of the study heel strikers were injured at twice the rate of their forefoot striking counterparts (the full text is here).

Of course, the study had nothing to do with barefoot running. But VIVO likes to do that whole "barefoot is best" followed quickly by the "we sell barefoot shoes...same difference" switcharoo thing. I'd do it too. It's the best bait and switch since this:



After 40 years of this, you'd think Charlie would have learned. Never trust a woman with a football.

Now, I read the full study. I nerd out on stuff like this. And I have to keep on top of this stuff so that I can report back on it to the four people who read my blog who actually care.

I had read it before I got this email, and I must say...headlines like the one crafted by VIVOBAREFOOT didn't pop into my mind. This study is hardly a ringing endorsement of the forefoot strike, let alone barefoot running. Why? Another important fact in the study...over its course 74% of participants were injured EVERY YEAR regardless of footstrike. That means that 3 out of 4 runners got injured every year, and 1 of those 3 had a forefoot strike.

Oh yeah...now I'm a believer...

The logic to extend it to barefoot running is a bit more strained. The headline about the study crafted by VIVO is, "heel striking causes two times as many running injuries as forefoot striking". I guess the logic that led them to their email title goes a little like this then: some people forefoot strike while barefooting....HEY LOOK OVER THERE...IS THAT BAREFOOT TED!!....barefoot is best.



How come Ted can make anything look badass? He even makes looking like a chimney sweep look cool.

I don't normally pick apart spam emails with so much detail. I just remember the last time something like this happened. You probably remember it too. It was back in the glory days of the study of barefoot running. You know...2009 and 2010. Those were the years that the same Harvard professor conducted and published his first study on the subject (full text here, and cool looking website with lots of pictures for non-smart people here). That was the one that made it's way into the best-selling book "Born to Run" by my brother from another mother Chris McDougall.

Then after appearing in BTR it subsequently became the barefoot running gospel and was paraded around for years as proof that barefoot running is the only way to run injury-free...hallelujah amen. Same stretched conclusions. Forefoot striking causes less injury than heel striking...therefore barefoot is best. Even though there's a statement in bold letters right on the study website that says: "We emphasize though, that no study has shown that heel striking contributes more to injury than forefoot striking."



Here's what we barefooters think about your silly Harvard cautionary language DOCTOR DANIEL!

One thing I wish would stop happening is exactly what VIVOBAREFOOT did in that email. Folks, we're not finding smoking gun stuff in these studies to support a headline like "barefoot is best". We aren't going to be able to point to a study and say that we won the war against shoes. In fact, a lot of it seems to fly in the face of what we've been saying for years.

For example, here's something that will blow the hair off your nuts (or whatever you have down there)...heel striking might not be all that bad for you. SAY WHAT?! Read the stuff coming out of the Natural Running Center from Jay DiCharry sometime. From what he's found so far, footstrike doesn't seem to be nearly as important as things like stride length (here's an article on what he's discovered so far). And cushioning...actually does it's job (at least when it comes to reducing impact forces). I know...weird right.

These sorts of studies don't do much of anything to validate my decision to run barefoot. Rather, they remind me how much we don't know about the science behind the various bald assertions thrown around in the barefoot running community. Even though a lot of great work has been done by Dr. Lieberman and others, we're still just beginning to learn about why things like barefoot running and forefoot striking seem to cause less injury.



In Jay's lab...blowing up some running form bullshit...

What we'll probably find out is exactly what I'm about to say. And it will save you all the nerdy research that I've done. Don't let some study or some self-proclaimed guru tell you that the way you run is wrong or that the shoes you own aren't "minimal" enough. If what you're doing makes you happy...go with it.

If you're 100% satisfied, that's the only statistic that matters...

Like the way I ended that? Pretty fucking clever huh? How about something more traditional? Like CHEERS CITIZENS!

39 comments:

  1. Your iconoclastic attitude and knowledge are greatly appreciated, along with Jason's restless curiosity and experimentation. Keep up the good work fellas! I love bare feet, but if people love their shoes just as much, who am I to disagree? Live and let live I say.

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  2. CP, I've recently been working on running at an increased stride rate/cadence, (Thanks Robillard) and I have to say I'm having more fun running. Though I dont always hit the "sacred" 180BPM, I seem to do ok at 170-176, and notice that I'm having higher turnover than most of the folks I'm running with. (On a side note, I wish we had a radar detector type device so we can see what people are actually running at, as I'm using BPM based on music on the ol' iPod.)

    And when it feels good, that leads to being satisfied, right?

