You may have noticed a recent trend towards minimalist, or ‘barefoot’, style shoes. This footwear style has been around for a long time, but caught some extra steam in 2011 with Christopher McDougall’s book “Born to Run”.[1] The trend has captured a significant amount of the population with a philosophy that the foot is most optimal when in a natural state (i.e., barefoot). Companies such as Vivobarefoot®, Xero Shoes®, Vibrams®, and Lems® have grown in popularity as minimalist shoe style options. Even mainstream shoe brands like Nike have jumped on the bandwagon with their semi-minimalist Nike Free technology. Why are these shoes gaining popularity and are they actually good for you?
Before we go any further, remember that shoe company marketing teams have one goal: Have you buy their product. Shoe company claims regarding the effectiveness of their shoes are often inflated, but it is important to remember that different shoes work well for different people. Let's jump into some of the science surround 'barefoot' shoes.
Parts of the Shoe
Before we talk about whether 'barefoot' shoes are good for you, it is important to understand what makes a shoe 'barefoot' (i.e., minimalist). The Journal of Foot and Ankle Research published research where 42 experts from 11 countries worked to standardize the definition of a minimalist shoe.[2] With this project they developed the Minimalist Index (MI). This index helps rate how minimalist, or 'barefoot', your shoes are on a scale of 0-100% (0% = maximalist; 100% = minimalist). The following shoe characteristics are used when identifying shoe minimalism:
Flexibility
Weight
Stack Height (How “thick” the shoe is; distance between your heel and the bottom of the shoe)
Stability and Motion Control Technologies (e.g., arch support)
Heel to Toe Drop
Click the following links to find out how “Minimalist” your shoes are
The Effects of Minimalist Shoes
Foot Strength
Minimalist shoes have been shown to decrease stress at the knee while running, but conversely do increase stress at the ankle.[3] When used correctly, barefoot shoes can increase foot muscle strength (i.e., calf and arch).[4,5] This is important because 20-25% of adults in the United States and Canada are diagnosed with flat feet and strengthening foot muscles can sometimes reverse this (this isn't always the case and can be dependent upon the cause of flat feet).[5] Interestingly, the prevalence of flat feet are significantly lower in cultures which do not have traditional shoes (e.g., hunter-gathers).[5] Check out this month's Trifecta for ideas on how to strengthen your feet.
Movement Patterns
Minimalist shoes have been shown to change foot strike patterns (i.e., how you land on your foot) while running. There are 3 foot strike patterns while running (rearfoot, mid-foot, and forefoot), and studies have demonstrated increased propensity to use a forefoot or mid-foot strike pattern while running barefoot, whereas, heel striking is more common with use of traditional shoes.[6] With this in mind, one of the industry leading running organizations (Pose Method®) state that forefoot striking is the most optimal of the striking patterns.[7]
Decompression
A hallmark characteristic of minimalist shoes is that they form to the natural shape of the foot. This means that the shoes are wider and don’t compress the foot together. Shoes with a narrow toe box potentially increase the chances of developing bunions[8,9] or even pinch nerves in the foot (Morton’s Neuroma).[10] Regardless of where your shoes fit on the Minimalist Index, a wide toe box is critical for foot health. This is so important that we even made a quick video about it (see below).
In short, different shoes work for different people (minimalist or maximalist), and understanding how to use the footwear and train in them is most important.
Do Minimalist Shoes Prevent Injuries?
An article from the Journal of Athletic Training assessed multiple studies that analyzed different shoe features and their relationship to running injuries.[11] Interestingly, research on footwear and injuries is inconclusive. Approximately 75-85% of running related injuries occur due to poor training programs and repetitive overloading that exceeds the body’s tissue capacity.[11] With this in mind, HOW you train is probably more important than what shoes you are training with. This research also pointed out that promoting optimal running movement patterns and having shoes that are comfortable may be the most important factors when considering injuries and footwear. In short, different shoes work for different people (minimalist or maximalist), and understanding how to use the footwear and train in them is most important.
Important Note
If you are thinking about transitioning to minimalist style footwear and you currently wear more maximalist shoes, it is important to note that injuries are common in this phase due to the shift in body mechanics and loading from the knee to the ankle. This isn’t due to the shoe per se, it is rather due to rushing the training phase and overloading tissue. Transitioning to minimalist shoes takes time and patience. If you are curious about what an appropriate timeframe would look like for you to transition to a minimalist shoe style, we recommend consulting with a medical provider or specialist before doing so.
References
McDougall C. Born to Run: A Hidden Tribe, Superathletes, and the Greatest Race the World Has Never Seen. 1st ed. Alfred A. Knopf; 2019.
Esculier JF, Dubois B, Dionne CE, Leblond J, Roy JS. A consensus definition and rating scale for minimalist shoes. J Foot Ankle Res. 2015;8(1):42. doi:10.1186/s13047-015-0094-5
Firminger CR, Edwards WB. The influence of minimalist footwear and stride length reduction on lower-extremity running mechanics and cumulative loading. J Sci Med Sport. 2016;19(12):975-979. doi:10.1016/j.jsams.2016.03.003
Fuller JT, Thewlis D, Tsiros MD, Brown NAT, Hamill J, Buckley JD. Longer-term effects of minimalist shoes on running performance, strength and bone density: A 20-week follow-up study. Eur J Sport Sci. 2019;19(3):402-412. doi:10.1080/17461391.2018.1505958
Holowka NB, Wallace IJ, Lieberman DE. Foot strength and stiffness are related to footwear use in a comparison of minimally- vs. conventionally-shod populations. Sci Rep. 2018;8(1):3679. doi:10.1038/s41598-018-21916-7
Larson P. Comparison of foot strike patterns of barefoot and minimally shod runners in a recreational road race. J Sport Health Sci. 2014;3(2):137-142. doi:10.1016/j.jshs.2014.03.003
Pose Method. THEORY + PRACTICE: WHY RUNNERS SHOULD NOT FOCUS ON THEIR FOOTSTRIKE. https://articles.posemethod.com/tag/forefoot-strike/
Menz HB, Roddy E, Marshall M, et al. Epidemiology of Shoe Wearing Patterns Over Time in Older Women: Associations With Foot Pain and Hallux Valgus. J Gerontol A Biol Sci Med Sci. 2016;71(12):1682-1687. doi:10.1093/gerona/glw004
Branthwaite H, Chockalingam N, Greenhalgh A. The effect of shoe toe box shape and volume on forefoot interdigital and plantar pressures in healthy females. J Foot Ankle Res. 2013;6(1):28. doi:10.1186/1757-1146-6-28
Summers A. Diagnosis and treatment of Morton’s neuroma. Emerg Nurse J RCN Accid Emerg Nurs Assoc. 2010;18(5):16-17. doi:10.7748/en2010.09.18.5.16.c7971
Malisoux L, Theisen D. Can the “Appropriate” Footwear Prevent Injury in Leisure-Time Running? Evidence Versus Beliefs. J Athl Train. 2020;55(12):1215-1223. doi:10.4085/1062-6050-523-19
Healthy Is Wellness, LLC (“Healthy Is Wellness”) is not a health care provider, and does not provide professional medical advice, diagnosis, and/or treatment. THE INFORMATION PROVIDED BY HEALTHY IS WELLNESS IS FOR INFORMATIONAL PURPOSES ONLY.
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