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From: Dennis Shavelson, DPM


When minimalist running, one reduces heel contact running, which for most of us, would be a good thing. Runners must be willing to break in their new stride, speed, and distances slowly to reduce fractures and other overuse injuries such as Achilles tendonitis. These rules apply when breaking any new activity or sport.  


The article states, “These days, more of Kirby’s patients are running with thicker-sole shoes than ever before. Every third runner he sees wears Hokas, a sneaker brand with the thickest underfoot cushions in the market today." I must interject that they may be dangerous for many runners. I published a white paper regarding Sketchers Rocker Shoes. I eventually wrote the 41 page brief involved in the successful lawsuit against Sketchers Rocker Shoes involving 300 injuries.


Rockers and flexible soled shoes designed to shock absorb and create cushioning using thick and flexible materials when married to the flexible foot types of many runners, will result in injuries to some of those feet, especially if runners transition too quickly. Rockers obviate the need for healthy internal biomechanics and predictably allow feet with high SERM-PERM Intervals to degenerate to the point that they need rockers all the time. Hokas are unproven short- or long-term as to safety and they are being poorly disclaimed. They are not the next Nike Waffle Trainer yet!


Dennis Shavelson, DPM, NY, NY

Other messages in this thread:



From: Chet Evans, DPM


I have read the comments concerning this posting regarding my resignation, and am concerned at the simplistic view some have taken regarding this issue. State boards are legislatively evolved bodies, and correction of the exposure to potential anti-trust liability requires legislative mandated changes to statues or laws. Nor is it resolved with the simple purchase of D&O insurance; it does not protect governmental entities. An individual can buy his/her own expensive anti-trust liability policy, but why should you have to do that as a volunteer representing the best interests of your state?


Recently, the Federation of Podiatric Medical Boards surveyed the various states on their response to this Supreme Court ruling from 2015, and you would be surprised at how few are doing anything legislatively. There is some traction here in Florida in Tallahassee, but it looks as if it is not going to make it through this legislative session, and if that is the case, the three professional members who remain on our board continue to be exposed. And keep in mind, this affects every professional board in each state. There are professional boards/board members that are being sued as we speak, having to pay for their defense and any damages, and it is certainly not a "simple" issue to them. 


Chet Evans, DPM, Winter Garden FL



From: H. David Gottlieb, DPM


I fail to see where this sudden sense of urgency comes from. First, the ruling only applies to members of state licensing Boards. How many podiatrists is this? Second, the referenced ruling is from February, 2015. State licensing Boards are aware of this decision and should be taking appropriate actions to comply with it. As I understand it, as long as the state board and the state professional association are distinct in function and structure, there is no problem. Prior to resigning, board members should check with their board's state attorney for guidance.


This ruling is only of comfort if one believes that state licensing boards exist as an anticompetitive agent as opposed to their true function which is protection of the PUBLIC good. Note the emphasis on public, not professional good. State professional associations are charged with promoting the profession and its members. State professional boards are charged with protection of the public health.


Disclosure: I am on a state licensing board.


H. David Gottlieb, DPM, Baltimore, MD



From: Steven Kravitz, DPM


Directors and officers liability insurance (D and O insurance) is easily available and covers the "Board" in question and its individual members for performing their normal and required duties. Fraud and illegal practices are usually spelled out and, of course, excluded from coverage. It is an unfortunate reality that such coverage is required in today's business environment. There should be a number of agencies providing such coverage in your geographic area and for the type of organization you are working with.


There can be significant differences in costs for similar coverage packages. The Executive Director or a board member should investigate what's available before making a hasty decision as to which agency and company you choose to work with.


Steven Kravitz, DPM, Winston-Salem, NC



From: Joseph S. Borreggine, DPM


I recommend that PM News readers pay attention to this recent U.S. Supreme Court decision in 2015 which makes it easier to sue State Licening Boards regarding anti-trust. If they are on a licensing board, then they should be fully abreast of the legal liabilities that they may face as a board member and heed Dr. Evans' advice and possibly consider resignation from their board if they feel uncomfortable with a possible exposure of anti-trust.


