Barefoot Running Lawsuit

Barefoot Running Lawsuit

Vibram, the Massachusetts based manufacturer of the Vibram Five Finger running shoes, has recently settled a class action lawsuit regarding its claims of health benefits of its shoes. The Five Finger shoes resemble gloves in that the toes have individual pockets, and the shoes are made of thin material and provide minimal support. They are also referred to as minimalist running shoes.


Vibram Lawsuit

Vibram Five Fingers Shoes


The lawsuit was filed by Valerie Bezdek in March 2012. The lawsuit states that Vibram was advertising the shoes deceptively and made claims about the benefits of the footwear without any scientific evidence to back it up. The specific benefits that Vibram was touting include:


  • Strengthening muscles in the feet and lower legs
  • Eliminate heel lift to improve posture
  • Improve balance and agility by neural function stimulation
  • Provide increased range of motion of the feet, ankles, and toes
  • Allow more free, natural motion

The amount settled via the class action suit was $3.75 million.  The shoes normally cost over $100 per pair, and runners who have purchased the shoes since March 2009 may be eligible to submit a claim form. A refund of up to $94 may be obtained, although the amounts in most cases will probably be between $20 and $50 based upon similar historical cases.

Additionally, Vibram will be prohibited from making unsubstantiated health claims about its shoes in the future. The federal settlement states that “Vibram will not make any claims that FiveFingers footwear are effective in strengthening muscles or preventing injury unless that representation is true, non-misleading and is supported by competent and reliable scientific evidence.”

The American Podiatric Medicine Association released a statement regarding the outcome of the case. They stated that “Barefoot running has been touted as improving strength and balance, while promoting a more natural running style. However, risks of barefoot running include a lack of protection, which may lead to injuries such as puncture wounds, and increased stress on the lower extremities.”

It is broadly accepted that switching to a minimalist shoe requires a transition period, and the running style needs to change as well. The Five Finger shoes are a zero-drop minimalist shoe, which means that the heel is very close to the same level as the front of the foot. This is quite different from traditional running shoes which have the heel 12 to 15 millimeters higher than the front of the foot. Traditional shoes are made for heel-strikers, while minimalist shoes are made for landing on the mid-foot area. There are transition shoes which are meant to be a bridge between traditional and minimalist running shoes.

On the Vibram website, the company posted a letter to its customers with vague reference to the lawsuit. The letter mainly acknowledged appreciation to its supporters through this difficult period. It also highlighted the company’s commitment to delivering a quality and innovative product. Some of the company’s long history in the field was mentioned, and they seem ready to put the issue behind them and move forward.

A recent post on this website discussed the problems that many runners have been experiencing with minimalist running shoes. This post can be found in the post archives at

A website has been established to give those affected the opportunity to file a claim form in regards to the class action lawsuit. The website is located at



Image courtesy: flickr/ Steven Erdmanczyk Jr

Jones Fracture

Jones Fracture

A Jones Fracture is a fairly common fracture which occurs at the base of the fifth metatarsal bone of the foot. This is the bone attached to the pinky toe. This condition has been in the news recently due to a Jones Fracture suffered by NBA star Kevin Durant, which is expected to keep him out of action for an extended period of time.

There are a couple of issues which can make this condition more problematic than expected. One is that it is often misdiagnosed and treated improperly, if it all. The other is that the supply of blood to this area of the foot is very small. This means that the healing process can be very slow even under normal conditions. If treated improperly, the blood supply can be practically cut off from the area. This can obviously impede the healing process dramatically, and can result in making surgery necessary.

Jones Fractures often occur when the foot or ankle twists inward, resulting in abnormal stress to the fifth metatarsal. This is not an uncommon occurrence for athletes and dancers. In particular, dancers can cause repetitive stress on the area when doing certain moves, and this overuse is a prevalent cause of Jones Fractures. The condition is actually sometimes referred to as Dancer’s Fracture because it is quite common for those individuals. Basketball players can often land awkwardly on the foot and stress the area as well.

