In my opinion Jean-Francois Esculier is #1 when it comes to evidence based clinic practice for treating runners. He has published several running related studies and is constantly updating his knowledge on all things running. JF does have a huge interest is shoe prescription relating to injury reduction, treatment & performance, so our discussion revolves around just that. We discuss when you should change running shoes, if it is okay to run in 1 shoe type, if we need running support & what we do for plantar fasciitis!! Find more info at https://therunningclinic.com/ Or follow JF on twitter https://twitter.com/JFEsculier If you would like to support the podcast and participate in future Q&As sign up for $5US per month at https://www.patreon.com/therunsmarterpodcast To learn more about the Run Smarter Online Course, including FREE preview head to https://courses.runsmarter.online/collections To follow the podcast joint the facebook group Becoming a smarter runner click on the link: https://www.facebook.com/groups/833137020455347/?ref=group_header To find Brodie on instagram head to: https://www.instagram.com/brodie.sharpe/ To work with Brodie Sharpe at The Running Breakthrough Clinic visit: https://breakthroughrunning.physio/
Expand your running knowledge, identify running misconceptions and become a faster, healthier, SMARTER runner. Let Brodie Sharpe become your new running guide as he teaches you powerful injury insights from his many years as a physiotherapist while also interviewing the best running gurus in the world. This is ideal for injured runners & runners looking for injury prevention and elevated performance. So, take full advantage by starting at season 1 where Brodie teaches you THE TOP PRINCIPLES TO OVERCOME ANY RUNNING INJURY and let’s begin your run smarter journey.
:
On today's episode, is there a right and wrong running shoe with J.F. Esquilier? Welcome to the Run Smarter podcast, the podcast helping you overcome your current and future running injuries by educating and transforming you into a healthier, stronger and smarter runner. My name is Brodie Sharp. I am the guy to reach out to when you finally decided enough is enough with your persistent running injuries. I'm Brodie Sharp. physiotherapist, the owner of the Breakthrough Running Clinic and your podcast host. I'm excited to bring you today's lesson and to add to your ever-growing running knowledge. Let's work together to overcome your running injuries, getting you to that starting line and finishing strong. So let's take it away. to have JF on today. He was the presenter at the very first running course that I ever took and I'd say probably about 70% of the stuff that I deliver and 70% of the knowledge I have for treating runners came from that course. There was some massive game changes for my beliefs, some massive misconceptions that I needed to address and JF did a really good job of explaining all of this in um... really nice detail in the right information and in the right form that I needed at the time. And you'll know exactly what I mean when you hear this interview in the way that JF really provides a lot of clarity and he communicates in a way that's very articulate and he's very careful with how he phrases his things because he wants to make sure that the advice that he gives is very methodical, it's very evidence-based and it's not doesn't have any like biases attached to it. So he does a very, very good job of presenting things like this. And I haven't done much of a topic on running shoes and running shoe prescription, so I thought this would be an excellent topic for him to discuss. Thank you to the Patreons and to those who are taking the online course at the moment and those on social media who have provided questions. This one was a great one because I asked the question or I asked the topic and the, um, guests that we're having on. and you guys pretty much laid out the whole entire outline of this topic. You did a great job of asking some really insightful questions and things that I didn't even think of myself but I'm like that's a great question we should throw that in there and so I'd say about 80% of the stuff we talked about today was based around your questions. So thanks to Janine who wrote in and asked what should we be changing our If we increase the support in our shoes, does that just lead to foot weakness? And is there a link between like pronation and the type of shoe that we should have, or is it just a marketing trick? Matt Plenty asked is what we recommend for mileage when it comes to swapping shoes or getting rid of shoes and does it depend on the shoe type? Dave asks are the best shoes for recovering plantar fasciitis and are the more supportive shoes? recommended. Aaron seconded that and said there's been two like waves of thought. Some is like wear really cushioned shoes, others is wear like minimalist shoes. So we'll address that today. Eddie asks, is there any truth when it comes to the born to run philosophy of minimalist shoes? And Letitia asks if there's shoes for recovering Achilles tendinopathy and mileage in a shoe. Again, when should we swap shoes? And Andre asks around running with orthotics, if that's okay for plantar fasciitis. And we touch base on all these topics and stay tuned for the end when I ask JF his main tips for shoe selection, for shoe subscription, and he answers it very, very concisely in a really, really good manner. It was a really good way to finish off the interview. So stick around for that. Without further ado, let's bring on JF Escoulier. So Jeff, I thought the topic of the discussion today, like the title would be, is there a right at a wrong running shoe? And it's a, it's kind of a hot topic. And a lot of people are a bit puzzled when it comes to this topic. And I'm excited to have you on because you're actually like the first guru that I've ever followed when it comes to the running research and you were the presenter at the first like