Comments on: Army Study: No Difference in Injury Rates Between Traditionally and Minimally Shod Soldiers

By: Luke Falk

Luke Falk — Tue, 30 Nov -0001 00:00:00 +0000

Exactly, they don't present a "uniform, military" appearance. I'd agree, except for some of the bright yellow and green shoes that I've seen in a PT formation.

By: Kyle Higgins

Kyle Higgins — Tue, 30 Nov -0001 00:00:00 +0000

In reply to Pete Larson.

I have seen a huge uptrend in minimalist shoes in the Army in the recent years. The New Balance MT10 are sold in almost every Post Exchange here in Germany and they're often out of stock of most common sizes. They're also extremely common to see out during physical training. Merell Trail Gloves are seen with some frequency due to the aforementioned Vibrams ban while in a physical fitness uniform.

By: Pete Larson

Pete Larson — Tue, 30 Nov -0001 00:00:00 +0000

In reply to Greg.

It's not a prospective study and that is always a concern. But, it's the best we have so far. I think some results from prospective studies are coming.

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By: Pete Larson

Pete Larson — Tue, 30 Nov -0001 00:00:00 +0000

In reply to Tuck.

50% of the runners I filmed who were wearing Vibrams at the NYC Barefoot run were heel striking.

By: Pete Larson

Pete Larson — Tue, 30 Nov -0001 00:00:00 +0000

In reply to beckip.

"What I would like to see is whether or not the injuries between the two groups differed" I agree, I actually made this same comment about the forefoot vs. heel striking that Craig references here in the comments. The fact that injury rates were not different is not as helpful as knowing patterns for specific injury types. Therapy would be very different depending on the type of injury.

I agree with your comments on pronation as well. I don't think shoes should be assigned based upon amount of pronation observed, but if there is a particular problem, such as medial shin splints or post tib tendinitis then looking at pronation makes sense. It could even be the case that the shoe is causing the problem if it is too soft and accentuating pronation.

By: Pete Larson

Pete Larson — Tue, 30 Nov -0001 00:00:00 +0000

In reply to Nick Eaton.

It wasn't a prospective study I don't think, so no baseline vs. conclusion comparison possible. I believe the sample was about 1105 traditionally shod, 226 minimal. The 24% number was just for neutral traditional shoes, I think they lumped all traditional shoes together since previous research by members of this group found no difference in injury rates among soldiers assigned stability, neutral, or motion control shoes. So

By: Tomas Tran

Tomas Tran — Tue, 30 Nov -0001 00:00:00 +0000

to prevent injury..I think its more about way you run and how/where you lay your foot on ground
...anyway ...I would never run back in super-cushion or stabilized or other than minimal type of running shoes ... I prefer minimus and thats it:-)

By: Cody R.

Cody R. — Tue, 30 Nov -0001 00:00:00 +0000

In reply to Matthew Noll.

i was never injured with TRS, and the only shin splints i ever got were from hurdling, TRS to track spikes will do that, but when i switched to minimal running shoes 3 years ago, and now going barefoot in the last year, i've still had no injuries, but i run substantially more comfortably, i'd say i run better now too, though when i made the switch i was building myself back up from 8 months of not knowing i had mono...yea, only the passed 6 months have i got close to being my old self

By: beckip

beckip — Tue, 30 Nov -0001 00:00:00 +0000

The best thing to come out of the minimalist movement was a better selection of shoes. The worst part was so-called experts interpreting studies however they saw fit (I've probably been guilty of this in the past to some extent too, though I have been making an honest effort to be more cognizant of "good" versus "bad" science and how I analyze research). So I'm really glad to see you preempt some of that in this post (and many of your other posts on research) and look at it pretty objectively. Guess that's one of the upsides to your background in scientific academia!

I'm assuming this was a retrospective study where the shoes were self-selected? (Just my guess based on them saying they collected injury data from the past 24 months). There's part of me that wonders who had what type of running background, and whether anyone changed shoes during those 24 months, and whether things like worn out shoes and whatnot were accounted for, but with a sample size that big, I figure things like that become less important, and outliers for whatever reason don't skew the data as much. (Plus not being able to control for that is all part of retrospective studies). Really, the big thing that's standing out to me is that everyone in a sample of people was given a similar training load (I'm assuming this is how the military is operating anyway), and some people were able to adapt to it at the rate it was given and others were not, regardless of their footwear.

