Author: Staff

APOS Therapy

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APOS therapy is a type of footwear that is adjustable to change joint moments that are claimed to be helpful for problems like knee osteoarthritis. The extent of teh claims are not back up by the evidence.

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The APOS (AposTherapy) system is a non-surgical, non-pharmacological treatment designed specifically for patients with knee osteoarthritis (OA). It is based on biomechanical principles and focuses on altering the way forces are distributed across the knee joint during movement. The system involves a pair of individually calibrated shoes with convex pods attached to the sole. These pods can be adjusted to shift the center of pressure during walking, thereby reducing stress on painful areas of the knee and improving overall function. This approach addresses not just pain, but also the abnormal movement patterns often seen in OA patients.

One of the key advantages of the APOS system is that it provides both symptom relief and functional rehabilitation simultaneously. By redistributing load away from damaged joint surfaces, patients often experience reduced pain within a short period. At the same time, the therapy encourages proper neuromuscular training, which helps retrain muscles and joints to move more efficiently. Over time, this can enhance stability, coordination, and gait mechanics, potentially slowing the progression of osteoarthritis and improving quality of life.

Clinical research has demonstrated positive outcomes with APOS therapy. Studies suggest that patients using the system report improvements in pain, stiffness, and physical function, as measured by standardized OA assessment tools such as WOMAC (Western Ontario and McMaster Universities Arthritis Index). Additionally, some trials indicate that APOS therapy can reduce the need for analgesic medications, delay surgical interventions, and contribute to better long-term mobility. The non-invasive nature of the treatment makes it an attractive option for patients seeking alternatives to knee replacement surgery.

Despite its benefits, APOS therapy is not universally accessible and may not be suitable for every patient. The system requires specialist calibration and follow-up to ensure effectiveness, and its availability is limited to certain regions and clinical centers. Moreover, while evidence is promising, larger-scale and long-term studies are still needed to fully establish its role in standard OA management guidelines. Nonetheless, for individuals with knee osteoarthritis who want to avoid or postpone surgery, the APOS system represents an innovative and practical biomechanical approach.

Most Useful Resources:
Apos Therapy (PodiaPaedia)
The APOS System (Foot Health Forum)
The APOS System (Podiatry Arena)
AposTherapy Biomechanical Devices (Podiatry Arena)
A is for APOS Therapy (Podiaty ABC)
Apos therapy (Podiatry Arena)

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The Ampla Running Shoe

Posted on by Staff
ampla running shoes

Ampla running shoes are designed with a cantilever under the forefoot, designed to encourage a forefoot strike when running as opposed to a heel strike.

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The Ampla running shoe is a performance-oriented footwear design created with the goal of improving running efficiency and reducing the risk of injury. Unlike traditional running shoes, the Ampla shoe incorporates a unique carbon fiber plate in the midsole that functions like a lever, helping to propel the runner forward with each stride. This design is intended to optimize ground contact and energy return, giving runners a sensation of smoother transitions and increased propulsion. It was marketed as a shoe for serious runners looking to enhance both speed and running economy.

A distinctive feature of the Ampla shoe is its segmented sole design, often divided into a forefoot platform and a responsive midfoot/heel component. This allows for controlled loading of the foot, encouraging proper running mechanics. For example, it promotes midfoot striking, which is believed to reduce impact forces compared to heel striking. The shoe’s structure was built not just for comfort but to actively influence gait patterns, guiding runners into more efficient stride cycles. This was a departure from the passive cushioning philosophy of many conventional running shoes.

In addition to performance benefits, the Ampla shoe sought to address common problems runners face, such as overstriding and poor energy utilization. The carbon fiber plate, working almost like a springboard, reduces wasted energy during push-off while maintaining stability. Athletes who tested the shoe often reported that it felt firm yet responsive, emphasizing efficiency rather than plush cushioning. Its design philosophy was rooted in biomechanics research, making it appealing to runners who valued science-driven innovation in footwear.

