As more and more of us proactively embrace preventive healthcare and intelligently active lifestyles, we are revising the specter of inevitable sharp physical decline as we age. The big business of anti-aging medicine brings us technically sophisticated wonders such as stem cell treatments, hormone replacement, PRP injections, and arcane nutritional therapies. Simpler, less-monetizable, but no less profound strategies often get overlooked. Spending time barefoot is one of those.
Walking barefoot helps to keep our musculoskeletal system well-tuned, helping prevent the movement impairments often associated with aging: greater caution, slower reactions, loss of balance - not to mention nagging pains. I frequently talk with clients about the benefits of walking and exercising barefoot as one part of recovery from plantar fasciitis, foot cramps, shin splints, hip pain, pelvic pain, back pain, and even neck pain. Cultivating resilient, mobile, strong, and perceptive feet is crucial for preventing all of the above and more, in addition to helping us maintain good balance and prevent falls.
These ideas have strong traction with many fitness and rehab professionals. The minimalist footwear market is also leading the charge. Where they don’t seem to have taken hold yet is in the mainstream health and orthopedic realms..
Perhaps even more profound, researchers are finding that direct physical contact with the earth without separation by manufactured floors can aid in the prevention and treatment of chronic inflammatory and autoimmune diseases. This article, though, will focus on the aspects of going barefoot most directly related to movement.
If the simple pleasure of walking barefoot isn't enough to break the cultural and habitual spell of always wearing shoes, science may help.
Like many things, shoes are a good idea that can be easily overdone.
We need their protection and their styles are powerful social identifiers, but their ubiquity often hides the slow damage to our bodies that can accumulate from years of inhibiting the natural function of our feet. They did not evolve to be jammed into limiting toe boxes and desensitized by heavy padding day in and day out.
Imagine duct taping your fingers together, wearing stiff heavy mittens all day every day, then putting your entire body weight on them a few thousand times each day. The nerve endings of your hand would desensitize, the muscles would atrophy, the tissues and joints would become stiff, the bones might deform. Instead of dexterous, sensitive, and strong connections to the environment, our hands would become what feet are for many of us: dull, weak, painful hunks of flesh somewhere out at the ends of our limbs. A nice pedicure is a poor consolation prize.
The foot evolved to support and move our weight with minimal muscular exertion.
The ability to walk and run long distances was one of homo sapiens' evolutionary advantages in an African savannah filled with stronger, faster quadrupeds. Our efficiency of movement is accomplished in part by the mechanical design of the foot and by its communication with the rest of body through the myofascial network and the neuromuscular system.
The tensegrity perspective on anatomy is helpful in explaining both the foot’s intrinsic mechanical efficiency and its role in body-wide elastic energy recoil mechanisms. The 26 bones of the foot are suspended within the tensional framework of fascia, muscles, and tendons.
There are four arches in a healthy foot. They are formed by the shape of the bones in conjunction with the tension of the soft tissues. The movement of the arches and the elasticity of the tendons and fascia - in the foot as well as in the ankle, pelvis, trunk - store a percentage of the incoming energy and then release it on the next step to help move us forward.
This built-in elastic energy storage system works well with our top-heavy bipedal design. Truly efficient walking and running is in part a controlled fall. We use some of the energy of our falling head and torso to help power our next step. Without the benefits of the elastic qualities of our tissues and their arrangement, we would exert far more muscular energy to move. This is why walking that involves lots of stops and starts, as in a museum, is often more tiring than continuous walking.
Keeping the feet and ankles pliable and strong helps to maintain smooth operation of the fascial and functional chains up into the legs, pelvis, and trunk.
Wearing overly supportive shoes over time will allow the muscles in the foot to weaken and atrophy while the joints and connective tissues become stiffer with lack of varied movement. This can distort and overload the elastic recoil system, resulting in damaged fascial tissue as in plantar fasciitis.
Problems in the feet very often lead in time to problems with the knees, hips, and back. The muscles, tendons, and fascia within the foot are linked through longer myofascial chains to the rest of the body. For example, the tendons that help form the transverse arch just in front of the heel have direct lines of pull to our hips on one side and our hamstrings and pelvis on the other. This is one way foot movements affect pelvic and low back positioning and vice versa. In my experience, there are often areas of myofascial tightness where release work in a small area has widespread positive impacts. Common examples include the suboccipital region at the base of the skull, the posterior shoulder, the low back, the hip flexor region, and the plantar surface of the feet.
