Friday, August 22, 2014

The Airia Running Shoes to Improve Performance

I have been following the development and social media spread of these shoes for a while. There was first a thread on Podiatry Arena (which the Airia CEO contributes) and I then did two blog posts about them:
The new ‘biomechanically perfect’ running shoe from Airia?
Another look at the performance claims by the Airia One running shoe; a theoretical context

These two posts pretty much sum up my views on the shoes.

The shoe comes with a lateral forefoot wedge or slant and claims that this can enhance performance. The company has some data that this is the case and I presented in those blog posts a theoretical context on how it could help enhance performance in some runners.

Since then, they have been getting some pretty good reviews (like this one in French!) despite the initial skepticism. They have not exactly set the world on fire yet and we watch this pace to see how they develop. More articles.

Wednesday, January 02, 2013

The Interest in Toning Shoes

I am starting to see some renewed interest in the toning shoes niche. These are the shoes with design features that are designed deliberately to make the shoe unstable. This instability make the muscles work harder, giving the so called tone up. Players in this market include the Masai Barefoot Technology (MBT), Skechers Shape Ups and the Reebok EasyTone. Gone are the early claims for these shoes that they will cure things like cellulite. However, the claims that were still made for the benefits of these shoes have certainly been over-hyped, leading to some of the companies having to settle with the FDA for multi-millions of dollars. This was because the science did not support the health gains. That did not mean that the claims were wrong; it just means they were not supported by the evidence. The American Council of Fitness also came out with a report casting doubt on the benefits of the toning shoes. This lead to some waning interest in the use of these shoes.

However, more recently there has been a whole issue of the journal, Footwear Science, devoted to the science underpinning these shoes. A number of clinicians are reporting them useful for some selected conditions such as painful hallux rigidus. I have a heard of a few chiropractors who trial them in patients with chronic postural low back pain. While most of the research to date as focused on the biomechanical effects of toning shoes, what is need is more on the outcomes with these clinical conditions so we can be better guided as to when and who to use them in.

I certainly hope that toning shoes are not relegated to the history books as a result of litigation and some negative research findings, as they will have some good clinical uses. They are not going to be much use to tone the butt, however. I have been working on a related project. and an eBook.

Saturday, March 31, 2012

Vibram Five Fingers facing class action suit

A class action suit has been filed against Vibram Five Fingers for the health claims that they made for their products that did not eventuate to those who are taking the action. Following the many blog and forums posts on this and the comments on them have been interesting with most missing the point of the suit.

Vibram made health claims for their product that was not supported by the evidence, when there is none that actually supports the claims. It is that simple. Reebok had to settle with the FTC for $25 million for doing the same thing concerning claims about their toning shoes. Skechers is also facing a number of class actions and is in discussion with the FTC for the same allegations. They have set aside $44 million to deal with this.

There have been calls, mostly on minimalist and barefoot websites, for a class action against the traditional running shoe companies. The point being missed is that these companies are not making medical or health benefit claims for their shoes. Just check the most recent editions of running magazines and look at the claims being made in the advertisements. The only claims regarding injury and health are being made by the manufacturers of the minimalist shoes. I suspect Vibram is just the first to face a class action and more will follow. A recent motion to dismiss the case was declined by the judge.

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Thursday, December 29, 2011

Overpronation in Runners

“Overpronation” has been some sort of buzz word in the running community for a long time, but is generally a meaningless term. It is widely used to wrongly prescribe a specific running shoe (ie motion control). The real problem with the term is that it is a substantial oversimplification of what is actually happening to the foot and the use of the term seems to have made experts in it by some health professionals, running shoe sales people, coaches and even runners who have no sort of medical or related qualification. The blogosphere is also full of non-experts pontificating on myths of overpronation. It is easy to see that they have no real understanding of biomechanics and foot function and what they write is easy to deconstruct. There are numerous reasons why a foot may overpronate, so to advocate one method to treat overpronation over another is just plain ignorance of what the causes of it are. Muscle strengthening will only correct overpronation if a muscle weakness is the cause. Muscle stretching will only correct overpronation if a tight muscle is the cause. Gait retraining will only correction overpronation if there is an abnormality in the gait amenable to gait retraining. Foot orthotics will only correct overpronation is there is an alignment issue with the bones. If you have overpronation, do yourself a favor and see someone who actually understands what it is, rather than listen to the unscientific pontifications of self-proclaimed gurus who just happen to have a blog. For more detail on this, I blogged about it here. There are so many overpronation myths to bust and so little times to deal with them!

