Warning: The following is for fun reading only.

Today’s opening thought: Is 26.2 the answer to life, the universe and everything? Or as Doug Adam’s  Hitchhikers guide has it, is it 42? But, let’s move on.

The newspapers and blogs have been full of reports on the science of why we should all run in minimalist shoes or barefoot. The scientific literature is continually expanding (just like the universe) with studies on similar topics. As of now the literature has utterly failed to demonstrate how to prevent running injuries. The literature may lead you to believe the only way to limit running injuries is to give up running and taking up swimming or cycling. Scientific studies haven’t been able to even show that a more gradual running program causes fewer injuries than a rapidly advancing program. These failures have led to new paradigms of running models. Looking at recent writing in the papers, books and the blogs, I’ve learned that our “species” has been running barefoot for 5 Million and perhaps more years. A degree in nuclear physics could lead you to the errant conclusion that arches were useful for moving around on tree branches, but there is no need for them on the ground (as described in the NY Times).

Our species, Homo sapiens, wasn’t around 5 Million years ago to run or even to walk barefoot. Nor was any creature of the genus Homo found at that time. Five million years ago is before even “Lucy”, an Australopithecus afarensis, appeared on the scene. Scientists of evolution do have a candidate for a 5 Million year old Hominid, Ardipithecus ramidus. “Ardi” was clearly not born to wear shoes as you can see from the illustration below. Ardi was in fact not born to run. The truth is that Ardi’s locomotion pattern may not have been like ours in most ways.

As far as having an arch in trees and not needing one for obligate bipedal locomotion in hominids, the science and study of evolution show that the arch can store kinetic energy by transforming it to potential energy and return it late in the stance phase of gait. And the windlass mechanism has been discussed for over 50 years.

As you can see from Ardi’s feet, we’ve come a long way, baby. The big toe can no longer grasp and is in line with the rest of the foot with the first metatarsal sitting closer to the other metatarsal bones. Daniel Lieberman and others have reviewed hypothesized evolutionary changes in more than one paper. Among other evolutionary changes the authors describe the evolution of shorter toes, development of a longitudinal arch, a lengthening Achilles tendon, and altered attachment and functions of the gluteal muscles. Australopithecus had a relatively flat foot, and was described as probably not being capable of long distance running. The genus Homo has been around since approximately 2.5 Million Years Ago (MYA) and humans, Homo sapiens since .2 MYA (about 200,000 years ago). Early Homo species were thought to be the first hominid bipedal runners. Wikipedia, while not an authoritative site, has a good outline of current thought and dates of hominid evolution at: http://en.wikipedia.org/wiki/Human_evolution

Recently I read of “like minded people” attending seminars on running injuries with the premise of we were born to run barefoot or in minimalist shoes. Over the past few years there has been an increasing amount of research on the biomechanics and effects of minimalist and barefoot running. It seems that everyone has been chiming in to support this idea from nuclear physicists to physical therapists, anthropologists, journalists, book authors and world-class runners. The mention of “like minded” folk had me thinking of other like minded groups such as political parties and religious groups.

Bill O’Reilly On The Universe

Bill O’Reilly can be inspiring. His thoughts on religion led me to look outside of cherry picked scientific ideas and see what the bible had to say on this topic. Of course, since Bill is such an authority on religion, we can go further than his thoughts on the movement of the tides and listen to what he says about astronomy. In late January of this year, he discussed his pre-Copernican worldview and noted that the Earth was given a sun and a moon while Mars was not.

While humor impaired, true believers of all stripes may be troubled by a discussion on minimalist running, I think all would benefit from watching O’Reilly’s analysis of how the world works. I did search for the isolated clip and hoped for an in depth discussion of his Ptolemaic inspired universe, but apparently Fox/O’Reilly arranged to have it removed from YouTube. The only available clip right now is via the Colbert show and has Colbert’s comments to shed light on Bill’s.

O’Reilly discussion starts at 2:32 of this clip (click if below clip is not working) from the Colbert Report.

