Introduction to Barefoot Shoes
There is a longstanding debate – primarily in the running community – surrounding barefoot shoes. Is it better to wear shoes that are cushioned and supportive? Thin and light? Or no shoes at all? Humans are obviously not born with shoes. Quite the contrary, most of human history was spent barefoot. Changes in the skeletal record suggest the introduction and proliferation of cushioned shoes from approximately 40,000 to 26,000 years ago. However, the oldest shoe ever discovered dates back only 9,000 years.1 The first shoes were likely born of function, to protect the wearer from injury. Over time, however, shoes evolved into lavish expressions of social status and personal style. A growing contingent has raised the question of whether this evolution has gone too far. Are our cushioned, “supportive” shoes doing more harm than good?
What are Barefoot Shoes?
Barefoot shoe design preserves foot mobility and sensitivity while providing only a thin layer of protection. They are a specific type of minimal shoe, falling on the most extreme end of minimalism in footwear. The defining characteristics of minimal shoes are a wide toe box, zero-drop, and as little cushioning/stack height as possible. Minimal shoes generally provide essentially no external support, and instead optimize for ground feel, flexibility, and low weight.
To clarify, the toe box is simply the front part of the shoe that contains the toes. Stack height represents the amount of material between the wearer’s foot and the ground. Finally, drop defines the differential in stack height between the heel and the forefoot. Zero-drop indicates that stack height is equal across the entire sole of the shoe. Among minimal footwear, barefoot shoes generally have the widest toe boxes, the lowest stack height, and are always zero-drop.
Relevant Biomechanics of a Bare Foot
The human foot evolved to withstand the forces of running, jumping, and lifting. It can tolerate this without external cushioning or support, provided that one has the prerequisite structural integrity, strength, and coordination. All of this is possible through natural changes in the bony alignment of the foot/ankle that occur during movement. These changes alternately allow the foot to soften (to absorb impact) and stiffen (for efficient force transfer).
First, let’s discuss the ability to soften and absorb impact. This softening takes place during the movement phase called pronation, which occurs as the foot contacts the ground during gait and begins to take on the weight of the body. During pronation, the front of the foot and toes spread out while the arch flattens. As a result, the entire foot becomes soft and pliable, spreading force across the whole sole. This softening also enables the foot to mold around objects that might cause injury if the foot remained stiff.
During the next phase of gait, the foot must transfer muscular force into the ground to propel your body forward. Attempting to push off with a soft, pronated foot is like kicking a deflated soccer ball, requiring significantly more effort to create movement. To solve for this issue, the foot moves into supination. During supination, the forefoot and toes compress, the ball of the foot drives down, and the arch lifts upward. This combination of movements makes the foot rigid, providing a solid lever to transfer force into the ground.
Plantarflexion describes the movement of pushing the ball of the foot and toes down away from the body. A typical heel raise exercise strengthens this motion. Plantarflexion occurs when pushing off during walking or running. Plantarflexion is naturally linked with supination during gait. Adequate plantarflexion strength is necessary for healthy, efficient walking and running.
Dorsiflexion describes movement of the ball of the foot and toes up toward the body. This motion occurs while walking or running as the knee moves forward over the toes. Dorsiflexion is naturally linked with pronation during gait. Adequate dorsiflexion mobility is essential for healthy movement. A common compensation for limited dorsiflexion mobility is externally pointed toes with excessive and/or uncontrolled pronation.
Dysfunction and Health
Pronation and supination are both often used incorrectly to describe movement dysfunction. Runners are categorized using these terms as either a “pronator” or a “supinator”. Better terms for these dysfunctional situations are over-pronation, under-pronation, over-supination, and under-supination. Controlled pronation and supination are both healthy and necessary for natural human movement. In a properly functioning foot these movements happen rapidly and unconsciously during gait.
A properly functioning foot/ankle requires a complex movement relationship involving coordinated action of multiple muscles, joints, tendons, and ligaments. At a base level, a healthy foot must have intact ligamentous support. A foot without intact ligaments will develop a condition known as acquired flat foot deformity, making healthy supination impossible. If caught early, prevention of severe flat foot deformity is possible with therapy that restores the normal function of the foot. In the later stages, however, this condition frequently requires rigid orthotic supports and occasionally surgical intervention.
Beyond the passive ligamentous support, there are a number of muscles that must be strong and coordinated. The most important for this discussion are the tibialis posterior, tibialis anterior, gastrocnemius, soleus, peroneus brevis, and peroneus longus. If any of these muscles are not functioning well, it will alter the biomechanics of the entire foot/ankle. Luckily, muscle strength and coordination both improve with proper training.
