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    • 06 MAR 17
    • 1
    The runner in front of his doubts

    The runner in front of his doubts

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    The runner in front of his doubts, that on mine

     

    Dr. Pere Mir

     

    The speed and penetration to which new studies and news come to the world of running surprises even those that we dedicate ourselves for years to it. Many are the doubts that the new technology and tendency suggest to the runners. 80% of the runners continue to have some type of injury every year. Today we will talk about minimalism and natural pronation.

    The new technology in sports shoes (drop, cushioning, reactivity, antipronation, …) leave many doubters who test them, because they do not decrease the rate of injuries. Natural pronation is the soft torsion of the foot in the reception on the floor. Its purpose is to gradually absorb the impact and shape the plantar arch to cushion the impact. Starting the contact on the outside and ending on the inside. The pronation depends fundamentally on the subtalar joint that is in the center of the back of the foot, although it ends up involving the entire foot.

    Pronation is a natural act of the foot that prevents injuries to the outside of the foot. The foot is composed of 26 bones, 33 joints, 12 tendons and 18 muscles, which can give an idea of its great complexity.

    Minimalism (anterior loading) argues that immobilization and indentation of our feet in cushioned shoes (posterior boot load on heel, EVA or Boost or Flytefoam or similar) produces atrophy by reducing the internal work of the foot itself. The problem is that when we avoid this hyperprotection (minimalist shoes) there are 6 factors that can overload our foot (weight, asymmetric load, arthropathy, lack of training, lack of adaptation or soft tissue imbalances). This is where the minimalist shoe increases the risk of injury (stress fracture, sesamoiditis, metatarsalgia, tendinopathy, fasciitis or arthritis of overload) mainly because of its front load.

    The human foot is designed to run. I need to write it to avoid misinterpretation. But not all feet can run in the same way, fundamentally conditioned by the rest of the body in terms expressed (weight, alignment, joint condition, training, psychology, …). That is why Sports Podiatry Units must tend to be Multidisciplinary Sports Pathology Units, due to the need to integrate dietitians, psychologists, sports doctors, traumatologists, physiotherapists and rehabilitators, as well as podiatrists. The load of the cushioned shoe mainly seeks the heel, the load of the minimal shoe undergoes an unconscious transition from the runner to the anterior (metatarsus). This implies a greater work of the midfoot and a load in knee flexion. That is to say, the cushioning of the classic shoe is transferred in the minimalist shoe to the knee (mainly to the knee, also participate hip and ankle).

    Running on a regular basis too and having a personalized workout plan is a good way to avoid injuries. In this sense the majority of studies specify between 3 and 4 trainings per week. Avoid increasing mileage from week to week, at least biweekly. If there is an overload to lower the pace and distance, if there is pain make an alternative training without load (swimming, cycling, elliptical, ..) that maintains some oxygenation and helps recovery.

    Comparative studies between minimalist / cushioned footwear have in most cases design problems. The most common problem of these studies is that runners who test minimalist footwear do not include a necessary adaptation period if they come from regularly wearing conventional shoes, but simply put them to run with one or the other shoe.

    My advice is very clear: a runner with BMI (body mass index) greater than 30, metatarsalgias, failure of the first radius, achilles tendinitis or posterior tibial, low level of training, subtalar arthropathy, knee arthropathy or previous stress fractures I do not recommend minimalism. I recommend avoiding it especially in women from the age of 50. On the other hand, runners with BMI <30, talalgias or fascitis / fasciosis or iliotibial gingival syndrome, habitual runners and good alignment of the hindfoot, I think that minimalism or naturalism (better this second) is a good option to keep an active work of the foot and avoid injury. From there obviously there are many intermediate and differentiated shoes that force you to maintain a close bond with your sports podiatrist and with our running technician. In any case, the transition between one and the other should be very slow and progressive, especially the cushioning to minimalism. At my 49 years old, with an important pronation (template holder), asphalt / road runner and with BMI> 30 I used, less than I should, a partially cushioned shoe with drop 8, 320 gr, and a wide (needed for my feet supports). Today I just released a Kayano 22, with gel front and back, without the Kayano 23 Flytefoam which I think is a very interesting alternative but not available in my 47 stand, and especially indicated for important pronation like me and with mild tendinitis of posterior tibial tendon. I’m going to a drop 10 and with it to heel more, and I will try to lower it when I am comfortable with half distances.

    I think being radical in one or another concept makes you lose many opportunities that gives you the sport.

     

    Dr. Pere Mir

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  • Posted by Carlos Danci on Wednesday March 8th, 2017, 06:28 PM

    Muy interesante y detallado. Me permite replantearme mis zapatillas deportivas, intentaré contactar con un técnico en calzado. Qué drop me recomendaría para un corredor de 3 días a la semana medias distancias sin pronación conocida?

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