Despite its unique engineering, the Ampla running shoe remained relatively niche in the broader market. Its specialized design was not for everyone, as some runners found the firm ride less comfortable for long distances. However, it carved out a reputation as a forward-thinking performance shoe, influencing later innovations in carbon-plated running footwear. In hindsight, the Ampla can be seen as an early precursor to the carbon fiber “super shoes” that dominate today’s racing scene, bridging the gap between traditional running footwear and the new era of high-tech performance shoes.

Most Useful Resources:
Ampla (PodiaPaedia)
New ‘innovative’ running shoe from Ampla (Foot Health Forum)
New ‘innovative’ running shoe from Ampla (Podiatry Arena)
New ‘innovative’ running shoe from Ampla (iPodiatry)

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The Airia Running Shoe

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The Airia one running shoes are a different type of running shoe in that they are zero drop and have a lateral slant (forefoot valgus wedge) under the forefoot. This will have different biomehcanical affects in different runners. The company that makes them claims that you can get a performance advantage using the shoe.

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The Airia One is a pretty unusual running shoe that was designed with a strong biomechanical twist. It was developed by a Swedish company (Airia Running) with the goal of enhancing running efficiency and speed. Their marketing claims were bold: something like “8 out of 10 runners see a performance gain between 1-7% when using them.”

Key design features include:

  • An asymmetric sole geometry, meaning the midsole is thicker under the lateral (outer) forefoot compared to the medial side. There’s a transverse drop (rather than only a longitudinal heel-to-toe drop).
  • A pronounced toe spring (the toe portion curves upward), and a rounded heel. The idea was to promote a more efficient toe-off and reduce ground contact time.
  • Lightweight materials: thin, breathable mesh uppers; Vibram rubber outsole; OrthoLite insoles.

What Users Found Good / Challenging

What people liked:

  • Once runners got used to them (after a few miles), many report a very natural, “rolling” running feel. The toe-off is often praised.
  • For shorter, faster runs (intervals, tempo runs) or for people who already run with a midfoot or forefoot strike, the Airia One could feel quite exciting: light, responsive, and pushing runners to engage different muscles in different ways.

Challenges & criticisms:

  • The design takes a lot of getting used to. Many users felt awkward at first, especially because the sole geometry forces different foot behaviour (e.g. landing and toe-off) than what many are used to.
  • Some discomfort was reported, especially around toes or the balls of the feet. The toe spring can cause pressure or rubbing.
  • Because of the firm ride and unusual sole, long runs could be tough; for many, the shoe was better suited to shorter distance performance work rather than full-marathon pacing.

Where it Stands / Legacy

  • As of now, Airia One is no longer available (production has ceased).
  • Despite that, it has made waves in the running community as a kind of “experimental” or “cult” shoe: one that pushes boundaries in how a running shoe can influence biomechanics rather than just cushioning or support.
  • Its biggest legacy might not be in how many people used them daily, but in how it sparked discussions about sole geometry, foot strike patterns, and what “running efficiency” really means. For runners curious about something outside the norm, the Airia One remains a reference point.

Most Useful Resources:
Airia (PodiaPaedia)
New “Biomechanically Perfect” Shoe (Foot Health Forum)
Airia Running shoes: the new “Biomechanically Perfect” Shoe (Podiatry Arena)
The new ‘biomechanically perfect’ running shoe from Airia? (Running Research Junkie)
Another look at the performance claims by the Airia One running shoe; a theoretical context (Running Research Junkie)
Airia Running Shoes (Podiatry TV)
AIRIA ONE : cette chaussure fait-elle vraiment courir plus vite ? (Runners.fr)

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Foot Problems in Ankylosing Spondylitis

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Ankylosing Spondylitis is primarily a problem of the spine, but the arthritis there can also cause arthritis in the foot and pain in the heel. The involvement of the spine also means the feet are going to be difficult to reach to provide self care for foot problems.

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Ankylosing spondylitis (AS) is a chronic, inflammatory rheumatic disease that primarily affects the spine and sacroiliac joints. It falls under the broader category of spondyloarthropathies, which are conditions characterized by inflammation of the joints and entheses (the areas where tendons and ligaments attach to bone). The hallmark feature of AS is inflammation of the axial skeleton, leading to back pain and stiffness, which often begins in late adolescence or early adulthood. Over time, persistent inflammation can cause the vertebrae to fuse, resulting in reduced flexibility and a rigid spine.