Proposed Benefits of Barefoot Shoes
Now that you have some background on foot function, let’s discuss why some people believe that barefoot shoes are beneficial. Most of the proposed benefits are related to strength, coordination, mobility, alignment, performance, and injury reduction.
Strength and Barefoot Shoes
One of the primary purported benefits of barefoot shoes is increased strength in the muscles of the foot and ankle. The claim being that without external structure and cushioning, the muscles must work harder to provide support, stability, and shock absorption. Furthermore, traditional shoes provide an artificial spring that is absent in barefoot shoes. Without a layer of bouncy foam, the natural “spring” built into the structure of the foot provides this propulsion instead.
There is conflicting evidence, some studies report that barefoot shoes improve foot strength and some conclude the opposite.5 6 7 8 Despite the conflict in the research, the argument for these shoes increasing foot strength makes good biomechanical and physiological sense. For what it’s worth, this has proven accurate in my personal experience as well as my experience with many clients and friends over the years.
Coordination and Barefoot Shoes
Our feet contain an array of sensory receptors that inform our brain about body position, forces, and the underlying terrain. In fact, the soles of our feet have one of the highest concentrations of nerve endings found anywhere in the human body – as many as 200,000 per foot!9 Traditional padded shoes result in less reliable input as these receptors are unable to “feel” the nuances of the terrain. Less reliable input means lower quality information and possibly impaired coordination and balance.10 11 The thin, flexible soles of barefoot shoes should allow these receptors to collect a larger quantity of reliable information. This input informs the brain about the interface between your body and the terrain. Your brain uses this data to determine the appropriate muscle activation to maintain balance and produce any desired movements.
Mobility and Barefoot Shoes
The argument for the effects of barefoot shoes on mobility is simple. Traditional shoes are stiff and supportive, while minimal shoes are thin and flexible. This flexibility and lack of support allows for more natural foot movement. Furthermore, traditional shoes are taller in the heel than the toes, which positions the foot in slight plantaflexion. In barefoot shoes, the heel is level with the toes, which naturally requires greater dorsiflexion mobility. Lastly, minimal shoes are designed with a wide toe-box. This extra space allows the toes and forefoot to splay out during movement. It is well known that joints and muscles stiffen when their movement is artificially constrained. When immobilized in a brace, joints and muscles become stiff, requiring time and therapy to regain mobility. It makes logical sense that the same would be true of feet that have been constrained in stiff traditional shoes.
If you want to learn more about mobility and how to get more of it, check my other post here.
Alignment and Barefoot Shoes
Similar to the arguments related to mobility, barefoot shoes may promote more natural alignment of the foot than traditional shoes. This is because they are zero-drop, resulting in the same heel and toe alignment present when barefoot. Additionally, traditional shoes have a narrow toe box that pushes the toes together. There is even some evidence that traditional shoes contribute to the development of bunions – a painful misalignment of the big toe.12 Some retrospective studies have shown a correlation between poor foot health and the ubiquity of traditional shoes, with habitually barefoot societies displaying healthier feet.13
An easy test is to compare the shape of your foot to the sole shape of a traditional running shoe. Now, try that with a dress shoe or high heel. The difference in shape between traditional shoes and our feet is immediately apparent.
Performance and Barefoot Shoes
Barefoot shoes are significantly lighter than traditional shoes, which may provide performance benefits. Limited evidence exists supporting lower metabolic demand while running in barefoot shoes, with other studies reporting the opposite.17 18 There are also examples of successful elite athletes competing barefoot or in minimal footwear.19 20 There are, of course, many more examples of successful elite athletes who compete in traditional shoes. The sensationalism surrounding barefoot running performance stems partially from the fact that barefoot runners are in the minority. As such, many people find it surprising that they can compete with runners in padded shoes. Given the limited evidence, it would be unwise to claim that barefoot shoes alone provide a definitive performance benefit. That said, the fact that there are professional athletes winning races while barefoot offers evidence that traditional shoes are not necessary for performance.
Injury Reduction and Barefoot Shoes
This is one of the more controversial topics in the debate surrounding barefoot shoes. Proponents of barefoot running point to studies showing reduced impact forces when running barefoot vs. shod.21 22 23 24 25 Another commonly touted effect of barefoot running is the shift from a rearfoot strike to a mid- or forefoot strike. Some evidence suggests that mid- and forefoot strike patterns reduce the risk of injury. There are also countless anecdotal reports that barefoot running helped solve this or that issue, though formal research is lacking. Others claim that barefoot running increases the risk of certain injuries, with reports that many runners developed pain after transitioning to minimal shoes. Many of these cases are likely related to transitioning too quickly and without proper training.
