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Ask Carter P.

PETERSON AIR FORCE BASE, Colo. -- With the New Year often come new resolutions to make our lives better. One of those goals for many will be to be healthier. The 21st Medical Group would like to help in that endeavor by offering a new feature.

Ask Carter P. will be available to dispel myths and answer questions you may have about health and human performance. Ask Carter P. will use a "Dear Abby" write-in your question format that will be answered by the 21st Medical Group staff. The article is in honor of the namesake of the Peterson physiological training facility, named in honor of Col. Carter P. Luna, an F-4D pilot and a physiologist.

On March 10, 1969, while flying a combat mission over Laos in Southeast Asia, Luna's aircraft was hit by enemy fire forcing him to eject from his burning aircraft. Both he and his weapon systems officer, Capt. Aldis P. Rutyna, maintained voice contact during parachute descent with search and rescue aircraft. Communications were lost with Luna one hour later. The two crewmen landed on top of enemy forces and for the next two hours, Rutyna served as a forward air controller calling in air strikes on the surrounding hostile forces. Rutyna was rescued three hours after his shoot down.

After 48 hours of unsuccessful search and rescue efforts, Luna was declared missing in action. On Aug. 20, 1975, Luna's status was officially changed to killed in action - body not recovered.

We honor our fallen colleague through this article and want to promote enhanced human performance by answering your questions and concerns.

Today's questions addresses minimalist shoes.

Carter P., I've heard that minimalist shoes may help me reduce injuries. Is this true or just another fitness fad?

From research on different running conditions, we know that running with shoes, even minimalist ones, is not the same as running barefoot. Many barefoot runners tend to strike the ground first with the forefoot (front of the foot) or mid-foot (further back on the foot toward the arch), causing the runner to take softer, shorter strides. On the other hand, wearing any kind of running shoe causes a runner to land on the mid-foot to heel first, which produces larger collision forces compared to true barefoot running. Wearers of minimalist shoes do shift toward running like they were barefoot with regard to their strike and stride but still not as much as if they were barefoot.

There is still much debate over whether this shift in stride and strike form minimalist shoes helps reduce injuries. One comparison of minimalist to traditional running shoes found no difference in running mechanics between wearers of the two types of shoes. In fact, while other injuries may be lower among barefoot and minimalist runners, they might be at increased risk for forefoot and mid-foot injuries such as stress fractures and plantar fascia injuries. Another recent study found that after 10 weeks of running some runners who transitioned to Vibram FiveFingers shoes had increased bone marrow edema--an early indication of inflammation or injury--in at least one bone.

Bone marrow edema may not be accompanied by pain and joint dysfunction, so a person may not be aware that an injury is developing. Some studies even suggest that minimalist running poses its own risk for different kinds of injuries, not necessarily fewer.

What does increase your chance of injury? Strong predictors of injury include your aerobic fitness level, weekly mileage, tobacco use and elevated body mass index. In addition, there are limits to physical training where physical fitness somewhat plateaus but injury risks significantly increases. Numerous studies show that if you run more than three times per week or greater than 30 minutes in a single session, your chances of injury more than doubles. However, regular strength training will decrease your injury risk by almost half.

If you decide to try a minimalist shoe, it is recommended you transition slowly with a transition shoe. Nearly every major running shoe brand now offers a transition shoe and it should be a very slow and gradual process to overcome decades of foot atrophy and loss of strength, balance, coordination, flexibility and proprioception. Going cold turkey without gradually and properly rebuilding, stretching and strengthening the muscles and tendons that have atrophied over the years, can and will do significant damage to your feet.

So, to sum it up, there is no general consensus that minimalist running shoes decrease injuries in runners. Running injuries are due to multiple factors and those are best assessed by a medical professional. At this point, the claims that minimalist runners experience fewer injuries are more from personal opinions, rather than scientific studies.

(If you have questions you would like answered through Ask Carter P., send them to 21amds.sgpt3@us.af.mil or call 556-4185.)

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