The exact cause of ankylosing spondylitis is not fully understood, but genetic factors play a major role. A strong association exists with the HLA-B27 gene, which is found in the majority of patients, although not everyone with this gene develops the condition. Environmental triggers, such as infections, may also contribute by activating the immune system in genetically predisposed individuals. Men are more commonly affected than women, and symptoms often present gradually rather than suddenly, which can delay diagnosis.

Clinically, the main symptoms include chronic lower back pain, stiffness that improves with exercise but not with rest, and reduced range of motion in the spine. Extra-articular manifestations are also common, such as inflammation in the eyes (uveitis), cardiovascular complications, and, less frequently, lung and gastrointestinal involvement. As the disease progresses, spinal fusion can lead to a characteristic stooped posture, sometimes referred to as a “bamboo spine” on imaging studies.

Treatment for ankylosing spondylitis focuses on controlling inflammation, relieving symptoms, and preserving mobility. Nonsteroidal anti-inflammatory drugs (NSAIDs) are usually the first-line therapy, while more severe or refractory cases may require biologic agents such as tumor necrosis factor (TNF) inhibitors or interleukin-17 (IL-17) inhibitors. Physical therapy and regular exercise are critical in maintaining posture and spinal flexibility. While there is no cure, early diagnosis and appropriate management can significantly improve quality of life and slow the progression of structural damage.

Most Useful Resources:
Ankylosing Spondylitis (PodiaPaedia)
Ankylosing spondylitis (Foot Health Forum)
Heel Pain and Ankylosing Spondilitis ? (Podiatry Experts)
Impaired Gait in Ankylosing Spondylitis (Podiatry Arena)
Tarsal involvement in ankylosing spondylitis (Podiatry Arena)
Ankylosing spondylitis (Podiatry Arena)

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Adidas Running Shoes

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The Adidas running shoes have been around since the beginning of the running shoes being more widely used. they are innovators and leaders in the market.

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Most Useful Resources:
Adidas (PodiaPaedia)
Adidas Springblade running shoe (Podiatry Arena)
Adidas Running Shoes (Podiatry TV)
Adidas Boost Technology (Running Research Junkie)
Adidas (Foot Health Forum)

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Achilles tendon rupture

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An Achilles tendon rupture is dramatic when it happens, but is surprisingly not often as painful as you might think. The diagnosis is obvious. The tretament can either be in a cast or surgical.

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Most Useful Resources:
Achilles tendon rupture (PodiaPaedia)
Achilles tendon rupture (Podiatry Arena)
Achilles tendon rupture (Podiatry TV)
Achilles tendon rupture advice (Podiatry Experts)
Achilles tendon rupture (Foot Health Forum)
Achilles tendon rupture (Dr the Foot)

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Accessory Navicular

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The accessory navicular is an extra bone on the medial side of the navicular that can cause pain due to pressure on the lump from footwear (especially things like ice skates) and also be a factor in flat or overpronated feet due to changes in the pull of the tendon from the muscle that is the main supporter of the arch of the foot.

