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Garmin & HR Training November 30, 2011

Posted by The Barefoot MD in : Health, Running, Thoughts , add a comment

I really enjoy being a part of the Google group hosted by Barefoot Ted.  I contribute to the discussion occasionally, but like to read what the good folks around the world have to say.  It’s focus is on minimalist running, but often the conversation strays into other avenues.  One recent thread of conversation introduced me to a book called The Big Book of Endurance Training and Racing by Dr. Philip Maffetone.  The premise of this book is very similar to another book I was introduced to by the same group called Van Aaken Method.  Both books focus on increased health through endurance training, and the best part is that neither of them condone training in such a way that you’ll feel like you’ve been run into the ground.

Van Aaken Method was published in 1976, but Dr. Van Aaken had published his “pure endurance” method, “first in a 1947 article entitled Running Style and Performance,” and mentions that his method, “was made available to the running world more than 10 years before Arthur Lydiard of New Zeland popularized a similar method.”  (1976)  In any case, Dr. Van Aaken, a sports oriented family physician from Germany, promoted an endurance method of training.  One that focused on “long runs at moderate paces.”  Dr. Van Aaken often said, “My whole teaching in one sentance is, ‘Run slowly, run daily, drink moderately and don’t eat like a pig.'”  He was also quoted as saying that “true health starts with endurance.”  (1976)  His method recommends that you keep your pace at ~130 bpm while running and a good way to measure that is by making sure you can maintain a conversation without interruption.  The book is small at ~130 pages and is written in a time before political correctness . . . it’s very refreshing.  It is a very efficient and succinct book, much like an endurance runner.  Not a lot of extraneous material found within.  I resonated with much of what he wrote.

Enter Dr. Maffetone.  Dr. Maffetone is a chiropractor by training, but was interested in a broader scope of treatment.  He shares in his book that, “it was my disappointment with the philosophy of the chiropractic profession and its narrow range of assessment,” that led him to contact his old boss for his old job back.  He discovered a group of students that were participating in, “weekend professional seminars offered by medical doctors, osteopaths, chiropractors, acupuncturists, and others who taught about natural hands-on healing, diet and nutrition, and exercise.”  (2010)  After getting into the book, I’ve been very impressed with his methods which I find very similar in scope to Dr. Van Aaken’s.  However, Dr. Maffetone seems to have refined his methods and has some details I find make it easier to apply his training methods to any individual.  First of all, you need a heart rate (HR) monitor.  It doesn’t need to be a fancy one, just something that will track your HR while you are exercising.  Second, he utilizes the years of data he has accumulated to come up with a formula to find your specific optimal training HR.  It all boils down to staying at your optimal training HR for the duration of your workout with a warm-up and cool-down on either side.  Once a month, you’ll do what he calls a maximum aerobic function (MAF) test to determine your current level of fitness.  He recommends performing this test every three to four weeks to track the progress of your training.

Honestly, you won’t feel like you’re exercising after you’ve finished your workout, but believe it or not you will get faster.  You don’t only have to run . . . you can do anything that will get you to and keep you at your specific training HR.  It takes time to get your heart and circulatory system in shape, so be patient.  Eventually, you will see that your speed has increased in order to keep the same HR.  It’s pretty amazing how you progress in speed when you haven’t been feeling winded during your workouts.


Aaken, E. v. (1976). Van Aaken method . Mountain View, CA: World Publications.

Maffetone, P. (2010). The Big Book of Endurance Training and Racing. New York: Skyhorse Pub..

Get Moving or Die November 29, 2011

Posted by The Barefoot MD in : Health , add a comment

I know the title is a bit harsh, but how else am I to convey the situation in which we find ourselves?  In any developed nation around the world, you can expect to spend a significant portion of your day sitting.  What have we done to ourselves?  I came across an article published in the European Heart Journal recently that is titled Sedentary time and cardio-metabolic biomarkers in US adults: NHANES 2003-06. It doesn’t take a genius to figure out that if you never exercise and sit around all the time . . . you’re going to have a pretty bad life.  However, in this article, some good data is provided to support the premise that we need to become more active in our lives.



Healy, G. N., Matthews, C. E., Dunstan, D. W., Winkler, E. A., & Owen, N. (2011). Sedentary time and cardio-metabolic biomarkers in US adults: NHANES 2003–06. European Heart Journal32(5), 590-597.

