Gait assessment?

It is worth having a gait assessment done before buying new shoes?

21 to 39 of 39 messages
17/02/2014 at 18:32
Mr Puffy wrote (see)

OK Ben I was being sarcastic, sorry, but the point remains, personal experience trumps gait analysis.

and if a runner has "problems" they need to see someone more qualified and experienced than - your own words again - a retailer.

 

Funnily enough, the more qualified person usually sent them to me!

17/02/2014 at 18:41
 

 

Flob wrote (see)
Ben- the only person who is not telling consumers lies when advising on shoe purchases is the retailer who claims to not know which shoes suit the customer, because the science does not back up any of the retailers claims about different footfall patterns dictating choice of shoe types.

There are lots of practices in our sport, where the scientific evidence supporting them is conflicted.  It is the nature of what we do, that we sometimes have to ride ahead of the scientific data, and wait for it to catch up.  This is just such a case. 

The biggest mistake you can ever make, is to think that selecting suitable running footwear is simple.  It is vary a minefield, and the individual variation is much greater then you would ever think.  There are overpronators who need neutral shoes, and there are neutral runners who need support shoes (yes they do exist), and you have to give them the 30 day guarantee just like everybody else.  Some overpronators become neutral over time, while others get worse, and some stay the same. 

The simple reality is that you can not accommodate this wide range of customer needs, simply by putting them all in a neutral shoe that feels comfortable.  Shops that offer gait analysis succeed, because those that don’t fail, and that is why people will always be willing to turn to somebody like me. 

Edited: 17/02/2014 at 18:42
18/02/2014 at 14:25
Poppycock.
18/02/2014 at 22:13

A fanatic is a man who consciously over compensates a secret doubt.

Aldous Huxley

19/02/2014 at 04:07
People who have no evidence often quite random shit to distract others from the discussion.

Flobious Forumiticus
19/02/2014 at 21:43
Flob wrote (see)
People who have no evidence often quite random shit to distract others from the discussion.

Flobious Forumiticus

But it is not strictly true that I have no evidence is it?  There are studies that suggest that gait analysis and orthotics reduce injury rates.  The “Fort Drum Running Shoe Study” which I have alluded to previously, found that injury rates were reduced by 50% across a huge sample of military personnel after gait analysis was introduced.  You have to acknowledge the existence of this study, even if you don’t agree with its conclusions, and if you feel that other studies are better, then you should give some justification as to why. 

Why do you think that the idea of overpronation causing injuries gained such currency in the first place?  The reality is that the most severe overpronators (admittedly about 1% of the sample) can hardly walk to the bus stop without hurting themselves.  This is part of the reason why podiatrists are in business.  Even if the concept of gait analysis were irreparably shattered, we would still be left with these problems, and they would still require solutions.  

The reality is that sports science has not yet answered all the questions here, and more importantly it has not provided all the solutions.  This is why we are working in a sport, where the cottage industry is still at the cutting edge in places. 



Edited: 19/02/2014 at 21:43
20/02/2014 at 20:43

From your so called evidence:

(2) Great caution must be taken in assuming that the shoe program alone was responsible for the decline in injury rates. It is possible that the Running Shoe Injury Prevention Program had the effect of encouraging soldiers to buy new shoes and that new shoes alone (rather than the specific shoes selected based on foot type) reduced injury rates. A study of Marine recruits showed that those who arrived at training with newer running shoes had fewer stress fractures during their 12-week training program (32). About 70% of soldiers in the convenience sample survey in the present study said they had bought new shoes while at Ft Drum but only 11% said they had used the shoe recommendation advise provided. 

 

Yet again you offer up evidence that does not agree with your stand point. Also, the most up to date study from the u.s armed forces suggests that everyone would be better served simply buying stability shoes, from an injury prevention standpoint, and that randomly allocating shoe types to recruits resulted in less injuries than using a selection system.

to say that doing something is better than doing nothing is admirable, but the studies that you espouse do not back up your argument.

I do still admire your zeal, you must be a great salesman.

20/02/2014 at 22:08

The study does agree with my standpoint, because the overall conclusion of the study is that the programe did reduce injury rates.  The authours have been rigourous in trying to disprove their conclusions as they should be, and you have cherry picked a couple of of particularly juicy snipets out of context, while ignoring the overall conclusion of the study. 

I think you might make a good salesman. 

