Is Minimalist Right for Your Feet?

by Mitch Hauschildt, MA, ATC, CSCS

The barefoot/minimalist revolution has been going strong for several years now.  Most of us can remember a few years ago when suddenly we were told that shoes were evil and everyone should be wearing some funny looking slipper type foot covers with lots of toes built into them.  Minimalist shoes and barefoot training came into the training and rehab world with great passion and fury and has since settled down into a bit of a niche market and training concept that people tend to love or hate.

For the record, I believe that minimalist shoes are good for most people in the right circumstance and for specific situations.  I have personally been wearing minimalist shoes for 7+ years and I have noticed a large impact on my Multiple Sclerosis symptoms since transitioning to them for my activities of daily living.  So, I not only see the impact on my patients and clients, but I have first hand experience with the concept.  One thing to note is that the look and feel of minimalist shoes has changed significantly in recent years.  Many minimalist shoes look very much like other shoes and most people don’t even notice that they are different until you point them out.

I do treat the foot on a regular basis, but I also know that I have a lot to learn about the foot and don’t consider myself a foot “guru.”  But, this is my current opinion as I see it and always reserve the right to change my opinion.

Why go Minimalist?

There are a lot of advantages of either going barefoot or wearing a minimalist shoe.  Here are a few of them:

• Neurological Stimulation:  We have 200,000+ nerve endings on the bottom of our feet.  There is a ton of information that comes through the bottom of our foot, but we unfortunately usually just cover our feet up with soft, thick, spongy shoes.  When you feel every crack, surface change, or rock under your foot, you can change how you feel and move because your nervous system is more sensitive and responsive.  As an anecdotal story, I have a friend who experienced a major fall and went through a lot of surgeries (compound femur fracture) and has experienced residual pain and dysfunction.  He recently transitioned to minimalist shoes and his chronic pain is gone.  For him, the extra neurological stimulus took him over the edge and changed his life for the better.
• Midfoot to Forefoot Gait Pattern:  It isn’t a requirement that you move with a midfoot to forefoot gait to be efficient and injury free, but most people move and feel better when they shift their weight forward.  A rearfoot gait tends to send a lot of force directly up the chain through the skeleton.  It doesn’t take advantage of the stored energy that exists in our soft tissue like a midfoot/forefoot gait does.  When wearing a minimalist shoe, you are forced to shift your weight forward because moving with a heel strike hurts as you heel hits the ground so we avoid it naturally.  Also, by eliminating the heel lift that exists in most shoes, we tend to shift our weight forward to the midfoot.
• Increased Toe Splay:  This doesn’t happen with all minimalist shoes because not all of them have a wide toe box, but most do allow for a larger toe splay than traditional shoes.  This is important for overall foot function and spreading loads over a larger surface area.  Narrow toe boxes contribute to bunions and metatarsal pain.  Wide toe boxes are better for just about everyone.
• Eliminate Heel to Toe Drop:  Most people don’t realize it, but most athletic shoes have a pretty significant heel to toe drop built into them.  That means that the heel is thicker than the forefoot.  Most people walk around all day in high heels without even realizing it.  This may help us get around poor movement patterns from time to time (i.e. squatting), but it has an effect all the way up the kinetic chain.  A heel lift will cause an anterior pelvic tilt because we have to adjust our center of mass so we don’t fall over forward.  In the long run, this will lead to ankle dorsiflexion issues, low back pain, performance problems and a host of other things.  Getting back to a flat, solid surface will eliminate a lot of these problems.

Why Not Minimalist?

Minimalist shoes and barefoot training are not for everyone.  There are things to consider and valid concerns to consider before going down this path.  Among them are:

• Difficult Transition:  It can be very difficult for a lot of people to transition to a minimalist style shoe.  A lot of people will experience foot and lower leg soreness, overuse injuries and even things like stress fractures if they don’t transition properly out of their normal shoes and into a minimalist style approach.  Everyone always wants to point to African runners who train barefoot and are such great distant runners as a reason for us to all go barefoot.  What people forget is that those people have been running barefoot their entire life, so they are used to it.  Very few Americans can make this transition easily on their own.
• Not for all Feet:  No two sets of feet are the same.  Anyone who tells you that everyone should do the same thing is either uneducated or trying to sell you something.  People who don’t know how to create foot structure on their own or have significant rear foot valgus might not be good candidates for this approach.  They probably need the help that a traditional shoe gives them.  If someone is a big time pronator, I’m going to go through quite a bit of training before I consider moving them to a minimalist approach.
• Can be Painful:  The shoes I wear have a 4 mm thick sole.  That’s it.  I literally feel everything through my shoe.  The downside is that when I step on a rock, it hurts sometimes.  And, my metatarsal heads tend to get sore and inflamed after a long day of being on my feet.  The increased pressure and lack of padding can make for some heavier callus patterns and sore feet in general.  If you are going to go minimalist, you have to be educated on this risk and how to manage it.

Should You Go Minimalist?

The big take home here is that a minimalist foot plan is not for everyone.  I believe that most people can tolerate and benefit from some barefoot time on a regular basis, but if someone is a significant pronator with very little ability to control their mid and rear foot in controlled situations, they probably shouldn’t be going minimalist.  They will likely have pain and biomechanical issues that carry up the chain quite a distance.  So, if your (or your patient’s) foot mechanics are really bad, you likely will want to do some foot intrinsic work and motor control training before considering barefoot training.

Once you determine that it is appropriate, make sure you transition slowly.  I don’t care how good your mechanics are, if you have never gone barefoot or worn minimalist shoes for very long, you will struggle at the beginning.  Your lower legs and feet will get tired and sore very quickly.  Start with a just a few minutes per day and slowly add a few minutes at a time.

I don’t recommend that people run in minimalist shoes.  Some people can tolerate it, but most people are asking for trouble by doing so.  They are great for activities of daily living, lifting weights and other general training.  But, going out for a long run is not a great idea in minimalist shoes.

For my athletes, I like to train them in a minimalist style and then compete in regular shoes.  We try to get out of their shoes when they lift if possible.  We also like to get them out of their shoes with recovery runs on the turf.  It gives the foot a good chance to work while protecting the met heads from bruising and soreness.

Recommendation

My current favorite minimalist shoe is the Merrell Vapor Glove.  They have a super thin sole (4 mm), a 0 foot drop and a wide toe box.  The are affordable at $80 on Amazon and fit true to size.  My only knock on them is that they aren’t overly durable.  I have torn holes in several pair.  But, at $80, I can replace a lot of them for the same price as a lot of the other options on the market.