Zion National Park – Barefoot July 25, 2011

Posted by The Barefoot MD in : Health, Hiking, Shoes, Thoughts , add a comment

This past week, I accompanied a varsity scout team on a high adventure campout to Zion National Park.  I’m known by the boys as the barefoot leader.  They’ve been influenced by my barefootedness and have started trying various activities barefoot.  We arrived in Zion on Wednesday of last week and that evening we hiked up Angel’s Landing to Scout Lookout.  I, of course, was barefoot and several of the boys tried it barefoot as well.  Much of the path is cement which wasn’t too bad.  However, there were parts of the path that were a type of asphalt that wasn’t smoothed out very well (worse than chip ‘n seal) . . . it required a lot of concentration and relaxation on my part to make it comfortable.  Overall it was a beautiful hike and the vistas were unparalleled.

The next day would be the ultimate test of my bare feet.  We hiked The Subway.  This is a 9.5 mile hike that begins on some flat sandy terrain through some evergreens, then descends over some sandstone fields, then descends into the bottom of a slot canyon.  There are several sections where you have to swim through pooled water that has been deposited by either runoff or rain then sits at the bottom of these deep narrow canyons seeing the sun only minutes a day.  In essence, the water is frigid!  I was in mild hypothermia through much of this portion of the hike.  One big advantage I had over the shod hikers in the water sections of the hike are that my feet dried quickly and my predisposition for the formation of blisters was virtually eliminated (I didn’t get one blister the entire trip).  Hiking in and out of water with shoes that don’t drain and dry very quickly softens the skin tremendously and blisters are not far behind.

The most picturesque section of the hike is how The Subway got it’s name.  There is a section that has been hollowed out by the water and wind to look like a subway.

Image by John B. Crane

After transitioning through the subway section of the hike, it’s mainly in and out of a river for three miles then a 400 vertical foot ascent over 0.75 miles on dirt and rocks to the end of the hike.  At the bottom of the ascent, I told one of the other leaders that I really surprised myself as I thought I would have put on the VFFs I had packed along as a backup option to barefooting the hike.  After the ascent, there’s a relatively flat 0.1 mile section over dirt to the parking lot.  It’s the only section where human intervention is obvious on the trail.  There are several sections where people have buried branches across the trail to facilitate the construction of “steps.”  Of course, the branches off these sticks were not completely removed and you therefore have “nubs” protruding.  You’re at the end of a long hike that’s fairly strenuous and tiring.  I had been paying attention to every step I’d made throughout the entire hike except for the one over one of the “steps” where I caught the front of the ball of my right foot just behind my big toe . . . ouch!  It was the only injury I incurred during the entire trip.  It only took off the first layer of skin and had to laugh that on the most tame part of the hike . . . I got my only injury.  The kids started calling me “the hobbit,” which I took as a compliment.

Many people in our group as well as others we passed during the hike asked me how I could endure the pain of hiking barefoot.  After thinking about it for a while, I figured out why my feet likely hurt less than the shod population.  When wearing shoes or hiking boots, people typically don’t pay much attention to where their feet are landing or how hard they are hitting.  In contrast, I was acutely aware of every footfall and made sure each footstep was gentle.  Engaging my “feetback loop,” as Barefoot Ken Bob calls it, allowed me to reduce the impact of the hike on my feet.  I felt like Legolas in Lord of the Rings prancing across the top of the terrain with the greatest of ease.

It’s amazing how much the human body can adapt to the environment.  Just another experience that confirms to me going barefoot is the way we were meant to be.

The next hike we took was through The Narrows.  After about a mile on a cement walkway along the Virgin River, you enter the river for the balance of the hike.  Again, the water was very frigid, and I wasn’t excited about having to wade through one section up to my chest as the hypothermic memory from the previous day was still quite vivid in my mind.  I ended up putting on my VFFs for the rest of the hike as the water obscured my view of the bottom enough that I wanted to have a bit of protection.  However, one lesson I learned from donning the VFFs is that bare feet do much better in this situation.  When my VFFs got a bit of sand on them it got somewhat slippery on the rocks.  The previous day in The Subway, I was very sure footed in and out of the water.  I had sand on my feet several times, but it didn’t really affect my grip on the terrain.  I didn’t fall either day, but came much closer to falling in The Narrows than hiking through The Subway.

