Here I am at work, feeling great in my Vivo Barefoot Shoes.

Al Gauthier of  ‘Living Barefoot’ just posted a frank, detailed audio interview with me about barefoot activity and barefoot running. Al and his partner, Tina Dubois, were a pleasure to speak with and they asked many insightful questions. In particular, they asked what I thought it would take for barefoot running to be accepted by the medical community—my answer may surprise you.

To hear this loose and open discussion about barefoot activity from the perspective of a podiatrist who has spent 20 years treating foot problems and has become a strong proponent of the benefits of barefoot activity, listen to the interview HERE.

I look forward to speaking with Al and Tina again in the future on more narrow aspects of barefoot activity.

Links: Living Barefoot
Living Barefoot Show Featuring Dr. Nirenberg

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Essentially, Sandler’s book is a great follow up to  Born to Run by Christopher McDougall. Sandler takes McDougall’s observations of the Tarahumara Indians amazing ability to run many miles regularly in flimsy sandals (Huraches) and adds the science of barefoot activity and a reasonable training regimen, and much more!

Sandler’s personal journey to barefoot running began with his realization that fewer injuries occur in less expensive running shoes than expensive ones, that there is a higher impact on the body in shoes than out of shoes, and balance is better in thinner, less cushioned shoes, and lastly, children who did not wear shoes were less likely to have fallen arches or other foot deformities. Starting slowly, Sandler describes his successful transition to barefoot running.

Barefoot Running is a comprehensive book, covering everything you could possibly want to know about barefoot running. Among the topics Sandler addresses: Barefoot running verses running in shoes, the philosophy and science of barefoot running, how to run barefoot, stretching exercises, foot care tips for barefoot runners, dealing with weather extremes, nutrition, minimalist shoes and much more. Other topics covered include:

• A brief history of barefoot running
• The latest science behind the benefits of barefoot running, including findings of Dr. Daniel Lieberman’s 2010 British Science Journal Nature study (very important!)
• How to heal and stay injury free
• Building balance, strength, endurance
• Building strong feet, legs, hips, muscles, tendons & joints
• Developing strong pads on the bottoms of your feet
• Training routines including cross training
• How to use shoes as a helpful tool
• Adjusting to different surfaces & terrain
• Children and Barefoot Activity (also very important!)
• Meditation, quieting the mind and connecting with nature

The book itself is well organized, beautifully designed and printed with an easy to read text, high quality paper, and great photographs (though I wish there was an index!).  

Critics of Sandler’s book will say that the scientific fact for barefoot running is thin, and it is, but scientific evidence that expensive, thickly cushioned running shoes are better for you is even thinner. 

Final Thoughts on Barefoot Running

Barefoot Running is not for everyone, nor is it safe for everyone, but if you are interested in learning about the incredible benefits of running bare or how to barefoot run safely, Barefoot Running is a must read!

I give Barefoot Running my highest rating — 5 Toes Up  

Links:

Michael Sandler’s Barefoot Running site

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Is this the Barefoot Walker’s Dress Shoe?

Vivo Barefoot Gives Balances Protection with Barefoot Benefits

More importantly, the Vivo Barefoot shoe provides basic protection for your foot, decent grip against the ground and mild foot support, but still lets your foot “feel” the ground. The best way to transition to minimalist or barefoot running or walking hasn’t been defined, but for those looking to make the leap, Terra Plana’s Vivo Barefoot may be the best way to go.

Vivo Barefoot Shoe's Removable Insole

To help with the transition to barefoot, the shoe is incredibly flexible to let your foot bend and flex naturally, has no added heel to throw your body forward, a thin sole, and the Vivo’s insole is removable. I recommend that those people who are new to barefoot activity wear the Vivo with the insole for a while, and then, as their feet adjust, they remove the insole.  As an aside, I removed the insole within a day or two to improve that great barefoot feeling (though, the insole was very comfortable).  

Vivo Barefoot Shoe's Sturdy Tread

A Minimalist Shoe that Feels GREAT

Speaking of comfort, this shoe has what it takes! It feels great on your feet. And, as a podiatrist, I liked the nice wide toe-box (that area at the front of the shoe). Plus, the roomy shoe let my foot breath (something that most shoes do not!).

Final Thoughts on Vivo Barefoot Shoe

The Vivo is a great shoe for stimulating barefoot activity that you can wear unobtrusively while at work, weddings and shopping. It is also a great intermediate shoe to help you on your journey toward barefoot walking or running. 

I give the Vivo Barefoot my top rating — 5 Toes Up 

Links of Interest:

Barefoot and Grounded Vivo Review

Barefoot Runner Vivo Review

Barefoot Walking Lifestyle Vivo Review

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Is it time to take off your shoes?