course, like the running course I've ever done. in Taronga in New Zealand. And so yeah, I'm really excited to have you on. So welcome to the podcast. Thanks Brody. My pleasure to be, uh, to be here with you on the podcast. I wouldn't call myself a guru, but, uh, happy to be here with you and happy if I could have inspired you when you started. When you, when we're doing the course and you were, um, with the running clinic, there was like two main things that sort of struck me when it came to you. And it was one. It was your knowledge of like the current literature than the, the like evidence-based stuff that's out there that just blew my mind. And the second was like your general demeanor to present as like unbiased as you can. And you didn't have any kind of like passion, like you weren't solely stuck on one side or another. You were just kind of like fluent in your opinions. Just you're just letting the evidence speak for itself. And if anyone was challenging, your current beliefs, you were just calm and just open to discussion and just like trying to help see like other people understand your side of things and you understand their side of things. So there were the two things that were really different and a lot of things when it comes to a presenter that I found that was very unique. And so can we just start off by just talking a bit about what you do with the running clinic and where you are, like with your academic career at the moment? Yeah, well, the Running Clinic is a continuing education organization. So we deliver educational content to clinicians, healthcare professionals from around the world, as well as to runners. So our goal is to basically get the evidence out there and disseminate as much knowledge as we can. So we do have life courses and we're starting also online courses at the moment. But our goal is really to get the knowledge out there. We also are involved in many different initiatives. And myself, I really enjoy the research and development. So everything about producing new content that could help healthcare professionals or runners. And that could be studies that are clinical trials, but also just knowledge transfer studies. So I've had interest recently for some survey studies, asking people what they think, what the gaps are in the literature, and trying to produce some resources to help them out. So from an academic perspective, I'm an adjunct professor at the University of British Columbia here in Vancouver, Canada. So I do that part-time. I do research part-time. I do. produce educational content, mostly full time now with the running clinic. And I practice also in the, in the clinic, seeing patients, um, also part time on average two days a week. Really cool. And in your line of work and working with runners, do you come across like a lot of mixed messages when it comes to footwear, running shoes and like running shoe, um, prescription? Yes, a lot. As you know Brody, there's a lot of debate out there. There's a lot of opinions that clash. And like you said, when you started the introduction, I mean, there's no right or wrong in shoes. I think it's all about how are you going to use different types of shoes for different purposes? Whether it's for treating an injury. shifting load to another body part for example. I think every shoe has its purpose but I'm very cognizant of the evidence that supports the different shoes and also trying to link all of that with marketing of the running shoe manufacturers that sometimes just blow my mind because they're promoting so many things and trying to make people leave that they will reduce injuries or prevent injuries or treat injuries sometimes. And unfortunately it's just not based on evidence. So obviously people are mixed up because they get conflicting information from different sources. Retailers do provide a lot of advice. Unfortunately, very often that's not based on any evidence. and they have more contact than we do as healthcare professionals with runners overall. So yeah, there's, there's a lot of conflicting advice out there. That's for sure. Yeah, definitely the marketing of running shoes is more in the forefront of people's minds and they get exposed to it a lot more than trying to get the latest researchers out there. Absolutely. I'm trying to put my mind into, like a listener who doesn't. doesn't know a lot about running shoes or different types of running shoes. So could you maybe just touch on some common features that might separate like shoe types? Yeah. I mean, um, again, if, like, if I want to separate between the main shoe types, uh, based on their effects on running biomechanics, I would have to go with different thickness, uh, thicknesses of the shoe and different, um, levels of call minimalist versus maximalist. Right. So to me, that's the main categorization in running shoes. So if your shoe is minimalist, it gets closer to being barefoot. So you have a shoe that has a lower stack height or less cushioning, a lower drop. And the drop is the difference between the height under the heel and the height under the forefoot. and then a shoe that's oh sorry were you going to ask something? No go for it. Okay and a shoe that would be more flexible and lighter and that's to me that would be the minimalist uh minimalist category there and then at the other end of the spectrum you'd have the maximalist shoe that would have more cushioning uh can have typically a bit more drop than a shoe that is And I mean, 95% of the market right now, when you look at the running stores, it's all about the traditional maximalist shoe. And I think that's a bit unfortunate, but those are the main categories that we have. Now if you ask the manufacturers to give you categories of shoes, they'll also give you all sorts of things like motion control shoe, neutral shoes, stability shoe, and all of that. features that they have come up with to try and solve whatever problem they thought were problems but that