I think your last paragraph nailed it very well, and that's the biggest challenge, determining what characteristics do lend themselves to certain shoes, because I think by now most of us realize it's not arch height, nor is it as simple as simply the extent to which the foot pronates, though it wouldn't surprise me if certain structural factors and stride characteristics that contribute to the extent to which the foot pronates (pronation used in the normal part of stride sense, not in the "overpronation" sense, since how much pronation is good and acceptable seems to be pretty individual too) in some way do factor in. And I have little doubt that it's a combination of factors, which is what makes everyone's response to different footwear so individual.

What I would like to see is whether or not the injuries between the two groups differed (for example, were the injuries in the structured shoe group injuries like PFPS and anterior shin splints/compartment syndrome and the injuries in the minimalist group injuries like metatarsal stress fractures, posterior tibialis dysfunction, and Achilles tendinopathy). I think that data would tell us a lot more and be more helpful for clinicians than just "both groups had a similar percentage of injured runners, once we controlled for age and fitness level."

By: Pete Larson

Pete Larson — Tue, 30 Nov -0001 00:00:00 +0000

In reply to johnny.

I prefer honest and objective, but suit yourself.

By: Tuck

Tuck — Tue, 30 Nov -0001 00:00:00 +0000

In reply to Kyle Higgins.

Trail Glove, fine. That's a zero-drop shoe, at least.
The MT10, however is a 4mm-drop shoe, which we know is enough to trick you into a heel-strike.

WIthout knowing what "minimalist" means it's tough to say if they've got a valid distinction between their two groups.

By: Craig Payne

Craig Payne — Tue, 30 Nov -0001 00:00:00 +0000

There is a second similar army study being presented at the same conference with similar results:

No Differences in Self-reported Injuries or Performance Between Characterized Foot-strike Patterns Amongst US Army Soldiers
Bradley J. Warr, Rebecca E. Fellin, Peter N. Frykman, Shane G. Sauer, Donald L. Goss, Joseph J. Seay.
Presented at 2013 ACSM Mtg

There is currently little data characterizing Soldiers’ foot-strike (FS) patterns and
the potential relationship to running related injuries and performance. Literature has
characterized FS pattern distribution in marathon runners reporting a heel-strike (HS)
prevalence of 75%-94% in marathoners, with the remainder (6-25%) exhibiting a midfoot
or fore-foot pattern (non heel-strike, NHS). Recent studies have reported that NHS
runners had fewer running related injuries and better performance.
PUR POSE: To characterize the distribution of FS patterns in US Army Soldiers and
determine if FS patterns are related to self-reported running injuries and performance.

METHODS : 342 male Soldiers (24.7±5.1 y/o, 177.3+7.3 cm, 81.7+16.9 kg) from a US Army Combined Arms Battalion completed a FS analysis and survey. Multiple foot-strikes were recorded in the sagittal plane using a high-definition video camera as each Soldier ran through a designated lane at a typical training pace. Soldiers then completed a survey related to training habits and injury history. The association between FS and the occurrence of a running-related injury was analyzed using a Chisquared test. Kruskal-Wallis test evaluated relationship between reported days that training was modified due to injury as well as 2-mile run time between Soldiers with NHS and HS patterns.

RESULTS: 13% of the participating Soldiers were characterized as NHS runners and 87% were characterized as HS. There was no significant difference (p≥.05) in the percentage of Soldiers reporting a running-related injury between those characterizedwith a NHS versus a HS (55.6 v 51.0%). There were no significant difference between NHS pattern versus HS pattern in the number of days training was modified due to injury (21.8±78.4 v 13.9±49.5 days/yr), or 2-mile run time (14.8±1.6 v 14.8±1.7 min).

CONCLUSIONS: This cohort of US Army Soldiers demonstrated a prevalence of HS similar to what has previously been reported in marathon runners. Based on this preliminary analysis, neither FS pattern is advantageous in terms of impact on selfreported, retrospective injury or performance.