Baby, you were born to run, barefoot?

Lately there has been a lot of interest in barefoot running, or running with minimalist footwear on. I think it would be really great to provide some quality general information about this for those considering the idea of running either barefoot or in something minimalist like Vibram Five Fingers.

In general I am a big fan of the concept that getting “back to the basics” is usually the healthy thing to do. I prefer my food unprocessed and whole. I like my exercise to be simple and functional. The idea of running barefoot has a certain appeal to it – after all, our ancestors managed to flee from man-eating predators without the benefit of $100 running shoes. But, does running without shoes on (or with minimal footwear) actually do us any good, or is it a dangerous fad that leads to injuries?

Before I delve into the topic at hand – running without traditional running shoes – I will quickly discuss the options available. You can either drop the footwear entirely and go barefoot, or you can go with a minimalist option like Vibram footwear. The minimalist choice will provide some protection to the soles of your feet, but will rob your body of the biggest form of feedback as you run – the feedback from the soles of your feet. Being barefoot will give your body and nervous system more input and more control, which is great for mastering something new like ditching the running shoes. So there is a trade-off you must make between the protection that minimalist footwear provides and the neural feedback and increased neuromuscular control that being barefoot provides. Also, being barefoot allows your feet to breathe and sweat more freely, and develop more strength and control in the small intrinsic muscles of your feet.

Some proponents of barefoot running claim that running barefoot as our ancestors did is healthier for our feet. One reason is that when running without shoes the outside front of the foot takes a lot of the impact, while running with shoes on leads to high-impact heel strikes, with the person placing all their weight on the heel and then pushing off from the forefoot. Without shoes on the runner will not land on their heel with such force, as this would be painful to do without shoes, and will instead use the front of the foot to provide most of the immediate shock absorbing and ground contact.

One way in which the foot is marvelously designed is the ability of it to absorb impact from running with minimal force being transferred to the knees, hips, or low back. This process of shock absorption built into our bodies was built in when we were evolving and when there was no such thing as modern footwear with thick cushioning. Now that we tightly encase our feet and provide padding underneath, we are able to land on our heels and run like we do currently. Unfortunately, this heel-striking that shod running promotes bypasses the natural shock-absorbing that occurs between the toes and heel, and transfers increased force up the legs to our knees. Being barefoot involves the entire foot to a greater degree than wearing shoes does, and allows our feet to work as designed and dissipate forces right there at the level of the foot. Put simply, being barefoot allows the body to function as designed with regard to shock-absorption.

Now, while words are great they are certainly no substitute for real world experience. So, if you are interested in the topic of barefoot running then you should stand up and go outside and run a hundred feet or so with shoes on. Really focus on how your feet are meeting the ground. You will notice that your heel is what hits the ground first, and then you push off with the front of your foot. Now, take your shoes off and find somewhere without too many rocks (or any dog poo or broken glass) and run a hundred feet barefoot. You might notice that landing on your heel hurts when you’re barefoot, and your feet might be more comfortable with you landing on the front of your foot and not even having your heel touch the ground at all.

This is a completely different biomechanical situation. Running with shoes means your heel strikes and then your foot flattens briefly as you transition weight onto the forefoot, and then you push off the front. Without shoes the heel strike shouldn’t occur to such a degree, and the force with which your foot strikes the ground will feel less forceful. It will seem a bit like “tip-toeing” as you run.

When your foot hits the ground, heel first, this causes all the muscles, bones, and joints in your leg and hips to react in a specific fashion to maintain stability and provide speed and strength. Running without shoes changes that biomechanical process so that there are different forces and stresses on your entire body, from your toes all the way to the top of your spine. As in any change in life, it is important to take it slowly and safely.

This is an important concept to focus on for a moment. Think of the force that is transmitted up your legs and into your spine as you run with a high-impact heel strike, and then think of the force transmitted up your body with the lower-impact forefoot strike that running barefoot promotes. Decreased mechanical forces putting load on our spines is a good thing. The benefit of diminished force being places on our skeleton and our joints is something that, as a runner, you will need to weigh carefully against the ability of your body to adapt to running without shoes and the different biomechanical forces that your feet and legs will be exposed to. If you can run without shoes on and gradually decrease shoe-usage in order to prevent injury, then it is certainly a good possibility that ditching the shoes and letting the feet breathe will be good for your body.

You don’t need to go from shoes to no shoes, though. There is a middle ground. Different shoe companies are all introducing minimalist footwear. One major brand is the Vibram Five Fingers. They provide barely anything in the way of support for your ankle and foot, but they do have a decent amount of padding on the bottom to protect you from sharp rocks or glass without providing so much padding that it’s like wearing shoes.