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  3. I personally think all this attempt to debunk clearly obvious data analysis is as a result of photos showing your own heel striking and in order to maintain your position at the top of the greasy pole of barefoot/ minimalist/swag grabbing bloggers/kudus. You are the Paula Dean of barefoot running ;)

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  4. And like Paula, it will come out I have diabetes from eating fried cheesecake despite my proclamations of being paleo.

    Rob, I also run with a BPM of around 160, though I've never really counted. That's another ridiculous rule that I wish would die.

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  5. GREAT post! Nothing to add, nothing to subtract.

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  6. That is so funny MGBG! I got the same thing from vivobarefoot and noticed that the excerpt had said nothing about barefoot, only the different strike patterns. I mentioned this to some brs friends and they apparently only heard the barefoot is best part until I mentioned the excerpt from the study said nothing about barefoot. Been trying to find a link to the full study so I could geek out too. Thanks for providing a link for me. I didn't want to pay for the study from Nature or anyone else.

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  7. Whew....I thought I was the only less-than-180 steps per minute guy.

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  8. Great post. I look forward to the day when the debate over barefoot is the same as which shoes to wear. How do I want to feel today? It really is that simple. Thanks fo the post.

    Jesse James Retherford
    http://www.tao-fit.com

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  9. I'm out at the Outdoor Retailer show and I've bumped into a number of Vivo sales reps... they are THRILLED that the "Harvard studies finally came out" and "proved that Vivo shoes are better for you."

    Now, I'll admit that as a business man, I was not going to miss my chance to piggyback on the publicity of the studies, but it's still clear that THE studies about barefoot have not been done. There are at least 4-5 I can think of:

    1) Take a statistically significant number of shod runners, have them start running barefoot... compare their injury rates over, say, 6 months, with a control group. Also check to see who naturally switches footstrike patterns and check for overstriding.

    2) Take a statistically significant number of NON-runners. Have some start running barefoot and others run shod... same distances, same frequency. Check injury rates. Check foot strike. Check for overstriding.

    3) Take a group of heel-striking runners and TEACH them to forefoot strike and not overstride (actually, those could be 2 different experiments). Check for injury rates compared to un-taught runners.

    When the only research available *suggests* that what you're doing has validity, it's not surprising that some (some more than others) will latch onto it. Any port in a storm... especially if that port can seemingly add legitimacy to what you're doing in the marketplace. But my empirical nature really hopes for REAL science, if for no other reason than curiosity. I know that going barefoot/Invisible has dramatically changed my running life, and I even have theories about why (lack of overstriding more than footstrike change, BTW), and I still love a good study.

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  10. Will somebody please give Pete Larson a huge sum of money so that he can do these studies?

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  11. Hey MGBG, is there a way for your email notifications of posts to be delivered around the same time as the post is posted? There's always a 24-hour delay.
    Great photos/art by the way ....

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  12. This is all the proof that I need to continue running barefoot. http://www.barefoottyler.com/2012/01/i-have-found-proof-that-barefoot.html

    But more seriously, I like running barefoot. That is the main reason I do it. If I didn't like it I wouldn't do it no matter how good it is for me.

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    Replies
    1. Attempts to find the wildJanuary 23, 2012 at 11:04 AM

      I totally agree. I started to run barefoot or minimalist cause of overwhelming evidence. Now I keep it up because I like the way I feel at the end of the day. Still I spend way too much time not running and sitting on the couch.

      Delete
  13. I haven't found a great system for email notification. But email me and I'll put you on my super secret list. We'll see if that works

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  14. I don't really understand the purpose of this beat down on VIVOBAREFOOT's post or Daniel Leiberman's study. Is VIVOBAREFOOT not allowed to create catchy headlines, and is Daniel Lieberman not allowed to do his best to scientifically quantify and substantiate why forefoot striking reduces injuries and why minimalist shoes improves efficiency? (For those that didn't read the post or the articles, there were two studies done; one on forefoot vs heel strike and injury rates, and one on minimalist shoes vs traditional shoes and running economy)

    Some of you will probably discount anything I say because I own a shoe store called, of all things, Born to Run, where we sell minimalist shoes and teach people correct running form. And since I am a business guy I must have only a monetary reason for opening such a business. The truth is that I believe that for the past 40 years that too many people have been getting injured and running with poor form because nobody challenged the status quo of heel strike running in traditional running shoes with elevated heels, a hefty amount of cushioning, motion control, arch support, and narrow toe boxes. With Born to Run - The Barefoot Shoe Store, I want to offer people an alternative to what they would get at a traditional running store.