Additionally, looking at the kinetic chain - they way our body parts move together as a cohesive whole - from the joint-by-joint perspective, when the foot is unstable, the postural control functions in the brain may stiffen the ankle in an effort to provide stability. When the ankle is stiff, the knee may suffer excessive torsional stresses. When the knee is unstable, the hip may stiffen in effort to provide stability. And so on.
Nerve endings in our feet help to coordinate our whole body movements.
The skin on the underside, or plantar surface of the foot contains thousands of nerve endings per square inch. Compared to other parts of the body it has a very high density of skin level small mechanoreceptor nerve endings sensitive to stimuli such as pressure, skin stretch, texture, and vibration. The joints, ligaments, fascia, tendons, and muscles of the foot - and the entire body - contain larger mechanoreceptor nerve endings.
Together, these mechanoreceptors feed a constant stream of proprioceptive information about the position and movements of the body to the spinal cord and the cerebellum in the brain. Below the level of conscious control, these networks make continuous adjustments in muscle tone and action throughout the body to coordinate the relative stability and mobility of every joint and to make micro corrections of our movements in order to execute the higher level, consciously driven macro movements.
In order for the elastic recoil system to function optimally, it needs good information about the ground below.
Before absorbing the incoming impact forces, the tendons and fascia must be stable. According to Dr. Benno Nigg’s Muscle Tuning Theory, they must be pretensioned before the foot strikes the ground. How is this accomplished?
Podiatrist and Movement Specialist Dr. Emily Splichal explains the important functional difference between the small mechanoreceptors on the plantar surface of the feet and the larger mechanoreceptors deeper in the foot and ankle.
The larger mechanoreceptors are part of a feedback network that sends signals to the brain after our foot strikes the ground in order to make micro corrections in our movements. This is what gets trained on unstable surfaces like a wobble board or bosu ball.
The small nerves are part of a neuromuscular feed-forward network. Eighty percent of the small plantar mechanoreceptors are sensitive to vibrations rather than pressure. It is these vibrations that tell us about the qualities of the surfaces we move on - hardness, slipperiness, etc. Based on input from the plantar nerves from our last 3-4 steps, the brain anticipates surface characteristics and pre-tensions our deep stabilizing muscles in just the right way order to protect joints and bones and create the foundation for the larger outer muscles to fluidly contract and move us along.
Wearing overly supportive or restrictive shoes and always walking on uniform surfaces will put a slight dampening on the function of the large mechanoreceptors. Wearing anything on our feet, even socks, will distort the vibrations sensed by the small mechanoreceptors on the undersides of our feet. Obviously, there is not enough signal distortion that we will fall over any time we put our shoes on, but there is enough distortion to increase the risk of joint damage, falls, and possibly stress fractures due to distortions in the muscle tuning system.
I experienced this phenomenon myself recently. An old ankle injury often prevents me from very much impact movement like running or rope skipping. I'm working on rebuilding the motor control and stability of my left foot and ankle to match the right. I found that when I started skipping rope barefoot, I could go much longer without pain than when I wore minimalist shoes.
Plantar proprioceptors also trigger the baby walking reflex, a graphic example that the movement pattern of walking is deeply ingrained in our nervous systems from birth.
Going barefoot helps to keep our internal body map accurate and functioning in real time.
When the proprioception system fails to provide accurate and well-timed information, movement efficiency decreases and distortions increase in the internal map of our bodies. The results can can range from simple clumsiness to severe problems with postural and movement coordination and joint function. When we have better information from our feet, our subconscious brains make better decisions about how to move safely. Foot pain, such as in plantar fasciitis, can be seen as a louder signal to change damaging movement patterns. An inaccurate map of the body within this network is also linked to chronic pain signals that have nothing to do with tissue damage.
Moving barefoot may help activate core and hip muscles.
Dr. Splichal contends that activation of muscles in the foot helps to turn on the deep stabilizing muscles in the core and hip through a second mechanism called muscle co-activation. This happens when the contractions of one muscle have an excitatory effect on other muscles. Muscle co-activation is a conscious strategy in weight training, acrobatics, and other endeavors requiring high strength outputs. Squeezing your legs and glutes when, say, lifting something overhead will have a measurable impact on how much overhead force you can generate.
