Why forefoot striking in minimal shoes might positively change the course of running injuries

It is believed that human ancestors evolved the ability to run bipedally approximately 2 million years ago. This form of locomotion may have been important to our survival and likely has influenced the evolution of our body form. As our bodies have adapted to run, it seems unusual that up to 79% of modern day runners are injured annually. The etiology of these injuries is clearly multifactorial. However, 1 aspect of running that has significantly changed over the past 50 years is the footwear we use. Modern running shoes have become increasingly cushioned and supportive, and have changed the way we run. In particular, they have altered our footstrike pattern from a predominantly forefoot strike(FFS) landing to a predominantly rearfoot strike(RFS) landing. This change alters the way in which the body is loaded and may be contributing to the high rate of injuries runners experience while engaged in an activity for which they were adapted. In this paper, we will examine the benefits of barefoot running(typically an FFS pattern),and compare the lower extremity mechanics between FFS and RFS. The implications of these mechanical differences, in terms of injury, will be discussed. We will then provide evidence to support our contention that FFS provides an optimal mechanical environment for specific foot and ankle structures, such as the heel pad, the plantar fascia, and the Achilles tendon. The importance of footwear will then be addressed, highlighting its interaction with strike pattern on mechanics. This analysis will underscore why footwear matters when assessing mechanics. Finally, proper preparation and safe transition to an FFS pattern in minimal shoes will be emphasized. Through the discussion of the current literature, we will develop a justification for returning to running in the way for which we were adapted to reduce running-related injuries.

Does orthotics use improve comfort,speed,and injury rate during running?A randomised control trial

BACKGROUND Running is a hugely popular sport.Unfortunately,running-related injury(RRI)rates are high,particularly amongst amateur and recreational runners.Finding ways to reduce RRI rates and maximise comfort and performance for runners is important.Evidence regarding whether orthotics can successfully improve these parameters is limited and contradicting.Further research is required to provide runners with clearer guidance on the usefulness of orthotics.AIM To investigate the effect of Aetrex Orthotics on comfort,speed and RRI rates during recreational running.METHODS One hundred and six recreational runners were recruited on a voluntary basis via running clubs and social media pages and randomised into either the intervention or control group.Participants in the intervention group ran with Aetrex L700 Speed Orthotics inserted in their usual running shoes,whilst participants in the control group ran in their usual running shoes with no orthotics.The study ran for an 8-wk period.Participants provided data relating to running comfort,distance,and time during weeks 3-6.Participants provided data relating to any RRIs they sustained during all 8 wks.Running distance and time were used to calculate running speed in miles per hour(mph).For each outcome variable,95%confidence intervals and P values were calculated to assess the statistical significance between the groups.For comfort and speed data,univariate multi-level analysis was performed,and for outcome variables with significant between group differences,multi-level multivariate analysis was performed to evaluate any confounding effects of gender and age.RESULTS Ninety-four participants were included in the final analysis(drop-out rate=11%).Comfort and speed from 940 runs and 978 injury data reports were analysed.Participants who ran with orthotics reported,on average,speeds 0.30 mph faster(P=0.20)and comfort scores 1.27 points higher(P≤0.001)than participants who ran with no orthotics.They were also 2.22 times less likely to sustain an injury(P=0.08)than participants who ran with no orthotics.However,findings were only significant for comfort and not for speed or injury rates.Age and gender were found to be significant predictors of comfort.However,the improvements in comfort reported by participants who ran with orthotics were still significant after adjusting for age and gender.CONCLUSION This study found orthotics to improve comfort and speed and prevent RRIs whilst running.However,these findings were only statistically significant for comfort.

Does orthotics use improve comfort,speed and injury rate during running?Preliminary analysis of a randomised control trial

BACKGROUND Evidence regarding the effectiveness of using orthotics in improving comfort,increasing running speed and helping to reduce injury rate during running is limited and mixed.Alongside the increasing popularity of running is the increasing rate of running-related injuries(RRIs).Further research into whether orthotics could be used to help reduce RRIs would be highly beneficial for those affected.Additionally,there is a need to clarify whether orthotics use increases comfort during running and helps improve running speed.AIM To investigate whether running with Aetrex Orthotics improves comfort and performance and reduces injury whilst running.METHODS Runners were recruited on a voluntary basis if they were 18 or older with no serious health conditions,ongoing foot pain or deformity,previous foot surgery in their lifetime or any surgery in the past 6 mo.Participants were randomly assigned to either an intervention group or a control group.All participants were asked to complete runs and provide quantitative data regarding comfort during running,running time and distance,and any RRIs over an 8-wk study period.Participants in the intervention group ran with Aetrex L700 Speed Orthotics,whilst participants in the control group ran without orthotics.Other than the addition of orthotics for participants in the intervention group,all participants were asked to run as they usually would.This report presents preliminary data from the first 47 participants recruited for this study.Running speed was calculated from running distance and time and given in miles per hour.For each outcome variable,the mean for each group,effect size and 95%confidence interval were calculated,and a t-test was performed to determine if between-group differences were statistically significant.RESULTS Data for all three primary outcomes was provided from a total of 254 runs by the 23 participants in the intervention group and a total of 289 runs by the 24 participants in the control group.Participants in the intervention group reported higher comfort scores(8.00±1.41 vs 6.96±2.03,P≤0.0001),faster running speeds(6.27±1.03 vs 6.00±1.54,P=0.013),and lower RRI rates(0.70±1.01 vs 1.21±1.53,P=0.18)than those in the control group.These findings were statistically significant for comfort and running speed but not for RRI rate,with statistical significance considered if P<0.05.No adjustments were made for group differences in age,gender,tendency for RRIs or usual running speed.CONCLUSION This preliminary report provides evidence for orthotics use in increasing comfort levels and running speed,but no significant difference in RRI rate.