Staying In Stride With Your Running Patients

Nicholas A Campitelli DPM FACFAS

I recently attended “The Running Event,” a symposium in Austin, TX for retailers and shoe manufacturers involved in the running industry. In addition to seeing the debut of new products, attendees heard lectures addressing a myriad of topics such as running form, injuries, lower extremity biomechanics and marketing strategies for retailers.

While I did not attend to hear the marketing strategies, I found the other lectures to be outstanding. They introduced current information and studies that are related to runners and shoe gear. It was also great to see two of our colleagues, Rob Conenello, DPM, and Paul Langer, DPM, lecturing as well. Presenters at podiatric conferences rarely discuss such topics, which are important for those treating runners.

It is important for DPMs who treat a fair amount of runners to attend events such as these and stay involved with the running community. The running community is a close-knit group of individuals who are typically knowledgeable in regard to inquiring about running injuries. They will recognize if the doctor they are addressing is not on the same page.

One of the trends I observed this year was that most, if not all, of the shoe manufactures are now introducing a line of shoes that could be categorized as minimalist shoes. While we still do not have a concrete definition for minimalist shoes, most will agree that these shoes should allow the foot to function as close to its natural state as possible. Some of the companies prefer to call this line a shoe that “promotes natural foot function” as opposed to a minimalist shoe.

For the physicians who have concerns about minimalist shoes, I would encourage you to familiarize yourself with the latest shoes that companies are introducing as well as the proper way to transition into these shoes safely to avoid overuse injuries. Many runners are choosing to go down the minimalist path. Those physicians who are not willing to accept these shoes as a viable option for their running patients may find themselves losing patients.

Editor’s note: Dr. Campitelli has disclosed that he is an unpaid Medical Advisor to Vibram USA. Dr. Campitelli is the author of a new iBook entitled Running In A Minimalist Shoe. For more information on the book, visit


Just finished reading several of Dr. Campitelli's blogs/comments about the wave of minimalist shoe. Last comment here was "those not willing to accept these shoes (minimalist) may find themselves losing patients." I think that maintaining your beliefs and convictions about what is best for patients should trump the concern about losing patients. How about doing what you feel is best for the patient?

Dr. C, with due respect as a colleague, I find all you say is chock full of anecdotal comments with nothing but what your own experiences tell you. Nothing wrong with an "opinion," but please don't pass this one as fact or the mainstream belief. Just because an elite athlete has success with something, it doesn't mean the average person will be helped by it. We are a celebrity-loving world and it is easy to adopt something because some famous individual does it, uses it, or likes it.

Elite runners RUN DIFFERENTLY! I have run for 38 years and I am a 2:51 PR marathon with multiple marathons under my belt but a far cry from an elite runner. I trained for years at 70-100+ miles per week. I trained the Lydiard method and it helped indeed. But train with racing flats with initial forefoot contact? No way.

How many of your patients that you treat are elite runners? How many these days are even sub 3-hour marathoners? I have treated runners my whole practice life and the vast majority are doing 15-30 miles per week and 4,5,and 6-hour marathoners. The late Dr. Pagliano published a paper surveying over 25,000 runners and his average pt averaged 15-20 miles per week! And you tell these people to use minimalist shoes and run forefoot first?

Many of my running patients are overweight as well and many are 50+ years old. Many have biomechanical abnormalities. Minimalist shoes for them? I am SEEING more plantar fasciitis now than ever before and many can be blamed on too lightweight a shoe and following some "guy" that told them the "new way to run" is to not allow heel contact. HELLO?

In my opinion, minimalist running shoes "may" be appropriate for a very small population who have the running biomechanics (elite) to do so. The vast majority do not and do better in a more protective shoe (no I don't mean Brooks Beast). The minimalist "craze" is a fad, a fashion craze. Everyone must have a day-glo color of shoe now and it must be super light weight. I hear comments that "it's so comfortable." Yes, maybe to walk around in. But to train in? No way.

Michael W. Heaslet, DPM, FACFAS
Fellow and Past President of AAPSM
Director of Fellowship Training
Irvine, CA
Runner since 1975

Add new comment