Dancer's Fracture

Jones Fracture Clear in X-Ray

The reason that the condition is often diagnosed improperly is that the symptoms are quite similar to sprains or avulsion fractures. Avulsion fractures occur when a bone fragment tears away from the main bone mass due to trauma to the area. This foot trauma can sometimes result in Jones Fractures as well. The symptoms for all of these conditions can be similar. These include bruising, swelling, and moderate to severe pain when walking. An x-ray is the only way to accurately diagnose that a Jones Fracture has occurred.

The severity of the Jones Fracture will usually determine the direction of the ensuing treatment. Less severe fractures are usually treated with a cast, splint or walking boot. This will be required for a six to eight week duration, a portion of which may require no weight bearing. Rest is mandatory to ensure proper healing has a chance to occur. From a nutrition standpoint, increasing the amount of vitamin D and calcium intake can be a healing benefit. This treatment is usually successful for 75 percent of less severe cases. NSAID’s (non-steroidal anti-inflammatory drugs) are often prescribed during this healing period to reduce inflammation. Following this phase of treatment, there will usually be a two to three week period of rehabilitation as well.

For more severe fractures, surgery is usually the only answer. This will likely be the next step in the event of improper healing for milder fractures as well. Chronic cases, even if not a severe fracture, will usually result in surgery to finally correct the problem.  A choice of several hardware devices can be implemented during surgery to ensure the fracture is stabilized. These includes pins, plates, screws, and wires. A bone stimulator can also be utilized to stimulate healing of the bone. This can be accomplished in several ways, and is beyond the scope of this post.

After the surgery, the foot is normally put in a cast for protection of the bone. Usually no weight should be put on the foot for up to two weeks after surgery, but this can sometimes be lengthened to as long as six weeks. A walking boot is often the next phase of the recovery. The normal recovery time to full activity after surgery is 3 to 4 months. The stabilization hardware installed during surgery is usually left in the foot unless it causes some discomfort.

For athletes, surgery is often recommended regardless of the severity of the fracture. This is due to the excessive stresses that they put on the foot. It is not unusual for these fractures to become chronic for athletes, so it is best to be cautious in allowing them to return to full activity. The majority of people are able to recover fully from Jones Fractures and return to all activities.



Image courtesy of flickr/Mills Baker



Best Running Shoe for Older Runners

Best Running Shoe for Older Runners

There are plenty of people who run regularly after age 50, and many are taking up the sport for the first time. But older runners have to worry about many issues that younger runners don’t even think about. Some of these include osteoarthritis, cartilage wear, bone density reduction, and loss of muscle elasticity. These make running trickier for the older crowd, and makes it essential to find running shoes which can give them some additional help.

Recent trends in running have been towards zero-drop, or minimalist shoes. The idea behind these is that having the heel higher than the toes, like traditional running shoes, leads to improper form which can lead to injuries. Minimalist shoes strive to level the foot out such that the heel and toes are on the same level. However, minimalist shoes are difficult to transition to, especially for older runners. A transition shoe is usually recommended first, which lessens the height between heel and toe. But older runners need more cushioning for shock absorption through the ankles and knees, and most transition or minimalist shoes are lacking in this area. But one shoe has been developed that actually has around 50% more padding than traditional shoes, in addition to a heel to toe drop of around 4 mm, which is approaching a minimalist shoe. This shoe is the Hoka One One, and it could be considered a game changer for some senior runners.

The Hoka One One was developed by Jean-Luc Diard and Nicolas Mermound. They were formerly executives with the well-respected French sporting goods company Salomon. The pair are ultra-marathon mountain runners who designed the shoes with their own performance needs in mind. Extra cushioning is evenly distributed along the bottom of the shoe so that the heel of the shoe is more in line with a minimalist shoe. Research by the developers done on elite runners has shown that landing on the mid-foot is paramount for the legs to absorb the shock and still provide a strong thrust forward. The Hoka is ideal for this because the extra cushioning is centered around the mid-foot.