    McDougall's book, Born to Run, was the first time, on a major platform, that the status quo was challenged. My store along with the other Natural Running Center stores is the first time the status quo of how a running stores should be is being challenged. We didn't open these stores because we have all the answers, although we do believe we have more answers than other traditional running store. We opened these stores because we want to challenge the status quo and we believe, through personal experience, anecdotal evidence, and the scientific evidence released so far (which there is plenty), that running barefoot and in minimalist shoes with correct running form will reduce injury rates and improve running efficiency. So for the first time in the world, we have shoe companies and shoe stores that want to actually base their shoe designs and shoe sales on a true understanding of human anatomy, biomechanics, and physics.

    Of course VIVOBAREFOOT is going to create a headline like "It's official: Barefoot is Best." This grabs peoples attention and they have every prerogative to create such a headline regardless of whether it's completely substantiated or not.

    Please read the next post, they are meant to be read as one post.

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  15. I have read the studies by Daniel Lieberman and his associates and I agree that they are not claiming that they have come out with the final scientific word that says that barefoot/minimalist shoe running is better than traditional shoe running. I have spoken with Daniel about the subject and he told me that the study that everyone is waiting for, such as the ones that Steven Sashen suggests, would cost about $200,000 or so to do. He has been trying for a long time to raise the capital necessary to do just a study. Until then I don't think layman criticism of the studies that can be done are of any value to anybody. Daniel Lieberman and his associates have, however, done these two studies and they have some noteworthy substance in making the case as to why barefoot/minimalist shoe and forefoot striking is better.

    People follow and are inspired by those who have strong convictions about why they are doing something. For example, people buy Apple products, not primarily because of how or what Apple makes, but because they know why they make such products, which is because they believe in challenging the status quo and they deeply subscribe to the motto to 'think different.' Apple's 'why' leads them to build innovative technology that is intuitive and easy to use and the result is that they make a lot of money. Just because they make more money than almost any other company in the world, doesn't mean that they do it primarily for the money. On the contrary, they do it to 'think different' and that's why people buy Apple products. Similarly, VIVOBAREFOOT, Daniel Lieberman, Christopher McDougall, Barefoot Ted, and The Natural Running Center affiliated stores including Born to Run, do what we do because we too, want to challenge the status quo, and we dream of day when all people can run to their heart's content without injuries.

    I believe your goal with this post was well intentioned, which as best I can understand, is to help VIVOBAREFOOT be more sensible about creating claims like "It's Official: Barefoot is Best," so as to not turn off the early majority that Jason Robillard wrote about recently. The problem is that this post does just the opposite. It makes the barefoot community sound very negative and self critical, instead of being united behind a common purpose. Additionally it tears down companies like VIVOBAREFOOT, who are progressing the movement, instead of supporting them.

    Personally, I am not concerned about the early majority or the everyday person being turned off by barefoot/minimalist shoe running because of the tenants of it, which is what VIVOBAREFOOT is doing, but because the people they meet or read about that are barefoot runners are not someone they want to emulate.

    In conclusion, I challenge the statement 'Don't let some study or some self-proclaimed guru tell you that the way you run is wrong or that the shoes you own aren't "minimal" enough. If what you're doing makes you happy...go with it." That's like telling someone who has been using a broom upside down to sweep the floor, that as long as they are happy with the way they sweep that they shouldn't listen to someone who is telling them that if they turned the broom around and used the brush end that they could sweep the floor more efficiently; Which if they did would undoubtedly make them happier.

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  16. Dan,

    I'm a relative noob to the barefoot and minimalist thing and sometimes don't always agree with MGBG, but it appears to me that what you took away from this was seriously one of the very last things Christian said. What I took from this posting was that it is bad to mislead people by saying that barefoot is best. That is not known just yet, at least by scientific studies. Anecdotal evidence suggests that it is way healthier to be barefoot and minimalist.

    I think by stating something that isn't true and misleading Daniel Liebermans study just fuels the fire for those that don't believe barefoot/minimalist is better. This breeds an even bigger distrust of anything to do with Daniel Lieberman. I've read lots of back and forth with Lieberman and some doctors who challenged his theories. To go and change what Liebermans study actually shows like Vivobarefoot did just goes to show others that we barefoot/minimalist people are liars and like to misconstrue the facts. Anyhow, I can't wait to get into one of your stores someday. Wish you had one in Portland area.

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    1. Nick,

      First I would like to say that I appreciate your comment and we do plan to put a Born to Run store in Portland within a year or so.