there's no evidence on. So to me it really comes down to mostly minimalist to maximalist and having all that range in between. I don't care that much about the whole motion control stability or neutral. Yeah cool and like you were discussing there's a range. So it's kind of like on a spectrum. You've got the minimalist on one side, which is mimicking closer to barefoot running. And then you've got the maximalist, which is the maximum amount of support and anywhere in between. And so one particular shoe might fall anywhere on that scale. And how about if we find a shoe that we really like, um, should we be trying to change like shoes or shoe types on a regular basis for, let's just say a runner who isn't injured or isn't managing an injury or returning from an injury. Um, should they be aware that they need to swap types of shoes? Um, I would say no. Um, and, and to me, you know, if you're not injured, if you're adapted to one shoe in particular, that you really like, um, and you're, I mean, you're happy with your performance, meaning you don't want to run faster, improve your times necessarily. I'd say, yes, stick with your one shoe. I think it's totally fine. If you don't change your shoe, you have less risk of injury. That's for someone who has only one shoe, right? If you want to alternate shoes, and I think that's where you are going with that, you know, if... Someone says, is it better to just run on Tuesdays with shoe A and on Thursday with shoe B and on Sunday with shoe C? Well, I'll say there's no evidence about that. And some people like to do it. They like to run speed workouts, wearing their light trainers or lighter shoes that are more performance-based. But on their long runs, they're gonna be wearing a bit more supportive shoes. If it's what they like, you know, go ahead and do it. Why not? Um, I'm just not sure that you need to have more support on your longer runs. Uh, the variety side of things is I think a good idea, but because I don't sell shoes, I tend to tell people just use the same shoe and vary the surfaces instead. Just go run on the road, just go run on grass, just go run on the trails. Uh, and you'll get your variety there and it will be way less expensive for you. Yeah. That's a good tip. And you touch on a good point because I know I, I came up with the scenario of a non injured runner because I know if I ask, like if, if there is an injury, it would depend or depend on the type of injury and how we might use a different shoe to perhaps shift load. But then you touched on really good point if you're happy with your performance. And so. What you're suggesting if someone isn't injured, but they might want us, um, become a better runner or run faster or have a faster time trial. Are you saying that, uh, we can maybe design or maybe spend more and more time in a shoe that is more performance based. So lighter. Yes, absolutely Brody. Um, that's definitely something that I recommend. There's a ton of evidence on the benefits of having lighter shoes for performance. Um, so I think you also need to adapt to those shoes if you want to perform better with them. Um, so in that sense, if you try and increase the mileage that you run with those shoes that are lighter and, uh, most likely a bit less supportive, um, I think it will be helpful also to get your feet stronger and hopefully to help improve your performance even more. Yeah. So actually using the shoe that is less supportive. as long as we transition and like allow that adaptation phase to occur, then you're actually getting stronger and helping with your performance. But if you don't allow enough time to adapt, then you might be putting yourself at risk for increases, amounts of load or spikes in load. Absolutely. And adaptation is really a key point there because I hear that quite often runners say, like you mentioned, they try to alternate their shoes. They say, I run on the track, I use my track shoes that are not the spike ones, but just performance shoes. But on their long runs, they say, I need support because if I wear my lighter shoes on the long runs, well, I get sore from my feet, I get sore from my calves. And it's understandable because they're not adapted to them. gradual and adding, you know, a few minutes more per week of wearing that performance shoe so that they can adapt to it and yes, build or feed stronger and, uh, and help with performance. Yeah. Very cool. How about if we, uh, starting to wear our shoes out a little bit and they, they might start getting old. I see this a lot in my clinic where people like, Oh, I should probably get new shoes as soon as they start noticing a few niggles here and there. Um, is there a formula or is there like a hard and fast rule for how long we should be running in shoes for? Uh, if I was trying to sell shoes, uh, I would tell you, please buy my shoes every 600 to 800 kilometers. Uh, and when I say that it's the, it's common advice, uh, in, in running shoes, stores and from manufacturers and you know, they want to sell your shoes. But their argument is that the cushioning properties in the shoe aren't as effective when you reach that point of 600 to 800 kilometers. And you know, I tend to disagree with that because first, I don't sell shoes. But second, because to me, if you're using your shoe and you're not wearing it out unevenly, you could keep it for longer than that. There's no issue at all with keeping the same shoe for a thousand kilometers or I've known people keeping the same shoes for 2000 kilometers, not a problem at all. As long as they're not bringing you into kind of different running mechanics than what you would have if your shoe wasn't uneven anymore, if you know what I mean. So if it changes the mechanics because of that rare pattern, then maybe you should change it. The other point is comfort. Some people say, well, they're not as comfortable anymore, then just go ahead and change them. And if I look at different shoe categories, for