Best running shoe for older runners

Hoka One One Running Shoe


Best Running Shoe for Older Runners

Extra cushioning is evident


The Hoka One One is attractive to runners of any age, but particularly for older runners because of the features listed above. The extra cushioning is apparent as soon as you try them on. The toe box is wider than most running shoes and has plenty of room. The sole of the shoe is also about 35% wider than standard running shoes, providing better stability and control. The shoe has a unique midsole geometry which Hoka calls a Meta-Rocker.  This “rockering” profile allows a smooth, energy efficient stride from heel strike through the push off. The volume of the midsole is about 2.5 times that of traditional running shoes.

The extra cushioning is made from performance specific material that provides excellent shock absorption. This greatly helps reduce stress on the lower legs and back. There is enough cushioning so that any terrain that you are running on feels comfortable, from pavement to wet trails. There are a variety of soles available to tailor the shoe to your typical running terrain. The wider sole provides optimum stability, and the midsole has soft density and greater rebounding foam that allows for the correct amount of deformation to keep constant contact with the ground.

The sidewalls are reinforced for additional stability as well. The shoes are still quite lightweight, however, even with the additional volume and cushioning.

The reviews have been excellent for the shoe, especially with senior runners. The extra cushioning is noticeable on your first run with the shoes, and recovery is generally quicker for the next run even after pavement training. The shock absorbing feature is great for those of us with cartilage issues in the knees which might allow for years of additional training.

The Hoka One One shoes are available for shopping on this site by following these links:






Barefoot Running Issues

Barefoot Running Issues

Barefoot running, or the use of minimalist running shoes, is a relatively new style of running that has evoked a lot of discussions, both negative and positive. A good discussion about minimalist, a.k.a. zero-drop running shoes, is linked to here in our archives. The supporters of this movement claim that it promotes a healthier running style which will allow injury avoidance. They point to our human ancestors who obviously were barefoot runners.  Their argument is that traditional running shoes alter the running posture in an unhealthy way as compared to the minimalist shoes.

Opponents of minimalist running state that the lack of protection and support that these shoes provide are quite unhealthy and simply lead to a different set of injuries. Their stance is that shoes were created to protect the feet from injury, and runners especially benefit from the support and cushioning of traditional running shoes.


Minimalist running shoes

One style of minimalist shoes


Until recently there wasn’t much evidence to validate either one of these positions. But in 2013 a radiologist in Utah (Dr. Douglas Brown) became aware of a lot of barefoot running injuries with the heel and foot, and he commissioned a study in conjunction with an exercise science professor at Brigham Young University. Dr. Sarah Ridge does sports injury studies at BYU and she agreed to take a look at the minimalist running issue. The results of the study are quite interesting.

Dr. Ridge recruited 36 experienced runners to take part in the study. This included both men and women who normally ran between 15 to 30 miles weekly with traditional running shoes. Baseline MRI scans were performed on the feet and lower legs of all the runners, and each were declared to be healthy. Half of the group were then assigned to start incorporating minimalist running shoes into their routines, while the other half were to keep their normal running schedules with traditional shoes. The minimalist shoes used in the study were the Vibram Five Fingers brand.

The Vibram group were told to gradually start using the minimalist shoe by running one mile in them the first week, two miles the second week, three miles in the third week, and as much as they desired after that. (This was the recommendation from Vibram). The study went on for a total of ten weeks. At the end of the study, follow-up MRI scans were performed on all of the runners in both groups.

The results showed no major injuries in the legs and feet of any of the runners. However, over half of the Vibram group were showing signs of early bone injuries in their feet. Dr. Brown observed this by looking at the amount of bone marrow edema present in the feet. This is an accumulation of fluid similar to bruising in the foot bones. The edema is graded on a scale from 0 to 4, with 0 indicating no edema present. A level of 1 is typical for most people, and higher levels can indicate bone injuries.