WWJD

Bill O’Reilly’s thoughts on this subject led me to search for guidance for a true believer and to the biblical reasons for which we should be using minimalist shoes or going barefoot for our running. Since this post is quite long already we’ll note in passing that there were no specific running shoes in existence during biblical times. People were in a close relationship with their sandals and the Word was disseminated not via Twitter, blogs and Facebook, but by people traversing the ground in minimalist footgear. And that is the gospel truth. As we wonder WWJD we find that Matthew 6.25-31 and Luke 25.21-31  lead us to consider the Lilies of the field that God provided and not even Solomon was not arrayed as well. Of course theological discourse could allow for different interpretations, but the passage is food for thought.

References:

Bramble D, Lieberman D. 2004. Endurance running and the evolution of Homo. Nature 432, 345-352 (18 November 2004)

Lieberman, Daniel E., Raichlen, D et. al. 2006. The human gluteus maximus and its role in running. Journal of Experimental Biology 209: 2143-2155

Lovejoy CO. 2009. Reexamining human origins in light of Ardipithecus ramidus. Science 326:74e1–74e8.

Lovejoy CO, Latimer B, Suwa G, Asfaw B, White TD. 2009a. Combining prehension and propulsion: The foot of Ardipithecus ramidus. Science 326:72e1–72e8.

Lovejoy CO, Suwa G, Simpson SW, Matternes JH, White TD. 2009b. The great divides: Ardipithecus ramidus reveals the postcrania of our last common ancestors with African apes. Science 326:100–106.

Lovejoy CO, Suwa G, Spurlock L, Asfaw B, White TD. 2009c. The pelvis and femur of Ardipithecus ramidus: The emergence of upright walking. Science 326.

The Evolution of Homer Simpson

You Gotta Have Faith, Limp Bizkit

I had a pleasant chat with Jon Anderson who writes for a number of the military times publications. This past week he covered the current status of minimalist running shoes in the service. The article, “On Your Toes” appeared in the Army Times. He quotes the figure of up to 35% of Navy Seals are incorporating minimalist shoes in their training. In addition to the interview questions we discussed what may make the minimalist shoes acceptable on more bases. One is that if wearing the shoes gets you out the door and has you enjoying your training this will support you mission of fitness.

Minimal Maximalist: I'm Free

This past summer Diane Rehm had a lively interview of Christopher McDougall, Amby Burfoot and myself. If you haven’t listened to it, I recommend the show in general and this session titled  “Running In America“. During the interview I was asked if I thought barefoot running was dangerous. My reply was “sitting down is dangerous”. Amby brings much wisdom to the discussion. Chris is the author of the best selling “Born To Run” and brings his thoughts on the subject which were summed up in his interview on “Real Sports Episode 158” in which he said at the end of the story “You were born to run. You were designed to run. Running is not going to hurt you…..When you get rid of all the shoes and all the technology and actually rely on your legs the way they have evolved to be used, you can actually run injury free for the rest of your life”.  This statement has converted a good number of runners to minimalist shoes. Is it true? That is the start of the discussion. There is more to the story. If you are interested in the topic, you have the chance to listen to an hour long chat.

If things are going well for you, don’t make unnecessary changes. If you are changing your foot strike or your shoe type, make the changes very, very gradually. This can not be emphasized enough.

Is there one opinion on this topic that will universally satisfy everyone? The answer is no. In the Diane Rehm show the concept of there being an necessary “great schism” in the running community was mentioned. It is important to recognize that exercise is good for you. Movement is good. It could be running, walking, hiking, swimming, and cycling that you enjoy. It could be with traditional shoes or not. Whatever works for you is what is best for you. All the articles you read may not offer guidance that is specific and right for you. The current exercise recommendations for adults are for a minimum of 30 minutes of moderate aerobic activity 5 days per week (or 20 minutes of intense aerobic activity – and  I recommend at least a 5 minute warm up and 5 minute cool down) and 2 days per week of strength training.