If you are going to try out barefoot running, or running with minimal footwear, then it is important that you do it correctly to avoid injury. Some tips include:

  • It might be a good idea to just go barefoot at home, or as you do your day-to-day activities, to accustom your body to the lack of protection and support.
  • Start slowly – if you normally go 3 miles each time you run, do only the last ½ mile barefoot.
  • Slowly (and I do mean slowly) add distance or time to your routine, so that you do not shock the body and cause an injury. Taking a month or more to transition to barefoot is a minimum, in my opinion.
  • Stop at the first sign of pain!
  • When running barefoot pay special attention to lifting your feet off the ground as opposed to throwing your feet into the ground in front of you. Run “lightly” without plodding or slamming the foot down.
  • You might notice yourself taking shorter strides – this is normal.
  • Be aware of how your entire body feels after running barefoot – that mans the soles of your feet, your ankles, your knees, your hips and low back, and anything else that feels different.

If you don’t get into barefoot running slowly, you may very well get sidelined by an injury that will make running – with or without shoes – painful and difficult. Some possible injuries include:

  • Pain in the calf or Achilles tendon – because shoes raise the heel off the ground a bit this chronically shortens the calf muscles, and when running barefoot this can overstretch this muscle before it learns to become more stretched naturally. Achilles and calf problems can then lead to…
  • Plantar fasciitis – pain at the sole of the foot that is worse when stretched, or worse n the morning when you first step out of bed.
  • Soreness on the topside of the foot – likely from shifting conditions of muscles, bones and joints in the feet as you get used to running without shoes.
  • Bruising or other injuries from pebbles or other things you may step on.
  • Sprained ankles – keeping your ankles surrounded by padding is good for preventing sprains, but is bad for developing neuromuscular control of the ankle, so transitioning too quickly to non-traditional footwear may lead to sprains if you aren’t careful.
  • Stress fractures – some people have reported getting stress fractures in their foot bones from jumping into barefoot running without proper preparation.

So, to summarize, running barefoot can be a great way to strengthen your feet and legs and to develop the small muscles of your feet. This can benefit your entire body by providing a more stable base and by decreasing wear and tear on your knees and other joints. It also carries risk, though, because you must ease into this new style of running slowly and deliberately, being mindful of pain and always listening to your body as it adapts to the world of barefoot running.

At Park Bench Chiropractic we adjust the spine first and foremost, but we also pay attention to the joints of your arms and legs – including ankles, knees, hips, shoulders, elbows, and wrists. Before you transition to less footwear, or throughout that transition, we encourage you to come in and have either Dr. Matt or Dr. Rob evaluate your lower extremity for joint imbalances that could make it more difficult for you to make the change, or to see if the change is even something that is right for you.

Feel free to call or stop by Park Bench Chiropractic if you want to talk about this with one of the doctors.

Antidepressants are now being prescribed by Medical Doctors (MD’s) to treat common lower back pain

In 1996 about 13 million Americans were using antidepressants. By 2005 that number rose to 27 million. Not only are more Americans being prescribed antidepressants, but those individuals are taking more antidepressants. (1)

More than 164 million prescriptions were written for antidepressants in 2008. More than 1 out of 10 Americans are on antidepressants as of 2008.

Researchers Olfson and Marcus examined the clinical data from 1995-2005 and focused on 50,000 people to study. They found that those on antidepressants were more likely to then go on to use more powerful anti-psychotic drugs and less likely to partake in psychotherapy. (2) In that sense, antidepressants are a type of gateway drug and they apparently aren’t effective enough in many cases because more powerful antipsychotic drugs are later prescribed.

Dr. Eric Caine of the University of Rochester in New York said he was concerned by the findings, and noted that several studies show therapy is as effective as, if not more effective than, drug use alone. “There are no data to say that the population is healthier. Indeed, the suicide rate in the middle years of life has been climbing,” he said.

Therapy is not as easy to simply popping pills, though, which leads us to the low back pain issue.

Low back pain is one of the most common and most expensive medical conditions in the United States. Most people will have to deal with low back pain at some point in their lives. The cost of prescription drugs and expensive surgeries are two of the major factors causing an explosion in healthcare costs in the past decade. Surgery is a significant cost associated with treating low back pain, and this is despite the fact that research repeatedly shows that chiropractic care is a safer, less expensive and more effective way to treat most cases of low back pain. (3) Research has also shown that contemporary medical treatment of lower back pain is more likely to lead to disability than is chiropractic care. (4) Still, most people do not know these facts and instead go see a medical doctor.

Medical doctors routinely prescribe painkillers and muscle relaxers to their patients who complain of low back pain, often doing so rather than referring them to a chiropractor. On top of those drugs, now medical doctors have begun to prescribe antidepressants to their back pain patients.

This is where we come to a thought experiment. Think with me for a moment: as anti-depressant use doubled in the United States from 1996-2005, did the incidence of lower back pain decrease alongside it?

If anti-depressant use has more than doubled, and medical doctors consider antidepressants a treatment for lower back pain, then the prevalence of lower back pain should have dropped significantly.

But it didn’t.

