Of Nike Sneakers and Healthcare reform

Several years ago, I wrote a post about things I knew for a fact that were true. That post was about how to walk and step properly. I’m an ultrarunner, and if you run 50 or 100 miles, such things become an issue. So, I felt pretty sure about that.

I later read a book called Deep Survival which cited a study that said that most major airplane accidents happened as a result of faulty safety equipment. This means the bad safety equipment actually causes the crash. This occurs because every time something goes wrong on a plane we build a safety into it to prevent that occurence. That adds complexity. The additional complexity increases chance of failure, and something like moral hazard occurs because of confidence in safety equipment. I.E. Apparently when planes had naked propellers almost nobody walked into them and got shredded because it was such and obvious and apparent danger. Now that jets are shrouded and the danger hidden many more accidents occur from carelessness.

Then I read this book called Born to Run which starts with a simple question from the author: “Why does my foot hurt?” He was trying to get into shape, and started jogging and immediately encountered all kinds of severe foot and knee problems. He saw orthopedic surgeons and podiatrists and they tried all kinds of orthotics, but in the end told him he probably shouldn’t run.

This pissed him off because he new of a group, the Tarahumara Indians. They are all dirt poor. They do not have the benefit of 30 years of sports medicine, modern running shoes, or anything else. The Tarahumara all run 100s of miles in sandals made out of old tires into their 60s 70s and 80s. Foot and knee problems are virtually unknown, as is cancer and diabetes, and obesity, and heart disease, yet they all drink and many smoke. He learned about them because some race property had brought five essentially random Tarahumara from their below sea level desert environment to 6,000 ft altitude Leadville Colorado to compete in one of the most grueling ultramarathons ever. They showed up in Serapes and Sombreros, smoking cigarettes, and all five of them beat every other elite athlete there by a wide margin, wearing their sandals made from old tires. One of them was a man in his 50s. They finished 1,2,3,4, and 5.

If they could do that without any technology or help, why couldn’t the author with all of medical knowledge, 30 years worth of running shoe design, biometrics, diet, etc etc run 3 miles without keeling over in pain.

The short answer, well proven in the book is that the shoes and the Doctors were causing the pain. Take for example, the arch. Any mason knows that an arch gets its strength from the downward pressure on it. If you push up from underneath an arch, you weaken it and it falls apart. Basic physics.

How then can one explain “arch supports?”

The Tarahumara are different. In reality, they are not great runners, they are really superior athletes. We think of athleticism as being able to do one thing really well. we specialize. We have swimmers, runners, weight lifters, etc.

Think of Tarzan. You never know what Tarzan will do. He could run, swim, lift a weight, climb a tree, fight a lion. He could do everything. The Tarahumara are like Tarzan. They can do everything. They run on broken terrain, live in cliffs. They are supremely confident at a wide array of physical skills. We rely on Nike shoes to cushion our feet and coddle them. They are in contact with the ground, so they feel and adjust their stride to avoid injury where we do do not, because our feet do not feel , and our knees and ankles and feet suffer for it.

It’s a good book. The author studies the Tarahumara and then runs a 50 mile race. I recommend the book.


We are not unhealthy because we don’t have health insurance and poor medical care, we are unhealthy because we eat too much shit and too much, period. We don’t exercise or take care of ourselves properly. We place the responsibility for our well-being in the hands of healthcare providers and other entities that cannot supply us with health or wellbeing at any cost. Their attempts to do so, not only often cause more damage than good, they present us with moral hazard in and of themselves.

This is not to say Doctors are bad. The Tarahumara die of broken bones, appendicitis, pneumonia and other issues that a Doctor can help with. They die from these things because they cannot rely on Doctors to help them.

However, because they do not rely on Doctors to help them they do not die of things that are killing us by the millions. We die of diseases of excess and indolence. They do not. Overrall, they are much healthier and live longer lives with greater quality of life than we do.

We could have the best of both worlds.

We do not have a healthcare crisis. It is not lack of insurance or available healthcare that is the problem. It is a misplaced reliance on those things to the exclusion of taking care of ourselves that is at fault.

Can we see the evidence for this extraordinary claim?

And by evidence I don’t mean that some guy said so on some web page. I mean an actual evaluation from a medical team skilled in doing community health surveys.

Because a claims that all of any population of octogenarians run hundreds of miles sets off my bullshit meter.

And claims that any ailment is “virtually unknown” sets off my bullshit meter, especially in population that drinks and smokes routinely.

I’d dearly love to see the medical evaluations that allow you to make these claims. Because at this juncture they seem awfully similar to the standard claims made by snake oil pedlars.