me, if you have a shoe that has more cushioning that is softer, you will tend to deform them faster just because the materials aren't. Um, there aren't as resilient and they can deform easier. Whereas if your shoe is thinner and there's less room for, um, for changing the shape of the shoe or the pattern of the shoe, or you can usually keep that for longer. So minimalist shoes, um, they tend to, to last longer before you actually perform them. It'd be a nice segue to Uh, ask the question, is it, can we gather any useful information when it comes to the wear and tear of a shoe? Um, I would say yes. Uh, I mean, you, you can see, you can see a lot of things on the wear pattern. You can, you can see how the runner actually runs in their natural environment is when you assess someone in the clinic, sometimes it's not necessarily, uh, they're normal. So I think it's useful for that. It's also useful to see any patterns of major asymmetry that could be relevant to an injury, for example. Not that an asymmetry is bad because everyone is asymmetrical, everyone is different right to left, it's not the issue. But if there's something major, then that would allow you to see it. Just be aware if people are using their shoes for walking and running, then you will get, you will get two, two types of information from their shoe and it's not just going to be a velvet running powder. Yeah. Good tip. If you have a runner come to you and you decide to look at their shoes, what's going through your mind? Where exactly on the shoe are you looking and how are you interpreting those findings? Um, well, I'm looking at the wet areas or worn out more and especially, um, you can guess where, where there's friction at the bottom of the shoe. And what I mean by friction is for example, a runner with a high breaking phase, someone who is, um, who is landing in front of themselves, you will see more wear pattern at that spot. Sometimes it's on the heel. Sometimes it's lateral, midfoot, and runners who are midfoot-ish strikers, but they still over-stride sometimes. So you will get that kind of information. You can also get information on any sort of whip or twisting that could inform you on someone's coming in for metatarsalgia, for example. So you have a better idea of where they're putting the load. on their foot. Very cool. And is there, if you were to look at someone's wear and tear, or if a runner was just to get their shoes, flip them upside down and have a look themselves, does it get to a point where there's significant wear and tear that they do need new running shoes? I mean, obviously if the outer layer, the carbon layer of the shoe is completely worn out, then after that the foam that is the next layer tends to wear out even faster or quicker. So it's usually a sign of your shoe will start deforming way faster from that point. So it's kind of a signal of maybe I should start thinking about getting new shoes. So that's usually my main point that I tell runners. I wouldn't tell people to try and change the way they run based on what they see under their shoes, unless they have a good knowledge about running mechanics. But I think it's a bit risky to do that. If you change your running pattern all of a sudden, then you're at risk of injury because you're just not adapted to that new pattern and you may be overloading different structures. So that's a bit risky. Yeah, okay. So I think The main overarching kind of message is you need significant wear and tear before like you might need to change shoes unless you're finding that you're losing comfort. If it's becoming a bit more uncomfortable, then you can consider getting new shoes. But why I ask the question is cause I see a lot of clients who think they need new shoes because they do, um, visibly see some wear and tear underneath their shoes, but that's just a normal process and your probably wanting to consider changing shoes once there's a significant amount of wear and tear. Am I correct in saying that? Absolutely Brody. And there's a test that I like to do. I can't show you because we're just on an audio, but if the listeners want to try to, you would put your shoe flat on a hard surface or on the table or counter and you would basically be seeing if there's a wobble in the shoe from side to side, if you're just pressing on the top of that shoe. So can you basically make it wobble right or left, or does it stay flat when you're just playing with the top of the shoe? And if it does some sort of dancing right and left, usually it's a sign of the shoe is starting to deform a little bit. Whereas if it stays flat, usually it's a sign of you're still good to go, even if there's some wear and tear underneath it. Yeah. So if you place the shoe on a hard flat surface and you try and like tap one side, tap the front, tap the back, you shouldn't see any wobble. It should just like stay in place. The front and back, not so much because very often there's, there's a bit of a rocker in the shoe. So the front and back are trickier, but I do take the top of the shoe, but the top. inside part and the top outside part and just tap on those two parts. Okay. Good tip for everyone to try it out. Do we need to worry about the level of support? Like I know people talk about support all the time with shoes and art doesn't have enough support art has too much support. And based on the population and the, I guess pronation of someone's foot. Do we make a correlation between the amount of pronation someone has and the level of support they should have in a shoe? Not at all. And that's also a very common belief that if you're pronating, you need more support in your shoe and you need motion control shoe. That strategy of recommending shoes is, is pretty much everywhere around the world. It's actually been invalidated by a few studies. Uh, and those studies, what they did, um, they basically assign shoes based on foot type. So if you had a flat foot or pronating foot, you would be