Freedom Comes In Different Flavors

Bipedalism (walking upright on two limbs) in hominids is considered a logical and efficient means of locomotion arrived at via hundreds of millions of years of evolution. At the newly instituted PLOS group of blogs a thorough post appearing on the newly moved blog Neuroanthropology describes Turkish individuals who are quadripedal and exhibit what is called Uner Tan Syndrome (UTS). There is some conjecture on the cause of this condition and on whether or not it is evolutionary atavism.

Human Quadrupeds

This syndrome was first discovered in 2005 by Üner Tan of Cukurova University in Turkey who is also a member of the Turkish Academy of Sciences.

I note that the quadripedal humans seem to be scurrying along at a fair clip. They are not wearing any coverings on their hands. From the photo it is difficult to determine what they wear on their feet. The video below does show some foot gear. At least some of the quadrupedal humans seem to have the forelimb contact on the heel of the hand, but others may contact further foreward.  I’m sure this will be looked at closer. Evolutionary analysis and better coaching may lead to improved 4 limb locomotion for these individuals. So far I have not come across any reports of any quadrupedal long distance endurance events.

This does appear to be a real syndrome however and the blog describes the symptoms and results of MRI and PET scans on subjects. The findings include:

“signs of cerebellar dysfunction including: intention tremor, dysdiadochokinesis (inability to execute rapidly alternating movements particularly of the limbs), dysmetria (lack of coordination of movement typified by under- or over-shooting the intended position), and nystagmus (involuntary rhythmic eye movement, with the eyes moving quickly in one direction, and then slowly in the other). However, the cerebellar signs are relatively mild, and they are no more pronounced in the quadrupeds than in the one affected brother who walks bipedally.”

My take on this is that the syndrome appears to be an inherited motor and sensory issue (HMSN). There are many disorders in this category with a variety of symptoms. Some of the more common ones include Refsum’s syndrome and Charcot-Marie-Tooth disease .

Both a BBC and PBS Nova documentary have been produced on this condition.

Links:

Neuroanthropology Blog Post on “Human Quadrupeds” by Greg Downs – thorough discussion, many reference links

John Hawks Discussion on “Turkish Tetrapods” in 2006

A New Syndrome With Quadripedal Gait Tan, U. Int J Neurosci. 2006 Mar;116(3):361-9.

Family That Walks on all 4s (NOVA show)

The Muppets on Early Gait Development

Image by Mitch Mandel (September 2010 Runners World)

Exercising while barefoot is a good way to work on your balance, proprioception (joint position sense) and lower leg strength. Runners World has a fine short article on Barefoot Exercise written by Adam Bean (which I was interviewed for) in the September, 2010 issue and online.

Several Videos of an agile athlete demonstrating the exercises are online and on the iPad app.

The wobble board exercise is particularly good for many ankle injuries as part of a recovery plan. The toe curls and toe pickups can be helpful in conjunction with an overall plan for plantar fasciitis. Overall the series of exercises was set up for a healthy runner. In you have an injury, check with your sports doc or PT for advice specific to your injury.

Toe Curls

Toe Pickups

Wobble Board

One-leg Hops

One Leg Squats

The Diane Rehm Show will host Christopher McDougall (author of Born To Run), Amby Burfoot (winner of Boston Marathon, 1968, Editor at large: Runners World) and myself on Monday. The topic will be “Running In America. We should cover a lot of ground. Both Amby and Christopher are knowledgeable and entertaining. It should be an interesting show. The discussion will be on NPR starting at 11 am. If I’m early, according to the schedule, it appears I could stop in for a spot of tea.

You can tweet your questions to the show on twitter or ask via the show’s Facebook page. More information on calling and email is available at the show’s website.

The Diane Rehm Show is  archived online and is available as a podcast through iTunes or as an rss feed.. I highly recommend Diane’s intelligent discussions and diverse subjects as food for the brain.

PEN has partnered with ESPN to create the PEN/ESPN Literary Sports Writing award. This award will honor the best non-fiction book on sports for 2009. The winner will receive $5,000 and be invited to speak at the 2010 CUNY Pen Literary Awards  ceremony on October  13, 2010.