Summary of the Proposed Benefits of Barefoot Shoes
In summary, there are many proposed benefits of barefoot shoes. Many proponents point to the evolutionary perspective that humans evolved to run long before the development of modern footwear. From a biomechanics perspective, minimal shoes allow the foot to function more naturally in terms of alignment and mobility. Unfortunately, research on the topic is limited and conflicting. Most reviews of the literature conclude that more evidence is needed to make an informed recommendation regarding the safety and utility barefoot shoes.
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Could Barefoot Shoes be Right For You?
Given the limited evidence, deciding whether or not barefoot shoes are right for you can be difficult. It is important to emphasize that the research does not provide a clear answer on the safety or benefits of minimal footwear.26 27 In my personal experience, minimal shoes can be a great option for many people in a variety of situations. That said, I do not think that barefoot shoes are right for everyone. Even if barefoot shoes are right for you, it is essential to transition slowly from traditional shoes into minimal ones. As explained, the demands on mobility and strength differ substantially in barefoot shoes vs. the traditional shoes most people wear.
Barefoot Shoes Might Be Right for You
The most important prerequisite for transitioning to minimal or barefoot shoes is baseline structural integrity of the foot. This means that you have intact ligaments that provide passive support and structure to your foot, including the arch. Without these ligaments, the foot will not be stable enough to tolerate barefoot shoes. A doctor of physical therapy with experience treating the foot/ankle region can perform an evaluation to determine if you have this basic structural integrity.
Beyond this underlying structure, you must fully recognize and appreciate the need for a slow transition. Most of the injuries that occur with the introduction of barefoot shoes are related to overuse from transitioning too quickly. The foot must develop strength and mobility to tolerate the increased demand that comes with the absence of arch support, heel rise, and a stiff sole. This strength and mobility takes time to develop through careful training.
Barefoot Shoes Might NOT Be Right for You
If you do not have the necessary prerequisite foot structure, barefoot shoes will likely never be comfortable for you. They could actually create more pain because without intact ligaments, your foot might physically need external support. In these cases, your physical therapist may recommend more supportive shoes and possibly even rigid orthotics.
Another reason barefoot shoes may not work for you is a lack of commitment to the necessary transition time. If you tend to be impatient, it may be better to save yourself the risk of pain and injury by sticking with traditional shoes.
What Situations are Right for Barefoot Shoes?
Barefoot shoes can work in most situations provided that one carries out the appropriate training ahead of time. That said, many of the surfaces that we walk and run on today are harder and less forgiving than the natural surfaces that our ancestors evolved with. While I know of many people (myself included) who wear exclusively minimal and barefoot shoes, I can see how someone who covers many miles on pavement could benefit from extra padding. Similarly, if you trail run on rocky terrain it may be prudent to seek more protection for the soles of your feet. Luckily, there are more styles available now than ever before, including many different levels of protection to choose from. This makes it easier to transition slowly, while allowing you to find what works for you, your activities, and the surfaces you spend the most time on.
My Personal Experience with Barefoot Shoes
As mentioned above, I wear exclusively minimal shoes – many of which could be classified as barefoot. I bought my first pair of minimal shoes in high school. At the time, I was experiencing some knee pain with running that just refused to go away. After consulting with a physical therapist, I decided to give minimal shoes a try. I had already spent a fair amount of time barefoot, so the transition was not a big shock to my system – though I still took it slow. The knee pain disappeared almost immediately after ditching my traditional running shoes.
In the time since, I have tried many different minimal shoes. Some have worked well for me, others not. I have consistently found minimal and barefoot shoes to be more comfortable than traditional shoes. Traditional shoes now feel clunky, heavy, restrictive, and stiff. This contrasts with the sense of agility and lightness I experience while wearing barefoot shoes.
How I Use Barefoot Shoes
I have worn barefoot shoes for everything from runs around the neighborhood to carrying a heavy pack up Mt. Whitney. While I occasionally bruise the bottom of my foot on a sharp rock, the pros far outweigh this small risk. I see these instances of pain as a reminder to pay attention to the terrain and maintain short strides with controlled foot strikes. Barefoot shoes also come with some small, unexpected benefits. They take up significantly less space than traditional shoes and weigh less, translating into an easier time packing multiple pairs of shoes when traveling. Minimal shoes also do not have cushioning to wear out over time. This means that you can safely keep wearing them until the tread is worn down.
