The recent proliferation of articles and blogs advocating minimalist running as an effective technique for managing plantar fasciitis deserves an informed response. A critical analysis is necessary to dispel the production of a popular myth about the most effective methods for dealing with this condition. Commentaries that promote minimalism or barefoot running as a solution often cite personal experience instead of scientific literature, and these articles tend to be written by people with no actual experience in a clinical environment treating this ailment. They are generally speaking from personal experience, and the reader should consider this carefully when reading such advice.
Plantar fasciitis affects runners regardless of the running style. Specifically, barefoot runners and minimalists experience this condition in proportions similar to runners who wear shoes. Even the blogs posted by minimalists reveal that many are still seeking advice on how to deal with this painful inflammation, so there can be little doubt that simply running barefoot will not prove to be an adequate solution. After reviewing many of the sites that make such recommendations, it became clear that certain popular myths are the driving force behind the incorrect information. Entrenched beliefs can be difficult to displace even when there is no supporting evidence available.
Believing that simply running barefoot or practicing minimalism is sufficient as a clinical treatment is completely unfounded, and it is a position unsupported by the vast amount of scientific literature available on the subject. The credibility of such assertions should be taken seriously, however. They tend to grow into unassailable popular wisdom when they remain unchallenged for extended periods of time.
Here are a few guidelines that readers can use when examining proclamations made by people who assign to themselves the status of expert:
• What is the quality of the evidence presented to support the claim?
• Does this evidence, if it exists, actually refer to any other peer-reviewed publications, or is it being produced without any regard to the existing, established treatments for plantar fasciitis?
• Does the writer understand that muscle strength is not mentioned in any prominent scientific publications on the subject?
• Why are most clinical practitioners not treating this condition with muscle strengthening exercises?
• Why does minimalism show no signs of increasing the contractile strength of the plantar muscles involved in flexing the toes?
• If minimalism actually relieves this condition, why do so many minimalist and barefoot runners still develop it?
• Why would a non-runner want to practice barefoot running while experiencing the pain associated with this condition?
The available scientific literature does not recognize muscle weakness as a significant factor, and clinicians do not use muscle strengthening protocols when treating this type of fasciitis. A recent study took up the question in response to the assertions outlined above and found no correlation between fasciitis in the plantar tissues and muscle strength. One recent clinical study did assert this connection, but it has serious flaws in the methodology. The author seems comfortable using flawed techniques to reach what appears to be a pre-determined outcome. These types of studies deserve rigorous peer-review prior to achieving a status worthy of citation.<>