Running research: Heel-toe or toe-heel?

Press Release:

New research from La Trobe University suggests there is no evidence that changing a runner’s strike pattern will help prevent injuries or give them a speed boost.

In a bid to avoid shin splints, sore knees and other injuries, many runners have adopted a toe-to-heel trend, running on the balls of their feet. This is often encouraged by coaches and health professionals.

However, in research out this week in Sports Medicine, La Trobe injury researcher and physiotherapist Dr Christian Barton found there is no evidence to suggest running on the front of your feet reduces injury risk or improves performance.

“We analysed 53 studies which looked at the impact of forefoot, rearfoot and flatfoot running patterns on injury, running economy and running biomechanics,” senior author of the study, Dr Barton said

“Our comprehensive review suggests that telling someone to run on the ball of their foot instead of their heel may make them less efficient, at least in the short term. Additionally, there is no evidence either way on whether running on the balls of your feet reduces injury.”

Dr Barton said switching your running style shifts the body’s loads but doesn’t make them disappear.

“Running toe-heel might help injuries at the knee, where loads are reduced. However, it may cause injuries to the feet and ankle, where loads are increased,” Dr Barton said.

“Put simply, when it comes to running style: If it ain’t broke, don’t fix it.”

Can the bunion correctors actually help correct bunions?

A simple search of Google will not give you the answer to the question as if bunion correctors work. You will see lots of posts and comments by podiatric and orthopedic surgeons saying that they do not work (they make their money by doing bunion surgery) and you see lots of posts and comments by people selling them say that they do work (they make their money by selling them).

So, who should you believe? Should you believe all the testimonials on the sites selling them. They can be fake. Lots of forum and social media posts ask if the work (eg here and here). Some podiatrists have tried to address the issue (eg here).

In these situations, you need to defer to what the unbiased published and peer reviewed scientific research says. Unfortunately there is not a lot to go on here as its not exactly a popular topic for researchers to look into!

There is one study that has looked at this and, yes it showed that bunion correctors do work at correcting bunions. However, it was only done over a 3 month period and its showed on average a 1 degree improvement per month in the angle of the hallux valgus. That is a reasonable outcome. What they study did not show is that if there is further improvement beyond the three months or if you need to keep wearing them to maintain the improvement. Maybe the improvement reverses when the corrector is no longer used.

There are lots of unanswered questions regarding the research on these, so unfortunately opinions is all that is left. There are opinions (eg here) that even if they do not actually correct the bunion or hallux valgus, they are still useful as a physical therapy type intervention to stretch and keep the joint mobile. This is a reasonable opinion and use of these bunion correctors.

Two different concentrations of benzoyl peroxide gel can be used to treat pitted keratolysis

Press Release:

Topical benzoyl peroxide gel 2.5% and 5% can both be used to treat pitted keratolysis according to study results presented at the American Academy of Dermatology virtual meeting in June, 2020.

Pitted keratolysis (PK), a common skin disease, is frequently accompanied by pitted lesions on the feet and malodor,” Charussri Leeyaphan, MD, of the department of dermatology, faculty of medicine at the Siriraj Hospital, Mahidol University in Bangkok, and colleagues wrote. “The over-the-counter drug topical benzoyl peroxide gel (BP) is used as a medication for PK. However, the appropriate dosage and duration of BP treatment of PK is controversial.”

Topical benzoyl peroxide gel 2.5% and 5% can both be used treat pitted keratolysis.
In a prospective randomized, controlled trial to assess the safety and effectiveness of topical 2.5% BP and 5% BP, 89 subjects diagnosed with PK were analyzed. Subjects were assigned either 2.5% or 5% BP and were asked to apply the topical medication once daily for 2 weeks. Safety and effectiveness were evaluated 2 weeks after treatment via clinical examinations and self-assessments.

Of the 42 subjects that were treated with 2.5% BP, self-evaluation of foot odor using a visual analog scale showed a significant decrease from 5.4 to 3.7 (P < .001). Of 47 subjects treated with 5% BP, the decrease was from 5.4 to 3.5 (P .001).

Pitted lesions were evaluated by treatment-blinded dermatologists, with a 69% improvement for the 2.5% BP group vs. a 63.8% improvement for the 5% BP group. Side effects were not statistically different between the groups, and moderate to high levels of satisfactions were reported from almost all subjects.

“This study demonstrated that either 2.5% or 5% BP can be used for the treatment of PK and foot malodor,” Leeyaphan and colleagues wrote. “Due to the similarities in their efficacies and side effects, the use of 2.5% BP may be preferable.”

New Balance Golf Shoes

Press release:

Boston, Mass., March 6, 2020 – New Balance Golf has added two new styles to its Fresh Foam LinksSL collection for spring.

New Balance’s Fresh Foam technology was first introduced in the company’s performance running shoes and is now used across almost all categories of New Balance footwear.

Fresh Foam Technology

CUSH+ – A molded insole for superior comfort and lateral stability.

FRESH FOAM – An innovative midsole with a data-driven design that identified zones in the midsole where altering levels of compression and resistance are aligned to provide ultra-soft cushioning and lateral stability.

SMART RUBBER OUTSOLE – The spikeless outsole on the Fresh Foam LinksSL has omni-directional traction lugs with pressure mapping colors to highlight key performance zones.