I am not an attorney, so I would consult with one before moving forward in a rash manner. Obtain all the facts before making a decision to resign. I understand that there is Board of Directors Insurance, and usually it can be a part of a State Affiliate Association if you are a board member of that association. As to whether you have that same coverage as a member of the State Licensing Board is another story. Click here to read an anti-trust blog on this topic,


Joseph S. Borreggine, DPM, Charleston, IL



From: Paul Eisenberg, DPM


Congratulations to Dr. Beach Davis on her award. 


I would like to see the study that supports her contention that podiatry was dominated by Jewish men. This remark was inappropriate and reeks of anti-Semitism. This was inflammatory. I await the study reference to which Dr. Beach Davis alludes. If there is no study, an apology is in order from the doctor. 


Paul Eisenberg, DPM, Mentor, OH



From: Erika Schwartz, DPM


Congratulations to Dr. Denise Beach Davis on the Women in Business Trailblazer Award she has received. I agree with her that podiatry has been "male dominated" for many years and can certainly understand her feeling of having to "prove herself" as a woman in this profession. What I do not understand is her calling our profession "Jewish male dominant". I would be surprised if there were any data to substantiate such a claim.  


It reminds me of when I was an extern looking at residency programs and was cautioned by people that the one I desired only "took Jewish men from PCPM". When I began at that program the next year, I found myself to be the only Jewish resident, and the only resident who had attended PCPM/Temple. But there had been two Jewish men who had graduated from the program within the previous five years. It appeared that some found this to be "dominant", but I would caution that it actually made them anti-Semitic.


Erika Schwartz, DPM, Washington, DC



From Ron Werter, DPM, Paul Kanter, DPM


I'll go one or two steps further. Not only should they be excluded from health coverage, but they should also be excluded from receiving any type of disability payments. That also goes for their spouses or family caregivers who have to give up their own jobs to care for the traumatic brain injury patient. No one wants to take away their choice, but let it be their sole responsibility, not their family's or mine.


Ron Werter, DPM, NY, NY


During my years at NYCPM, I always wore a helmet driving my Honda Twinstar to school and would have done so even if it was not a law. However, I disagree about not providing helmetless bikers necessary healthcare just as I would not deny a type 2 diabetic patient or a clinically obese patient with heart disease proper healthcare because they chose a not so healthy lifestyle.


Paul Kanter, DPM, Palmerton, PA



From:  Robert Hilkemann, DPM


Thank you for including the story about the motorcycle helmet bill. I did lead the filibuster to make it mandatory for riders of motorcycles in Nebraska to wear an approved helmet. We kept the helmets in place by ONE vote. One senator who supported repeal was not present at the time of the vote and asked for a reconsideration of the vote. The speaker did not let that happen - effectively keeping the helmets in place for at least one more year.


Robert Hilkemann, DPM, Omaha, NE



From: Justin Sussner, DPM


It is horrible indeed that a repeal of the helmet law is considered. Maybe if those who chose to not wear a helmet also gave up their right to healthcare related to their un-helmeted injuries. Nobody wants to be accountable for their own actions anymore.


Justin Sussner, DPM, Monroe, NY



From: George Jacobson, DPM


It's the dumbest repeal in the world! Florida repealed it several years ago. Not smart. We are dumb. My daughter witnessed a motorcycle accident this past week on I-95. It wasn't a pretty sight. She can't get the images of the motorcycle driver without a helmet out of her mind.


George Jacobson, DPM, Hollywood, FL 



From: Charles D. Clayton, DPM


I agree with Senator Hilkemann. I've had personal experience with the benefits of wearing a motorcycle helmet. In October 2015, I had a motorcycle accident.  Even though I was wearing a helmet, I suffered a traumatic brain injury. Though I don't remember the accident or the next week and a half, I suffered no significant permanent damage. I returned to my normal activities including finishing my sport pilot flying lessons and getting my license. Had I not been wearing a helmet, there is no question that I would not be writing this.