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Wednesday, December 21, 2011

Navicular Stress Fracture

Navicular stress fractures are a diagnostic challenge and the existence of the so called “N spot” over the navicular is an important diagnostic suspicion. X-rays are not always helpful with a significant number of false positives. There are no short cuts with a navicular stress fracture, the time non-weightbearing away from sport is a minimum of 5-6 weeks. There is no way around this. I have recently spoken to a couple of colleagues who had to deal with athlete with this and they were looking for ways to avoid that. There is no way. The outcomes and success rates and the return to sport for a navicular stress fracture, regardless if it is a surgical or conservative management plan seem to be about the same. The athlete has to be told: no weightbearing for 5-6 weeks. Find a non-weightbearing activity for them to keep going.

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Tuesday, December 13, 2011

Running With a Cadence of 180 Steps a Minute

The concept of runners shortening the stride length and increasing the cadence to 180 steps a minute has been coming up as a concept a lot me recently. I am not sure what to make of it. Some prominent coaches and running form experts are advocating it to reduce the risk of injury. At the same time a number of sports scientists are dismissing it as not valid. Most runners tend to naturally adopt a running form that is the most metabolically efficient for them. Any change to that tends to come with a metabolic cost. Those that advocate it are very passionate abut it, but as we know that the more passion there is in defending a theory, the less likely there is to be any evidence that supports it (Paynes First Law). I am certainly seeing injuries in those runners who use a 180 cadence, so I going to wait until the science tells me which is the better way to go on this one.

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Wednesday, September 14, 2011

Does the Circulation Booster Work at Improving Circulation?

We have all seen the adverts for the Circulation Booster, but can it really boost the circulation? Surely the claims “as seen on TV” and the reliance on testimonials in the marketing should be enough to set off the ‘snake oil’ alarm bells. There is certainly no good scientific data to support its use at improving circulation to the lower limb and the Therapeutic Products Advertising authority in Australia forced the company to modify the claims that they made. A similar ruling was given by the Advertising Standards Authority in the UK.

So how is the Circulation Booster supposed to work?

When we are walking the rhythmic contraction of the muscles in the lower limb act as a muscle pump to help pump the blood back up to the heart. This is an important way to stimulate the venous return part of the circulation. The idea behind the Circulation Booster is to provide a small electrical stimulus to the bottom of the foot while sitting to gently stimulate the muscles to contract and thereby help the venous return to the heart. This has nothing to do with the arterial supply or the about improving (or “boosting”) the amount of circulation down to the foot and lower limb!

So, at best, the Circulation Booster may help blood go back up the veins, but the blood supply down to the feet and legs come via the arteries and it won’t affect that! This maybe help prevent DVT and other thromboembolic events… but so will walking and this will be a whole lot better for people than sitting with their feet on the device. There has been some research that has shown some improvement in the venous parameters, but that is NOT the arterial circulation (funny how the company promotes these scientific studies, but do not point out they are on the venous side of things and not the arterial side!)

Going for a walk around the block is going to get that venous muscle pump working harder and do a lot more good for the venous circulation that sitting with the foot on the Circulation Booster. Going for a walk (ie gentle exercise) is going to help fitness, general well-being, prevent osteoporosis and actually improve the arterial circulation. So what you going to do? Sit down for 30 minutes on the Circulation Booster or go for a 30 minute walk. Which one is going to help your circulation more? Which one is going to hurt the wallet more?

Until I see some credible data, think placebo effect when people say they help.

See the Podiatry Arena discussion on the Circulation Booster.

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