Fresh Foam LinksSL

The Fresh Foam LinksSL features a waterproof performance mesh upper and a spikeless smart rubber outsole. The smart rubber outsole has pressure mapping colors to highlight key performance zones during the swing. The suggested retail is $99.95. The green and white colorway is available March 15th and the red, white and blue colorway will be available May 1st.

About New Balance

New Balance, headquartered in Boston, MA has the following mission: Demonstrating responsible leadership, we build global brands that athletes are proud to wear, associates are proud to create and communities are proud to host. Manufactured in the U.S. for over 75 years and representing a limited portion of our U.S. sales, New Balance Made U.S. is a premium collection that contains a domestic value of 70% or greater. New Balance owns five factories in New England and one in Flimby, U.K. New Balance employs more than 6,000 associates around the globe, and in 2018 reported worldwide sales of $4.1 billion. To learn more about New Balance, please visit www.newbalance.com.

More on injuries in golf.

Paratrooper™ Plantar Plate System Receives 510(k) Clearance – 1st Dedicated System Allowing Surgeons to Repair the Plantar Plate Through Either a Dorsal or Plantar Approach

ENGLEWOOD, Colo., Feb. 7, 2020 /PRNewswire/ — The Paratrooper™ Plantar Plate Repair System was developed to allow surgeons to use a dorsal or plantar approach to the plantar plate repair procedure using a single, all-inclusive kit.

The Paratrooper™ Plantar Plate Repair System uses an all-suture anchor implant that can be fixed into bone or soft tissue. By using an all-suture implant, the surgeon can perform the plantar plate repair using a variety of fixation and approach techniques, while preserving surrounding bone and tissue. When the Paratrooper™ suture implant is inserted and tensioned, the implanted suture “sock” will contract and form into a low profile, flat anchor that will prevent the implant from pulling out of the site.

Surgeons face a variety of challenges and complications in plantar plate repair using the dorsal and plantar approach:

  • Exposure to the plantar plate from the dorsal approach
  • Difficulty implanting into bone or soft tissue
  • Step-heavy procedure with complicated instrumentation

The Paratrooper™ Plantar Plate Repair System was designed with these challenges in mind.

The system includes all instrumentation necessary to gain adequate exposure to the plantar plate from either the dorsal or plantar approach.  Paragon 28® designed the Paratrooper™ Plantar Plate implant and instruments to allow for simple insertion into tissue and bone through use of an innovative insertion tip, custom needle, and delivery method. Instrumentation is provided to directly address plantar plate deficiency and is included within one kit and is used to facilitate exposure, drilling, and implant placement within a small, limited vascularization environment.  The Paratrooper™ Plantar Plate Repair System was specifically designed to facilitate proper step execution and limit complications intraoperatively.

Paragon 28® is planning for full commercial launch of the Paratrooper™ Plantar Plating System in June 2020.

Concussions Increase Risk Of Lower Extremity Injuries

Press Release:

A new study shows that college athletes who sustain concussions are more likely to have a lower extremity injury in the same season after they return from the concussion.

Dr. Daniel Herman, a fellow in primary care sports medicine at the University of Florida, presented this research at the American Medical Society for Sports Medicine conference in San Diego, California. Athletes with concussions were 3.79 times more likely to get a muscle or ligament injury than their non-concussed teammates. The severity of the injuries was not statistically different between the two groups. This research takes the popular topic of concussions in a direction that many people have not thought about.

“These results may have clinical implications ranging from pre-season injury risk stratification to post-concussion rehabilitation practices to return to play considerations, said Dr. Herman. My colleagues and I are working to develop additional studies investigating the impact of neurocognitive performance on musculoskeletal injuries.”

Dr. Daniel Herman, a fellow in primary care sports medicine at the University of Florida, received his MD and PhD (Biomedical Engineering) at the University of North Carolina, and completed his residency in Physical Medicine and Rehabilitation at the University of Virginia. His research focuses on neuromuscular and neurocognitive risk factors for musculoskeletal injury, and he is a prior recipient of the American Orthopedic Society for Sports Medicine’s O’Donoghue Award for Sports Injury Research. He will be starting at an Assistant Professor in the Department of Orthopedics and Rehabilitation at the University of Florida in July 2013.

A new study shows that college athletes who sustain concussions are more likely to have a lower extremity injury in the same season after they return from the concussion.

Dr. Daniel Herman, a fellow in primary care sports medicine at the University of Florida, presented this research at the American Medical Society for Sports Medicine conference in San Diego, California. Athletes with concussions were 3.79 times more likely to get a muscle or ligament injury than their non-concussed teammates. The severity of the injuries was not statistically different between the two groups. This research takes the popular topic of concussions in a direction that many people have not thought about.

“These results may have clinical implications ranging from pre-season injury risk stratification to post-concussion rehabilitation practices to return to play considerations following concussion, said Dr. Herman. My colleagues and I are working to develop additional studies investigating the impact of neurocognitive performance on musculoskeletal injuries.”

Dr. Daniel Herman, a fellow in primary care sports medicine at the University of Florida, received his MD and PhD (Biomedical Engineering) at the University of North Carolina, and completed his residency in Physical Medicine and Rehabilitation at the University of Virginia. His research focuses on neuromuscular and neurocognitive risk factors for musculoskeletal injury, and he is a prior recipient of the American Orthopedic Society for Sports Medicine’s O’Donoghue Award for Sports Injury Research. He will be starting at an Assistant Professor in the Department of Orthopedics and Rehabilitation at the University of Florida in July 2013.