assigned a motion control shoe. And if you have, uh, what people tend to call a normal foot, which I think is a bit of a strange term, but you would get a stability shoe. And if you have a calveous foot, then you would get a neutral shoe, right? So different levels of support for different types of foot. But the other group were prescribed the same shoe regardless of their foot type. And the results in those studies is that there's no difference in injury rates. So basically recommending shoes based on foot type does not make sense from the scientific point of view. It doesn't help to prevent injuries. So I think people need to be aware that it's not because they pronate that they needed more support. And also sometimes you'll go to a running store and they'll look at you running and they'll say, oh, you pronate and they'll put on a motion control shoe and they'll tell you, oh, you pronate less. But, um, you know, the issue is that they're looking at the movement of the shoe and not the movement of your foot within the shoe, because the shoe will maybe collapse a little bit less, but your foot inside the shoe will do exactly the same thing. So it's, it's not, um, it's not a relevant, uh, tip or a method of assessment that I would recommend. Cool. And I think it's worth mentioning as well. One of the main revelations I had when studying your course was if you do have a lot of pronation, then your body adapts to that pronation, your, your tendons, your ligaments, your bones will, um, as long as you allow it enough time and enough load to for that adaptation process, then your body would just almost just get used to it. That's a key point Brody. I mean, a lot of people believe that pronation is bad. and that flat feet are bad. But in the end, if you look at the research, I mean, there's no evidence to say that flat feet will lead to more injuries. And again, it's something that I travel around the world to teach. And I hear that everywhere. It's just ingrained in people's mind, but there's no link. There's no research suggesting that if you have flat feet or if you pronate, you will get more injuries. You can adapt to that. the structures of your body will get stronger and, uh, and it's not true that you'll be more at risk of injury. How about when it comes to supportive shoes, um, and foot weakness, because I know a lot of people have talked about plantar fasciitis and like certain, um, conditions or just foot weakness in general. Are we, are we not allowing the foot to get stronger if we are in one of those maximalist shoes or ones that offer a lot more support? Um, you know, actually if I think if you run overall, you are stimulating your foot, right? You won't make your foot weaker. If you run, the question is, are you going to limit the adaptation of your foot compared to using a shoe that would make your foot work a bit more? And the answer is yes. So we do have research on that. There's actually there's, I think six studies showing that, and most of them being randomized controlled trials, so a high level of evidence showing that if you randomize people, you assign them to a running program with minimalist shoes versus more maximal issues or traditional cushion shoes, there will be a greater increase in strength. of the foot muscles and a greater increase in muscle volume to your muscles and your feet will get bigger if you run with more minimalist shoes or less support. So I mean, I'm not aware of any research saying that they will weaken your feet if you run. I mean, if you have more cushion, more support, but for sure, based on the evidence that If you load them more, they will get stronger and bigger. We can probably see that you're not getting all the adaptation that you should with running. And I think that's a major point. There's also another aspect of adaptation that I think is really important is your tolerance to pressure. So if you're used to having a lot of cushioning and you take off your shoes and walk on the, just on the road. Uh, your feet will have a harder time to tolerate it, but if you're used to having better contact with the ground, it will feel much easier. So two things there, just the strength of the foot and the tolerance in terms of pressure. Okay. So we can kind of establish that the foot might not be getting weaker, but you're saying if someone was to transition carefully into a minimalist shoe, then the foot might get stronger and the muscles might get bigger. And so I might phrase the question a little bit differently. Do we need that level of strength and do we need the muscles to get stronger if we were, uh, if we wanted to transition into a minimalist shoe or do we need to transition to minimalist shoe to get that strength gain? Well, there's different approaches. There's a, you know, there's people, for example, um, hiring Davis in, uh, in the U S who says she, uh, she prefers recommending a, um, strengthening program. for runners before they transition to minimal issues. You can just try and prepare them for that transition and minimize injury risk. I mean, there's nothing wrong with that. I just think that it's not a necessary step, at least not in everyone, because you can also transition very, very gradually to more minimal issues and get those adaptations. So, you know, I don't think we absolutely need a conditioning program before we would transition. And to your other question, do we need stronger feet? Well, you know, I would argue that a lot of people train in the gym, they train a lot of muscles in their legs to try and run faster and then get stronger. But yet they will wear supportive shoes. prevent their feet from getting all the potential adaptations they can get and potentially help with performance if that's their goal. So I think it makes sense to recommend at least to get your feet stronger if you're a runner, if you have a performance objective. Now if your goal is to prevent injuries, we don't have any evidence on that. perhaps