Most of the group using traditional shoes had normal edema levels of 1 in their feet. But in the Vibram group, the majority of runners had levels of 2 or more. Three of these runners had a level 3 edema which is considered an actual bone injury. Two others had full stress fractures, which quantifies to an edema level of 4. One of these stress fractures was in the metatarsal bone, and one was in a heel bone.

Additionally, nearly all of the Vibram group were running less than expected in the minimalist shoe by the end of the study, likely due to the increasing foot pains. Dr. Ridge was unable to ascertain why some runners had problems with the minimalist shoes but others did not. But is is probably a combination of things such as running style, body weight, foot biomechanics and other physical factors.

Dr. Ridge and Dr. Brown both emphasized that these results cannot be extrapolated to any runner who decides to give the minimalist shoes a try. But the data does point out that the transition period into a minimalist shoe must be approached with extreme caution in order to avoid foot injuries. In fact, a mile per week in the barefoot shoes is likely too much initially. There is a big risk of tendonitis and plantar fasciitis in this period, in addition to stress fractures.

The American Podiatric Medical Association has actually stated that barefoot running improves strength and balance while promoting a more natural running style.  But the risk of puncture wounds and increased stress on the feet and legs lead to overall inconclusive results about the benefits of minimalist shoes.

The best information gleaned from this study is to proceed slowly and cautiously if you wish to try minimalist shoes. Details and results of this study can be found by following this medscape link.




Image courtesy:  flickr/Maggie Osterberg



Achilles Injuries

Achilles Injuries

The Achilles tendon runs from the middle of the calf down to the calcaneus, or heel bone.  It is the thickest and strongest tendon in the body. It has an important role in standing, walking, and running. It is also subjected to a lot of stress; it can be loaded up to 7.7 times the body weight during running. It is not surprising that achilles injuries are one of the most common leg injuries.

Flat feet are often associated with Achilles injuries.  In this case, orthotics are often needed to provide support for the plantar fascia and the Achilles tendon to reduce the chance of injury. Also, women who often wear high heels are putting significant stresses on their Achilles tendons and are at risk for injury.


Achilles Tendon

Achilles Tendon Anatomy

Achilles injuries happen most often when an athlete’s training rate increases rapidly. This tendon is subjected to the most force during quick running starts, which is typically when these injuries occur.  One of the best methods to prevent Achilles injuries is stretching of the calf muscle. These will increase its strength and flexibility.  Follow this link to view some exercises for the calf muscles and the plantar fascia.

There are three common injuries to the achilles tendon, and they are all treated uniquely. These are Achilles Tendinosis, Achilles Tendonitis, and Achilles Tendon ruptures. Tendinosis and Tendonitis are sometimes referred to as Achilles Tendinopathy, but the two conditions are not the same injury.

Achilles Tendinosis is pretty common, but is often misdiagnosed and treated improperly. It is much more common than tendonitis; both are normally overuse type of injuries.  The tendon will be sore and tender to the touch. There will not be any inflammation, but the tendon will often thicken. The fibers of the tendon actually become damaged with micro-tears, and are disorganized and scarred. The damaged area is usually, but not always, in the mid-portion of the Achilles tendon. This injury results in weakening of the tendon to varying degrees, and the risk of rupture to the tendon is significantly increased.

Tendinosis is usually investigated by an MRI and/or ultrasound techniques. Anti-inflammatory medication is not normally prescribed, as inflammation is usually not associated with this injury. Rest for one to three weeks is usually recommended, and training post-injury should be ramped up slowly at first. A customized stretching program and physical therapy are usually encouraged. In more severe cases, a boot or brace may be worn to stabilize the tendon and give the micro-tears a better chance to heal. Surgery is rarely needed unless traditional methods show little progress for at least 6 months.

Achilles Tendinitis is essentially inflammation of the Achilles tendon. The pain and soreness can be similar to tendinosis, which frequently leads to improper diagnosis. Rest is usually required for several weeks. Icing is encouraged, especially in the early stages of the injury. The use of anti-inflammatories (NSAID’s) is usually a part of the treatment.  Corticosteroid injections are sometimes prescribed as well. Calf stretches and heel lifts are usually part of therapy to combat the inflammation and strengthen the tendons. There is no structural damage to the tendons, only inflammation. Surgery is normally not required.