The Biggest Con of Barefoot Shoes: Style
The biggest downside to barefoot shoes for me personally is the styling. Many barefoot shoes on the market have a “duckbill” shape due to the wide toe box and flat sole. I must say that this has gotten significantly better over time, and there are more options available now than ever before. Despite the improvements, you won’t find nearly as many options for barefoot shoes as for traditional ones. Again for me, the pros far outweigh the cons, but it is worth mentioning and will undoubtedly be a deciding factor for many people.
Conclusions About Barefoot Shoes
You now have the information to make an educated decision on whether barefoot shoes are right for you. While the research is limited and offers no clear consensus on the benefits of barefoot shoes, there are a number of strong biomechanical and physiological arguments in their favor. Barefoot shoes are certainly not right for everyone. I recommend them only if you have the desire, prerequisite foot structure, and patience to safely give them a go.
In summary, barefoot shoes have potential to improve foot strength, increase mobility, boost coordination/balance, improve performance, promote natural body alignment, and possibly even reduce the incidence of certain injuries. There is a wealth of anecdotal reports and some scientific evidence supporting these claims, but ultimately the decision is yours. If these arguments sound compelling enough, just make sure you check with your physical therapist first. At Stoke PT, you can get a full foot/ankle assessment with detailed recommendations for transitioning to minimal or barefoot shoes. Beyond the tangible benefits listed above, being more connected to the ground beneath your feet just feels good. Please comment below or reach out if you have any questions and best of luck on your barefoot journey!
If you want to learn more about me, check out my about page here. For more blog entries, go here. And if you want to schedule a free consultation give me a call at 323.609.7073 or fill out the form here.
Health Advice Disclaimer
This article provides examples that are applicable to many, but not all people. They are based on typical presentations seen in my personal clinical practice. These recommendations can in no way take the place of professional evaluation and treatment by a licensed medical practitioner. It is impossible to provide 100% accurate diagnosis or prognosis without a thorough physical examination and likewise the advice given for management or prevention of any injury cannot be deemed fully accurate in the absence of this examination.
This article is not intended to be a thorough review of the available literature or a formal recommendation for or against barefoot/minimal shoes. While some of the information is cited and comes from peer-reviewed research, this article also contains a large proportion of personal professional opinion. If you are currently experiencing any pain or injury, seek professional evaluation before undertaking this or any footwear changes. Ensure that you are medically cleared for before undertaking this or any other major footwear changes. Significant injury risk may occur if you do not seek proper evaluation. No guarantees of specific outcome are expressly made or implied in this article.
- BBC News
- Dorsiflexion and Plantarflexion
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- Elizabeth E. Miller, Katherine K. Whitcome, Daniel E. Lieberman, Heather L. Norton, Rachael E. Dyer, The effect of minimal shoes on arch structure and intrinsic foot muscle strength, Journal of Sport and Health Science, Volume 3, Issue 2, 2014, Pages 74-85, ISSN 2095-2546, https://doi.org/10.1016/j.jshs.2014.03.011.
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- Franz, Jason & Wierzbinski, Corbyn & Kram, Rodger. (2012). Metabolic Cost of Running Barefoot versus Shod: Is Lighter Better?. Medicine and science in sports and exercise. 44. 1519-25. 10.1249/MSS.0b013e3182514a88.
- Fuller, Joel & Bellenger, Clint & Thewlis, Dominic & Tsiros, Margarita & Buckley, Jonathan. (2014). The Effect of Footwear on Running Performance and Running Economy in Distance Runners. Sports Medicine. 45. 10.1007/s40279-014-0283-6.
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- Ruder M, Jamison ST, Tenforde A, Mulloy F, Davis IS. Relationship of Foot Strike Pattern and Landing Impacts during a Marathon. Med Sci Sports Exerc. 2019 Oct;51(10):2073-2079. doi: 10.1249/MSS.0000000000002032. PMID: 31525171.
- Irene S. Davis, Hannah M. Rice, Scott C. Wearing, Why forefoot striking in minimal shoes might positively change the course of running injuries, Journal of Sport and Health Science, Volume 6, Issue 2, 2017, Pages 154-161, ISSN 2095-2546, https://doi.org/10.1016/j.jshs.2017.03.013.
- Perkins KP, Hanney WJ, Rothschild CE. The risks and benefits of running barefoot or in minimalist shoes: a systematic review. Sports Health. 2014 Nov;6(6):475-80. doi: 10.1177/1941738114546846. PMID: 25364479; PMCID: PMC4212355.