‘Grounding’ or ‘Earthing’ is still bollocks

It is disappointing to feel the need to write about ‘Grounding’ or ‘Earthing’ again. I have done it before here and here. Many others have done the same as it is great fodder for skeptical writers. ‘Grounding’ or ‘Earthing’ is still bollocks and made up pseudoscience nonsense. What is disappointing is those who have the benefit of allegedly developing the critical thinking skills that are supposed to come with getting a degree from a University fail to see through the nonsensical claims and blindly share it with no clue what is wrong with it. We have to do better.

The promoters and sellers of products for ‘Grounding’ or ‘Earthing’ claim that we can connect with the Earths negative surface charge by being barefoot in order to balance your internal circuitry and restore a lost electrical charge to help things like improving blood flow, reducing inflammation, reducing pain, treat cardiovascular disease and allow for better sleep. The claim is that free radicals in our bodies which are lacking an unpaired valence electron, need to get those electrons from the Earth to balance out and restore our health. Spending time indoors and in shoes is claimed to break this link with the Earth and have those negative consequences for our health. Going barefoot on the Earth or sleeping on a mattress that is connected to the earth or grounded (that you can buy from the promoters) is claimed to restore our health.

I did my best originally to learn what I could about it and have the book from from 2010: Earthing: The Most Important Health Discovery Ever! (the second edition is from 2014). The book claims that shoes are the most dangerous invention in the history of humanity. This most important health discovery ever has been there for over ten years now and they still have not been awarded the Nobel Prize for Medicine yet for it. That should be the first red flag.

Any physicist will easily point out that the claims are totally bunk and the mechanism of balancing “electrons” is impossible (it would have to break some of the basic laws of physics if it was possible!). Electrons are electrons – there is nothing special about the electrons that are in the Earth. The experiments demonstrated by the promoters (mostly in YouTube video’s rather than scientific peer reviewed journals) using voltmeters are meaningless and do not actually show what they think they show.

There is nothing wrong with being barefoot and ‘connecting with nature’. We all like that sensation of walking barefoot on soft grass. Just don’t make up bullshit to justify it. Just do it and enjoy it (and watch out for what you are stepping on).

Come on, we have to do better. Stop falling for it.

My Not So Scientific Study on Calcaneal Apophysitis (Sever’s Disease)

I have previously written on all my clinical work, research and teaching experiences with calcaneal apophysitis and just how much I realised I did not know and just how much I learnt when my own child got it. As my daughters have just come out of the age bracket where the condition is common, I used that opportunity over the last few years to chat to as many of their friends and their friend’s parents that I could about their experiences with ‘Severs Disease’ whenever I could (an unrepresentative purposively selected sample with recall bias and no ethics approval, but, hey no worries).

Based on my own recall bias, here is what I found:

  • most of the kids either had it or had a friend that had it
  • almost all of them knew of the special type of growing heel pain that occurs in kids
  • of those that got it, only a bit over half of them actually went to a health professional for treatment or advice
  • a wide variety of treatments were used and advice given
  • some of that advise or treatment, in my opinion, was bad and would have made no difference to the natural history of the condition
  • they all got better at an age before the growth plate would have merged with the rest of the calcaneus
  • a bit under two-thirds of them attributed the getting better to taking it easy (eg during school holidays) and not due to any specific treatment given
  • for many it lasted a while, but the symptoms were always there and manageable, but they got better eventually by doing nothing much
  • of those that got foot orthoses, NONE of them thought they actually made any difference (except one)!

Over recent years, I have started to question if there is actually anything we can do for Calcaneal apophysitis (Sever’s disease). I talked about a particularly painful case here with a massive improvement that all I did was say to them on Thursday, that I will see you Monday. Now I know you are not supposed to give much weight to anecdotes, especially if they fit in with your agenda or world view, but if you combine that anecdote with the experiences I had with my daughters, the unscientific study above and what was being published in peer-reviewed journals, then it is time for some self-reflection on one’s beliefs about the condition.

When we get to this stage, we should be relying on high-quality evidence from proper controlled and unbiased studies. There are not many. This one told us that heel raises do a bit better than foot orthoses, but neither really had a big impact (and that is sorta consistent with my unscientific study above). This study showed that doing nothing and just ‘wait and see’ works pretty well (and that is sorta consistent with my unscientific study above).

The use of foot orthoses to treat this is particularly problematic. The study linked in the previous paragraph showed they did not do too well. My cohort thought they were not particularly useful, yet you still see on a lot of podiatry websites claim that “overpronation” is a factor in calcaneal apophysitis (Sever’s disease) and therefore foot orthoses are needed. We know from the evidence that the claims about “overpronation” and this condition are false which removes the rationale as to why foot orthoses would be used.

Does this mean that we should just leave Calcaneal apophysitis (Sever’s disease) alone and not treat it? Of course not. I do now believe that this condition has its own good natural history and it gets better pretty much on its own regardless of any intervention. Yes, I know they grow out of it when the growth plate merges with the rest of the calcaneus, but I am talking about before that stage. Our role is simply one of education about the nature of the condition, managing expectations and managing loads. Terminology and words matter. Combine that with some ice for pain relief if it gets bad and maybe a cushioned heel raise and we good to go.

Any advocacy for any other treatments or interventions for this are going to have to be accompanied by actual evidence that they are better than a placebo or doing nothing due to the nature of the natural history of this condition. In clinical practice, did it get better because the intervention is better than a placebo or doing nothing or did it get better because it was going to anyway (ie natural history). That is why we need the actual evidence rather than unsubstantiated claims.

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For more, please check all the threads on this on Podiatry Arena and our PodChatLive with Alicia James.