Clapham Manual Therapy and Functional Movement

Why you should consider going barefoot

barefoot-1149848_1920I recently attended the Barefoot Training Specialist course with Dr Emily Splichal.  You may ask why such a course is necessary – if you want to go barefoot surely all you need to do is take your shoes off, or buy a pair of those strange Vibram five finger shoes and then just get on with it.  However, if you have spent most of your life wearing stiff, vibration-damping casts on your feet, AKA ‘normal shoes’, then you need to do some work to get your body ready for going barefoot. Remember that each foot contains 26 bones (a quarter of all the bones in the body) along with 33 joints and over 100 muscles and tendons, so it’s not an inanimate slab, but a highly adaptable, active base that allows us to move across all types of terrain. Feet actually need the sensory input and movement provided by the varying surfaces and slopes of the ground in order to be healthy. Wearing conventional shoes can be analogised to wearing a plaster cast on a limb for several months. At the end of that period, the limb is both muscularly weak, and neurologically deficient from the lack of stimulation.  As this Guardian article shows, learning to strike forefoot and using minimalist shoes reduces injuries. So even if you have no intention of going barefoot, but you want to avoid or get rid a plethora of lower extremity issues such as shin splints or Achilles tendon problems, then read on.

As we walk (or run) our intrinsic foot, lower extremity and core muscles need to maintain a level of contraction to create tension in the muscles and fascia of our legs and core to absorb the impact forces that occur every time a foot hits the ground.  An analogy is thinking about an old fashioned tent.  To keep it up, you need to create tension by tightening the guy ropes, without which it is just a floppy sack on the floor.  In a healthy foot this tensioning mechanism will be initiated when sensory nerves in our feet are stimulated.  These respond mainly to vibration that comes from the ground with every step.  However, after a lifetime of wearing shoes that are designed to minimise these sensations, these nerves are unresponsive so the impact forces are not dampened, but instead are absorbed by our joints, tendons and bones. This has led to an epidemic of plantar fasciitis, Achilles tendinopathy and stress fractures. So, to get ready to walk and run injury-free (even if you are going to wear conventional shoes), you need to wake up the sensory nerves in your feet by walking around barefoot at home as much as possible, preferably on uneven surfaces, and using golf or spiky balls under your feet to roll them out.  Next you need to do some form of exercise, such as the short foot illustrated here, to activate the intrinsic muscles in your feet. Then you can consider walking around in ‘barefoot shoes’ such as Vivobarefoot or Vibrams.  The key elements of these shoes are as follows:

  • Thin flexible soles that will allow the bottoms of your feet to be stimulated, and activating the joints within your foot.
  • Large toe boxes which do not compress the front of your foot. This compression is one of the causes of bunions, and that affects men too, particularly those fond of the pointy Italian dress shoe.
  • A ‘zero drop’, which means that the heel and front of the shoe are at the same height. Most conventional shoes are essentially high heels, and even most trainers will have the heel a couple of centimetres higher than the front.  This changes your posture, pushing your whole body forward, so you compensate and put strain through every joint in your legs, back, and up to your head to stay standing up straight.

The key is to start slowly and go through the sensory awakening and foot exercise protocols before starting to walk barefoot or in minimalist footwear. Running in minimalist shoes is the end result of much preparation and for some people may not be advisable at all.  If you currently wear orthotics or are suffering from foot or ankle pain, you should seek advice and help from a professional, such as Backs Etc. Osteopathy, to achieve your goals.  But in the meantime everyone can take their shoes and socks off, massage those tired feet, and have a go at the short foot exercise.