Forefoot pain (metatarsalgia) is a condition indicated by pain and inflammation under the ball of the foot. This is increasingly prevalent in runners who are making a change to minimal footwear, barefoot running and Newton Shoes.

As with virtually all running injuries, forefoot pain is a result of doing too much, too fast, too soon. When people blame the shoes, consider whether they would have had the same thing happen running barefoot or in minimalist footwear? It’s a lot like saying “this helmet injured my head”, “this oven mitt burned my hand” or “these shorts tore my ham string.”

The bio-mechanical sensor plate in all Newton Shoes can lead people to believe the shoes are too hard and stress their feet. It actually works the other way around. The midsoles of regular running shoes are unnaturally soft (compared to the natural surfaces we evolved to run on), commonly leading to large, uneven depressions where the EVA foam collapses. Unlike Newton’s Action/Reaction technology, EVA never fully recovers, leaving an uneven surface under the foot.

The unfortunate result for many runners is misaligned metatarsals as the foot adapts to the soft surface and digs increasingly deeper holes into their shoes. Over years and decades it is common for people to end up with badly misaligned bones, like uneven keys on an old piano. Returning to a naturally firm surface like barefoot, minimal or Newton Shoes can be a painful experience as the bones realign, pulling on connective tissue and stressing the nerves.

Leaving the condition untreated can lead to other problems such as stress fractures of the metatarsals or Morton’s neuroma. As with most medical conditions, the cause should be removed (often too much too soon) and then treated. Once addresses, it is important to ensure good running form and appropriate running shoes, with a conservative amount of time to adapt.

Here Dr. Shawn Allen of The Gait Guys further discusses this gait problem in running form. The Cross-over gait is a product of gluteus medius and abdominal weakness and leaves the runner with much frontal plane hip movement, very little separation of the knees and a “cross over” of the feet, rendering a near “tight rope” running appearance where the feet seem to land on a straight line path. In Part 2, Dr. Allen will discuss a more detailed specific method to fix this. You will see this problem in well over 50% of runners. This problem leads to injury at the hip, knee and foot levels quite frequently.

Here Dr. Shawn Allen of The Gait Guys works with elite athlete Jack Driggs to reduce a power leak in his running form. The Cross-over gait is a product of gluteus medius and abdominal weakness and leaves the runner with much frontal plane hip movement, very little separation of the knees and a “cross over” of the feet, rendering a near “tight rope” running appearance where the feet seem to land on a straight line path. In Part 2, Dr. Allen will discuss a more detailed specific method to fix this. You will see this problem in well over 50% of runners. This problem leads to injury at the hip, knee and foot levels quite frequently. To date we have not met anyone who had a good grasp on this clinical issue or a remedy quite like ours. Help us make this video go viral so we can help more runners with this problem. Forward it to your coaches, your friends, everyone.

Thanks for watching our video, thanks for your time.

-Dr. Shawn Allen, The Gait Guys

Next Monday, July 11 and Tuesday, July 12, come to Gord’s Running Store in Calgary, Alberta, Canada, for a Newton Natural Running ™ Sympoisum and Form Clinic with Newton Running’s Director of Education and Research, Ian Adamson.

Learn the principles of running biomechanics, injury prevention and how to adopt a natural running stride.

The natural running presentation begins at 5:15 pm at Gord’s Running at 919 Center Street NW, Calgary, Alberta, and the form clinic is on Tuesday at 7:00 pm.

For more information, visit www.NewtonRunning.com or www.GordsRunningStore.com.

Chiropractor Dr. Lane just posted this video explaining why he recommends Newton Running shoes to his patients and delves into what differentiates our shoes from other running shoes in the market.

Thanks Dr. Lane for the cool demo of the Action/Reaction Technology and explaining the principles behind natural running form!

In less than a year, Two Rivers Treads Center for Natural Running and Walking has sold over  1000 pair of Newton Running shoes. Newton Runner Dr. Mark Cucuzzella (pictured left) opened the concept store in June  2010.

Dr. Mark, one of the earliest adapters of Natural Running, began researching and learning about better running form after several foot operations in 2000. He discovered the effects of footwear affects as a runner for Brooks Sports and working on minimalist shoe projects. “By cutting the heels off shoes I understood the feel of zero-drop,” says Cucuzzella. “I didn’t need any more data to realize that elastic recoil and natural motion were enhanced with my foot in its anatomic position.”