One plausible pathway for foot-to-core activation is through the muscles of the deep calf, the adductors, the pelvic floor, spinal stabilizers, and the diaphragm. This myofascial continuity is part of the Deep Front Line as described by Tom Meyers. It is one of many lines transferring mechanical pull, and possibly muscle co-activation, across the body.
Even if the foot-to-core reflexive stability response may be severely diminished in many of us, moving barefoot can help bring it back. Additionally, In a rehab environment, we can use selected full body movements to reawaken the reflexive core stability that is innate to our physical development. We can also use conscious movement practices to help bolster the communication between our feet and core. That could be through specific exercises or by deliberately altering our daily movements. For example, when we are functioning well, we shouldn’t have to intensely brace core or consciously activate our feet in order to walk up a flight of stairs. But if that activity is difficult or painful, bracing can lighten the burden a bit and help recondition muscles that may not be used very often.
What if it hurts to walk barefoot?
A number of conditions could contribute to painful walking when barefoot. Cardiovascular issues, diabetes, or deformities could be factors. Many painful foot conditions, though, including neuromas, plantar fasciitis, and bunions are often driven by myofascial restrictions, muscle weakness, compromised movement patterns, and postural issues. These can often be addressed with manual therapy, movement training, and targeted exercise. The first step is to get evaluated by a movement oriented practitioner who considers body wide dynamics as drivers of isolated tissue conditions.
Very often, orthopedic pain is driven by less than optimal muscle co-activation patterns leading to over-use injuries or altered joint mechanics. One common pattern is the gripping of the muscles on the back of the neck in order to get the core to work, leading to neck tension, headaches, etc. Other patterns may be highly individual, such as shifting the jaw to the left to help activate the muscles that rotate the trunk to the left.
Patterns like these are a testament to the resilience and adaptability of the human organism in response to injury, trauma, and all the myriad circumstances and environments we find ourselves in. We all have movement dysfunction to some degree. It is not necessarily a problem until pain or movement difficulties arise.
Shifting those maladaptive patterns is often a good way to improve symptoms. I use functional neurology testing (Neurokinetic Therapy) along with gentle release and activation techniques to decouple dysfunctional co-activation patterns and help the body relearn better movement strategies that are more in line with our natural structure. I can also coach you through simple exercises or tweaks to your current exercises that help your system integrate the new patterns.
Going barefoot for even just a small part of our day can have benefits.
Analyzing these dynamics can get complicated, but the first line strategy for regaining healthy feet is simple: allow the skin, bones, muscles, nerve endings, and fascia to react to the surfaces we walk on and support the weight of the body in movement without the unnatural intervention of footwear.
Improving foot function can mean different things to different people. If your feet rarely see the light of day, sitting in a chair and rolling your bare feet on a massage roller or a dryer ball can begin to wake up the bottoms of your feet. The next step could be as simple as padding around a carpeted floor or walking in the sand at a beach. The more activities and surfaces involved, the better. If you normally wear shoes or slippers in the house, see what it feels like without them. Look for opportunities to feel the grass, the pine needles, or the sidewalk. Take note of your reactions: physical, energetic, emotional. How does shoe-wearing factor into assumptions about yourself or the world around you?
If going barefoot at home is old hat for you, you can take your foot fitness to the next level. While different feet have different needs, most of us can benefit from improving the mobility, stability, and eccentric strength of the foot and lower leg along with conscious foot to core activation. Dr. Splichal has many good videos for simple exercises you can do at home. I suggest starting with plantar myofascial release, posterior tibialis activation, and the short foot exercise.
If group exercise is your thing, yoga, pilates, barefoot dance, and kettlebell classes are great for cultivating strong, integrated feet.
The bad news for all of us is that the cultural expectation of being shod almost everywhere and our prolific love of good looking shoes can over time compromise our ability to bring ease to our daily routines and maintain the physical confidence to do activities we love. The good news is that this is something we can easily start to balance out in our own lives. Yes, smart footwear choices can make a big difference (that is a topic for another article), but time outside of shoes is a crucial ingredient of foot health. Say hello to your feet and notice their aliveness, strength, responsiveness and sensitivity. Then take them out for a nice walk in their natural habitat. Your entire body will thank you for it!