Featured Article

  • PDF Poster #1 : The minimalist running shoe

    This poster describes the characteristics of a minimalist running shoe in order of importance.
    Use it as much as you want for your running shoe stores and clinics, it's a very useful tool!

    PDF
  • PDF Poster # 2 : "How to select your running shoe" (detailed)

    This poster will help running shoe retailers and runners to be well guided towards the right type of shoe with given specifications (running history, injuries, etc.)
    Use it as much as you want for your running shoe stores and clinics, it's a very useful tool!

    PDF
  • PDF Poster #3 : "How to select your running shoe" (simplified)

    This poster will help runners to be well guided towards the right type of shoe with given specifications (Simplified version).
    Use it as much as you want for your running shoe stores and clinics, it's a very useful tool!

    PDF
  • Q-A about cadence

    Here is what I'm wondering:
    Q: Is 180 strides per minute the ideal cadence for all runners?
    A: 170 and higher... ideal is different for each individual... take off your shoes on the road and you will know what is the ideal cadence for YOU (+/- 10)...


    Q: Does it matter the speed a runner is going, or should you always maintain the same cadence?
    A: +/- 10 around the optimal personal cadence for any speed... even at speed of 'efficient' jogging (faster than 10km/h)


    Q: Do most elite and Olympic runners stick to the 180 cadence?
    A: 170 and higher... most of them are around 180-184 (for male)... from 1500 m to marathon


    Q: What benefits does it have for performance?
    A: Efficiency (less O2 consumption) by increasing running economy (more elastic recoil, less muscular work, less vertical displacement, ...) ref: 2007(R)-Midgley, 2006-Conoboy, 2005-Dallam, 2004(R)-Saunders, 1994-Morgan, 1995-Hamill, 1992-Martin, 1990-Kaneko, 1989-Cavanagh, 1982-Cavanagh, 1982-Power


    Q: What benefits does it have for injury prevention?
    A: It decreases the vertical loading rate, the stress on skeletal system - knees - hips - lower back.... but a little more stress on the Achilles tendon and foot (short term... until you get adapted)... ref: 2011-Heiderscheit, 2008-Tseh, 2008-Fletcher, 2005-Mercer, 2005-Dallam, 2004-Arendse, 2003-Stergiou, 2002-Mercer, 2001-Rowlands, 2000-Derrick, 1999-Eston, 1995-Hamill


    Q: How can overstriding hurt a runner both physiologically and performance wise?
    A: Higher chances to increase breaking phase, heel strike in front of the center of gravity, .... .... (One of my patient had a cadence of 128... average recreational runners in my clinic have a cadence of 150-155)


    Q: Is it difficult to retrain cadence?
    A: No... it's easy to learn for 90% of people... to increase the ability to keep good cadence on long term, run barefoot (ideal) or with minimalist shoes -low heel, thinner, less supportive and cushionned-(more practical) will help a lot to retrain this biomechanical change.


    Q: Any consideration would be much appreciated!
    A: The other interesting things about cadence is that cadence decreased across the last 30 years because of the "big bulky protective" shoes (ref : 2008-Fletcher, 2006-Conoboy, 2005-Mercer, 2005-Dallam, 2005-Jordan, 2005-Gerlach, 2003-Mercer, 2000-Derrick, 1995-Hamill, 1989-cavanagh, 1988-Messier, 1885-Petray, 1982-Cavanagh)... Also, the average cadence for barefoot runners are 182 (Squadrone-2009)

  • Why a majority of runners, even among international elites, are heel strikers?

    Phobia of heel striking is starting to reach runners who, seeing themselves in action on pictures, are questioning their biomechanical effectiveness. And they are right to be concerned because some with heel strikes experience negative consequences to their performance and the incidence of injuries. Here are some related explanations.