That should tell you all you need to know about using prescription psychiatric drugs to treat a problem with your lower back.

1.       http://www.ncbi.nlm.nih.gov/pubmed/19652124

2.       http://www.ncbi.nlm.nih.gov/pubmed/21135326

3.       http://www.ncbi.nlm.nih.gov/pubmed/21036279

4.       http://www.ncbi.nlm.nih.gov/pubmed/21407100

Major New Study Conducted by the U.S. National Institute of Health (N.I.H.) Finds that Raising “Good” Cholesterol DOES NOT REDUCE THE RISK OF HEART ATTACK OR STROKE

In fact, it appears to increase the likelihood of stroke…

So, if increasing the amount of “good” cholesterol doesn’t actually make you any less likely to have a stroke or heart attack, then are we still calling it “good”?

Here is the most important line in the article to digest:

“The results are part of a string of studies that suggest that what doctors thought they knew about cholesterol may be wrong.”

It is a peculiar arrogance of man that allows him to believe that he can fully understand and even outsmart the human body. If there are raised levels of cholesterol in the blood, perhaps this is part of a beneficial or benign function the body is performing, a process more commonly occurring in those with poor cardiovascular health? Cause and effect is unknown.

That is merely a very simple thought, but it is a source of reasonable doubt to anyone weighing that thought without prejudice.

Now, there is no standard measure of doubt which may exist in a doctor’s mind before he or she may prescribe medication to treat a condition, but there is a standard I hold myself to when it comes to me putting things into my body.

NIASPAN (niacin) is an unscored, medium-orange, film-coated tablet for oral administration and is available in three tablet strengths containing 500, 750, and 1000 mg niacin. NIASPAN (niacin) tablets also contain the inactive ingredients hypromellose, povidone, stearic acid, and polyethylene glycol, and the following coloring agents: FD&C yellow #6/sunset yellow FCF Aluminum Lake, synthetic red and yellow iron

The above illustration and accompanying description is that of the medication in question.

What is purely factual is that scientists have discovered a link between high levels of so-called “bad cholesterol” and increased risk of heart attack or stroke, but they still have not uncovered the nature of that link. Scientists and drug companies then made the assumption that since lowering levels of “bad” cholesterol decreased the likelihood of a stroke or heart attack, that then increasing the levels of “good” cholesterol would similarly protect cardiovascular health. This assumption was just proven wrong. In fact, increasing levels of “good” cholesterol was found to expose people to an increased risk of stroke.

Despite the multitude of potentially dangerous drugs on the market to solve the cholesterol “problem”, the problem hasn’t truly been unmasked and defined clearly. Rather, there is a relationship involving cholesterol and heart health, but the relationship is currently not well understood. Perhaps it will be fully understood in time, but presently there are only theories which are currently being tested on millions of Americans who use these medications.

In scientific education, one of the earliest and most important concepts any good thinker must embrace fully is the appreciation that correlation does not equal causation. A relationship between “A” and “B” does not mean one causes the other in a strictly linear fashion. They both may be influenced by another, presently unknown, variable…“C”.

Far too often the other, unseen variable is waiting to be recognized, and that discovery unlocks a whole new level of understanding, and everybody is forced to admit that they had no idea how little they understood the topic previously.

“Not surprisingly, doctors thought that if they could raise H.D.L. levels, their patients would benefit. So far, that assumption is not panning out. Nobody knows why.”

So, what does this mean to the millions of Americans currently taking expensive prescription medication that they were told would help keep them safe from heart attack or stroke? It means you may have been taking that medication unnecessarily. Modern medicine’s best effort may have failed you and millions of others and exposed you to side-effects as-of-yet undocumented.

When you watch the commercials for medications like these types, please notice the warnings about how certain medications are not safe for people with liver problems. This is because the liver is the vital organ that filters toxins out of your body. These medications are viewed by your body as toxic foreign substances, and the liver has to put in additional work trying to cleanse your body of the “hypromellose, povidone, stearic acid, and polyethylene glycol, and the following coloring agents: FD&C yellow #6/sunset yellow FCF Aluminum Lake, synthetic red and yellow iron oxides, and titanium dioxide” inside the pill.

The effectiveness of a medication has to be weighed against any possible toxic effects on the body. If a medication truly does prevent stroke or heart attack, then this certainly can be an important benefit, and is likely a medicine worth taking no matter the extra work your liver has to do to break it down and send it on a one-way trip into your toilet.

In closing, I would like to mention that the drug in question is called Niaspan. It is a slow-release form of Niacin. Niacin is commonly known as Vitamin B3. Yes, you read that right…vitamin B3. Vitamin B3 can be found in a wide variety of fruits, vegetables, and meats. In order to get Vitamin B3 into a slow-release capsule the ingredients and additives listed above in italics were added to a vitamin.

Abbot Laboratories sold just under $1 billion worth of Niaspan in 2010.

The original NY Times article is here.