To be honest with you, the probles with the more recent military study are far more serious.  The process they employed was not gait analysis, it was a simple wet newspaper test.  This method has been obsolete for about 20 years, and even the industry itself does not regard it as being accurate.  The method in this study is at least remotely similar to the process used by running retailers. 

Incidentaly, there are a few military studies that link arch height to injury rates. 

Edited: 20/02/2014 at 22:32
20/02/2014 at 23:31
The wet foot/foot shape test was what was used at Fort drum too, in all of the Studies conducted there. And they did not state that the shoe allocation reduced
Injuries, they stated that injuries went down during the time of the study and that only 11% of those studies actually wore shoes as recommended by those running the study so I have not cherry picked anything. The other interesting thing is that each time they had Physios involved, the number of injuries that prevented running went up, insinuating that the physios did more harm than good. A bit like the shoe allocation.
I could not sell anything I do not believe is good for the buyer- so I will never sell running shoes. As you're a believer it is a good choice for you.
Edited: 20/02/2014 at 23:33
21/02/2014 at 07:26

A 300 person study revealed that injury rates increased by assigning 100 people stability shoes, another 100 people assigned motion control shoes experienced higher rates of injury shoes than the 100 assigned stability shoes. 100 people assigned neutral shoes experienced the least amount of injuries. Could it be that neutral shoes should be assigned in order to minimise injuries, promote natural foot movement and to provide adequate cushioning for protection. When shoes shift more towards protection and correction there is an increase rate of injuries.

http://colpts.com/pronation-does-not-cause-running-injuries/

Choosing a running shoe based on your foot type does not reduce your risk of injury. If you have flat feet or are an overpronator, it is unlikely a motion-control shoe will reduce your injury risk.

Why does pronation control or modification not change running injuries? This is likely due to the fact pronation is a normal motion that helps with shock absorption. The muscles, tendons and ligaments of our foot are designed to withstand the forces of running. As such, preventing the naturally occurring motion from occurring with a rigid shoe may be counterproductive. Based on these newer scientific studies it appears making your running shoe decision based on comfort and how the shoe feels is more appropriate than choosing a shoe based on your foot type. Fortunately, we are learning that other factors such as weakness of the outside hip muscles and the foot strike pattern (heel strike versus mid foot) can increase injury rates and can be easily addressed.

Edited: 21/02/2014 at 08:16
21/02/2014 at 18:49
Flob wrote (see)
The wet foot/foot shape test was what was used at Fort drum too, in all of the Studies conducted there. And they did not state that the shoe allocation reduced
Injuries, they stated that injuries went down during the time of the study and that only 11% of those studies actually wore shoes as recommended by those running the study so I have not cherry picked anything. The other interesting thing is that each time they had Physios involved, the number of injuries that prevented running went up, insinuating that the physios did more harm than good. A bit like the shoe allocation.
I could not sell anything I do not believe is good for the buyer- so I will never sell running shoes. As you're a believer it is a good choice for you.

You are wrong on two key points here.

1. The Fort Drum study did not use the wet footprint test, they also looked at the range of movement of the ankle, which is the key factor which cannot be determined using the wet footprint test.  We therefore have to consider their methodology to be more in line with the type of gait analysis offered by most retailers, than that employed in the 2011 test.

2. They study does not state that only 11% of the sample used the shoes recommended, it states that of those who replaced their shoes over a period of the study, only 11% replaced them with the recommended shoe. Given that the study took place over a period of a number of years, this is hardly surprising.  I have to think that the same problem was probably also a factor in the 2011 test.

This study is not a knockout blow for the running industry for the reasons stated by the authors, but it is better than the 2011 study, and might just be the best study we have. 

Either way, your previous position was that there are no studies validating gait analysis, not that there was a study and that you disagree with its conclusions. You are also being a bit naughty by trying to misrepresent the conclusions of the study. I had actually thought better of you than that.

If you are going to continue to argue that there are no studies that uphold the idea of pronation causing injury, then this study is only the start of your problems, because there are plenty of those floating around.

21/02/2014 at 18:56
RoadWarrior wrote (see)

A 300 person study revealed that injury rates increased by assigning 100 people stability shoes, another 100 people assigned motion control shoes experienced higher rates of injury shoes than the 100 assigned stability shoes. 100 people assigned neutral shoes experienced the least amount of injuries. Could it be that neutral shoes should be assigned in order to minimise injuries, promote natural foot movement and to provide adequate cushioning for protection. When shoes shift more towards protection and correction there is an increase rate of injuries.

http://colpts.com/pronation-does-not-cause-running-injuries/

Choosing a running shoe based on your foot type does not reduce your risk of injury. If you have flat feet or are an overpronator, it is unlikely a motion-control shoe will reduce your injury risk.