getting a stronger feet could help you in the future, just to increase the capacity of your feet to tolerate the stress of running. So I don't know, there's no research, but, uh, that would be my thought on that. Yeah. And it would seem to make sense that if you wanted to work on increasing the strength and function of your foot, that it might just be that, um, adding that little 1% towards becoming a more resilient runner, you could say. Um, It does seem to make sense, but what you're saying is the evidence is it doesn't clearly define that. Yeah, correct. We would need studies to, to support that. And that's why I'm saying, you know, that's my thought, but I can't support it with, with any research at the moment, but I think it does make sense. Um, but yeah, there's just no research yet. Yeah. Cool. When I asked this question, all right. Um, told my audience that we're having JF on, we're going to talk about shoes. A lot of people started asking plantar fasciitis questions. It seemed to be the main common questions. So I thought we would do a little like sort of mini, um, topic here and break down plantar fasciitis. And, um, so I thought I'd start with asking the question when it comes to plantar fasciitis, should we aim for a type of shoe? Should we aim for a more supportive shoe for plantar fasciitis? I think it's a great question. I think it depends on what we call the stage of the injury. So is it an acute injury? Is it a recent injury or is it more of a persisting injury? Has it been there for a while? So if your answer is, I've had plantar aficionados for four days, for a week, for two weeks, it's way better clinically just to support. the foot and to minimize the stress that we're applying on the foot, at least in the short term. And that's the key point, because if a structure of your body is injured, you want to give it some rest. You want to give it a chance to start the healing process, right? So you want to support it. However, if you've had plantar fasciitis, or you should probably call it plantar fasciopathy, or plantar heel pain even for months or years. I think if you keep supporting your foot, you may not get all of the adaptations that you could get if you had less supportive shoes and stimulating your body than you are. And there's only one study that I'm aware of, at least, that looked at using more flexible shoes and shoes with less cushioning in people with persistent. uh, plantar aficionado and they found that people using the more flexible shoes had better, uh, outcomes. They were getting better than those who were supportive shoes. Um, so I think, you know, in that sense, it's always that same thing. Do you want to protect on the long term or you want to adapt your body and stimulate it? And that's where I guess someone like you or a health professional could help a runner. kind of determine what stage they're at because there might be acute on chronic. They might have a, um, six month plantar fasciopathy and then, uh, recent, like seven days of a spike in symptoms, which might need to get them on that supportive side of things. And for the short term, allow that healing phase with supportive shoes while we discuss, you know, trying to overcome and address longer term outcomes with increasing strength through minimalist support. Okay. Uh, would you agree in saying that? Yeah, absolutely. It's always better just to get a personalized assessment and advice. Uh, so sometimes it's not black or white. It's somewhere in between them and definitely it helps you to get an assessment. Yeah. And when it comes to things like say a heel drop or like wearing minimalist shoes, um, does, would someone running in those shoes lead to plantar fasciitis? Are they more at risk? Well, if you're not used to it, right, if you're used to more cushion shoes, traditional shoes or maximalist shoes, and all of a sudden you're deciding that you want to try minimalist shoes, that is a high risk for an injury to your foot, to your calf or your Achilles tendon, so plantar fasciitis is part of that, obviously. So I've seen a lot of people who tried to transition too fast to made-up shoes, and they ended up with plantar fasciitis. So always remember one very important thing, the tissues that you're loading may be adapting, they can adapt, but only if you're not loading them beyond their capacity for adaptation. And some people may need more time. Some people may adapt faster. But if you transition too quickly, uh, you may get plantar fasciitis. Yeah, that's a good key point. And if someone isn't too familiar with the adaptation phase and finding like that sweet spot, they can always go, um, further back in the podcast, back in the archives, uh, we have season one talks all about that. So if they're not too familiar, then I encourage you to go back and learn more. It seems like there is a when it comes to minimalist shoes, there's kind of a risk if you aren't allowing it to adapt. But if you do, and you're continuing to, uh, wear minimalist shoes within that adaptation phase, you can actually, um, help plantar fasciitis because you're becoming more resilient, like you said, with increasing strength and muscle bulk within the foot. Is that, um, would you agree with that? Yeah, I do. I agree with that. And I hear quite often people saying, you know, it's risky. Why would we recommend people transitioning to minimal issues? Well, yeah, it depends why you want to do it. And in a case of an injury, uh, like this, uh, that you may want to try and stimulate and load more, um, and you have done this repeatedly with, uh, with patients and it works quite well. Yeah. And just like, anecdotally speaking, I spend. 