Achilles Tendon Ruptures occur when there is a complete or partial break in the Achilles tendon. The injury can vary from mild to severe, and the treatment methods vary accordingly. Minor injuries usually heal of their own accord, although rest is required. Icing for 20 to 30 minutes several times per day is helpful. 

More severe achilles ruptures require immobilization and sometimes surgery. Many typical achilles ruptures can be treated either surgically or non-surgically.  A boot, or brace, can be fitted to immobilize the tendon and give it a chance to heal. Orthotics can be used successfully in milder cases to provide re-alignment and relief for the tendon. However, the nature and severity of the rupture may dictate that surgery is needed to repair the injury. It can take over a year to recover from a severe Achilles rupture.



— Image courtesy flickr/doctorwonder



Pain Medications

Pain Medications

This post will discuss some of the most popular pain medications used, particularly for heel and foot pain relief.


Pain Relief

Medication for Pain

OTC Pain Relief

The majority of foot and heel pain issues are addressed with Over the Counter (OTC) medication instead of prescription strength. There are two general classes of over the counter pain relievers available. These are the Acetaminophens and the Nonsteroidal Anti-Inflammatory Drugs (NSAIDs). Both are used regularly for foot issues, but they work in different ways.

Tylenol and Aspirin-Free Excedrin are examples of acetaminophens. These are good for relieving muscle aches and stiffness as well as fever reduction. They work by affecting the part of the brain that receives and processes pain signals from nerve endings. They do not relieve inflammation. The NSAIDs, however,  are good at both relieving inflammation AND providing relief for sore muscles. They provide pain relief by limiting the production of a hormone that causes pain, known as prostaglandins. Some common over the counter NSAIDs include Ibuprofen, Advil, and Aleve. Physicians often recommend prescription strength NSAIDs as well.

It is important not to take more OTC pain medication than the label clearly specifies. Also, only a physician should advise if it is permissable to combine the two types of OTC pain relievers, or if they can be taken in addition to a prescribed medication. Too much acetaminophen can cause health problems, although this is rare. More than six 500 mg tablets daily is considered excessive, and has been linked to liver damage. Acetaminophen should not be used if you have liver or kidney disease. It should not be used if you have more than three alcoholic drinks per day also. NSAIDs sometimes can cause an upset stomach and can raise the blood pressure.

There are also several topical OTC pain relievers available that can be helpful. Examples of these include Ben-Gay, Icy Hot, and Aspercreme. These are useful for muscle pain relief and some arthritic pain relief.

Follow this link for a good selection of OTC pain relievers.


Prescription Pain Relief

Corticosteroids are powerful anti-inflammatory medications that are usually injected into an area of musculoskeletal injuries. They can also be prescribed in pill form as well. Some examples include Deltasone and Hydeltrasol. They can have some side effects, including mood alterations, immune system weakening, headaches, stomach aches, and weight gain. Because of the potential for significant side effects, they are prescribed in the lowest possible dose for the shortest length of time as is reasonable to relieve the pain. These drugs have other applications as well, including treatment of allergies, asthma, and arthritis.

Opioids are another powerful prescribed medication for pain relief. They contain natural or synthetic opiates for very acute pain, such as for post surgical procedures. Some examples of opioids include oxycodone, codeine, morphine, and fentanyl. These drugs work by modifying the pain messages coming into the brain from receptors. Some of the common side effects of these drugs include nausea, constipation, itching, and drowsiness. Another big problem with these is the possibility of addiction, so treatments using these drugs are very closely monitored. The dosage can be raised as tolerance to them develops.