Any guesses on the possible winner?

Best quote of the day was by Chris Mcdougall in the New York Times:

“You know any sport has gone off the rails when you have to remove body parts to do it,” said Christopher McDougall, the author of a recent book about ultrarunning called “Born to Run.”

With it’s motto of “all the news that’s fit to print” the Times seems to have not had room to fit the rest of what I’m sure Chris said. First, “Born To Run” is about a quest to run, and Chris’s quest was answered by running barefoot or in minimalist shoes. What I’m sure Chris said was that it might be easier to remove your shoes than have your toenails removed at their roots.

The article highlighted ultramarathoners who had elected to have all of their toenails removed rather than suffer thick nails, ingrown toenails, and bleeding underneath the nails. This is not something that would be done often or by many. It is not something that should really be necessary to do. Many runners, tennis players, and other athletes have problems with “black toe” or bleeding underneath a toenail or two. The first thing to do is make sure there is enough room at the front of the shoe. Be certain you have a fingers width in front of the longest toe. Make sure your socks fit well and don’t pinch your toes. Your socks should be made of a wickable material. Cut your toes just at the end of your toes, not too long, and not too short.

If you’ve developed bleeding under your toenail and it has turned black, don’t panic. If you have Diabetes, or any other medical problem that could cause foot insensitivity or a neuropathy, get to your doctor or some place to be checked fairly quickly. If it hurts see your podiatrist for evaluation and advice. You may gradually have the nail fall off, but the new nail will reattach properly over 90% of the time. With repeated injury the toenail will usually thicken and in some cases it may not attach quite as well.

For toes that repeatedly grow in at the corners, having a portion of the ingrown part permanently removed might be the best option and a wise choice. For a toenail that has fallen off after bleeding underneath, and has a new toenail growing,  the new nail will usually reach the end with no problem. It moves forward slowly like a glacier and pushes the skin down in front of it. On occasion a corner won’t grow out and it will have to be removed. Only rarely does the entire front edge dig in and require removal of the whole nail. But, removing 10 toenails permanently? Sorry, I don’t expect to be doing that any time soon. I’d rather have you toss your shoes, and find a better fit. And Chris would get you out for a barefoot run.

Can Shoes Be “Tiny Coffins”. Yes, they can.

(Please read comment section below. Author Chris McDougall has posted an informative comment and added to the quotes seen in Born To Run.  I’ll extract from the quotes, but be sure to read the comment. (If it says “comments closed”, which the blog does automatically at a set time interval, please click on the blog title which will open this entry in full, with the comments visible.) The thrust of this blog entry will remain the same. For me the deadly shoes I’m speaking of point to the neuropathic foot which was a large part of Paul Brand’s professional life work. )

Paul Brand, M.D. (1914 – 2003) was quoted by Chris McDougall in Born To Run as essentially saying that if everyone stopped wearing shoes, his office would be less busy and most foot problems would disappear in a generation.

Paul Brand 2002

While many may think Paul Brand had an ordinary waiting room, he did not. Brand did not specialize in treating the usual foot problems. He was a brilliant innovator on the special problem of diseases which cause loss of pain sensation via neuropathy.  He worked for many years at the National Hansen’s Disease Center at Carville in Louisiana. He specialized in  the orthopedic treatment of Hansen’s Disease (leprosy). Among other innovations, his work led to contact casting to help heal ulcers in feet with neuropathy, such as diabetics and those with Hansen’s Disease.  He contributed a good deal to knowledge about the significance of neuropathy in the creation of ulcers and to the care of insensitive feet. (Brand also worked extensively on hands with problems related to neuorpathy and insensitivity.) These neuopathies also affected strength rations of opposing muscle groups which often led to significant foot problems including hammer toes and bunions. Insensitivity combined with altered biomechanics, physical deformity, create special problems in walking and wearing shoes, particularly ones that are not fit well and do not serve to balance areas that are overloaded by pressure (pressure points on toes, hallux valgus, or on the plantar surface (metatarsal area or any other part of the bottom of the foot).