Few people would deny that exercise is good for us, and our feet. Now, mounting evidence suggests that exercising the foot’s arch muscles can not only strengthen our feet, but may even increase the height of our foot’s arch.

Our feet are one of the most muscle-rich areas of our body. In fact, there are 18 muscles within the arch of our feet, with additional muscles originating in our leg, inserting into the arches.

It is well known that the more a muscle is worked, the stronger it becomes. Of course, the converse is also true (we have all heard “use it or lose it”).

Now, breakthrough research by Headlee and Fiolkowski shows that when the muscles within the arches of our feet weaken, the arches will actually lower and become flatter.

If the foot’s arch decreases when our foot muscles weaken, it reasons that strengthening the muscles in our foot will raise the arch. Anecdotal evidence from runners who run barefoot shows this to be the case. These barefoot runners relate stronger arches and higher arches. Research by Robbins supports these findings.

Robbins showed radiographic changes in the feet of runners who gave up their shoes and began to run barefoot. In his study, the bones that make up the ball of the foot were shown—radiographically—to move closer toward the rear of the foot. That is, barefoot activity shortened the length of the foot’s arch. Robbins paper did not say the arch increased in these barefoot runners, but when the foot’s arch shortens, it height must rise.

Recently, Mark’s Daily Apple commented on the beneficial effects of exercise on feet, and I second it. Shoes lessen the need for and use of most of our foot’s muscles. As a result, the muscles weaken and the arch will weaken.

It’s time to take off your shoes and start exercising your feet.

I have written previously about foot exercises HERE.

The best foot exercise is barefoot activity — walking, running and playing barefoot! Barefoot activity is the best way to strengthen the muscles of your feet (assuming that you have good health — that is, you are not diabetic or plagued with poor circulation or other ailments). 

Like any exercise, start slow. Let your foot muscles gradually adapt to barefoot activity, and only go barefoot in safe environments – there’s no point having good foot muscles if there is a nail in your foot!

References:

Fiolkowski P, Brunt D, Bishop M, Woo R, Horodyski M. Intrinsic pedal musculature support of the medial longitudinal arch: an electromyography study. J Foot Ankle Surg. 2003 Nov-Dec;42(6):327-33.

Headlee DL, Leonard JL, Hart JM, Ingersoll CD, Hertel J. Fatigue of the plantar intrinsic foot muscles increases navicular drop. J Electromyogr Kinesiol. 2008 Jun;18(3):420-5. Epub 2007 Jan 8.

Robbins SE, Hanna AM. Running-related injury prevention through barefoot adaptations.Med Sci Sports Exerc. 1987 Apr;19(2):148-56.

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The purpose of shoes is to protect feet and provide warmth. Beyond these basics, some shoes are a fashion accessory, while others supposedly help us run faster, walk better, tone our legs, or even alleviate foot ailments.

Comparing the feet of people who did not and currently do not wear shoes with those who wore shoes and currently wear shoes provides insight into the consequences of wearing shoes.

1. Shoes Weaken Bones in Our Feet

According to renowned anthropologist Erik Trinkaus of Washington University, humans began habitually wearing shoes 40,000 years ago. He reached this conclusion by examining the toe bones of people who lived in the range of 10,000 to 100,000 years ago and found that at 40,000 years ago, the bones became less robust. That is, when humans began wearing shoes the bones in our toes (digits 2 to 5) became less thick and strong; or in other words, the toe bones became more delicate and smaller.

Bones adapt to the loads placed under them. In response to increased loads (or forces), bones become stronger and thicker. Conversely, if the loading on a bone decreases, the bone will become weaker and thinner (Wolff’s Law).

Wearing shoes changes how we walk and how weight (or the ground’s loading force) spreads out across the bottom of our feet. Trinkaus describes our toes as being large and robust for most of human history, but suddenly with the wearing of shoes, they became “wimpy.”

Essentially, shoes limit the peak force on our toes by distributing loading across the entire forefoot and shoes eliminate the traction role of our toes. The result is weaker bones, leaving them at increased risk for fractures or other problems.

Shoes don’t just limit the peak forces on toes, they change the way our feet work. The actually working of our feet is referred to as the foot’s biomechanics and within shoes, our feet function differently. Essentially, shoes alter the foot’s natural motion. 

2. Shoes Limit and Alter the Normal Motion of Our Feet

Changing the way our feet work, can lead to problems. Earlier we discussed how supportive shoes obviate the need for many foot muscles to the point where, during normal walking, they are not used. Muscles that are not used weaken. Weak muscles on the bottom of our feet increase pronation motion (Headlee et al). Up to a point, foot pronation is normal. Too much pronation or over-pronation can cause foot pain, problems, and deformities. 