Charles D. Clayton, DPM, Mastic, NY



From: Joel Lang, DPM 


I have only admiration for and congratulations to Dr. Kor, for not only surviving and persevering, but overcoming and thriving. It only validates my philosophy to be kind to “everyone” you meet, because you have no idea what road they have travelled, what challenges they have overcome, or what burdens they still carry. Please share this message.


Joel Lang, DPM (retired) Cheverly, MD



From: Janet McCormick, MS


Dr. Splichal's comments on formaldehyde in polish are true - sort of. The full story is is that only foreign-manufactured polishes, as in a few made-in-wherever ones, purchased by Internet-based companies have "formaldehyde" - as in formaldehyde resin, which is different than formaldehyde - in them now, and that no American-made brand has it. The reputable lines are manufactured here in the U.S. as 3-free or even 5-free, meaning so-called toxic chemicals are no longer in their formulations, and have not been for years. I won't go into the names of the chemicals removed (available all over the Internet) but I will tell you that the U.S. manufacturers have worked very diligently to remove these chemicals while still producing quality products. 


The tests that "proved" these chemicals toxic in polish are rediculously false. They feed the lab rats tablespoons of 100 percent concentrations of the tested ingredient per day, which measures nothing as polish has thousands of times less in applications, even over years of polish changes. The naive legislature falls for it and demands change, so the manufacturers do it becauase it was too much trouble/costly to fight these types of claims by those who make millions on sensationalizing false claims. Consumers fall for it and it is not profitable to fight stupid, for certain! And it has proven to be good business for them to make the changes, of course. If they are 3-free or 5-free, they sell well, simple as that. 


Janet McCormick, MS, Fort Myers FL



From: Andrew Levy, DPM


Congratulations to Dr. Rubin and the entire governing body of the ACFAS. We could not possibly be under a better or more dynamic leadership. I am excited for the future of ACFAS!


Andrew Levy, DPM, Jupiter, FL



From: Robert S. Steinberg, DPM


I tried to find a report linking failed instrument sterilization to a post-op infection, but could not. I found reports on instruments not being properly cleaned to reduce "bio-load", but not that they caused a post-op infection after sterilization.


Someone stands to make  a lot of money, if enough people are frightened into believing that all instruments need to be disposable.


Robert S. Steinberg, DPM, Schaumburg, IL



From: Steven J Berlin, DPM


I want to congratulate our Congressman, Brad Wenstrup of Ohio, for his most recent appointment as the Subcommittee Chairman of the Veterans Hospitals. I am sure he will make a difference in the healthcare delivery for our military veterans.  


Steven J Berlin, DPM, Baltimore, MD



From: Daniel Chaskin, DPM


I agree that it is unfortunate that such a ruling puts board members at risk and I fully agree that they should be immune. They volunteer their time to help others and they try their best. Every podiatrist should be hired as a state employee whenever they sit on a podiatry or medical board. The employer will be responsible to indemnify and pay for all actions of the employee within the scope of their employment as a board member. Every board member will be required to fill out a job application. Every decision involving a loss or denial of license should be forwarded to the state attorney general for an advisory opinion as to if any federal civil rights or antitrust laws has been complied with. 


Daniel Chaskin, DPM, Ridgewood, NY



From Robert Scott Steinberg, DPM


While anecdotal, it is rare that I see a patient with plantar fasciitis who wears a stability or motion control shoe, either all day or for exercise. When I do, more often than not, they slip their shoes on and off without untying them. What I do see are athletic patients wearing low drop flexible/hyperflexible shoes presenting with plantar fasciitis. When they purchase a stability or motion control shoe with 10-12 mm drops, they begin their recovery from plantar fasciitis. 


Robert S. Steinberg, DPM, Schaumburg, IL



From: Bret Ribotsky, DPM


To Dr. Peacock's point that we are genetically made to be barefooted, I’d remind him that before the advent of shoes, humans rarely lived past 40 years of age. There are clues from real life that can add to this discussion. Recall that when you watch the Olympics, you notice that each athlete 's body type seems to look like others within the sport they are competing in. Each of us (maybe via genetic code) are pre-determined to be good at some things and not good at others. 