Overall, it was one of the most incredible barefoot experiences I’ve had in the outdoors, and taught me a lot about my feet.

Transition to Barefoot/Minimalist May 9, 2011

Posted by The Barefoot MD in : Health, Running , 2comments

I’ve been a member of an online discussion group on google hosted by Barefoot Ted for the past several months.  There are many dedicated runners on that forum that have brought up a lot of good points.  Many have no formal degree related to healthcare, but nonetheless have done extensive research and have made themselves proficient, if not masters, in the field.  One of the topics that has caught my attention has been the discussion related to stress fractures of the metatarsal on transitioning to barefoot/minimalist running.  I reviewed bone physiology from my med school days and was reminded of the following:

When enough stress is applied to a bone to create microtrauma or microfractures, (such as what happens during the transition from shod to unshod) the cells around the microfracture die and send signals for the osteoclasts (the bone cleanup cells) to come in and essentially clean out that area.  This process takes about two weeks.  Then, more signals are sent for osteoblasts (the bone manufacturing cells) to come in and lay down a matrix of new bone.  This process takes approximately 3-4 months.  Over the next three years, the matrix that was laid down continues to become mineralized and increases in density and strength to that of the surrounding mature bone.  So, here’s another testament to why we should not make the transition to minimalist/barefoot running too quickly.

I don’t know how ethical a prospective study on people transitioning from heel striking to forefoot landing without proper instruction would be, but I’m sure there are enough people out there transitioning to a forefoot landing stride that didn’t listen to the signals their bodies were trying to send to see if this is something isolated to barefoot/minimalist runners or if it would hold true in “modern” running shoes using a forefoot landing.

Fructose = Poison February 9, 2011

Posted by The Barefoot MD in : Diet, Health, Thoughts , 6comments

Not too long ago I was made aware of a seminar on the deleterious effects of fructose.  Before I tell you about it, I’ll give you a little primer on fructose.  Fructose is contained in what we know as table sugar or sucrose.  Sucrose has two sugar units on it.  The first one is glucose.  Our body uses glucose to create energy.  We store the extra glucose as glycogen in our liver and muscles.  When we need the energy, it is released as glucose.  The other unit in sucrose is fructose.  Fructose is only metabolized in the liver and it doesn’t have the same profile as glucose when it comes to what our body does with it.  Fructose is also contained in high fructose corn syrup (roughly 55% fructose and 45% glucose). In fact, as you’ll see in the following video, fructose has many of the same effects on your body as consuming too much alcohol.

The seminar is titled Sugar, the Bitter Truth, and is by Robert H. Lustig, MD.  Dr. Lustig is at the University of California San Francisco.  The video run time is around 1.5 hours, but is worth every second you spend viewing.

I started watching this seminar about a month ago. Dr. Lustig mentions a book during the course of his presentation called Pure, White and Deadly by John Yudkin. After hearing about 30 minutes of Dr. Lustig’s presentation, I had to find the book which he had referenced and spoken so highly. After jumping through what seemed like 1,000 hoops, I was able to get my hands on the book for a short period of time. I’m currently reading it.  At the very least, this book is highly enlightening . . . at the worst, shocking.

I got back to watching this seminar Sunday night and finally finished it.  When he talks about being able to show that fructose is a poison . . . he nails it with ease.  The biochemistry from medical school came flooding back as he reviewed the pathways by which our body metabolizes glucose, then ethanol (alcohol), and finally fructose.  In essence, the consumption of high quantities of fructose, found frequently in the “Standard American Diet” (SAD), not contained in fruit can lead to metabolic syndrome, which includes nice things like obesity, type II diabetes, and high blood pressure (hypertension).

One of the most poignant comparisons within the presentation was that of the body’s metabolism of ethanol with that of fructose.  After that comparison, he compared the effects of chronic alcohol abuse with chronic ingestion of fructose.  It was mind blowing!  Here are effects of chronic exposure to ethanol and fructose.  (I’ve bolded the similarities ethanol has with fructose.)

