Tuesday, July 17, 2012

My Take on the FiveFingers Lawsuit


Several people have asked me what I think of the recent Vibram FiveFingers lawsuit, so here is my brief response. First, a disclaimer: I am not privy to the details of the suit. All I know is that someone has initiated a class-action lawsuit against Vibram over “deceptive and misleading health benefit claims” and injuries. So, here is what I think.

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While I hold no love for FiveFingers or Vibram (as a company they are arrogant and aloof), I think the lawsuit is absolutely baseless. The complaint states that Vibram’s claims of “health benefits are false and deceptive because FiveFingers are not proven to provide any of the health benefits beyond what conventional running shoes provide” and “FiveFingers may increase injury risk compared to running in conventional running shoes, and even when compared to barefoot running.” Thus, the complaint has two major allegations: 1/ Vibram has not proven that their shoes are healthier to use than conventional running shoes, and 2/ FiveFingers cause injuries.

Beyond what conventional running shoes provide?
The first allegation is laughable since consumers have spent billions of dollars on traditional running shoes in the past five decades and received untold numbers of injuries in exchange. The conventional shoe makers have spent virtually zero dollars on any research beyond marketing, and the independent scientists actually investigating the relationship between your body and running shoes have solid evidence that those traditional running shoes are the cause of many running injuries. Certainly, no major running shoe company has ever demonstrated scientifically that their shoes are “proven to provide health benefits,” so why is Vibram now being held to a higher standard? (In fact, there’s not even a single orthotic that has been proven to live up to its claims; podiatrists be warned). The filing continues: “false and misleading advertising campaign has allowed them to reap millions of dollars of profit at the expense of consumers they misled.” Again, laughable in light of the half-century of reaping by motion-controlled, ultra-padded, microchip-embedded shoe makers.

FiveFingers cause injuries
The second allegation has some merit in that FiveFingers can lead to injury, but Vibram has been careful to warn people of the risks so I doubt they can be held culpable. Experienced barefoot runners have from the beginning also cautioned people about the potential injures from using Vibram FiveFingers and other minimalist shoes:

“I recommend all runners learn to run barefoot prior to adding minimalist shoes to their training routine. Learning to run barefoot first will allow you to learn good form and strenghthen yoru feet, legs, and other anatomy to help prevent injuries. While it is possible to learn to run in minimalist shoes first, the lack of tactile sensation with the ground will interfere with the process.”[emphasis added].  – Jason Robillad, The Barefoot Running Book

“The biggest challenge with FiveFingers is that you still don’t feel the ground nearly as much as you do when barefoot, so it’s easy to overdo it.” [emphasis added]. – Michael Sandler, Barefoot Running

“The Vibram FiveFingers is praised by many runners tired of traditional athletic trainers… However, some barefoot running experts warn that minimalist shoes may cause overuse injuries in new barefoot runners since they encourage a barefoot-type gait but reduce biofeedback from the foot sole.” [emphasis added]. – Daniel Howell, The Barefoot Book

In the above statement I was referring primarily to Barefoot Ken Bob, who says it saliently in his book, Barefoot Running Step-by-Step:

“Vibram FiveFingers… can be dangerous if not used properly. I am not totally against Vibrams… but beginning barefoot runners should simply not use them.” [emphasis in original]. – Barefoot Ken Bob Saxton, Barefoot Running Step-by-Step

Again, Vibram has always concurred with these experts and cautioned new FiveFingers users accordingly, so I can’t see how Vibram is liable. So, the way I see it, shoes companies that have for decades promised the moon to runners with high-tech devices that alter gait and cause injuries are guiltless, while the company that tries to keep runners moving naturally and clearly warned customers of the hazards is culpable.

The most common injury I've seen from FiveFingers (and barefoot running), is TOFP ("Top Of Foot Pain"), or metatarsalgia. The pain seems to originate from microfractures in metatarsal bones and, if you keep running, can lead to a full-blown metatarsal break. Ironically, I do not blame Vibram (or barefoot running) on this injury, but the traditional shoe we've been wearing since childhood that has weakened our bones nearly to the point of debilitation. It takes years for those bones to strengthen after adopting barefoot or minimalist running. Not coincidentally, TOFP and metatarsal breaks usually occur after 1-2 years of barefoot running.

Hopefully, the end result of this lawsuit will be a more educated public with respect to their feet.


Thursday, July 12, 2012

Top 10 Reasons Why You Must Wear Shoes


1.  Shoes protect your feet from germs.
Actually, although many people believe that the world is full of germs just waiting to make your bare feet fall off, this is a myth. Well, the world is full of bacteria, but most of those bacteria are perfectly harmless and some are even beneficial. The nasty germs, like Pseudomonas, actually live inside shoes and are otherwise not present on your skin. Same goes for the fungus that causes athlete’s foot (Tinea pedis). In truth, the shoe is a warm, moist, hotbed for microbial growth and is the leading cause of foot infections. Going barefoot exposes the skin of your feet to refreshing air and sunshine, which inhibit microbial growth and infection. Need proof that shoes are germ factories? Wear your shoes all day and then smell them and your feet (if you dare), then go barefoot for a day… no stinky feet. You could try the same experiment with gloves.