Muscle relaxants are another class of prescription pain relievers. They work on tense muscle groups through sedative action in the central nervous system. These are more frequently used for the large muscles of the back and shoulders than for the feet. They are used sometimes for sciatica nerve problems that can extend down to the ankle and feet. Some examples of muscle relaxants include Soma, Flexeril, and Robaxin. There are several side effects to these drugs, including drowsiness, dry mouth, addiction, and urinary problems.

Of course, a physician must be consulted about any prescription drug usage, and about the use of OTC drugs in conjunction with other medication.



– Image courtesy



Kinesio Tape

Kinesio Tape

Kinesio tape is rapidly increasing in popularity as a complement to some physical therapy treatments. More than just a replacement for the old white athletic tape, it is more accurately described as a treatment modality for many musculoskeletal problems and injuries.  It can be useful for treating plantar fasciitis in addition to many other types of injuries.  Kinesio tape can be observed on many top athletes and is conspicuous by its bright colors and patterns.

Kinesio Tape Knee

KT Tape on runner’s knee

The difference between kinesio tape and its predecessors is its elasticity. The tape can stretch longitudinally by 60%, in stark contrast to the rigid nature of most athletic sport tapes. Kinesio tape is similar in elasticity to the human skin. This allows the wearer to keep full range of motion, while the tape still provides the desired level of support for injured muscles and tendons. This is ideal for treatment of plantar fasciitis as well. Kinesio tape is not suited for cases where complete immobilization is required because of its elasticity. However, a big majority of conditions are treated best with support instead of immobilization, and this is where Kinesio tape performs well.


Kinesio tape can be purchased online by following this KT link .


Kinesio Tape Back

Kinesio Tape on back

Kinesio tape adheres to the skin with an acrylic-based adhesive on the back of the tape. It is not a solid layer, but has a wavelike pattern such that the adhesive has an alternating stick/no stick arrangement. This allows for moisture to flow out of the taped area easily. This benefits athletes greatly, since the tape is not affected nearly as much by perspiration during activities. The tape even performs well in water for swimmers.

From a modality standpoint, the wavelike pattern of the adhesive  works well to relieve pain and inflammation by creating a pressure differential in the tissues which it is covering.  Kinesio tape is very beneficial to muscles recovering after an injury or surgery due to its supportive yet non-restrictive qualities. Additionally, the tape is gentler on the skin and does not usually cause any kind of irritation. The same taping can generally be worn for several days if needed.

Kinesio tape has roots in Japanese culture, and it was thrust into the international spotlight during the 2008 Beijing Olympic Games. There are well defined methods of applying the tape for its maximum benefit. There are numerous books available on the application methods.

Several varieties of kinesio tapes available. For example, Rock Tape is geared specifically for boosting athletic performance. It has a stronger adhesive, and is applied carefully over an entire series of related muscles, joints, and tendons to provide additional strength and support during an event. This is also known as Power Taping. For specific athletic injuries, Strength Tape is available in customized pre-cut strips. For medical conditions, standard KT tape is used for numerous beneficial purposes, such as carpal tunnel relief, and regaining muscle control after a stroke has occurred.


KT Tape

Kinesio Calf Taping

For plantar fasciitis specifically, Kinesio tape has provided adequate relief to many people who had little success with other treatment methods. The tape can alleviate the plantar fasciitis pain and promote healing. When applied correctly, it provides much additional support for the plantar fascia and helps reduce the inflammation in that area. Most successful cases involve traditional treatments as well, such as NSAIDs, stretching, icing, and weight loss.


A video showing the use of KT tape for plantar fasciitis treatment is shown below:


Kinesio tape can be purchased online by following the KT link here on this site.

A wonderful resource for Kinesio taping of all kind is located at the Kinesiology Tape Info website.



Images courtesy:


Reflexology and Massage Therapy

Reflexology and Massage Therapy

Reflexology is an alternative medicine form which focuses on the feet for treatment of pain in other parts of the body. It is similar to acupuncture in that it divides the body into zones which can be treated via reflex points. The feet are where these reflex points are located, and reflexology claims that virtually any organ or body part can be positively impacted by applying pressure to these points.

