Robert – I think you are spot on here. Regarding your question about timing
of bone remodeling, I hopefully have something in the works. Muscles adapt
quickly, bones take longer, and this may very well play a role in why
fractures sometimes occur a few months after beginning the transition. Also
wonder how long it takes a stress fracture to develop to the point where it
is noticed…

Pete

“No,” he reminded me, “I’ve been running barefoot for 3 years.”

“Yeah,” I said, “you’ve been doing it wrong for 3 years” (I was in a glib mood, and I sensed that he could take a minor ribbing). “In fact, I bet that when you put on these sandals and go running you’re going to hear a loud slapping noise… that you won’t hear from me when I run next to you.”

Sure enough, he put on his sandals, we went for a run and… SLAP, SLAP, SLAP.

“You’ve been overstriding for 3 years, and overstriding causes the problem you reported and results in slapping noises when you wear sandals.”

I gave him a couple of cues and within a few minutes he changed his stride. Did it stick? I don’t know.

But now that I’ve seen thousands of barefoot runners, I can tell you: Some people are more aware of their sensations than others. Some people adapt and change faster than others. Some people think they need to “work through the pain” and other try to find a way to get rid of pain. Some people are more adept at trying different movement patterns than others.

In other words, JUST taking off your shoes is not necessarily enough (whether you go barefoot, in VFFs or in Invisible Shoes).

I’m thinking of automating things like the 10% rule of thumb, giving runners a heads up that they might be increasing their risk of injury.  One could also use online reporting of ache and pains such that an expert system could pick out possible injury patterns. Perhaps one could start with a system where it’s collecting data for analysis and as patterns emerge the expert system could get better at picking out likely problems.

Such a system could easily be used by health care professionals in both research and in diagnosis and final treatement.  There are potential privacy issues one would have to deal with, so one wouldn’t want to put too much information in the system.  

One could start with just adding a little to what is already gathered on sites like dailymile/sportpal/etc, so from mile+pace one would add the actual shoe used.  Knowing which shoe (or lack of) would allow the system to know how long that particular shoe had been worn, how long a runners has been in that shoe type.  The next stage would be adding in enabling the logging of aches and pains on different sites on the body.  Being able to associate pictures or video with runs might be another diagnositic tool – for either crowd sourcing a diagnosis or providing this to professionals.

Such a system you’d want to just use regardless of whether you are injured or not, it’d need to be fun and easy to use.  I’m not about to volunteer to write such a system, but maybe those who have might see an opportunity to add to their system… 

This post, and the one on metarsial stress fractures made me think about the phases of transition of adaptation of the gait, and the muscles, tendons and bones.    The study discussed above shows that it a tranistion in gait can happen in 6 weeks, and I’d expect that the gait changes will also be in unison with muscle and tending strengthing.  I’d also suggest that gait changes will lead the soft tissue changes, but full gait changes won’t be able to retainied for long distances untill the soft tissue is strong enough.   This would be the initial phase of transition.The end of intial phase the gait has changed, and the muscles are now strong enough to support extended periods of running and at faster paces.  Now into the second phase, running further and faster puts more stress on the bones, and with these new stresses they could either start to fail and we’ll see stress fractures, or if we are more gradual about the upping the stress the bones density will start to increase and they will become stronger and be able to handle the increasing loads.   There is a fine line to tread here, and one we aren’t neccesserily used  to detecting. We all know about over doing and having aching muscles in the days following a hard run, we can take it easy for a couple of days and then we’re back even stronger.  Contrast this to bones stress and regrowth – unless you really overdo it’s difficult to know that the bones are struggling to keep up, and the regrowth is far slower than muscles.  It’s also all to easy to put ache and pains as familiar soft tissue complaints and not spot bones stress as the source.I would even stick my neck out and proposing the idea that perhaps those who don’t adapt their gait quickly might be at lower risk of bone injuries.  It could be that those heel strikers in Vibrams might not have the prettiest gait, but perhaps they could be using their body in a similar enough way to what it’s used that it’s not  overloaded.I’ll finish with a question for those with more knowledge about medicial side – how long does it take for bones to become stronger? And what is the best stimulus for bone growth?  Are there things we can do to make ourselves more aware of where the line between stress that causes bone growth and overdoing it and accumulating damage faster than it’s repared? 

Anyway thanks for a good article.