2.  Shoes protect your feet from injury.
Wrong again (sort of). Shoes can protect your feet from some acute injuries, but I’ve noticed that people step on nails with or without shoes. Many people fear broken glass, but broken glass is rather rare these days (“plastics make it possible”) and is actually not that dangerous anyway. While stepping blindly and forcefully on a huge shard of glass can cause a severe cut, that kind of thing is not likely to happen on the sidewalk. (Ironically, it is likely to happen while wading in a littered river, which lots of people do, barefoot). On the sidewalk, most broken glass is small and lies flat. As for nails, it turns out that it’s better to actually step on a nail barefoot than while wearing shoes. Why? Because the shoe is a hotbed for bacteria (remember that Pseudomonas?) and the likelihood of a dangerous bacterial infection skyrockets from your shoe. Lastly, while shoes may offer some protection against acute injuries, they are responsible for most of our chronic foot injuries, like bunions, Hallux valgus, hammer toe, over-pronation, fallen arches, etc. etc.

3.  Shoes give you better grip on car pedals.
I’m not aware of a study that demonstrates this declaration. In fact, a strong argument can be made that shoes reduce your grip on car pedals. The skin on your feet is well-designed for traction, you even have skin prints on your soles and toes just like you do on your fingers for improved grip. You can also hold the pedal with your toes. Shoes, on the other hand, often have slick, slippery soles (especially when wet). Flip flops are notoriously dangerous for getting caught in pedals and high heels limit your ankle’s range of motion. Experienced barefoot drivers compare driving barefoot to driving bare handed, which is also arguably safer than driving with stiff, bulky gloves. Of course, you should keep your car floors clean of debris, but you should do that whether you drive barefoot or in shoes.

4.  Shoes improve your gait.
Shoes definitely seem to change your gait, but those changes are likely not improvements to the barefoot style. The higher the heel, the more the shoe will modify your gait (alter stride length, weight distribution in your feet, which muscles are active and when, etc.).  Other shoe features will impact your gait, as well, such as the toe spring, arch supports, motion control, side panels, and so on. Probably you have heard about the barefoot running debate. There is a lot of research being done these days that indicate running barefoot is healthier than running in shoes. Logically, the same goes for walking.

5.  Shoes correct bad posture.
Again, no. Indeed, shoes create bad posture and, once again, the higher the heel, the greater the impact of the shoe. If your body was rigid, only a 1-inch heel would suffice to tip you over (and virtually every shoe has at least a 1-inch heel). You do not tip over because you make postural adjustments to remain upright. In 3-inch heels, your pelvis tilts about 15 degrees and this puts strain your back and hip joints. In heels, more of your body weight is carried by the front of your knee and this may be why women suffer from knee osteoarthritis 4x more often than men. Also in 3-inch heels, about 90% of your body weight is supported by your forefoot and the weight-distributing arches are rendered useless. Back pain, hip pain, knee pain, and foot pain can all be traced back to your shoe and bad posture.

6.  Shoes are required by health codes.
This is widely believed, but it’s another myth. Health departments regulate eateries, not their customers. The health department is concerned primarily with three things: how the restaurant stores their food, how the restaurant handles their food, and how the restaurant cooks their food. Health departments exist to protect the customer from the restaurant, not to regulate customer behavior. Health departments do not require customers to wash their hands, take a bath, brush their teeth, or wear clean clothing (or any clothing at all) in a restaurant. Nor do they require shoes.

7.  Shoes are required by OSHA.
Yes and no. The Occupational Safety & Health Administration (OSHA) does require footwear for some occupations, but shockingly few. Indeed, OSHA is one of the last government agencies which gives wide discretion to the business owner / manager to decide what is best for the employee (in this case, whether shoes should be required or not). And certainly, OSHA regulations pertain only to employees, never to customers.

8.  Shoes are required for reasons of liability.
Not usually. Most retail stores have nothing to fear from bare feet. A shopping mall and its stores, for example, is probably a very safe place for feet. Lawsuits from a barefoot patron due to a foot injury are exceedingly rare, and judicial victory even more rare (I found two in the past 50 years). On the other hand, 20,000 women per year go to the hospital from high-heel injuries, and lawsuits involving shoe-related falls and injuries are too numerous to count (well, there’s a lot). To my knowledge, there are no insurance riders or other requirements for customers to wear shoes for any business, not even car shops (though customers are often not allowed in a commercial garage without an escort). Bottom line, shoes are more of a liability than bare feet.

9.  My boss requires it.
Okay, that’s a valid reason if you want to keep your job, but be aware that this is a cultural reason, not a legal, physical or health reason. Shoes are unhealthy and are not required by law or health codes. Given the health benefits of going barefoot, our culture should ease up when it comes to shoe rules. If you are the boss, please let your employees work barefoot!

10. Shoes make the outfit.
Well, maybe they do sometimes. But in my opinion, bare feet go with everything!

*There are references for all my claims in The Barefoot Book. I was too lazy to pull them out again for this blog post. :)