When these projects were shelved, Dr. Mark contacted Newton Running‘s Danny Abshire, of who was building a shoe designed to facilitate proper running form. Dr. Mark and Newton Running continue to learn and evolve with  a common goal of having runners embrace the notion of “No Pain…Thank you”, not “No Pain…No Gain”.

In 2009 Shepherdstown started hosting running events that soon become the largest in the state.  There is now an entire Freedom’s Run Series of Events (www.freedomsrun.org) with partnerships with the National Parks.  The all-volunteer group builds trails and gardens for schools and has established the Historic Region as a National Heritage Area.

The events have grown such that a race headquarters was needed. Freedom’s Run race committee members Tom Shantz and James Munnis, stepped up to the challenge of creating a shoe store specializing in flat and minimalist shoes.

“The Sir Isaac Guidance Trainer has been an excellent and safe transitioning shoe for many new and experienced runners,” says Shantz. “It is durable and allows the feel and protection of a shoe as runners start to learn and understand better form at their own pace”

“We are big supporters of barefoot running as a supplement to land better and improve posture,” he adds. “Most who have not achieved proper strength, mobility and efficiency would trash a pure minimalist shoe and their bodies in two to three weeks. The resiliency and firmness of Newton Running’s midsole and its sustainable properties make it unique in the shoe market. We also teach the components of healthy movement in weekly clinics and at each customer interaction.”

The Distance Light Weight Trainer is the shoe of choice for State Champion Jefferson High School Cougars. Whereas most coach recommend cushioned trainers to their athletes, Jefferson Coach Scott Biola understands it is critical not to let his runners transition to a dysfunctional heel-to toe-pattern.  One Newton runner who has achieved great success is multiple state champion and 4:15-miler Brandon Doughty.  Brandon has but over 1200 miles in his Newton Running Gravity Neutral Performance Trainers and has avoided injury.  He will run for Oklahoma next year.  Five of Biola’s runners broke 10 minutes over 2 miles this year, when five years ago he would have had trouble finding five runners to break 5 minutes in a mile.

“Chi Running principles have helped me overcome my own injuries,” says Biola. “Getting away from heel striking is an essential aspects to teaching proper mechanics to high school athletes. I prefer to see them land on either the forefoot and rearfoot touching simultaneously or the ball of the foot (forefoot) touching first.”

“It seems that the older the athlete, the harder it is to transition away from the heel strike,” he adds. “Time spent in traditional training shoes definitely has a lot of us accustomed to heel striking. I’ve found that the Newton shoes and other lightweight minimalist models help reinforce proper mechanics. In addition to getting people away from heel striking, these shoes are also light in weight which is essential to having a rapid cadence. That quick turnover not only makes for faster running, it seems to help reduce injuries.”

Dr. Mark has these thoughts about the future: “We are seeing many runners now graduating into less shoe in a healthy and progressive way.  We look forward to the launch of the MV2 in the fall.  It will be a fresh option for those who have learned and evolved. The Isaac , Gravity, and Distance will continue to be our focus for the new and transitioning runners.  With over 1000 pair of these out now I have yet to hear of a customer or their doctor come back to us blaming the shoe. I give credit to my staff who teach patience and progression.”

After the lead of Two Rivers Treads, several stores are now opening with a similar model of selling only flat and minimalist shoes. They are aligning in a partnership and all are Newton Running retailers:

• Born To Run; Bellevue, WA
• Natural  Running Center; Dallas, TX
• Good for the Soles; MA
• Revolution Running; WI
• The Runners Sole; Chambersburg PA
• Hunter Gait; Newcastle, Australia

The store started in a 500-square-foot second-story space and just last week moved to a beautiful  new street level space with triple the space and a new visibility.  The future looks bright for both Newton and Two Rivers Treads.  Two Rivers Treads wishes to thank the support of Newton for a successful first  year. Newton has also been instrumental in the success of Freedom’s Run as a major sponsor (www.freedomsrun.org)  and the US Air Force Running Team, of which I have been a part of for almost 20 years.

Meet Dr. Mark and learn about Newton Natural Running at this weekend’s Running Injury Prevention Conference in Shepherdstown, West Virginia. Click here for more details and registration.