Ethanol:  Hematologic disorders, electrolyte abnormalities, hypertension, cardiac dilatation, cardiomyopathy, dyslipidemia, pancreatitis, malnutrition, obesity, hepatic dysfunction, fetal alcohol syndrome, addiction.

Fructose: Hypertension, myocardial infarction, dyslipdemia, pancreatitis, obesity, hepatic dysfunction, fetal insulin resistance, and habituation if not addiction.

He ends the seminar with some recommendations.

  1. Drink only water & milk
  2. Eat your carbs with fiber (fruit is ok)
  3. Wait at least 20 minutes for your second portion (you might actually be full)
  4. Buy your screen time (TV & computer) minute for minute with physical activity

In the end, it really comes down to what kind of quality of life you want to have.  However, when the agencies in our government charged with the protection of our country are aware of something that can do this type of damage and do nothing about it . . . someone has certainly dropped the ball.  Once we have the information, at least we can make our own decisions even though our food supply is fraught with fructose.  So, here I am trying to let as many people know how to be healthy . . . if they choose.  As I always say . . . your health is in your hands!

The Long Winter February 1, 2011

Posted by The Barefoot MD in : Diet, Health, Running, Thoughts , 2comments

It has been a bit of a long Winter . . . and with a high temperature in the next 10 days of 37°F, and a low of -4°F it’s clearly not over.  I got all gussied up to fight the cold with a new beard and some nice base layers, but it hasn’t worked out like I’d envisioned.  It turns out I’m pretty much a wimp when it comes to cold weather, but that should not come as a surprise to anyone who knows me.  Whenever I am asked where our family will settle down . . . I invariably say, “somewhere warm.”  After living in the Caribbean for more than two years, I learned to value warm weather.  I don’t mind the cold . . . for a short time.  I really enjoy being able to wear shorts and a t-shirt every day.  Although, I have made good use of my base layers by keeping warm wherever I go.

To continue increasing my mileage, I’ve been running on the treadmill.  I have a goal to get to 175 miles per week.  Last week I ran 27 miles and am attempting to increase my mileage by 10% per week.  So, if I remain injury free and can keep it consistent, I should reach my goal the week of June 13.  So far, I haven’t had any injuries and have really enjoyed running.  Oh, by the way . . . all of these miles have been/will be barefoot.  After I recovered from my five week respiratory infection (which ended in early January) I began running again.  I took most of December off.  Since I began logging my miles this year, I’ve run 85 miles barefoot on the treadmill.  My longest run to date was eight miles which I’ve done twice.

My diet also changed a bit as I came into the holiday season.  I dumped the conventional wisdom and started eating a diet more heavily concentrated in vegatables, fruits, and meat.  Saturated fats are no longer taboo.  One of the key concepts of my diet is that I only eat when I’m hungry.  An interesting thing about fat is that it triggers the satiety response and keeps us full for longer periods of time.  I end up eating fewer calories and haven’t been really hungry since I began this style of eating.  I cut my consumption of refined grains significantly and have subsequently lost 26 lbs.  I feel fantastic.  I have more energy and the aches and pains I was experiencing prior to consistent running have pretty much vanished.

I’m looking forward to Spring, but feel like I have made this a productive Winter.

Dailymile.com January 31, 2011

Posted by The Barefoot MD in : Gadgets, Health, Life, Running, Thoughts , add a comment

I was recently introduced to www.dailymile.com (you may have noticed the new widget on my sidebar).  It’s a neat website that allows you to keep track of your workouts: running, fitness, cycling, swimming, walking, weights, yoga, cross training, spinning, rowing, commuting, eliptical, core fitness, hiking, crossfit, cross country skiing, or rock climbing.  Whew . . . that was a mouth full.  I’ve only been using it to keep track of my running as that’s pretty much all the exercise I’m doing right now.  I’ve found it very motivating to be a part of a community of like-minded individuals and seeing how many people run is inspiring.  In fact, there is one woman I’ve met on there who is 61 years old.  She’s running around the same pace and mileage I’m running.  Truly inspiring and I certainly have a goal to be doing the same when I reach her age.

Here’s a link to my profile.  Try it out and see how motivating it can be!

