Barefoot Running

Some years after the surge in popularity of barefoot running or running in minimalist shoes, there is enough data for an orthopaedic review article.  The verdict?  A decrease in anterior knee pain (runner’s knee) and a decrease in chronic exertional compartment syndrome.  But, an increase in risk of repetitive stress injuries to the foot and ankle.

Some years ago I saw a rash of stress fractures and posterior tibial tendonitis, around the time barefoot running was gaining in popularity.  Over time that has tapered off, and I’m now seeing the usual mix of anterior knee pain and shin splints along with tendonitis and stress fractures.  The change in injury trends probably relates to adoption of a popular new technique, followed by adaptations, including the use of mimimalist shoe wear rather than running unshodden.  These days I see a lot more runners in “typical” running shoes than the minimalist version, but I do see both.

It’s interesting and frustrating that despite all the effort that has gone into the study of running gait and running injuries over the past 40 years, the incidence of running injuries hasn’t changed.

I’m hoping this article may be of interest to my running patients.  There are many great health benefits to running, but those benefits don’t come without risk.  Any runner who makes a decision to change foot strike should consider those risks particularly in light of any previous history of running injuries, and consider the supervision of a good physical therapist or running coach.


NSAIDs and Tendinitis

The New York Times published an article in the past couple of days about NSAIDs and their use to treat tendinitis.  The basic point is, tendinitis really isn’t an “-itis.”  That is, it is not an inflammatory condition but rather one of tissue breakdown and as such, NSAIDs treat only symptoms and are not curative.  In some cases, NSAIDs may impair the healing response.  These are facts that have been well known by doctors for many years, but usually come as a surprise when I explain this to my patients. Take a look at this article.  The facts are correct, and useful information for everyone.  NSAIDs are useful tools, and I do prescribe them a fair amount, but most tendon conditions (short of complete rupture of course) are most definitively addressed by a specific exercise program.