The highly successful “New Trends in the Prevention of Running Injuries” is returning to Shepherdstown, West Virginia, and this time, is paired with a Newton Natural Running™ Coaching Certification Program.

Citing more than a thousand scientific articles and systematic reviews, this edition of New Trends in the Prevention of Running Injuries questions many current practices in the treatment of both runners and non-runners alike. With high quality audio-visual material, this course will integrate the theory and practice of a number of advanced concepts on running.

Topics include:

• Injury etiology and theory
• Diagnosis and treatment of injury
• Planning of training sessions
• Evidence based stretching and strength training
• Biomechanical gait analyses taught by the world’s expert Jay Dicharry
• Analysis of the running shoe
• Teaching barefoot running style with Dr. Mark Cucuzzella recently presented at 2011 Boston Marathon See video
• Optional group runs with experts in the field

The three-day course will enable you to efficiently treat your patients whether they are runners or active in other sports. You will leave with clinical tools such as a DVD (running mechanics, demo exercises, warm-up sequence, etc.), a CD with a PDF document (evaluation sheets, exercise programs, tips, running programs) and portfolio that includes all the academic content of the course.

The course is instructed by three internationally known teachers and leaders in running medicine:

• Blaise Dubois is a physiotherapist who teaches at the Faculty of Medicine at Laval University. Blaise has developed the Running Clinic Canada and has taught over 50 conferences around the world. His involvement with the Canadian athletics team has led him to travel around the world enriching his knowledge and adapting his clinical approach.
• Jay Dicharry is a physiotherapist at the University of Virginia and director of the SPEED Clinic. Jay is the world’s leader in gait analysis and running injury evaluation and treatment.  Runners of all abilities travel from around the world to visit his treatment center.  He has published dozens of studies and reviews and teaches around the country.
• Dr. Mark Cucuzzella, the conference host, is one of the world’s leaders on teaching gait mechanics and injury prevention.  He is an authority on footwear and in the small town of Shepherdstown, West Virginia he opened Two Rivers Treads Center for Natural Running and Walking- the first store focusing exclusively on flat and minimal shoes. In his spare time he directs the Freedom’s Run Series of Events and continues to run at an elite level as a Masters runner.
• Dr. Robert Wilder is Chair of the Department of Physical Medicine and Rehabilitation at the University of Virginia and Director of the Runners Clinic.  He has published several texts and articles on running injury, prevention, and treatment.

Gifts, snacks, networking, and free monthly updated literature are some of the many extras you will receive by attending the 24-hour training course. Register now….course limited to 30 participants.  24 hours of CME approved for physicians and physical therapists.

Date: June 23 – 25, followed by the optional Newton Natural Running Coaching Certification Program on June 26. (see below for details).
Program  8:00 a.m.to 5:00 p.m.

Special rate $545 (usually $650 USD in Europe and Canada)

Military rate $495

Location: Bavarian Inn
Shepherdstown, West Virginia
304-876-2551
www.bavarianinnwv.com special rate $119/night

Register here at The Running Clinic.

Newton Running Natural Running Coaching Certification Program

Following the three-day course, participants may also take place in a one-day intensive Newton Natural Running™ Coaching Certification Program at Two Rivers Treads in Sheperdstown, West Virginia on June 26. This is normally a three-day program.

The registration free of $250 includes a pair of Newton Running shoes, Natural Running book by Danny Abshire and running apparel. (Exception: Newton Running retailers are free). **You must attend the New Trends in Running Conference to register for this coaching certification program**

Newton Natural Running™ form coaching certification provides coaches with knowledge designed to assist clients with efficient running form, injury prevention and training goals.

Newton Natural Running™ Form Coaching Certification requires participants to:

• Practice a Newton Natural Running™ form
• Attend a three day coaching certification clinic
• Pass written, oral and/or practical examination

Certified Newton Natural Running™ Form Coaches can:

• Teach and analyze Newton Natural Running™ form
• Present Newton Natural Running™ talks and clinics
• Use Newton Natural Running™ certified logos and marks
• Obtain a free listing on newtonrunning.com
• Get discounts on Newton Running products
• Become a Newton Running Affiliate

Cost: $250 (free for Newton Running retailers)
Location: Two Rivers Treads, 113 W. German Street, Sheperdstown, WV
Time: 8:00 am to 3:00 p.m.
To register, contact Dr. Mark Cucuzella at mark [at] freedomsrun.org
For more information, visit: http://www.newtonrunning.com/community/running-coach-certification

This post is by Dr. Mark Cucuzella, a Family Physician at Harpers Ferry Family Medicine and Associate Professor at West Virginia University School of Medicine.