Brand worked with patients whose shoes often did create significant and even life threatening problems. Lacking sensation, because of neuropathy, they couldn’t feel the blisters, ulcerations, and infections developing. Another one of his sayings was “Pain is god’s greatest gift”. A shocking statement, but he said that because those lacking normal sensation did terrible damage to themselves.

As tiny coffins in this case, the shoes which caused the problem could lead to an amputation of a foot or leg in a diabetic which would lead to a second amputation more than 50% of the time within 2 years. Amputation in diabetics also is known to have a high mortality rate over 5 years (up to 74%, note that bypass operations may help). Slow healing ulcers have a death from all causes mortality of up to 50% within 5 years. This is worse than many forms of cancer.

Chris McDougall has provided some direct quotes, ( I believe from one of Brand’s biographical works – which will is now added to my reading list.) I’ll add some of those here. For the remainder, please be sure to read the comment section.

“A high proportion of the world’s population walks barefoot most of the time, and the average person who walks barefoot has much healthier feet than the average person who wears shoes.”, said Dr. Brand. Speaking of his own personal experience he said that “The barefoot walker receives a continuous stream of information about the ground and about his own relationship to it, while a shod foot sleeps inside an unchanging environment. Sensations that are not used or listened to become decayed and atrophy. There is a sense of aliveness and joy which I experience walking barefoot that I never get in shoes.”

Chris reports that Dr. Brand said this of normal people in normal shoes. And adds that Dr. Brand was a proponent of barefoot walking and sports. We will accept that as Dr. Brand’s opinion and statement and warn people who do suffer from pain insensitivity to not take this as advice directed at them. They are usually given special advice to not go barefoot, and in many cases to have carefully designed shoes, often custom, with special insoles or diabetic orthotics designed to decrease pressure, and to lessen excessive pressures over areas at risk. In spite of this care problems may still develop and this is only a cursory and incomplete look at these problems and their causes.  Patients with pain insensitivity must perform a self-inspection daily.

I was lucky to meet Dr. Brand in 2002 at the American Podiatric Medical Association meeting in Seattle, Washington. Dr. Brand opened a special section on insensitive feet which included presentations by his former prodigies on their current work. While I spend more time working with athletes, all knowledge is helpful, and Dr. Brand was a true icon.

While I scoffed the other day at  the quote in the New York Times about shoes as tiny coffins that halted evolution, in cases like these they truly are tiny coffins. They could cause your loss of limb and ultimately put you at a much higher than normal risk of death. Seeing the New York Times quote calling them “tiny coffins” did immediately make me think of the neuropathic foot. We’ve previously discussed the cost of amputation. We also see that diabetic ulcers and amputation are also deadly problems.

Preventative care, helpful? Yes, of course.  Make sure it gets properly included in any health care reform. Medicare ( a government run system) includes special shoes, non-custom inserts, yearly foot checks, and some  insurance carriers include this also. Some policies cover custom orthotics for diabetics, but not for runners. The policies and medicare aren’t quite up to speed but they are improving. Make sure that encouraging healthy life habits and preventative care is incorporated in some fashion and included as a core feature in future health policy to assist in decreasing the overall cost of care and in particular the cost of chronic illness. If you are diabetic, get your feet checked regularly, check them yourself, and learn how to both check and care for them. Exercise as recommended by your physician, and make sure you eat correctly, and monitor and control your blood sugar appropriately. Follow advice from your podiatrist on what foot wear  and socks are best for you.

For the runners, I expect you should shortly find here some blogs on what bad can come to you from your shoe, and what steps to take.

References:

Diabetic foot ulcers: prevention, diagnosis and classification.
Armstrong DG, Lavery LA. Am Fam Physician. 1998 Mar 15;57(6):1325-32, 1337-8.