    10 things to know about runners heel striking, answering the question “Why a majority of runners, even among international elites, are heel strikers?”
    1. Pictures rarely reveal reality. Only rely on high definition cameras or a highly experienced eye. A picture taken just before the impact loading will show the foot in dorsiflexion (pointing upward) for a majority of runners.
    2. 60% of high level athletes running road race (even international elites) are heel strikers... (Note that they all use "racers" running shoes with heel-toe vertical drop of 4-10mm ... a technical aspect of the shoe that promotes heel striking!)... but 90% of track athletes are forefoot strikers.
    3. The majority of these good level athletes, however, have what we call a"prorioceptive heel strike" (the foot flattens smoothly as soon as it hits the ground). We believe this way the foot grounds is no more harmful and no less effective than midfoot or forefoot striking because it doesn't involve a strong braking phase or brutal impact force.
    4. The further we go back in the race pack, the more heel striking we encounter, and the more that "proprioceptive" heel strikes give way to extreme heel strikes.
    5. Over 80% of barefoot runners do not heel strike... and 20% of them have a "proprioceptive" heel strike.
    6. The heel strike is not the only thing to look at. A heel strike may be acceptable if the shinbone is vertical, the knee is bent, and the impact loads just in front of the center of gravity. A biomechanical analysis must therefore be global. The 4 biomechanical clues which often combine and express the same problem are:
    A. less vertical orientation of the tibia/shinbone
    B. deceased knee flexion during contact
    C. ground contact far ahead of the center of gravity
    D. the heel strikes the ground first
    7. We do not know (scientifically) if local, national or international level athletes would improve biomechanical effectiveness over the long term by making technical efforts to run better (correcting points A B C and D)... but the trend suggests that it is possible!
    8. The majority of athletes have developed bad habits caused by shoes that affect their biomechanics. They mostly train (up to 80% of their training volume) with cushioned shoes with a big heel-toe differential, a type of footwear which promotes less efficient biomechanics and a larger heel strike. Their biomechanical learning is consequently different from their biomechanical performance, which may explain why many of them retain these biomechanics when in competition.
    9. I think if athletes incorporated more barefoot training, ran 100% with their performance shoes, and if their competition shoes were "heel-toe zero differential", we would see slightly different biomechanics and most likely improved performance for some ... simply by improving their "running economy"!
    10. I think if recreational runners incorporated more barefoot training, ran 100% with performance shoes, and if these "racer" shoes had "heel-toe zero differential", we would see much different biomechanics and improved performance for the vast majority... simply by improving their "running economy"!


    Enjoy the analysis!

    PDF
  • Lettre envoyé à Protégez-vous (22-07-11) en réaction à l'article sur "Les «gougounes» sont-elles dangereuses pour la santé?"

    À qui de droit,
    Je me permets de réagir une fois de plus à un article qui manque de façon flagrante de rigueur journalistique. Une dizaine de faussetés sont avancées dans cet article qui interroge 2 vendeurs d’orthèses plantaires. Les citations avancées comme des faits sont scientifiquement et cliniquement ridicules, sans rigueur et semble fortement biaisées.
    Je vous invite à consulter d'autres spécialistes non biaisés commercialement, de présenter un droit de réplique sur le sujet, d'effectuer un ajout à votre dossier web sur le sujet (pour offrir à vos lecteurs une vision plus complète et non biaisée) et de compléter un travail qui, présenté de cette façon, ne permet pas au lecteur de faire la part des chose et de faire un choix éclairé.
    Dans l'attente de vos commentaires
    cordialement
    Blaise Dubois


    See french version

  • Réaction à l’article de Protégez-vous « Chaussures de sport, juin 2011, sur la chaussure de course à pied »

    J’ai été choqué par votre article puisqu’une grande majorité du contenu n’est pas représentatif des connaissances scientifiques actuellement disponibles. Le "bon choix" d'une chaussure de course à pied devrait plutôt porter les qualités de "simplicité - légèreté - flexibilité" plutôt que de "qualité absorbante - technologie antipronation - talon haut".
    Pour m’expliquer, voici quelques points essentiels sur la chaussure moderne de jogging que vos lecteurs devraient connaître (notez que cette liste de points est largement supportée par la littérature scientifique.)


    La chaussure moderne :
    1. et l'ensemble de ses technologies (absorption, contrôle, stabilité, antipronateur, talon surélevé) sont sans fondement scientifique et n’ont aucun rôle dans la prévention des blessures en course à pied ;
    2. change la biomécanique de course en augmentant l’attaque au sol du talon et en ralentissant la cadence du pas de course, ce qui augmente la vitesse de la force d’impact, facteur associé aux fractures de stress ;
    3. ne diminue pas le stress sur le squelette. … et pourrait même l’augmenter ;
    4. diminue significativement la performance en augmentant la consommation d’oxygène ;
    5. n’est pas perçue par les coureurs comme plus confortable que les chaussures moins technologiques et moins absorbantes.


    Notez aussi que la pronation n’est pas un problème en soit, ne devrait pas être corrigée pour la majorité des coureurs, et n’est absolument pas corrigée par les antipronateurs des chaussures de sport. Ne soyons donc pas dupe de la fausse information véhiculée par les compagnies lucratives de chaussures de course et répété par des promoteurs de produits!
    En conclusion posez-vous juste deux petites questions : Que valent les 30 années d'évolution technologique de la chaussure de course à pied comparé aux deux millions d'années d'évolution du pied de l'être humain ? Sommes-nous plus intelligents que notre propre évolution pour vouloir imposer au pied les caprices d'une technologie sans fondement scientifique ?