My Feet Have Changed August 23, 2010

Posted by The Barefoot MD in : Health, Running, Shoes, Thoughts , 1 comment so far

True to my desire to give barefooting a good try, I have only had three different situations surrounding my feet.  If I’m in a somewhat dressy situation, such as church, I wear my Sanuk Boardrooms.  If I have to enter a public building where shoes are required, but it’s not a dressy situation, my footwear of choice is my Vibram Five Fingers.  Every other situation I go sans shoes or any other type of foot covering.  So, being summer and all, I’ve been shoe-less quite often.

Of course, I’m still running barefoot.  Just this past Wednesday, I ran/walked (mostly ran) 4.5 miles.  This was quite a unique run.  Not only was I barefoot, but it was also dusk when I started.  It’s amazing how the senses in your feet really compensate for diminishing amount of eyesight you have at night.  I hit a few pebbles on the trail, but my body did exactly what it was meant to do.  My body’s reflex made me do a double-step.  The pebbles were no more than split-second annoyances.

As I’ve continued running barefoot and utilizing the muscles and structure of my feet the way they were designed, I noticed something that I had read was going to happen.  My feet have gotten bigger.  I used to have the most narrow feet.  Now . . . They’re beefy.  They’ve really bulked up in the mid/forefoot.  What really made me notice the change was about a week ago I was sitting in church in my Sanuk Boardrooms.  My feet were feeling kind of claustrophobic so I kicked them off.  It was like taking a breath after being underwater for several minutes.  It felt good.  It was that moment I connected: my my shoes didn’t used to fit like that.  It’s been a very gradual thing, but as I’ve read from several sources . . . my feet got bigger.  I haven’t measured my height to see if I’ve gotten taller, but it wouldn’t surprise me if I grow a centimeter or so.  🙂

Here’s to the amazing ability of our bodies to adapt to nearly any situation in which we put them.

Keeping Track July 19, 2010

Posted by The Barefoot MD in : Gadgets, Health, Running , add a comment

A little while ago, I met someone that was really into cycling.  When I say he was really into cycling . . . it’s an understatement.  This guy admitted to me that he had spent close to $20,000 in one year on bikes and cycling equipment.  WOW!  Was I ever glad the tool of my exercise/hobby came with me out of the womb.  However, he did show me one thing that really piqued my interest . . . because I’m a total gadget guy.  He has a Garmin GPS sport watch that has a heart rate monitor, plots your course and uploads it to the internet, shows you your pace, calories burned, climb . . . I think it even does your taxes for you.  I started thinking of how I could justify the $200 price tag.  No matter how I looked at it, I couldn’t figure out how to justify it on my in-between-med-school-and-residency income . . . which is, in round numbers, zero.  Then it hit me!  There’s gotta be an app for that!

Sure enough, here it is: Runmeter

Obviously it has a prerequisite . . . the iPhone, but who wouldn’t love to justify that into their hands?  As I’m learning from this incredible app, it’s super smart and does a ton of things while you’re not even thinking about it.  One of my favorite features, that I haven’t experienced yet, is that it will post your run to Facebook and when people comment on it . . . Runmeter will read their comment to you!  I guess that could either be good or bad . . . depending on your friends. 🙂  The only feature it doesn’t seem to have is the wireless heart rate monitor.  This app is definately worth the $4.99 on iTunes.

“Can’t You Get Parasites by Going Barefoot?” June 29, 2010

Posted by The Barefoot MD in : Health, Running , add a comment

Chances are, if you’ve told anyone about your desire to try running barefoot you’ve heard that question.  So, can you get infected by a parasite by running or walking around barefooted?  I hate to say, but the answer is . . . yes.  The parasite you’re at risk for acquiring when going around barefoot is hookworm.  Pretty gross, huh?  Don’t let this stop you from kicking off your shoes.  Even with this bad news, I’ve got some good news to share.  Although going barefoot is a risk factor for a hookworm infection, it’s not the only risk factor.  Nor is it the most important risk factor.  It is, however, probably the most easily changeable risk factor in hookworm infections.  Hookworm infection is acquired through skin exposure to larvae in soil contaminated with human feces.  Honestly, how many of you can say that this applies to you?  Hookworm infection in the United States is rare and only really played a role in the impoverished South until the 1930’s.

So, can you get infected?  Yes.  Is it likely? Not really.