Sebastian Wolf at the University of Heidelberg compared foot motion of children 8 years old when barefoot and in shoes and found significant differences in biomechanics. Wolf found that shoes impaired the foot’s normal motion and shoes limit the normal widening of the forefoot while walking.

Interestingly, Wolf found that the foot’s need to widen while walking was more limited in the average commercial children’s shoe than in a much thinner, more flexible shoe even though the width of both shoes in the forefoot was identical.

Previously, the culprit for many foot ailments (such as Morton’s Neuroma or hammertoes) has been the tight-fitting shoe. Based on Wolf’s findings, perhaps we need to add to add to “tight-fitting,” the inflexible shoe and the thick-soled shoe.

In October of 2009, foot and shoe data from the prestigious Framingham Study of 3,378 subjects over the years 2002 to 2008 found past shoewear use in women was associated with hindfoot pain. Meaning, even if a woman’s shoe is not causing foot pain now, it could later—even after the woman has long stopped wearing the shoe.

Specifically, the Framingham study states:

“Young women should make careful choice regarding their shoe type in order to potentially avoid hindfoot pain later in life.”

The Framingham study faults the use of high heel shoes and encourages women who persist in wearing these types of shoes to perform stretching exercises to decrease the likelihood of foot pain occurring later.

Beyond altering the normal motion of our feet, wearing shoes can actually change the normal structure and shape of our feet. 

3. Shoes Deform Our Feet

Overwhelming evidence shows that wearing shoes deforms our feet. Foot deformities can potentially cause pain and other problems.

Udaya Rao at the Department of Orthopaedic Surgery, Kasturba Medical College, Karnataka, India compared flatfoot deformity in children (age 4 to 13) who wore shoes with those unshod. He found the incidence of flatfoot was 8.6% in those who wore shoes and 2.8% in those who did not wear shoes.

Further, Rao discovered that flatfoot occurred most often with children who wore closed-toe shoes and less often when children wore sandals, slippers, and least in those children who walked barefoot. He concluded that shoe wearing in childhood is detrimental to the development of the foot’s normal arch.

Simon Mays in the Physical Journal of Anthropology published a study on bunions. Bunions are painful protrusions of bone on the inside of our feet and are associated with the big toe drifting toward the other toes. Mays states that the majority of bunions result from wearing shoes; few are hereditary.

Mays says bunion deformities are rare in non-shoe wearing populations until the people start wearing shoes. Then the incidence of bunions rises sharply.

Further, Mays says that incidence of bunions in a population is related to the type of shoes worn. In populations wearing more constrictive Western-style shoes as opposed to loose-fitting footwear, the incidence of bunion deformities increased.

Kristiann D’Aout compared barefoot and shoe-wearing populations and found differences in both foot shape and the peak pressures under the foot. Barefoot peoples have wider feet and exhibit more equally distributed peak pressures. Shoe-wearing peoples had narrower feet and showed higher focal pressures at the heel, big toe and ball of the foot.  These higher peak pressures put the foot at more risk for injuries, such as metarsalgia, capsulitis, fracture or tendonitis.   

Further, Dr. Bernhard Zipfel at the University of the Witwatersrand has dedicated his academic career to the evolution of the human foot. Zipfel’s research paper “Shod versus unshod: The emergence of forefoot pathology in modern humans?” concluded that shoes were a factor in the development of foot pathology. 

Ways to Protect Our Feet from Shoes

Dr. Lynn Staheli, Director of Orthopedics at Children’s Hospital and Medical Center in Seattle asserts that, optimum foot development occurs when barefoot.

Clearly, in general, shoes are not good for the development of our feet. The best shoe merely protects feet from the environment.

When it comes to toddlers and children, the best advice I can give parents is try to have their children go barefoot as much as possible. I cannot emphasize this enough!

Of course, going barefoot is not without risks. Parents must find areas where it is safe to walk without shoes. Further, when possible have your child walk barefoot on uneven terrain to encourage his or her feet to use as many muscles as possible.

During times when children must wear shoes, choose the most flexible, barefoot-like shoe you can find. If my child had to wear a shoe, I would put them in soft shoe or even a sandal or flip-flop before a big, stiff well-padded running shoe.

For the shoe-wearing adult who has healthy feet and no concomitant medical problems (i.e. diabetes or poor circulation), to stop wearing shoes suddenly, would likely cause foot pain and problems.

These adults should start by SLOWLY transitioning to less supportive, more barefoot-like shoes. They should look for shoes with a wide toe-box (wide around the toes) and less stiff, more flexible shoes. Some shoes that help simulate barefoot activity while providing some degree of protection include, Vibram Five Fingers, Nike Free and Terra Plana’s Vivo Barefoot.