“Detailed studies over the last few years have concluded that there is no evidence sufficient to support the use of reflexology for any medical condition.”

Proponents of reflexology contend that treatment via the reflex points sends signals to the nervous system regarding the appropriate area. This in turn triggers hormones that can reduce pain and stress in the area. This theory is not accepted by many in the medicinal world, who suspect that the treatment is little more than a good foot massage. In fact, detailed studies over the last few years have concluded that there is no evidence sufficient to support the use of reflexology for any medical condition. Indeed, the claims of benefits to other organs by foot treatment could seem unrealistic to some.

However, for conditions of the feet, such as heel spurs, plantar fasciitis, bunions, etc, reflexology has some interesting connotations simply because the feet are the area needing treatment. Plantar fasciitis in particular can be very stubborn, and some sufferers have found reflexology to be the best treatment for them. Best results are usually obtained when used in conjunction with a podiatrist’s treatment, or ideally with a podiatrist who has a reflexology background. It may be difficult to find this combination, so the best alternative is to find a relexologist who has experience in the foot area. However, repeated treatments are normally recommended, often spanning several months.

Foot massage

Reflexology treatment

Initial reflexology treatment is very similar to a foot massage. From a purely medicinal standpoint, the benefits of this would be improved circulation in the foot and lower leg. Manipulations of the feet could also give some temporary relief for arthritic conditions. The massage relaxes the muscles and ligaments in the lower leg, aids flexibility, and reduces inflammation and pain.

The middle of the bottom of the foot is actually an ideal place for a massage. For one, the arch of the foot is closely related to plantar fasciitis. These muscles take a pounding every day, and get can stiff and inflamed. A gentle foot massage can aid in the recovery of these muscles. Also, the bottom of the foot is rich in nerve endings, similar in density to the face. This enables a massage on the foot to be particularly soothing and relaxing, and can have great therapeutic effect.  The muscles in the arches are all very accesible and easy to massage properly.

Reflexology and massage therapy could be a good option to try if you have had little success in other treatment methods for foot pain. Unfortunately, many of these treatments are not covered by insurance plans. Another possibility would be using some self foot massagers which have been very effective for many people. A good selection of these are available here on this site  for much less cost than traditional massage therapy.




Image courtesty


Chi Running

Chi Running

Chi Running

Chi Runner

Chi Running is a technique that aims to reduce the wear and tear on the body in a runner’s training regiment.  The program is based on many principles drawn from a Chinese form of martial arts known as T’ai Chi, customized for the runner. Chi (rhymes with Free) running was developed by Danny Dreyer,  a marathon runner who has authored many books about running and injury prevention.  Proponents of the chi running technique claim that it is effective in the prevention of plantar fasciitis and other overuse injuries in distance runners.

In Chi Running, more emphasis is placed on using the large core muscles to help with the running movements. There are two very obvious benefits to this. First, it will lessen the load on the leg muscles, allowing you to run more efficiently with less chance of overworking those muscles. This will reduce the chance of injury, which generally occurs when muscles are tiring. Second, you will be working out the important core muscles more when you are running. Most modern workout strategies incorporate more core muscle exercises, and this is an excellent way to combine running and core activity at the same time.

Another important aspect of Chi Running is detailed attention to proper posture to keep stresses off the back and legs. The technique advocates using gravity to help with your run by leaning forward slightly. It has been described as effortless running, which is really not accurate.  It is running which requires less effort than traditional running, but it is still an excellent workout.

Many traditional runners tend to have a pronounced heel strike,  usually a result of over-striding. This heel strike is thought to aggravate the plantar tendon and its connection to the heel bone through the fibrous membrane known as the fascia. Landing heel first can create a force of up to six times your body weight to be applied to the heel. This pounding often leads to the painful plantar fasciitis condition.

With Chi Running, however, shorter strides are emphasized to eliminate heel striking. You strive to have your foot land directly under your center of gravity instead of slightly out in front.  Your weight is distributed more evenly over your feet if you land on the middle of the foot instead of on the heel. The result is significantly less stress on the plantar fascia area, and much reduced risk of plantar fasciitis.