    Blaise Dubois
    La Clinique du Coureur

  • Planned Obsolescence for running shoes?

    I recently watched a documentary called "Planned obsolescence" which deals with the persistence of large global companies to maintain control over the consumption of the population by putting on the market non-durable goods to be replaced in a calculated future. (This documentary is available for free on internet)


    I quickly drew a parallel with major running shoes companies that make hundreds of millions of dollars in profits by often selling several pairs of shoes to one runner during a single year.


    Question: It is instilled in our habits of runners that our "normal" running shoes will only last 500 to 1000 km in general. Who decided this? Why do they fail making them more durable? Isn't the deformation of the midsole's absorbent material (ex: EVA) calculated in advance so that we renew the purchase several months later? In 2011, why is it not possible to create a material whose elastic range (reversible deformation) would match the EVA, but with a practically unattainable plastic range (irreversible deformation)? I wonder ... although I am not an expert in strength of materials ...


    Our famous minimalist shoes through all this? In addition to features you already know (injury prevention, increase the efficiency of the running gait, ...) most of them are less prone to premature wear because of the absence or very small amount of absorbent materials with irreversible deformation.


    Enjoy the reflexion!


    Lee-Manuel Gagnon
    Collaborator at The Running Clinic™

    http://www.therunningclinic.com/en/clinic-physios/lee-manuel-gagnon.php

  • Modern running shoes and cholesterol

    If profit-making companies were to introduce a category of pill to reduce blood cholesterol levels, and the pill became extremely popular, being sold to all hypercholesterolemic patients…
    And, a few years later, it became clear that not only was the pill ineffective in reducing blood cholesterol, but it also caused several unpleasant side effects such as muscle pain and digestive problems…
    What would you do? Pull the pill from the market, gradually to minimize withdrawal symptoms such as headaches, …and, above all, no longer prescribe it to newly diagnosed hypercholesterolemic patients.


    If profit-making companies (1) were to introduce a category of running shoe to reduce skeletal stress (and therefore injuries) (2), and the shoe became extremely popular and was sold to all runners (3) …
    And, a few years later, it became clear that not only was the shoe ineffective in reducing skeletal stress (4) (and therefore injuries)(5), but it also caused several unpleasant side effects such as increased strike force (6) and weakened feet (7) …
    What would you do? Pull the shoe from the market, gradually to minimize withdrawal symptoms such as pain in the Achilles tendon (8), … and, above all, no longer prescribe it to new runners (9)!!!


    PDF
  • Mechanical Stress Quantification

    When looking for tricks and advice to give to active individuals to help them prevent injuries, a variety of stretching, strengthening and proprioception exercises are frequently used. The results that we believe to be clinically significant are often mixed with other therapies and parameters which make the scientific demonstrations for these exercises quite difficult (Brushoj, 2008). We know that physical activity is the best way to prevent soft tissue degeneration by stimulating the tissue to adapt to the mechanical stress that it is subjected to. Proper quantification of the mechanical stress seems to be the answer to our problems! But, how much stress? At which frequency? In which way? How do we make running the best tool for the prevention of knee arthroses (Chakravart, 2008)? All the answers in the post-graduate course “New trends in the prevention of running injuries”.

  • Running Biomechanics

    Most running reference books convey the notion that 80% of distance runners are rearfoot strikers or heel strikers, which means that their heel is the first part of their foot that hits the ground with every stride. This kind of running gait that is described as "normal" is in fact a consequence of the running shoe, which over-protects the foot from nociceptive stimuli and disrupts real natural running biomechanics. Barefoot running obliges a much softer foot strike (a barefoot runner will never heel strike). Questions abound: Is there a "normal" running gait? Is running gait innate? Can it be taught or changed? Is there an efficient (for performance) and safe (without injuries) running gait? All the answers in the post-graduate course “New trends in the prevention of running injuries”.

  • Plantar Fasciitis

    Plantar fasciapathy is one of the most common pathologies in runners. Clinical practice guides that evolve from scientific literature (Neufeld, 2008) are very important in the choice of modalities that we use for our patients. However, literature reviews used to make these clinical guides often have very low levels of evidence and do not allow us to conclude on "best practice". Literature reviews often raise more questions than they answer: Should NSAID's be a part of the treatment plan for plantar fasciapathy? What is the role of taping? What about plantar orthoses and manual therapy? Which surfaces should my patient run on? How and when should he start training again to avoid recurrence? All the answers in the post-graduate course “New trends in the prevention of running injuries”.