      Anyway, If what MGBG's main point is that it is "bad to mislead people by saying that barefoot is best," then I challenge that statement as well. I don't think VIVOBAREFOOT is misleading people. I think we are way past the point were we need to wait for the final scientific study that proves "barefoot is best." I want to encourage people to be more bold about it. There is so much evidence out there that I don't believe that we should be ashamed of saying that we believe that running barefoot or in minimalist shoes with correct form is best.

      In fact, I challenge anyone who runs in traditional shoes with a heel strike, whether they have ever been injured or not, to come buy a pair of barefoot shoes from Born to Run and take a course in correct running form from us. If after 6 months of proper transitioning you don't feel that running in minimalist shoes is better, than Born to Run will buy you your next 10 pair of traditional running shoes.

      If someone is not willing to transition to running in barefoot shoes and with good running form, then by all means that is their choice. But I boldly say that if they do make the transition properly, than I promise they will not regret it.

      Delete
  17. thank you for your comments. When I first started barefooting I got caught up in all the crap. I was attacked by those saying it was so bad for me and i was supported by others who said it was the perfect thing. The truth is that yes, i run better, harder, faster, stronger, and i enjoy running a lot more. i no longer tire out like i did before, i love it...but that doesn't mean that it wouldn't demolish someone else's love for running either. I have my opinions and lifestyle and barefoot or minimalism seems to be the perfect fit. it took a lot of energy to explain to people that YES, there is good evidence supporting bare footing, but there is also good evidence supporting the opposite. My official view on injury prevention goes like this...before you spend thousands of dollars on other options, why not try minimalism or barefoot to help you keep running? if it doesn't work, start spending if running is that important to you. i love running, and whatever keeps someone enjoying it so much is alright by me.

    thanks again for your opinions and your support for the belief that what makes you happy is the best statistic.

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  18. Dan, movements that don't look critically at themselves succumb to dogmatism. It's more important to me to provide correct information then to advance a particular slogan. I'm not doing it to cater to a particular group. I'm doing it because it's the truth.

    I do agree that the Lieberman studies give us great data on the benefits of a forefoot strike. They do not warrant the conclusions made by Vivo, and Lieberman would be the first to say that.

    In conclusion, nobody sweeps the floor with the head of a broom. Your example is dumb.

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    1. MGBG,

      I agree that movements need to look critically at themselves and I appreciate your intention in doing that.

      What I really object to about your post is the way you shy away from people and companies saying things like "Barefoot is Best." I am challenging that ideology. I think we should be more bold about it. I will quote what I said in a reply post above:

      "I think we are way past the point were we need to wait for the final scientific study that proves "barefoot is best." I want to encourage people to be more bold about it. There is so much evidence out there that I don't believe that we should be ashamed of saying that we believe that running barefoot or in minimalist shoes with correct form is best.

      In fact, I challenge anyone who runs in traditional shoes with a heel strike, whether they have ever been injured or not, to come buy a pair of barefoot shoes from Born to Run and take a course in correct running form from us. If after 6 months of proper transitioning you don't feel that running in minimalist shoes is better, than Born to Run will buy you your next 10 pair of traditional running shoes.

      If someone is not willing to transition to running in barefoot shoes and with good running form, then by all means that is their choice. But I boldly say that if they do make the transition properly, than I promise they will not regret it."

      The way to be bold is to speak from personal experience and to challenge them to try it for themselves.

      Delete
  19. I had a discussion with some of my students (middle school) over just this type of issue today. Health topics - diet, exercise, and treatment of illness and injury to name the biggies- are so subject to the "trends of thought" brought about by the latest publicized study that it's ridiculous. Objectivity when dealing with these topics is incredibly important... and incredibly rare. I think Vivo overstepped quite a bit. But hey, they make a hell of a shoe!

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  20. Bald statistics don't - and can't - tell the whole story. You can't conclude heel striking is bad just because X number of heel strikers get hurt, just as you can't say forefoot striking is better because there are fewer injuries proportional to the number of forefoot strikers. There are way too many variables that can't be controlled:
    - Experience
    - Surface run on
    - Miles under the belt
    - History of injuries
    - Genetic predisposition
    - Increase in mileage
    - Shoes used by the heel strikers
    - Speed
    - Weight of the runner

    To do something statistically valid, you'd need a HUGE pool of participants who, if they were inclined to run at all, would already be running.

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  21. You were right! Googling 'maple grove barefoot guy' was the best thing I did all day :) Great article and nice to see some rational thought on the matter.

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  22. P.S., a friend's older brother has run (shod) at least one mile every day for over 40 years (he even ran after having surgery for kidney stones). He's currently number five on the streak list. Is someone who's been running barefoot for a year or two seriously going to tell him he's doing it all wrong?