The plantar fascia (PF) is a strong ligament that runs from the heel to the metatarsal heads in the front of your foot. This ligament helps absorb the shock that occurs when your foot contacts the ground. It has function in the windlass mechanism recreating the arch on takeoff.

Plantar fasciitis is the common term for what should be more accurately termed Plantar Fasciosis. itits is an acute inflammation caused by a trauma or infection. osis is chronic degenerative condition.

No evidence exists for an ideal treatment of this condition without identifying and treating the causes, which can be many. Since we have no literature to guide us, I offer this advice based on my experience treating hundreds of runners and guiding them in self corrections.

What Causes Plantar Fasciitis?

The PF is designed to manage a relatively small amount of stress. The intrinsic and extrinsic muscles of the foot are designed to receive signals from the fascia and in turn manage the majority of the load. When those muscles are dysfunctional, the load is transferred to the PF, which is unable to handle it, and results in tearing.

You can repair these tears by using palliative methods, but PF may return as soon as you resume running. The only way that you can actually fix plantar fasciitis is to address the root cause: weak foot muscles. (Thank you Lance from Barefoot Science for the insight).

Several structural causes can contribute to PF:

• Weak intrinsic foot muscles
• A misaligned and weak first toe
• Tight, shortened calf muscles
• Tight plantar fascia

Other important contributing factors:

• Increased mechanical stress from running or other activity
• Obesity
• Suddenly switching from supportive footwear that inhibit intrinsic foot muscles to flat shoes (flip flops) or barefoot
• Poor walking and running mechanics
• Wearing overly supportive footwear weaken the foot and make it less stable.

How Do You Correct Plantar Fasciitis?

Try a combination of these treatment principles (which is most effective will  depend on the cause):

• Using an orthotic, arch support or taping should be a temporary mode of relief while you strengthen and lengthen the tissues. Applying a support device over a long period of time is akin to wearing a cast on a broken arm forever (resulting in muscles atrophy from disuse).
• HTP heel seat is a useful, non-supportive tool for short-term relief while you strengthen the foot.
• Perform eccentric heel dips from a stair. Place your foot on stair and drop your heels down. It is OK to have a little pain doing this as long as it progressively improves.
• Dorsiflex the big toe to lengthen a tight plantar fascia.
• Gradually stop wearing any type of shoe with a heel during ALL activities.
• Work on foot intrinsics, such as picking things up with your toes and walking barefoot. For more foot exercise ideas, see this video at Heel That Pain.
• Practice natural running technique that involves making light ground contact, reduced loading rate, and more proprioceptive cueing. For more info, check out Chi Running by Danny Dreyer, this instructional video by Newton Running, Evolution Running by Ken Mierke, and the excellent teaching of Lee Saxby of Terra Plana VIVOBAREFOOT (see video).
• Throughout the day, strengthen your big toe by pushing it into the ground as often as you can whenever you are standing. This will wake up the foot muscles and help recreate the arch.
• If you first toe curves inward, consider a straightening product like Correct toes by Dr. Ray McClanahan.
• Use the principle of gradual progression and body sensing when making any changes.
• Avoid NSAIDS (Motrin, Ibuprofen, etc). These drugs interfere with natural healthy healing processes.
• See a good health provider who understands natural running and walking.
• Wear minimalist footwear!

About the Author

Dr. Mark Cucuzella is a Family Physician at Harpers Ferry Family Medicine and Associate Professor at West Virginia University School of Medicine. As a Lieutenant Colonel in the Air Force Reserves, he is coach and captain of their marathon team and designing programs to reduce running injuries in military personnel. His passion for health extends beyond the walls of the clinic into the medical home’s “backyard”- the trails and open space that create the arena for optimum wellness.

Read more about Mark on his website: http://www.trtreads.org

Over 150 people turned out (and another 50 or so were turned away due to lack of space) for last week’s speaker panel  discussion about natural running in Sheperdstown, West Virginia.

Event attendee and blogger Pete Larson (www.runblogger.com) was struck by the turnout in a small town in West Virginia, which has a reputation as one of America’s most obese states. “I couldn’t believe it!” Larson wrote on his blog. “Here we were in a state renowned for it’s inactivity, and I had to weave my way through a crowd of people who were squeezing into a room like sardines.”

