Barefoot running did’t work, what now? – wrapping it up

So to recap – our runner has anterior shin pain as a result of tibialis anterior over activity. Taking her shoes off increased her pain.

Last week, two potential options for retraining were proposed. It was great to also see many other retraining strategies proposed by people. I am sure that John Foster will be pleased that numerous proximal cues were also tried, but unfortunately the runner struggled to implement these (in the immediate term anyway).

Here the original barefoot video, and videos related to the two cues , with outcomes now stated.

Original barefoot video (anterior shin pain worse than shod)

Runner cued to “land on your toes”

Anterior shin pain was abolished. However, calf pain developed immediately. This makes plenty of sense considering the drastically increased ankle joint loads on landing produced by this change. I would think this is a poor option for this runner.

Runner cued to “take shorter faster steps and land softer”

Anterior shin pain is also abolished here, but there is still some mild calf pain (less than landing on toes). Again this makes sense as this runner is still over-striding and the load has been shifted by a change to strike pattern. However, the increased step rate has reduced over-stride slightly, and cues to land softer seem to have improved shock attenuation (most likely better muscle function). Sorry, the audio is not good so I have not included it with the videos, but the runner was noticeably quieter. Unfortunately, the mild calf pain is likely to increase with running duration, so still may not be a great outcome, at least in the short term.

So the #FridayFun question today is:

What else do we need to do with this runner? This is an open ended question I know, so let’s priotise. You get 160 characters on twitter to describe your planned intervention including the #FridayFun and web link

For example: #FridayFun Put bulky shoes back on, prescribe custom rigid foot orthoses, dry needle anterior compartment

Maybe you have a better solution. At least I hope so :)

Nb: This will be the last post for 2014, but #FridayFun will return in the new year. I think it has been fun and great to see so many really good discussions. Let’s keep this positive learning process going!

Merry Christmas and have a great New Year all!!