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    1. It's not about telling him that he is doing something wrong. He doing something wonderful, just by virtue of the fact that he has been running everyday for 40 years. It's really about telling him that even though he has had good results in the shoes that he uses that, if he is willing to try it, he will get even better results if he were to transition properly to barefoot/minimalist shoe running.

      After Tiger Woods had become a professional athlete and was already heralded as great golfer, he realized that his swing was not biomechanically and physically as good as it could be. He spent 6 months or so transitioning to a new swing against most people telling him that it was a bad idea. He did it anyway and the result was that after he changed his swing he became known as the greatest golfer ever.

      Delete
    2. I dunno Dan, I think most people have a 'if it ain't broke, don't fix it' mentality. You have to convince them that something is wrong, but if their bodies are telling them that everything is fine, it's a tough sell. When the science shakes all this stuff out, we'll probably find that a significant amount of people can run with 'bad' form, no problem. That said, I have no idea what what kind of form my friend's brother runs with. He's been running since the early seventies, so perhaps he uses something like racing flats. I should've also mentioned that he's a dietician at the Mayo Clinic, so he's probably not going to be convinced by an casual runner like me with rudimentary (at best) knowledge of biomechanics. I think we're best just telling people what works for us, why we like BFR, and say the evidence is suggestive that it could help anyone with recurrent shod injuries, and then let them decide. I've been a barefooter for 30 some years, and I know a lot of people are just not going to give up their shoes, whether they're runners or not.

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  23. I think there are plenty of people in the world saying "barefoot is best" Dan. That's not really my role. I tell it like it is. You spread your message and I'll spread mine.

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  24. Wow, really impressed by your well-thought out and eloquent post. I'm glad to see there are barefoot runners like yourself and Jason Robbilard who aren't dogmatic. Honestly, some of the outrageous claims being made by some barefooters was getting a bit much and it wasn't helping to open the minds of other runners to at least look at barefoot and minimalist running.

    @Dan - you said "we dream of day when all people can run to their heart's content without injuries". This day will never come. One of the few consistent findings in almost all studies on running injuries is the factor of excessive volume. Runners who want to run more than their bodies can handle is always going to be an issue; their heart's desire will exceed their musculoskeletal limits regardless of form and what they wear (or don't wear) on their feet. Yes form is important. Yes shoe choice is important. But to stay injury free the most important factor is to have a well-thought out training plan AND to know when and how to adapt that plan when needed.

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  25. Curb, you're totally foreshadowing one of my future posts about chronic cardio. The title will be something like "Born to Run does not mean Born to Run A Lot"

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  26. Dear All,

    First of all, I would like to apologise for our over-enthusiastic response to Prof. Liebermans research (I've been making and promoting barefoot shoes, against the tide, since 2003 and this was an exciting moment!). We are currently updating our approach.
    It is true that nothing is ‘proven’, and it is true that over-striding whilst forefoot striking can be just as injurious as heel striking, and it’s worth noting that the sample set in Dan’s latest study were all elite athletes.
    But, ‘twice’ as many injuries and up to 8% more efficient is statistically significant whichever way you slice and dice it.
    I would like to echo Dan F’s sentiments (and yes, I am a business owner and have products to sell) that it is coming time to be bold and proud of what we believe in and know to be true. We believe in the bare foot (it’s not about the shoes), we believe that proprioception is the foundation of skill and skillful movement is injury free movement (technique is everything!).
    I agree with MGBG’s statistic that if you are 100% happy and injury free heel striking in conventional running shoes, you shouldn’t change what you are doing.
    But, equally I would also like to join forces with Dan’s challenge that anybody that buys barefoot shoes (zero drop, anatomic toe box, with soles no more than 6mm thick) and takes the time to transition properly (we would love to show you how at trainingclinic.vivobarefoot.com) and still doesn’t like it (prefers to carry on sweeping with the broom upside down) then I’d be happy to go halves with Dan F on the 10 pairs of conventional running shoes promise.

    Uncommon Sense: Barefoot is best, and we’re more enthusiastic than ever to be part of the revolution to encourage anyone that is not happy heel striking in overly padded shoes to re-discover proprioception and good form fore foot running… All our focus is on trying to make the best 'barefoot' products (with maximum proprioception) we can and on creating education for healthy transitions...
    Lets join forces and do what we can to help educate the world about the benefits of fore foot strike (barefoot) running that we know and love…
    There’s a lot more transition to go!

    Galahad Clark,
    Managing Director
    VIVOBAREFOOT

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