Interesting post. I think you’re onto something, but applying it too strictly. I’m not really worried about type 2 diabetes or boner pills or fixing my knees - because I eat right, exercise, and just generally take care of myself - but I am worried about breaking my arm, getting appendicitis, etc., which I need some kind of medical coverage for.

These guys do the Leadville ultramarathon every year or so (or every year they have it), and they do in fact win it wearing huaraches. That’s pretty well documented.

Why don’t you check the book out of your library? It’s a good book.

Do you have a cite for this?

I doubt that this is true. First, it would seem that some of the Tarahumara are great runners because they run a whole lot. Probably more than most ultra-marathoners, and definitely more than the average person. Maybe they are good because they do it very often. Or as this cite states:

Like African-Americans with basketball, Canadians with hockey, and Dominicans with baseball, when a disproportionate amount of cultural value is placed on being good at something, you often see individuals excel in disproportionate amounts.

While our own lifestyles may be deleterious to our health, I’m not sure we have much to learn from the Tarahumaras. From the same cite

Would you really want to hold up a society, where the average life expectancy is 45, as a model of health? Maybe the reason why they don’t get heart disease, etc. is because they are already dead.

In fact, many of the things you mention are the problems that come with success. We generally don’t have people dying of things that kill people in the developing world. People generally don’t starve to death here. We have a lot of problems, and we could definitely improve our eating habits, but rest assured most of our problems come from our successes.

Are all those infant mortalities in or out of the equation?

Foot arches have ligaments and tendons holding them together, so pushing up does not weaken them.

I don’t see how your argument is that doctors and health care are deleterious to our health, but rather that modern society with its overabundance of plenty and few actual work requirements does the damage.

I had Rheumatic fever twice, appendicitis, and 2 bowl obstructions before I was 14 years old. I was a normal healthy kid who spent his life playing baseball and other sports. You just do not know what will come your way.

Ouch. That must have hurt.

Further shoes without arch supports will make your feet sore. Where as flip-flops, sandals, and going barefoot without arch supports is fine. My guess is arch supports are great for dealing with the stress caused by the rest of the shoe.

So then you support public help for things doctors can help with?

I’m not really the connection to health care reform. I mean, it’s not as if doctors aren’t telling their patients they need to eat better and exercise more already. Too, many of the ailments we suffer in a developed nation are more common specifically because we can cure many of the infectious or physical injuries that are killers in poorer societies. If you can reliably treat sepsis and pneumonia and broken bones, then you’re much more likely to end up dying from cancer or heart disease, or some other ailment that’s the result of not poor living, but simply living too long.

And thats a pre-existing condition!

Slight Tarahumara hijack: Richard Grant’s God’s Middle Finger: Into the Lawless Heart of the Sierra Madre talks about his encounters with tribemembers and their early sucess in the Leadville race.

There was also a fairly recent article in National Geographic about that tribe.

My brother recently pointed out to me that he would’ve been dead twice over before he was 30 if not for modern medicine. He had a platelet disorder when he was a toddler and he had appendicitis when he was 29. My brother-in-law and one of my best friends also had appendicitis. If I’m not mistaken, it’s close to 100% fatal without surgery. Scary thought.

It sounds to me as if the Tarahumara do not live long enough to procreate unless they are remarkably fit and healthy. The application of this healthcare strategy is largely frowned upon in civilized societies.

Is the debate here healthcare reform and Nikes versus running our asses off in sandals, drinking and smoking freely, having 10 kids to raise 4, and dying around 45?

I’m a size 11, thanks.

It’s certainly an interesting debate. I think though that there’s a problem in whether we can have the best of both worlds. I mean, at the moment, I wouldn’t say that we rely on doctors and healthcare systems to the total exclusion of attempting to take care of ourselves more already; we are already as I see it in a situation where both are pushed. If the conclusion of this is that we should push taking care of ourselves more, then that sounds reasonable (although of course there’s the problems of people thinking they can take on too much, and of people getting a poor idea of the healthcare system because of any reliance that they have).

However, so far as I can tell, this does only make sense for those things which could either be taken care of or prevented by non-medical methods or seeing a doctor. If the problems in question are entirely of that sort, then it would be fair to say there is no healthcare problem. If, however, there are problems of that type, then it seems to me there is, if not accounting for the entire situation. I mean, we die of diseases of excess and indolence, but we also die of diseases that can’t be attributed to any misbehaviour on our part. That we have greater access to help for these than the Tarahumara does not necessarily mean we have perfect access, which is what your conclusion would require.