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Sunday, October 17, 2010

Vibram FiveFingers: Should You Run With Them??

On Sun, Oct 17, 2010 at 5:20 PM, Elizabeth wrote:


My name is Elizabeth and I am an editor for my school newspaper.

I would love your help in answering a short interview for a story I am writing on the shoes called Vibram FiveFingers.

Thank you for the help, and I have included the questions below.

Assistant Sports Editor

1. What is your full name and title at your health center?
2. Have you heard of Vibram FiveFingers? I've heard that these shoes strengthen the muscles and tendons in the foot. Is this true and why?
3. Are the Vibram FiveFingers better than a regular running shoe, considering support and weight?
4. Would you recommend these shoes for a young athlete?
5. Do you think humans have evolved so far as that shoes with this little "substance" would be unhealthy to wear?

Sure, and good luck with the article. I am answering this also on my blog tonight. Thanks for the questions.

Dr Richard Blake, Center For Sports Medicine, Saint Francis Memorial Hospital

Yes, by separating each toe they help the toes move better, thus allow the muscles and tendons into those toes work more. The more tendons move, the more strength they can gain.

Regular running shoes provide more stability and more shock absorption for running. The faster you run, the body needs to absorb upwards of 5 to 10 times body weight, especially down hills. I would want the most protection I could get. The hype with these shoes is that it strengthens your foot and leg muscles and tendons while you run, but there are many better ways to safely strengthen feet and ankles, without the increased risk of injury. I have had thousands of patients in the last 30 years that were wearing unstable shoes for them and got injured. When we switched these patients to more stable shoes, their injuries got better.

Athletic shoes have gone through cycles in those 30 years from more supportive, to less supportive, to more supportive, and now back to a run on less supportive shoes. Only time will tell us what injuries we will be facing. As you watch the video below, I am impressed by the break in part that is mentioned, but the running community must be intelligent about how this type of shoe is worn, how it is broken in, what type of warning on the label should exist, etc, to protect the consummer.

 I would assume that the younger the athlete, and the more immature the skeletal system is, the more protection it needs if it runs long distances. The foot does not become structurally sound until 18 to 20, and even 22 in slow developers. I would therefore be cautious with young athletes.  After examining thousands of feet, there is 20-30% of all feet I would consider weak feet, very injury prone. Can anyone tell that patient, even recognize who they are, to intelligently steer them away from this type of shoe in the first place? I just don't see that sophisication in the running shoe stores.

I therefore would be very cautious about these shoes for athletics. There is a little less protection for our toes, and toe injuries can be very serious. And there is a little less protection for the rest of the foot as well. Wearing this shoe will make our feet, ankles, knees, and hip move differently than what they are use to possibly setting up potential injuries. The body does need time to adapt to different environments. Being in sports medicine, I see so many injuries with the ultra light weight shoes for long distance training, that I worry that these shoes will produce many serious injuries because people won't know when to wear them.

That being said if you gradually begin to wear them on stable surfaces with short runs and listen to your body never running through pain, it is probably fine. I love the idea that you should  walk around in these for 30 hours before ever running with them. You would start with 1 hour the first day, adding 15 more minutes per day, until you were up to 30 hours. Then, when you start running, run 1 mile the first time, adding 1/2 mile to each additional run up to 5 or 6 miles. With running you should run the shorter runs with the Vibram FiveFinger, and the longer runs in the traditional shoes. This alternating of shoes prevents alot of injuries since the stresses put on your body is totally different with each shoe type. When you run with any shoe type day after day you can develop an overuse injury. Alternating shoes is a great way to reduce injuries.

I am not sure about the evolution question, but I believe in general populations that wear shoes have weaker feet than unshod populations. But, walking in the cement jungle we call home, I would strengthen my feet with exercises and take the protection shoes give me from the broken glass and sidewalk cracks out there. I hope this helps you Elizabeth. The video below at least emphasizes the break in process.

PS I love these shoes for my bunion patients as a house slipper.

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Thank you very much for leaving a comment. Due to my time restraints, some comments may not be answered.I will answer questions that I feel will help the community as a whole.. I can only answer medical questions in a general form. No specific answers can be given. Please consult a podiatrist, therapist, orthopedist, or sports medicine physician in your area for specific questions.