Case in point: LeBron James is possibly the best basketball player ever, but would be a complete failure as a jockey. When a 250 pound person comes into your office and says that his feet hurt when jogging, I tell him to get in the pool, as his body has selected him for something else to excel at.  


Bret Ribotsky, DPM, Boca Raton, FL



From: Don Peacock, DPM, MS


I would like to weigh in on the comments by both Dr. Shavelson and Dr. Kirby. Both of these men are biomechanics experts and I am not. I am a person that has exercised for years and have done my fair share of running. After numerous and continuous exercise injuries, I became smarter about how to work out. I did this by following many of the recommendations fostered in the paleo community. One of their recommendations is barefoot walking, and I have followed this protocol for 6 years and am injury free. 


The human body is not made for running on the surfaces that most people run on, and it is not genetically made for running in shoes for repetitive bouts of daily pounding, regardless of shoe or surface. The human body is made for walking long distances and for...


Editor's note: Dr. Peacock's extended-length letter can be read here.



From: Dieter J Fellner, DPM


I agree with Dr. Kirby's analysis and opinion of the Hoka One One. Comparing the Hoka with the Sketcher's Rocker Shoe is comparing apples with oranges. I am quite confident the people who used Dr. Shavelson's information to sue Sketchers got great advice and good value.


The customers who try Hoka One One leave mostly positive reviews. A few comments on the shoe: the men's shoe tends to be undersized and quite a few runners complain that the shoe perhaps wears out more quickly than other brands. Some do not like the garish color designs. That aside, there are a lot of positive health comments about comfort, and less foot and knee pain too.


Dieter J Fellner, DPM, NY, NY 



From: Elliot Udell, DPM


Dr. Kirby reports that he sees a rise in certain foot injuries as a result of patients jogging with minimalist shoes. In this past issue of the patient flyer put out by the Massachusetts General Hospital, there was an article stating that barefoot running is a treatment for memory loss. If enough people read this article, it would appear that we might be seeing a lot of people who suffer with early dementia presenting with metatarsal fractures.


Elliot Udell, DPM, HIcksville, NY



From:  Kevin A. Kirby, DPM


To clarify, the article in Scientific American in which I was recently quoted on barefoot running, that one in three of my runner-patients now wears Hoka One One shoes. These patients are not injured because of their Hokas, but rather have switched to Hokas in order to try to find a more comfortable running shoe. However, a few years ago, I did see many injuries in runners trying to train in Vibram FiveFinger shoes. Vibram FiveFinger shoes seem to have lost their popularity since they settled out of court for $3.75 million for making repeated unsupported health claims for their five-toed shoes.


Regarding Dr. Shavelson’s comments about “Sketchers Rocker Shoes”, as anyone who has run or walked in Hoka shoes knows, the Hoka One One shoe line is not the “Sketchers Rocker Shoe.” Dr. Shavelson’s comment, “Rockers and flexible soled shoes designed to shock absorb and create cushioning using thick and flexible materials when married to the flexible foot types of many runners, will result in injuries to some of those feet” is not supported by any medical literature, to my knowledge, and has not, at all, been my clinical experience with Hokas. 


All podiatrists who are interested in treating runner-patients should try on a pair of Hoka shoes to see and feel for themselves how these shoes are very unique in construction and “feel” when compared to other running shoes. I have no financial ties to Hoka One One.


Kevin A. Kirby, DPM, Sacramento, CA



From: Craig Payne


Actually minimalist running is dead. The most recent sales figures have reported that minimalist running shoes sales have fallen to only 0.3% of the running shoe market. If that is not dead, I do not know what is. Runners have voted with their feet.


Craig Payne, Melbourne, Australia 



From: Richard Mann, DPM


What a wonderful story. Although I do not know Dr. Becker personally, I wish to express to her and her family how very happy I am for the miracle of the birth of their beautiful son, Jacob. I would also like to wish her a speedy and complete recovery.


Richard Mann, DPM, Boca Raton, FL
Laser Nail Therapy