80 or 90% of my running in minimalist shoes, around about like the 80 out of 100 on the minimalist scale. And like I've had plantar fasciitis twice and both of those were caused not from running but from standing too much at work. And I think I like to think that my feet are quite strong and I have done really fast mileage. I've done an increase around amount of mileage in minimalist shoes and I've never encountered any. plantar fasciitis symptoms from running. So if we just have that anecdotally, then we could, I guess it's a good case study to have. How about orthotics and running? I do know that there's a lot of recreational runners out there that feel more comfortable running in orthotics, just because I guess their belief is it helps with more support. Do you have an opinion or is there any literature to... give some advice when it comes to running with orthotics? Yeah. Orthotics for me, they have a role, mostly in the treatment of injuries, not so much in the prevention. And, and you know, if you look at the research again, you want to, you want to try and find some, some guidelines out there. And there's a ton of research on orthotics and still we can't right now find any good reason. to recommend orthotics to runners to prevent anything, any sort of injury or whatever. So I don't recommend them for prevention. For treatment of foot injuries, they work. They can work like a charm. So it depends what the injury is. Again, it's probably better if the listeners just go in and get an assessment if that's their case, but... It can work really well. Now, if you have been running with orthotics for a while and you're not injured and you're fully adapted to them, I mean, you could keep running with them, why not? But are they necessary? Again, it's a supportive device. It's a device that may not help you to get all the adaptations that you could get, getting stronger feet, for example. But maybe there's a reason why people want to keep them in and that can be totally fine. So it's very individual, but the key point here is I don't recommend them for prevention. I recommend them for treatment of foot injuries and that would be more on the short term. So don't keep them after that for the rest of your life. Okay. Good point. I think I might add in as well that. If there's a runner who is running with orthotics and says, JF doesn't think I should wear them because I'm not injured. Let me take them out. And then they start running without orthotics. That's kind of like an acute change that might lead to injury and might lead them to believe that, Oh, maybe like, as soon as I get rid of my orthotics, that's my pain comes on or I've got foot or calf, um, so on us now, let me put the orthotics back in. They're actually good for me. But what you're doing is you're taking, um, an acute load and sort of putting your body at risk. So what I'd suggest is probably transitioning out of orthotics gradually in order to not lower your risk of injury. Would you say that? That's very accurate Brody. You know, and it's the same as changing your shoes all of a sudden and, and it's risky to get a new injury because you're just loading structures that are not adapted to it. And you know, where I used to live in Quebec, that's the eastern part of Canada, we had a lot of snow in the winter. So what happens is a lot of people during winter time, they travel to Mexico or to the Caribbean just for a week and they start running in the sand, but barefoot. And then they would all come back home with plantar fasciitis because, you know, they all of a sudden they started loading their fascia so much more. And then they would say, well, I actually really need my orthotics because see what happened. But it's exactly like you said, it's all about adaptation. And we just need to make sure people understand that. If, you know, I give you an example of how I would recommend some people to clean them off. If not talking about running, but just talking about everyday use, you would say, you know, I wear my orthotics every day from morning to. your evening, I would say, well, the first week, uh, take them off for one hour during your day and the second week, two hours per day without orthotics. And third week is three hours, uh, all the way to that eight hours ish. Uh, so that would take you about two months to, to wean them off. Um, and then if you're a runner, then you need to also consider that in the equation. Yeah. And the more gradual, I guess it's more. safer, it's more safer for a transition because you're allowing more time for that adaptation to take place. Can we talk about Achilles tendinopathy just quickly? Do the two go hand in hand when it comes to support and like risk of injury, that kind of thing? If someone was to have Achilles tendinopathy, should they be more considerate or should they have a type of shoe that they recommend more than others? Uh, I would say that it's, uh, it's a bit similar to the plantar fasciitis because, you know, if it's an acute injury, you want to protect your Achilles. And if that's your case, if it started recently, you should consider shoes that have a more cushioning, a higher drop, um, just to, to reduce the load on the Achilles tendon. So that would be kind of the first line of treatment if you have an acute Achilles tendonopathy or tendonitis. If it's been there for a while, then it's also the same concept. You can start loading it a bit more. So you could consider having shoes that have, that are a little bit more on the minimalist, higher on the minimalist index, not necessarily a hundred percent, but you know, don't be scared of going to shoes that have 50 or 60% just to try and load your tendon a little bit more. So kind of similar considerations as a plantar fasciitis. Cool. Fantastic. And I think when it comes to the Achilles tendonopathy, what I might add is it's also a little bit more influenced by terrain. Like a plantar fasciitis might not be as influenced with change in like uphill downhill, but the Achilles definitely when it comes to like speed and increasing, like maybe uphill running, um, definitely has a higher load. So it might be, might not be the shoe. It might be the actual terrain that someone's subject to that could lead to a fluctuating