Evaluation of Removable and Irremovable Cast Walkers in the Healing of Diabetic Foot Wounds: A randomized controlled trial. D. G. Armstrong, L. A. Lavery, S. Wu, and A. J.M. Boulton. Diabetes Care, March 1, 2005; 28(3): 551 – 554.

Revisiting the Total Contact Cast. Maximizing off-loading by wound isolation. Petre, M, Tokar, P, et. al. Diabetes Care  April 2005   vol. 28  no. 4  929-930

The total contact cast. A therapy for plantar ulceration on insensitive feet
WC Coleman, PW Brand, and JA Birke. J Am Podiatr Med Assoc, Vol. 74, Issue 11, 548-552, November 1, 1984

Mortality rates and diabetic foot ulcers. Robbins JM, Strauss G, Aron D, Long J, Kuba J, Kaplan Y. J Am Podiatr Med Assoc. 2008 Nov-Dec;98(6):489-93.

What is the most effective way to reduce incidence of amputation in the diabetic foot? Apelqvist J, Larsson J. Diabetes Metab Res Rev. 2000 Sep-Oct;16 Suppl 1:S75-83.

Diabetes Res Clin Pract. 1997 Jul;37(1):41-7. Mortality following lower extremity amputation in minorities with diabetes mellitus. Lavery LA, van Houtum WH, Armstrong DG, Harkless LB, Ashry HR, Walker SC.

Amputation and mortality in new-onset diabetic foot ulcers stratified by etiology. Moulik PK, Mtonga R, Gill GV. Diabetes Care. 2003 Feb;26(2):491-4.

New ulceration, new major amputation, and survival rates in diabetic subjects hospitalized for foot ulceration from 1990 to 1993: a 6.5-year follow-up. Faglia E, Favales F, Morabito A. Diabetes Care. 2001 Jan;24(1):78-83.

Sense and Sensibility

Note: There are several comments, but the interface on word press blogs will only show them if you click on the title and view only this blog entry.

The media seems to have decided that barefoot running is the trend that can’t be stopped, and should perhaps be encouraged. “Throw away your shoes” seems to be the dominant theme, if not the only thing we hear. And no one wants to stand against the tide and seek balance.  I’ve run barefoot on the beach for miles, and enjoyed it. And I’ve done that for years starting in middle school. During high school, I enjoyed barefoot running along the beach during the run up to soccer season. And, even at that time professional football teams were said to do the same. But the current persistent hyping of barefoot is as balanced as are the discussions on health care reform. Some years back, HMOs were touted as the solution to all of our health care needs. But, they aren’t singing that tune any more.

Now we are told that we evolved to run barefoot. Shoes are tiny coffins for feet and have stopped evolution. Tiny coffins that stopped evolution? Really? Evolved to run barefoot? Well, yes we did evolve to run barefoot. But we’ve had 30,000 years to develop body coverings and improved aids to motion, comfort and speed. We’ve made shoes – one shoe fits either foot, domesticated horses (and even tamed elephants) to catch  a ride, added lifts to our sandals to move faster in battle (Caesar), made steam and coal powered engines for trains, boats, sailboats, steam boats, shoes – designed for right or left foot, made cars, bicycles, airplanes and rocket ships that have carried us to the moon.

We’ve gone from eating nuts and greens to meat and back to nuts and greens. We’ve made other aids like glasses, robot flown drones, satellites to explore the rest of the solar system. But wait, did we evolve for this? Or is it wrong? Should we be barefoot and living in trees or in caves? Could we run faster without shoes?

It is said that shoes don’t help prevent injuries. But does running barefoot? Does wearing “unbalanced” shoes help? Do those shoes help you burn more calories? One person’s opinion quoted in the NY Times was that they did, they made her legs sore, so they must burn more calories. To me, that just shows that she overdid it and was a victim of the “terrible too’s” – too far, too fast, too soon, (too often and too little rest).