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The accessory navicular (AN) is a common anatomical variation of the foot that can cause discomfort and pain in some individuals. It is an extra bone or piece of cartilage located on the inner side of the foot, near the arch.
What is an Accessory Navicular?
The accessory navicular is a congenital condition, meaning it is present at birth. It is estimated that around 10-15% of the general population has an AN, although not all individuals with this condition will experience symptoms. The AN can be classified into three types:
  • Type 1: A small, rounded ossicle (bone) within the posterior tibial tendon.
  • Type 2: A larger, triangular-shaped bone connected to the navicular bone by a synchondrosis (cartilaginous joint).
  • Type 3: A bony prominence that is fused to the navicular bone.
Symptoms of Accessory Navicular
While many individuals with an accessory navicular do not experience symptoms, others may develop pain and discomfort due to various factors, such as:
  • Overuse or repetitive strain: Activities that involve repetitive stress on the foot, such as running or dancing, can cause irritation and inflammation.
  • Poor foot mechanics: Abnormal foot pronation or supination can put additional stress on the AN, leading to pain and discomfort.
  • Trauma: A direct blow to the foot or a sudden injury can cause pain and inflammation in the AN.
Common symptoms of accessory navicular include:
  • Pain or tenderness: On the inner side of the foot, near the arch.
  • Swelling or redness: Around the AN.
  • Limited mobility: Stiffness or limited range of motion in the foot or ankle.
  • Difficulty walking: Pain or discomfort while walking or engaging in activities.
Diagnosis and Treatment
Diagnosis of accessory navicular typically involves a combination of:
  • Physical examination: A healthcare professional will assess the foot and ankle for pain, tenderness, and range of motion.
  • Imaging studies: X-rays, CT scans, or MRI scans may be used to confirm the presence of an AN.
Treatment for accessory navicular depends on the severity of symptoms and may include:
  • Conservative management: Rest, ice, compression, and elevation (RICE) can help alleviate pain and inflammation.
  • Orthotics and shoe modifications: Custom orthotics or shoe inserts can help redistribute pressure and reduce stress on the AN.
  • Physical therapy: Stretching and strengthening exercises can help improve foot mechanics and reduce pain.
  • Surgery: In some cases, surgical removal of the AN or repair of the posterior tibial tendon may be necessary.
Prevention and Management
While it is not possible to prevent an accessory navicular, there are steps that can be taken to reduce the risk of symptoms:
  • Wear supportive shoes: Choose shoes with good arch support and cushioning.
  • Use orthotics: Custom orthotics can help redistribute pressure and reduce stress on the AN.
  • Stretch and strengthen: Regular stretching and strengthening exercises can help improve foot mechanics and reduce pain.

Most Useful Resources:
Accessory Navicular (PodiaPaedia)
Surgery for accessory navicular (Podiatry Arena)
Accessory navicular (Podiatry Arena)
Classification of the Accessory Navicular (Podiatry Ninja)
Accessory Navicular (Foot Health Forum)

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Abebe Bikila – the Barefoot Marathoner

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Abebe Bikila won the 1960 Rome Olympic marathon running barefoot. He is often held up as a poster boy by the barefoot running community. He went on to win the 1964 Toyko Olympic marathon in world record time, this time wearing shoes.

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Abebe Bikila, the legendary Ethiopian marathon runner, etched his name into history when he won the 1960 Rome Olympic marathon running completely barefoot. Competing without shoes was not a symbolic choice at first—he had trained extensively barefoot and found it natural, but it also highlighted his extraordinary resilience and discipline. His victory was especially significant because he became the first Black African athlete to win Olympic gold, inspiring a new generation of African distance runners who would go on to dominate the sport.

What made Bikila’s triumph so remarkable was not only the barefoot feat itself but also the manner of his victory. He ran through the cobblestoned streets of Rome, finishing with a time of 2:15:16, a new world record at the time. His calm, upright stride and steady pace symbolized strength and endurance, and his success challenged Western assumptions about who could excel on the world stage in long-distance athletics. Bikila’s performance brought international attention to Ethiopia and put African runners at the forefront of distance running.

Four years later, at the 1964 Tokyo Olympics, Bikila proved his dominance again—this time wearing shoes—by winning gold once more, despite recovering from an appendectomy just weeks before. This back-to-back Olympic victory cemented his reputation as one of the greatest marathoners of all time. Tragically, a car accident in 1969 left him paralyzed from the waist down, but even then he showed immense courage, competing in disabled sporting events before his untimely death in 1973. Abebe Bikila’s legacy continues to inspire, not just for his barefoot marathon, but for his unbreakable spirit.

