Let Them Get Sick (running)

I wrote recently about how our health care system resembles a protection racket. In a protection racket, you or someone else threatens people so that you can make money protecting them. Modern health care, especially in America, ignores prevention. It says let them get sick. Let the general public get sick so that we (health care providers) can make money treating them.

The profitability of let them get sick is illustrated by some numbers in Run Barefoot Run Healthy, a new book by Ashish Mukharji  (who gave me a copy). Ashish has run several marathons. Before he started running barefoot, running caused all sorts of problems. To deal with them was costly:

  • Two or three pairs of orthotics (a type of insole): $200-$300 each.
  • One MRI, for what turned out to be ITBS (Iliotibial Band Syndrome, a thigh injury): around $1,000.
  • Twenty or more deep-tissue massage treatments for ITBS: around $80 each.
  • Corns removed (twice): $500 per treatment.
  • Twenty or more sessions of physical therapy for ITBS and Achilles tendonitis: $100-$250 per session.
  • Several visits to orthopedists and podiatrists: $150 per visit.
  • Cortisone injection for plantar fasciitis: $200.

Since he started barefoot running (3 years and 2 marathons ago), he has incurred no (zero) running-injury expenses. Interviews with other barefoot runners convince him this is typical. Long ago a runner friend of mine told me everyone who runs eventually hurts themselves. The truth of this was confirmed many times by runners I met after she said this. Now it appears she was right because all the runners she and I knew wore shoes.

I started barefoot running/walking on my treadmill a year ago. I have never had running injuries (probably because I walk — uphill fast — much more than run). Going barefoot saved time. During the first few months, I got four or five cuts (actually, splits) on the sides of my feet. The skin was split by  downward pressure. The cuts made ordinary walking (in shoes) a little unpleasant. I did nothing  about them. They healed and have not recurred.

A better health care system would have discovered the damage caused by running shoes long ago. We are lucky to live when personal scientists such as Ashish can figure out the truth themselves and tell others.

15 Responses to “Let Them Get Sick (running)”

  1. Tuck Says:

    “A better health care system would have discovered the damage caused by running shoes long ago.”

    It did. In 1912. Somewhat shakes your faith in humanity, science, and the notion of “progress” to realize that all this was known and forgotten 100 years ago.

    “The Soldier’s Foot and the Military Shoe”

    http://books.google.com/books?id=frFJAAAAIAAJ&printsec=frontcover&source=gbs_ge_summary_r&cad=0#v=onepage&q&f=false

    We shod milllions of Americans in “barefoot-style” shoes, and then forgot all about it.

    Oops.

  2. Steven Sashen Says:

    I switched to barefoot 2 years ago after I heard it could cure my various running injuries.

    Well, within a month they were all gone and haven’t come back. And, as a sprinter, going 2 years without an injury is unheard of.

    Geek that I am, I started making high-tech huaraches (so I could be almost barefoot all the time, and still get into restaurants ;-) ). That turned into http://www.invisibleshoe.com and I’m thrilled to say we’ve now helped over 10,000 people make the transition.

    I’m also happy to report that last year I decided to see how long I could make it into the Colorado winter before I wanted to put on shoes…. next thing I knew, it was Spring! ;-)

  3. Michal Says:

    or just stop running all together.

  4. Evelyn Majidi Says:

    Stopping in a local physical therapy office I saw a bulletin board advising patients about future amateur athletic events, some of which were quite dangerous to life and limb. Drumming up future business no doubt.

  5. Alrenous Says:

    Tuck, it doesn’t shake my faith too much, as A: I already know that kind of thing happens and B: there’s a fairly good explanation.

    We have forgotten, but before the industrial revolution people feared nature because it had much more power in their lives than they did. And didn’t particularly care to use that power for good, obviously.

