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02/04/2020    Kevin A. Kirby, DPM

Pose Method Running (George Jacobson, DPM)

The “Pose Method” and “Chi Running” are styles
of running popularized over the past decade
where coaches teach runners to try to land more
on their forefoot, and not on their heels,
during running. These two running “methods”
were created by individuals who have sold
books, produced videos, and have trained
coaches to teach runners on “the proper way to
run”. Neither of these running methods, which
have likely made their creators lots of money,
have been shown to be more “natural”, more
metabolically efficient or less injury-
producing than other running styles.

Pose and Chi Running became popular during the
Barefoot Running Fad of 2009 to 2015, where
many self-proclaimed “running form experts” on
the internet asserted, without supporting
scientific research evidence, that running with
a heel-striking gait was “unnatural”, was
harmful or caused more injuries. These
individuals also claimed that barefoot running
was better than running in shoes, and that
running in five-toed, thin-soled shoes was good
and that running in thick-soled, cushioned
shoes caused more injuries. As of this date,
none of those claims that forefoot striking
running is more natural or beneficial, that
cushioned-sole running shoes cause more injury
or that barefoot running is a better way to run
has been supported by research evidence.

In fact, the opposite is true. In 2013, Ridge
et al showed that runners wearing the five-
toed, thin-soled Vibram FiveFinger shoes
developed significantly more bone marrow edema
than control runners wearing cushioned-sole
shoes (Ridge ST, Johnson AW, Mitchell UH et al:
Foot bone marrow edema after 10-week transition
to minimalist running shoes. Med Sci Sp Exer,
45(7):1363-1368, 2013). Of the 5,918 runners
in eight research studies that were performed
on the footstrike patterns of runners during
actual races from 1983-2014, 90.7% (5,366) of
those runners were rearfoot strikers, with less
than 10% being midfoot strikers and about 1%
being forefoot strikers.

In addition, in a study of 37 rearfoot-striking
(RFS) and forefoot-striking (FFS) runners, RFS
runners were shown to be more metabolically
efficient and burned less carbohydrate than FFS
runners at slow to medium running speeds
(Gruber AH, Umberger BR, Braun B, Hamill J:
Economy and rate of carbohydrate oxidation
during running with rearfoot and forefoot
strike patterns. J Appl Phy, 15;115(2):194-201,
2013). Finally, in research on twenty sub-
elite distance runners, rearfoot strikers were
5.0-9.3% more metabolically efficient than
midfoot strikers at submaximal speeds (Ogueta-
Alday A et al: Rearfoot striking runners are
more economical than midfoot strikers. Med Sci
Sports Exerc. 46(3):580-5, 2014).

The most interesting research specifically
regarding Pose running, was that where the
creator of Pose running, Nicholas Romanov, was
involved in. Romanov and coauthors studied
sixteen sub-elite triathletes that were split
into a “Pose” running group and a control group
that maintained their respective running
techniques over a 12-week period. At the end
of the 12-week training period, the oxygen cost
of running for “Pose” group increased by 7.6%
with the control group showing no increase in
the oxygen cost of running (Dallam GM, Wilber
RL, Jadelis K, Fletcher GJ, Romanov N: Effect
of a global alteration of running technique on
kinematics and economy. J Sports Sciences,
23:757-764, 2005). Basically, this study, where
the creator of Pose running, Romanov, was a
coauthor, concluded that Pose running, where
runners are taught to unnaturally run on their
forefoot, actually was a less efficient way to
run for the athletes being studied.

All this being said, it behooves the podiatrist
to be very skeptical when these new running
fads, including Pose and Chi running, barefoot
running, and Vibram FiveFinger shoes become
suddenly popular in the running community. Many
runners injured themselves adopting these new
running forms, wearing these five-toed shoes or
running without shoes at all. Our patients rely
on us as foot and shoe experts to stay informed
of the most recent running and running shoe
research so we can provide them with good
advice, based on scientific research, and not
from self-promoting “experts” on the Internet,
regarding their running form, running shoes and
running training programs. We owe it to our
patients to keep them safe from all the
misinformation that is propagated via the
Internet, and elsewhere, so that they can
continue to enjoy their running, without pain
and without injury.

Kevin A. Kirby, DPM, Sacramento, CA

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