  • Hyponatremia

    The most common cause of complication in marathons is hyponatremia (imbalance between plasmatic sodium and total water volume). The over-consumption of liquids during the marathon is the primary cause of this pathology. Other factors, such as the intake of NSAID's can also influence the onset of this pathology... But, which patients are at risk? How much liquid can be ingested in order to avoid this problem? How does a health professional deal with a runner who is showing signs of confusion upon finishing his/her marathon? What are the differential diagnostics? All the answers in the post-graduate course “New trends in the prevention of running injuries”.

  • Stretching

    It is widely accepted now that stretching before physical activity will not prevent delayed onset muscle soreness and will have a negative effect on performance (speed, strength and endurance). The role of stretching in the prevention of injuries is also now being questioned; certain types of stretching could actually increase the risk of muscle strain. What kind of stretching? How long before the activity? How must our athletes prepare for an activity, which involves excessive ROM? How do we properly assess flexibility? What is normal? All the answers in the post-graduate course “New trends in the prevention of running injuries”.

  • Biomechanics and Pathologies

    A health professional specialized in musculoskeletal pathologies is always looking for intrinsic factors to explain the appearance of a new non-traumatic injury. Many studies have tried to answer the following questions: Is the human body symmetrical? Is there a relationship between anatomical peculiarities (static measures like the Q-angle) and pathologies in runners? Is there a relationship between biomechanical peculiarities (dynamic measures such as degree of pronation) and pathologies in runners? Are these measures or intrinsic factors important when looking for the causes of pathologies in runners? All the answers in the post-graduate course “New trends in the prevention of running injuries”.

  • Osteoarthritis (OA) and running

    Belief
    Running increases OA of the knee, because of the impact with the ground and repeated movements. Such stress creates lesions on the cartilage which become irreversible with time.
    Fact
    Recent studies have shown that runners do not have more OA than people who do not run.
    (2008-Chakravarty, 2008-Krampla, 2008-Stahi, 2007-Hanna, 2006-Schmitt, 2006-O’Kane, 2006-Cymet, 2006-Weidekamm, 2005-Weidekamm, 2005-Hohmann, 2005-Lamontagne, 2002-Conaghan)
    My opinion
    A runners’ patellar cartilage is thicker and stonger than one of a sedentary person. This can be explained by the simple fact that the fabric has adapted to mechanical stress. Insofar as the stress is applied gradually and that it does not exceed the adaptation capacity of the fabric, a tissue remodeling will be positive. In other words, cartilaginous tissue, which is a living tissue, will rebuild more than it worsens.
    The force of the impact could have an influence on the degree of stress on the cartilage and consequently its degeneration. The shoe’s absorption or the softness of the surface does not change the impact of the stress on the skeleton, contrarily to the intrinsic mechanisms that play a critical role (run smoothly!).
    The traumatically injured cartilage would have a very limited potential healing. Because of that, some sports where traumatic injuries by twisting and physical contact are more common, have a higher impact on OA.


  • Planned Obsolescence for running shoes?

    I recently watched a documentary called "Planned obsolescence" which deals with the persistence of large global companies to maintain control over the consumption of the population by putting on the market non-durable goods to be replaced in a calculated future. (This documentary is available for free on internet)


    I quickly drew a parallel with major running shoes companies that make hundreds of millions of dollars in profits by often selling several pairs of shoes to one runner during a single year.


    Question: It is instilled in our habits of runners that our "normal" running shoes will only last 500 to 1000 km in general. Who decided that? Why do they fail making them more durable? Isn't the deformation of the midsole's absorbent material (ex: EVA) calculated in advance so that we renew the purchase several months later? In 2011, why is it not possible to create a material whose elastic range (reversible deformation) would match the EVA, but with a practically unattainable plastic range (irreversible deformation)? I wonder ... although I am not an expert in strength of materials ...


    Our famous minimalist shoes through all this? In addition to features you already know (injury prevention, increase the efficiency of the running gait, ...) most of them are less prone to premature wear because of the absence or very small amount of absorbent materials with irreversible deformation.


    Enjoy the reflexion!


    Lee-Manuel Gagnon
    Collaborator at The Running Clinic

    http://www.therunningclinic.com/en/clinic-physios/lee-manuel-gagnon.php