Dr. Mark Cucuzella, organizer of the event, titled The Re-Evolution of Running: Discover Pain Free Movement for Life, attributes to tremendous response to a phenomenon called positive deviance. “That’s when large change happens as a result of observing and following what is happening in a small sector, and then applying it widely,” he says.

Cucuzella is also a family doctor and owner of Two Rivers Treads Center for Natural Running and Walking store in Sheperdstown, West Virginia.

Blogger Miss Zippy shares in this recent post what she learned from the panel of experts that included Danny Dreyer, founder of ChiRunning, Jerry Lee, CEO of Newton Running, Dr. Jay Dicharry, PT and Director of the SPEED Clinic at the University of Virginia, Dr. Peter Larson, Blaise Dubois, running injury authority, among others.

Natural running symposia are held across the country and overseas. For a complete listing of upcoming events, visit the Newton Running website at http://www.newtonrunning.com/community/natural-running-symposium-form-clinic.

Running-injury prevention leaders from around the globe are gathering in Shepherdstown, West Virginia, for a three-day conference to discuss best evidence and best practices to prevent and treat running injuries. As part of the gathering, the group will meet the local community and share stories, experience and knowledge.

“The Re-Evolution of Running: Discover Pain Free Movement for Life” will be hosted by Two Rivers Treads Center for Natural Running and Walking, the Bavarian Inn, and the Running Clinic Canada on Friday night January 28, 7 to 9 p.m. at the Bavarian Inn.

Guest panelists include leading clinicians, researchers, teachers, writers, athletes and footwear experts from around the globe:

Danny Dreyer

• Founder: Chi Running and Chi Walking
• Asheville, NC; Internationally-acclaimed injury-prevention coach, ultramarathoner and best-selling author

Dr. Craig Richards

• Newcastle, Australia; General Practice, Sports Medicine, Runner
• One of world’s lead researchers on running injuries and footwear

Jay Dicharry, PT

• Director SPEED Clinic University of Virginia
• International Authority on Gait Analysis and Running Injury

Dr. Peter Larson

• Professor of Biology St. Anshelm College New Hampshire, Marathon runner
• Author/host of world’s most widely read site on running innovation- www.runblogger.com

Blaise Dubois PT/Sean Cannon, PT

• Quebec City, Canada; International Leaders in running injuries
• Authors and Instructors of over 40 international conferences

Jerry Lee

• Boulder, Colorado; Co-Founder and CEO Newton Running
• Innovator in first shoe company with primary mission of injury prevention.  Ironman competitor

Ian Adamson, MS Sports Med/BS Biomechanical Engineering

• Boulder, Colorado; Director of Research & Education-Newton
• Ultramarathoner and 7-time world champ Adventure Racer

Dr. Daniel Kulund, USAF

• Chief Health Promotions Pentagon
• Physician, Innovator of Running Medicine. Opened first true “Runners Clinic” in the 1970’s.

Dr. Mark Cucuzzella,

• West Virginia University, Coach USAF Running Team, National Level Masters Runner
• National speaker/teacher of healthier running; sub 2:35 marathons in 4 decades

Jeff Horowitz

• Arlington, Virginia; Editor at Competitor Magazine

Speakers will share their most important discoveries and then allow questions and conversation with the audience.

“This is an amazing privilege to have all of these leaders in one room together willing to share and converse with the public,” says Mark Cucuzzella, MD. Over 60 percent of runners are injured every year. If the CDC were to evaluate this data they would shut down running events. Insurance companies now are reevaluating the advice to get fit if it involves running and the subsequent injuries and costs of expensive imaging studies and treatments. We need to develop entirely new approaches to running injuries and staying healthy for life”

The event is free to the public and geared toward walkers and runners of all abilities.

Date: January 28 2011, 7:00 – 9:00 pm
Location: Bavarian Inn, Shepherdstown, WV  25443, www.bavarianinnwv.com

Free to the public.  Coffee and dessert will be provided. Cash bar.

For those wishing to dine prior to the event, call the Bavarian Inn at 304-876-2551 to make a reservation.

For more information, contact  Two Rivers Treads Center for Natural Running and Walking or  phone 304-876-1100.