In addition, adults transitioning out of stiff, supportive shoes should do foot strengthening and stretching exercises. Years of wearing supportive shoes will have weakened many of the small muscles in the arch, ball and toes of the feet, and these muscles need to get strong again. Gradually, these adults should begin barefoot activity.  

Lastly, persons with foot problems, such as impaired sensation (i.e. diabetics), poor circulation or other problems or deformities should not go barefoot or try barefoot-like shoes without first checking with their podiatrist. 

Where Do Podiatrists Stand on Shoes?

The American Podiatrist Medical Association (APMA) has issued a statement on going barefoot, entitled “Podiatrists Urge Americans to Think Twice Before Going Barefoot.” You can read the APMA’s statement by clicking HERE. 

Final Thoughts on Shoes and Foot Problems

Podiatrists are quick to point out that there are people who have never worn shoes and suffer from foot pain and problems, including flatfeet, bunions, hammertoes and other problems. This is true.

Foot deformities and problems are not always due to wearing shoes, and can occur due to a myriad of reasons: congenital, ligamentous laxity, rheumatoid arthritis, obesity, structural factors within the foot (metatarsal head shape, first ray hypermobility), over-pronation, trauma, diabetes, polio, vascular problems and the list goes on.

When it comes to foot deformities and foot problems, shoes are one possible factor. Shoes may be part of the problem for a particular person or the whole problem.  

Interesting Links:

Take Off Your Shoes and Walk

Parents for Barefoot Children

Naturally and Healthy Barefoot Activities

Why Shoes Make Normal Gait Impossible

Living Barefoot

References:

Dufour AB, Broe KE, Nguyen US, Gagnon DR, Hillstrom HJ, Walker AH, Kivell E, Hannan MT. Foot Pain: Is Current or Past Shoewear a Factor? Arthritis Rheum. 2009 Sep 29;61(10):1352-1358.

Headlee DL, Leonard JL, Hart JM, Ingersoll CD, Hertel J.  Fatigue of the plantar intrinsic foot muscles increases navicular drop. J Electromyogr Kinesiol. 2008 Jun;18(3):420-5. Epub 2007

Mays SA. Paleopathogical study of hallux valgus. Am J Phys Anthropol. 2005 Feb;126(2):139-49.

Rao UB, Joseph B. The influence of footwear on the prevalence of flat foot. A survey of 2300 children. J Bone Joint Surg Br. 1992 Jul;74(4):525-7.

Staheli LT. Shoes for Children: a review. Pediatrics. 1991 Aug;88(2):371-5.

Trinkaus E. Anatomical evidence for the antiquity of human footwear use. Journal of Archaeological Science, Volume 32, Issue 10, October 2005, Pages 1515-1526.

Tinkaus E, Hong S. Anatomical evidence for the antiquity of human footwear: Tianyuan and Sunghir. Journal of Archaeological Science, 35(7):1928-1933.

Wolf S, Simon J, Patikas D, Schuster W, Armbrust P, Döderlein L. Foot motion in children shoes: a comparison of barefoot walking with shod walking in conventional and flexible shoes. Gait Posture. 2008 Jan;27(1):51-9. Epub 2007 Mar 13.

Zipfel, B., Berger, L.R. 2007. Shod versus unshod: The emergence of forefoot pathology in modern humans? The Foot. 17: 205-213

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Barefoot Running is a Conscious Feat!

Okay, I didn’t even know about neuroanthropologists until I Googled barefoot running, but now that I do I am impressed.

Neuroanthropologist Greg Downey recently posted a fascinating article, Lose your shoes: Is barefoot better? It is must reading! (I can’t wait to read more from this brilliant guy!)

Downey touches on many aspects of barefoot running and the evolution of our feet, but one of the primary premises of the piece is: “the ways that our nervous system adapt to different situations, such as having heavily padded feet or being barefoot when we run, illustrates well how even unconscious training is a form of phenotypic, non-genetic, adaptation.”

Is barefoot running really an unconscious activity?

Downey is half-right here—running in padded, expensive running shoes is unconcious. These runners believe their feet are safe and protected and as a result, these runners become less aware of “feeling” the ground as each foot lands. The secret of successful barefoot runners is that their running is done consciously. Barefoot runners are very aware of the ground, “feeling” it with their feet with each footfall, and adjusting to the surface.

New barefoot runners almost immediately change their biomechanics. Is this unconscious or perhaps, a Pavlov-type response to the pain of landing on the ground without padding?

If the almost immediate gait changes that occur in barefoot running are in response to pain, then this new gait is actually a conscious response.

I would love to hear from successful barefoot runners and from those who tried barefoot running and could not “adapt” to it.

Source: Lose your shoes: Is barefoot better?

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