Two year long case study demonstrating an increase in arch height from wearing Minimalist Running Shoes

Below is an excerpt from a blog written by a fellow podiatrist.  In the
post, he leads the case that wearing minimalist running shoes can
increase a runners arch height.  This is just one case though,  I am not
to sure that this rationale holds true for most runners with low arch.

I am not to sure where I stand on this topic.  I do believe that we need
to strengthen the muscles in our feet, which will lessen our pain. However, I am not to sure about the
correlation between increasing arch height and  wearing minimalistic
shoe, to me it seems a little far fetch.
Can people increase their arch height this way?   Or is it only the case
for some people?  If we go back to a more minimalistic  shoe type would
we all benefit from it?  These are just some the questions that comes to
mind after reading this article?

What do you think?

Two year long case study demonstrating an increase in arch height from running in minimalist shoes.

The debate is ongoing as to the use of minimalist shoes and running
barefoot. Few studies have been done and there are so many variables to
control which makes these existing studies practically irrelevant. To
see the true effects of what happens to our foot by removing the
external support from a traditional motion control running shoe,
it takes time. Years actually. I would like to share an example of a
runner who had abandoned her rigid orthotics and motion control
ASICS running shoes and began wearing minimalist shoes. The New Balance Minimus with a zero drop to be exact.
She was 34 two and a half years ago and had flexible flat feet, a valgus
position of the calcaneus ( the heel bone angles inward when observing
from behind), and a valgus knee deformity (knock knees). Her symptoms
consisted of knee pain as well as frequent lower back pain. She was
wearing custom rigid orthotics which were implemented to realign her
arch and heel bone. We had her follow my transition protocol of removing
the orthotics for the first part of a run and then replacing them for
the remainder. As an example, for a three mile run the orthotics would
be removed for a half mile then placed back in for the remaining 2.5
miles. This was gradually increased each week until she was able to
comfortably run without them. The same was done for the motion control
shoes but in a slower manner. I advise using the 10% rule. Each week
mileage is increased wearing the minimalist shoe by 10%. Again, the new
shoe is worn first and the run is completed in the traditional shoe.
This can sometimes take up to 6-8 weeks or more depending on the level
of running a person is doing before the complete transition is made.
Many times I tell the patient it takes 3 months to safely transition.
Remember, three months can be a blink of an eye in the whole scheme of
things as many patients present to me with years of pain.
Of course what I am about to share is anecdotal. I realize that.
However, this is a two year example of the changes that can occur to an
adults foot that results from strengthening the postural muscles of the
foot, specifically the abdcutor hallucis muscle. This is not the direct
result of simply wearing a minimalist shoe. This is the result of what
happens when you stress the foot and let it work the way it was intended
to and become stronger. It has not relied on external support and
adapted to the stresses placed upon it. The studies that are currently
being published share weeks or sometimes a few months of results. This
is a 2 year example. My colleagues and I are also submitting for
publication a 6 month study that will show objective results of a
similar finding. Let’s see what happens to the foot when you do not rely
on orthotics and motion control shoes.
Side View
A side view of the foot demonstrates a mild increase in the height of
the medial longitudinal arch. It is not possible for me to measure the
hight change as the images were not taken from a set distance but one
can see the increase in curvature of the arch.
lateral before after
To demonstrate the change, this color fill was added to shoe the increased curvature or height of the medial longitudinal arch.
lateral before after with arch fill
Heel Alignment
The below pictures shows the improvement in the alignment if the heel
bone known as the calcaneous. You can see in 2012 the calcaneous was
more everted or slanted inward as a result of a weak abductor hallucis
muscle which leads to a collapse of the medial longitudinal arch. In
2014 the calcaneous is now more rectus or vertically orientated. This is
a result of a stronger abductor hallucis muscle pulling and shortening
between the great toe and heel bone which improves the arch and
straightens the heel or calcaneous bone.
“Outward Toes”
Next is an example of what clinicians refer to as the “too many toes
sign”. When viewing the foot again from a posterior or “behind” view we
can see in 2012 there were more toes visible on the outside of the foot
demonstrating a weak or collapsing arch. In the 2014 image you can see
the lateral or outside column of the foot has realigned and the toes are
no longer visible.
The Arch
Finally we examine the medial longtitudinal arch. This is the arch of
the foot that most people refer to when they say they have a “flat
foot”. To simplify, the arch height will be absent or pressed against
the floor with a flat foot or in someone with weak foot musculature.
Here we can see in 2012 there was very little if any arch height present
on the inside of the foot. After 2 and a half years of strengthening
the foot and lower extremity musculature in 2014 there is now an
increase in arch height.
In summary, this is anecdotal, but these are the changes we are seeing
in runners who have transitioned to less of a shoe. These results were
seen and described by many in the barefoot running community and now we
are exponentially increasing numbers as runners are switching to
minimalist type shoes. This is just one documented example of many with
photographic evidence that I have seen in my practice. Why is this so
significant? Because this is proof that running in a minimalist shoe can
strengthen intrinsic foot musculature which can then change the shape
of the foot and arch over time. I hope to soon have more similar
objective results published!!
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