Could we run faster without shoes? Since 1960, only at the Mexico City Olympics,  has the Olympic marathon been won as slowly as Abebe Bikila ran it while winning in Rome in what was a world record time in 1960 (2:15:16, an impressive time). In 1964, Bikila wore (Puma running) shoes in Tokyo, ran faster, and set another world record. He took 3 minutes off of his previous world record, running 2:12:11. The current world record of 2:03:59 is held by Haile Gebrselassie, who does wear shoes while racing. Of course the shoes the elite runners wear during races are usually racing flats. During training, there will be some variety, and some elite runners incorporate barefoot drills into their regimen.

Running barefoot should strengthen the intrinsic muscles of the foot. Those are the muscles that start in the foot and end in the foot. It could also have a strengthening effect on muscles in the leg. And for those who do need more support, it could have these muscles working harder than they should and not feel very good. Running barefoot or with minimalist shoes helps balance and joint position sense. Over cushioned shoes are distinctly bad for joint position sense (proprioception).  So yes, running shoes can cause many problems through bad fit, bad design, mismatch of foot to shoe, and in many other ways. That has been the subject of many lectures and articles. Unfortunately, there no longer seems to be a balance in approach to shoes versus barefoot, when it should be shoes and barefoot.

Looking at 30,000 (ya) year old to 2 (mya) million year old bones will tell you where we’ve been, but won’t tell you where we are as a species now. Wired magazine had a recent article quoting a renowned anthropologist who felt that running barefoot was the way to go, and that evolution would have taken care of plantar fasciitis and runner’s knee. Unfortunately, that may be a nice hypothesis, but we are all built differently and have different needs. Some are knock kneed, some are bow legged, some legs are just right. Some people have high arches, some have low, and some are just right. Some of us have 20/15 vision and can fly jets, others could run barefoot and naked in the sun without sunscreen and never get a melanoma, but that is not wise for most of us. Some can run a marathon in 2:05, others in 3:05 or 5:05, but there are vast differences between them.

In evolution there are many expressions of genes called “phenotypes”. There is no one size fits all. Regarding melanoma, skin color and vitamin D, an excellent example of evolution is apparent. With Africa the presumed origin of the genus homo, migration from Africa led to genetic (genotype) changes in the genes that affected melanin. Putting it simply, the northerners had a mutation that led to less melanin in the skin and a lighter mutation. This allowed for better absorption of UV and production of Vitamin D in the northern climes (less light, less intense solar impact). It is another example of differences through evolution and adaptation to the environment with survival of those best suited to the environment.

While some wonder if human evolution has stopped, many believe it continues in many ways. Social relations, altruism, tribalism, and many things have deep roots, but also morph and change. There are differences between us and among us. We all aren’t prepared to comfortably run barefoot. But some of us are. Those who are and those who want to should start slowly with a few minutes and gradually build on that. Don’t look at it as necessarily a cure all for everything. It will feel great for some, and not so great for others. It may solve some problems in some, it may create problems or not solve problems in others. So, no, I am not claiming that barefoot is all good, all the time, for everyone. And I’m not claiming that barefoot is awful,  bad for everyone, something for everyone to avoid, always. (There is no simple answer, there are few informative studies. But, to quote Leigh Peele with her classic and often used statement “it depends“).

On the subject of barefoot running, my views have evolved. My first interview on this topic was with a journalist who wanted everything black and white and refused to accept the possibility that in my opinion some may have a foot better designed for barefoot running than others. There was a refusal to accept that while I didn’t think barefoot was all good, I didn’t think it was all bad. The quotes used in that article didn’t reflect a nuanced approach but were couched as a warning not to run barefoot. This was not what I felt was correct for all. Not long after that another journalist got it right. I pointed the second journalist to the same barefoot subject pictured in the first article. The runner was shown with beautiful “C” shaped, mud covered feet after completing his first marathon barefoot. She wrote about it in the Orlando Sentinel, along with suggestions on how to start barefoot running. (The Philadelphia Inquirer and Washington Post within the past few months had recent quotes on starting barefoot running slow and easy and a little at a time in the context of a review of “Born To Run”.)