Other differences between Chi Running and traditional running include an arm swing that help keeps a proper cadence, and a pelvic rotation which engages the core muscles to aid in the running process.

For the novice, there is a less intensive way to begin the program, known as Chi Walking. Many of the principles are the same as Chi Running, with some subtle differences. This can progress into Chi Walk-Run, and eventually to Chi Running. There are some good Chi Running books and DVDs available for purchase on this site which provide details to ensure you get the maximum benefit out of the program.

Additionally, Danny Dreyer maintains a good Chi Running website which provides additional details about all aspects of the Chi family of fitness techniques.


Chi Running

Chi Running aims to reduce injury.




Image courtesy of Serge Bertasius Photography /

Image courtesy of David Castillo Dominici /




Active Release Technique

Active Release Technique

The Active Release Technique (ART) is a relatively new procedure being used to treat soft tissue injuries, including plantar fasciitis and related foot conditions. The method has been praised by many people who have used it to alleviate stubborn, lingering injuries that have seemingly been immune to most other treatment attempts.

The driving force behind the ART system is P. Michael Leahy, a Certified Chiropractic Sports Physician, who developed the technique in 1986.  Dr. Leahy founded Champion Health Associates and has been helping people, especially athletes, combat problem injuries for over 15 years.

Most soft tissue problems addressed by the ART technique are a result of overactivity. The muscles and tissues deteriorate due to pulls, tears, and an accumulation of many small micro tears. Blood flow to the area can be inhibited by all of these factors. As a result, the tissue never gets a chance to heal, and scar tissue develops. This internal scar tissue, or adhesions, can greatly inhibit the mobility of the affected area. The muscles become shorter and weaker as the mobility decreases. Tendons become more stressed and tendonitis develops. Additionally, nerves can become pinched which can cause numbness, tingling, and further weakening.

Traditional treatment methods would include physical therapy, modalities, ultrasound, and anti-inflammatories. The ART technique goes in a somewhat different direction which is more aligned with massage treatments and chiropractic methods. The technique depends heavily on the technician’s ability to get a precise feel of the injured area, especially the texture and tension. The technician learns by feel to shorten the tissue, apply a precise tension to it, and realign it with respect to the surrounding tissue. With proper technique, the ART method can restore smooth and free movement of tissues and relieve pressure on impacted nerves. This is accomplished by removing the adhesions in the soft tissues using the appropriate protocols. The changes made are fast and lasting, and in many cases relieve the problem area significantly.

These treatments are very specific and require that the health professional becomes certified in the Active Release Technique methodology. There are over 500 unique treatment protocols within the ART umbrella. The certifications are made for targeted areas and conditions of the human anatomy. There are certification courses for upper and lower extremities, the spine, nerve entrapment, complex protocols, active palpation, and others. These courses are geared at learning the tissue makeup of the problem area in extremely fine detail. Understanding the feel of the affected tissue, and how it moves relative to the surrounding tissue, is the key component leading to successful treatment. Specialists usually become certified only in their area(s) of expertise.

In the case of plantar fasciitis, the practitioner would obviously be certified in the lower extremity ART methods. Plantar fasciitis is indeed a soft tissue condition which has been successfully addressed with ART.  In this condition there are many small tears in the plantar fascia, such that adhesions are usually present and are an impediment to movement and blood flow. The trained health professional can zero in on these adhesions by feel, and can work with the ART protocols to reduce them and restore mobility to the tissues. The treatment usually encompasses a larger area than just the plantar fascia, as the root cause of plantar fasciitis is usually related to the surrounding tissue as well.

A short video below gives a brief description of plantar fasciitis, and explains the use of ART techniques in treating it:


Much more detailed information about the Active Release Technique can be found on the ART website. Descriptions of the certification courses and details about the treatments can be found here.  Additionally, an ART provider can be found using the locator tool on the site.