Why does pronation control or modification not change running injuries? This is likely due to the fact pronation is a normal motion that helps with shock absorption. The muscles, tendons and ligaments of our foot are designed to withstand the forces of running. As such, preventing the naturally occurring motion from occurring with a rigid shoe may be counterproductive. Based on these newer scientific studies it appears making your running shoe decision based on comfort and how the shoe feels is more appropriate than choosing a shoe based on your foot type. Fortunately, we are learning that other factors such as weakness of the outside hip muscles and the foot strike pattern (heel strike versus mid foot) can increase injury rates and can be easily addressed.

My main criticism of this study, would be the very small sample size compared to the other studies mentioned. Even so, its methodology seems to be sound, so it has to be discussed in the argument.

Interestingly, some of the studies that suggest that pronation causes injuries, found that a little bit of pronation was better than none or too much. In that sense the two sides of the argument might ultimately align.

21/02/2014 at 19:03

Why does gait analysis necessarily have to equate to orthotics?

Gait analysis can highlight a running anomaly that can be addressed by improving the conditioning of certain muscle groups - restoring balance or improving form.  

My opinion of orthotics?  Rolling a turd in hundreds and thousands and expecting it to taste like chocolate. 

Gait analysis - analysed by a professional = good.

Gait analysis - analysed by the monkey at a national sports warehouse = probably better of asking a veteran at your club.

 

23/02/2014 at 16:33

I come back to an earlier point that Running shoe shops don't offer gait analysis, they offer pronation analysis viewed from behind only.

23/02/2014 at 19:57
Shoes smell like horse piss wrote (see)

I come back to an earlier point that Running shoe shops don't offer gait analysis, they offer pronation analysis viewed from behind only.

I guess that I would have to ask what your definition of gait analysis is?

 

I would expect a shop assistant who was any good, to look for the following points in a video analysis:

 

  • Where the foot strike occurs.
  • Whether the foot pronates, and to what extent.
  • Whether the action of the foot causes the shin bone to be displaced laterally.
  • The angle between the base of the ankle and the knee during foot strike.

 

I would also expect them to discuss the customers injury history with them, and try to relate it to what was seen on the video. 

 

Edited: 23/02/2014 at 19:58
23/02/2014 at 20:36

Can you see how far in front of the hips the foot lands from behind?

Can you see the angle between the base of the ankle and the knee during foot strike from behind?

Can you see if the runner plantar flexes just before the foot leaves the ground suggesting a 'push-off' from behind?

Can you see if the knee straightens before the foot pulls off the ground from behind?

Can you see if the runner lands with a straight knee from behind?

24/02/2014 at 21:10
 

 

Shoes smell like horse piss wrote (see)

Can you see how far in front of the hips the foot lands from behind?

Can you see the angle between the base of the ankle and the knee during foot strike from behind?

Can you see if the runner plantar flexes just before the foot leaves the ground suggesting a 'push-off' from behind?

Can you see if the knee straightens before the foot pulls off the ground from behind?

Can you see if the runner lands with a straight knee from behind?

There is nothing forcing you to place the camera behind the customer, but you generally do so.  It comes down to whether the factors you have listed will impact upon shoe recommendation, and whether you can really do anything about them.    

I would always recommend looking at how far in front of the hips the foot lands, and how the foot lands, as this gives you an idea of what sort of injuries are likely to occur further down the line. 

I do not think that running shops should be correcting customers running style, because the risk of injuring them would be considerable.  There are only a very small number of people who are qualified to do that IMHO. 

Edited: 24/02/2014 at 21:11
25/02/2014 at 11:51

My list wouldn't impact on shoe recommendation, because shoes wouldn't correct any of the faults in the runners stride and their associated injury potential, but proper gait analysis lets you look at those things, which is why I say that shoe shops don't offer gait analysis -it's just pronation analysis...and so what?

25/02/2014 at 18:53

It is not comprehensive gait analysis, for the reasons that you have outlined, but I do not think that it would be doing it justice to call it "pronation analysis". The pronation itself is not the problem, although it has been associated with metatarsal fractures. The problem (in theory) is that it imparts a sharp lateral force upon the base of the shin bone, which impacts the shin, and in turn can effect the knees hips and even lower back.


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