in symptoms. I wanted to finish with, um, you're talking about some tips in shoe prescription or if someone was to go to a shoe store and totally, um, like plug their ears when it comes to a salesman, talking to them and prescribing a shoe and telling them to come back every six months to replace them. Um, if someone was to, you know, just head straight to the, the wall of shoes, uh, with your guidance. Um, can you have any recommendations on what shoe they should prescribe for themselves? Uh, yeah, absolutely. And, and maybe I'll just start by saying shoes are, are only one piece of the puzzle. And when people try to prevent injuries or treat injuries, It's obviously a podcast about shoes, but like you just mentioned, we would always as physios, as healthcare professionals, we would always address training loads first and there would be something else in the training plan potentially like exercises or changes to running gait and footwear is part of that equation, but it's not all about footwear. So just keep that in mind. So when you go to the running store and you want to try new shoes, well, my first question for you would be, are you injured right now or not? If the answer is no, I'm not injured, I would just ask you, are you comfortable in your current shoes? And if you say yes, I'll say, well, do you want to improve your performance or not? If you say no, I'll say, well, try to stick with shoes that look like the ones you have right now, because you're fully adapted to these shoes. And if you change them and you go to something that's quite different, then you're at risk of injury. So remember that adaptation, it's all about your habits. So that's kind of my first point. After that, if you say, well, I actually am not injured and I want to change my shoes form better, I want to improve my time on 10k or half marathon, then I'll say you probably need lighter shoes. So I would go and try to find shoes that are a little bit higher on the minimalist index, not go to 100%. It's not the point. But try to get shoes that are lighter because every 100 grams in your feet is 1% more oxygen that you use. So it's a huge difference, but just be careful again, not to shift too much in terms of type of shoes that you're wearing. So every change has to be gradual. And the last part is if you're injured, well, then it will depend on where the injury is and if it's an acute injury or a more persistent injury. In that case, it's obviously better just to get some personalized advice based on. proper assessment by a healthcare professional. Very well said, very well summarized. I think like when we're talking about, is there a right or wrong shoe? What shoes right for me? Yeah. You've just nailed it. I think it's just, it's summarized so concisely and makes so much sense if you are injured or if you're wanting to increase performance or if you're happy with the amount of performance you have, um, then you like based on those answers, that's what you would go with. It just, It's really cool. It's a really way, a really good way to finish up this topic as well. JF, if someone's wanting to learn more about you, they love your knowledge and they want to find out more about you. Are there any social media platforms that they can go to or are there any ways they can find more of your courses or online courses that you might be starting up? Yeah, I mean, the running clinic, the running clinic.com is our website. That's where we put all the educational material that we have. So what I just said there about running shoe selection, it's all on our website. If you're wondering what level of minimalism your shoes have, well, you can go on our website as well. There's a footwear section with now thousands of different shoes that are listed with their index. So it can give you some sort of guidance on how to transition if you want to transition to your new shoot. There's a lot of videos there, there's a lot of content. So feel free to have a look at that. And from a personal point of view, you can find me on Twitter. That's where I'm a little bit more active. So on Twitter, I'm at JFSQDA. And that's usually where I interact more with people. So don't hesitate to, uh, to just tweet me or send me a message. Unreal. I'll include those links in the show notes as well. I do highly recommend people go to the running clinic and have a look at their advice on shoes. And they have a really nice, like you said, like a huge database of the running shoes and where they fall on the minimalist scale and then how to. transition if you were to go from a certain score to another score. So highly recommended that they go there. JF, thanks for coming on. Thanks for like sharing your wisdom and just like providing a lot of clarity in such a topic that, you know, it's seems to be so jumbled and like the water is so muddied with this topic. And so thanks for doing that. Thanks for coming on. And also thanks for your greater mission of just trying to. understand the research to the best of your ability and then just getting it out to the Physios to the health professionals to the runners. It's like a massive undertaking. It's like a monstrous task but it needs to be done so Thanks for taking on that responsibility and thanks for coming on and sharing your knowledge today Thank you very much Brody. It's been a pleasure being on the show and I hope people will enjoy it and Keep up the good work, you're doing great stuff too. So thanks a lot Brody. Thanks for listening to another episode of the Running Smarter podcast. I hope you can see the impact this content will have on your future running. If you wanna continue expanding your knowledge, please subscribe to the podcast and keep listening. If you want to learn quicker, jump into the Facebook group titled, Become a Smarter Runner. If you want tailored education and physio rehab, you can personally work with me at brea Thank you so much once again. And remember, knowledge is power.