But, as we look at the one size fits all solution, we see a trend in approaches to a variety of injuries. While many years ago, people were told to stop running, they then were told that almost all injuries came from foot problems. Now it is core weakness. No one solution fits all problems. Each problem is really solved only by a “total approach” that looks at the injury in a multi-faceted way, and looks for what changes can be made in training, equipment, muscle imbalances, stretching and strengthening. One “fix” is not enough to get it right.

Insulin is a nice medicine. We don’t all need to inject it though. L-Dopa is good for Parkinsons, but we all don’t need to take it as a supplement.  Prozac is helpful for many, running does it for others. One size doesn’t fit all, nor does one solution.

NY Times Article

Best quote:

“In 95 percent of the population or higher, running barefoot will land you in my office,” said Dr. Lewis G. Maharam, medical director for the New York Road Runners, the group that organizes the New York City Marathon. “A very small number of people are biomechanically perfect,” he said, so most need some sort of supportive or corrective footwear.”

Pithy quote:

“The shoe arguably got in the way of evolution,” said Galahad Clark, a seventh-generation shoemaker and chief executive of the shoemaker Terra Plana, based in London. “They’re like little foot coffins that stopped the foot from working the way it’s supposed to work.”

Related Posts:

Comments on Chris McDougall’s fine book at http://www.drpribut.com/blog/?p=325

Bipedal Beginnings: http://www.drpribut.com/blog/?p=331

Evolution and Exercise: What Made the Brain Get Bigger: http://www.drpribut.com/blog/?p=368

Walk This Way: Oldest Bare Footprints – 1.5+ Million Years Old: http://www.drpribut.com/blog/?p=215

For more information and to visit a community forum I recommend the Runner’s World Barefoot Runners Forum with links and discussions on all things barefoot.

Music: Barefoot by Ray Collins Hot Club

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Chris McDougall’s book “Born To Run” is probably the most fun and enjoyable book I’ve seen written about running. The prose is wonderful. The story telling is rich. And Chris develops both his characters and presents his thoughts on the evolution of running in a careful and thorough manner.  While I would disagree with the apparent conclusion that Chris and some others have reached that we have all evolved so well that barefoot running is right for everyone, I found so much else in this book that I recommend it whole heartedly. Chris covers diverse people and topics ranging from Barefoot Ted to Professors Bramble and Lieberman. I’ve read and thought about much of the scientific literature that Chris mentions in his book.  And I have a take on it that is much the same.  I will try to detail my take on some of the issues, but will not be casting any polemics towards this thoroughly enjoyable book. The science is only a small part of the book. The story is the thing. But the science is still worth thinking about.

This year is the 200th anniversary of the birth not only of Abraham Lincoln but also that of Charles Darwin. Darwin’s “Origin of Species” was published 150 years ago.  It is worth a look at how we got here, where we are, and how we fit into society and the world. We should look at why many of us like to run. Why is movement good for us and is life enhancing in many ways, and even life extending.

We’ll try to take a look at how we evolved to stand upright and run. We’ll look at what are the purposes, benefits and drawbacks of shoes in society and sport. What aspects of barefoot running are good and is barefoot the way to go for all of us? And up front, I’ll admit to having spent significant time running barefoot myself. Hopefully over the next few months we’ll have posts up detailing this and more.  With a long and ever changing list of topics to write on blog about, I’ll do my best to keep this at the forefront of my “to blog” list.

But I’ll again recommend reading “Born To Run”. It will make for enjoyable and thought provoking summer reading and you won’t have to wait for serial publication of the next chapter. You’ll just want to keep reading to find out what happens next. And after I finish the last 20 pages, Born To Run will sit in an honored place on my bookshelf. Right next to George Sheehan’s “Running And Being” and “This Running Live” and next to Amby Burfoot’s “The Runner’s Guide To the Meaning Of Life”. Murakami’s “What I Talk About When I Talk About Running”  is there too, along with many others, but a bit further over on the shelf.

If you’d like to see some of the details on hominid development of endurance running, see Bramble and Lieberman’s article from Nature (2004).