Most Useful Resources:
Abebe Bikila (Podiatry FAQ’s)
Abebe Bikila (Running Hero’s)
10 September 1960 (Today in History)
Abebe Bikila as a poster boy (Podiatry Ninja)

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The Abductory Twist During Gait

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An abductory twist is a reasonable common observation during a gait analysis and is caused by a number of different things. It is commonly associated with ‘overpronation‘. It is seen as a sudden abduction or whip of the heel medially (abduction) just as the heel comes off the ground. See this video for what it looks like:

The abductory twist is a subtle motion observed during the gait cycle, specifically in the propulsion phase of walking. It occurs when the heel lifts off the ground, and just before the toes push off, the heel shows a slight medial rotation (inward turn). This twist is often not dramatic—typically visible as a quick, small flick at the heel—but it can be a key indicator of underlying biomechanical inefficiencies or pathology in foot mechanics. It reflects a delay or compensation in the foot’s ability to resupinate (return to a supinated or rigid state) in preparation for toe-off.

From a biomechanical perspective, the abductory twist is closely tied to the function of the subtalar joint and midfoot stability. In a typical gait, the foot pronates (flattens) after heel strike to absorb shock, then transitions into supination as the body moves forward to create a rigid lever for propulsion. When this resupination is delayed or incomplete—due to issues like overpronation, forefoot varus, or tight calf muscles—the rearfoot compensates with a twisting motion to allow toe-off. This can cause excess stress on the plantar fascia, medial knee structures, or even contribute to hip and lower back pain if not addressed.

Clinically, the abductory twist is often associated with conditions like posterior tibial tendon dysfunction, flatfoot deformity, or excessive pronation syndromes. Identifying this motion during gait analysis helps clinicians determine the need for orthotic intervention, strengthening of intrinsic foot muscles, or stretching regimens. In children, a persistent abductory twist may suggest developmental alignment issues. Ultimately, while it might seem like a minor detail, the abductory twist provides valuable insights into kinetic chain dysfunction and should not be overlooked in comprehensive gait assessment.

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Most Useful Resources:
Biomechanics of abductory twist (Foot Health Forum)
The abductory twist (Podiatry Update)
The doc said I have an abductory twist… ? (Podiatry Experts)
My advice if you have an abductory twist (Running Injury Advice)
The Medial Heel Whip (Physio Ninja)
An Abductory Twist (Dr the Foot Without the Dr)
Abductory Twist: Throw the kitchen sink at it (Kitchen Sink)
Understanding the Abductory Twist (AgonyDeFeet)



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The ‘Shill’ Gambit

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The ‘Shill’ Gambit come in an argument or disagreement when one side accuses the other of being a paid shill for the cause. For example, accusing them of secretly working for a running shoe company and promoting their product or a pharmaceutical company. It generally is used when the person doing the accusing is loosing an argument or arguing from a weak position.

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The “Shill Gambit” is a rhetorical fallacy often seen in debates, especially online. It happens when someone dismisses an opponent’s argument by claiming they are secretly motivated by hidden interests — usually financial ones — rather than addressing the argument itself. For example, if someone defends a pharmaceutical product, an opponent might say, “You’re just a shill for Big Pharma,” without providing evidence. This tactic doesn’t engage with the reasoning or evidence presented; instead, it undermines credibility through accusation.

At its core, the gambit is an ad hominem attack — it targets the person, not the argument. By suggesting the speaker is paid off, biased, or part of a hidden agenda, the shill gambit tries to delegitimize discussion without actually proving anything. This can be persuasive in heated discussions, because it plays on distrust of corporations, governments, or institutions. However, it is logically weak: even if a speaker did have financial backing, their points would still need to be judged on evidence and logic.

The danger of the shill gambit is that it shuts down meaningful dialogue. Once someone is branded a “shill,” their contributions are ignored, regardless of merit. It also fosters echo chambers, since accusations of shilling discourage dissenting opinions. While conflicts of interest should always be taken seriously — and transparency matters — simply assuming bad faith without proof is a shortcut to intellectual dishonesty. A healthier approach is to evaluate both the argument itself and any documented conflicts of interest, rather than defaulting to the gambit.

Most Useful Resources:
Shill Gambit (PodiaPaedia)
“All anti-barefoot running research is paid for by the running shoe companies” (Running Research Junkie)

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