    Thick soles were probably psychologically motivated by wanting to reject this dangerous ‘nature’ stuff. To us it’s obvious that we can’t design a better shoe-ground interface than nature did. (At least, not for a while yet.) To them it was just as obvious, but they were too invested to accept it. In 1912, the culture hadn’t yet forgotten its fear and hatred of nature. Even though nature had already been conquered, these feelings take a while to subside in cultures, just like feelings take a while to subside in individuals.

    The whole ‘nature is good’ thing is really new and was, as far as I’m aware, spurred by the whole radioactive consumer goods debacle. Before that, the emotional affect of ‘all-natural’ was held by the words ‘artificial’ and ‘synthetic,’ which you can check by looking at period advertisements. Subsequent events with pesticides etc. have played into confirmation bias.

  6. Unshod Ashish Says:

    Sadly, individual hospital chains within the US healthcare system (possibly excepting Kaiser) appear to have no incentive to improve their patients’ health or reduce injuries – quite the opposite. To podiatrists, just the mention of barefoot running is a red flag waving in front of their face, as they see all business disappearing.

    I need to get my book in front of decision-makers at Kaiser.

  7. Jazi zilber Says:

    They say running injuries increased 70% since the introductiin of running shoes in 1972

  8. SPalmer Says:

    There are inexpensive biofeedback insoles like Barefoot Science that will help promote a strengthening of the foot. It is a wierd arrangement. The parent company encourages people to be barefoot and strengthenn their feet the most natural way possible, but if you need to wear shoes, for running or anything, then you use their insoles to combat the negative atrophying effects of the shoe. The stronger healthier foot makes the transisition to be being barefoot faster and safer, and yes, it also would show huge cost reduction benefits to the helath care system

  9. Virgil Says:

    I would not blame the medical system for the above problems, but the shoe manufacturers. Given that plantar fasciitis and ITBS are pretty nasty problems which, left untreated will result in excruciating pain and inability to walk, I’d say the medical system here did a pretty good job – it diagnosed and treated the patient. If the patient then continued with the damaging behavior (running in regular shoes), that’s not the medical establishment’s fault. Expecting the medical establishment to be fully aware of problems with running shoes, when hundreds of millions of people use them every day without issue, is also unreasonable. I know your blog is usually biased (sometimes correctly) against the medical-industrial-complex, but in this case I think the rage is mis-directed. The shoe manufacturers should be the target.

  10. Seth Roberts Says:

    Virgil, you write: “The shoe manufacturers should be the target.” Hmm. They are not going to voluntarily stop making shoes. Therefore they cannot take seriously the idea that barefoot running is best.

    In contrast, medical school professors (and by extension doctors ,who repeat what med school professors say) can take seriously that idea. Nothing stops them from learning how to prevent, not just how to cure. The medical system did a bad job here because it focused on the symptoms and ignored the cause of the symptoms.

  11. Seth Roberts Says:

    That’s an interesting way to make money from barefoot running.

  12. Alex Chernavsky Says:

    The New York Times recently had a short article about barefoot running:

    http://well.blogs.nytimes.com/2011/09/30/are-barefoot-shoes-really-better/

    The comments are interesting, too.

  13. Stephen M (Ethesis) Says:

    You know, when I used to train in Judo and Karate, I remember having trouble running, so I never jogged (using jogging shoes) but when they made us run some laps as part of the workouts (barefoot), I never had trouble. I never really thought about it then.

    Jogging shoes = foot problems. No shoes, no problems.

    On the other hand, I do have shoes I walk in that give me no trouble at all.

  14. michelle@healthylifetoolkit.com Says:

    Hey Seth.

    Great post! This is only one of the many ways the health care industry fails us. And one I hadn’t considered. The band-aid approach (throw a pill at it) rather than address the underlying cause of an issue is the norm. As a nurse, I see this all to often and find it very frustrating. Glad to see a post on the subject.

  15. reycroxas Says:

    I have been running barefoot for almost ten months now. And from my experience, it is more comfortable to do. Hence, less injury. Seth is right, shoe manufacturers will not stop making shoes because they make a lot of profit. In order for us to prevent such injuries, we must be wise on what decisions we make.