|Posted on 18 July, 2016 at 4:50|
“The Shoe paradox: We’ve come to believe that shoes, not barefoot, are natural and comfortable, when in fact wearing shoes simply creates the need for wearing shoes. Shoe designers are convinced our feet need to be protected against the ground, and the result is our feet are so sheltered they do become fragile” (Adam Sternbergh, The New Yorker 2008).
It is estimated that shoes (in some form) have been around for approximately 30 000 years. They can be seen in ancient cave paintings, and remnants of footwear have been found on mummies and other burial remains. Without doubt it is assumed that for humans to have survived in the cold glacial periods prehistoric populations must have had some form of insulating protection on their feet.
Today, the environment, as well as cultural norms and fashion trends, still have a large impact on our footwear choices. We no longer spend most of our lives in a natural environment. For many of us our days are spent on concrete, tiles and other hard flooring. We may also run the risk of foot damage from sharp metal, glass or needlestick injuries. Additionally, we have a far more sedentary lifestyle than our ancestors, and have therefore become weaker through our whole body, including our feet.
What’s in a foot?
Each of our feet consist of 33 joints, 26 bones, 20 muscles and many tendons, ligaments, blood vessels and nerve pathways. While most of us pay little attention to our feet as long as they carry us around through our everyday life without a problem, they are actually capable of some amazing things. In other cultures, feet are commonly used for tasks such as holding fishing lines and scaling trees. With practise, feet can be used instead of hands for skills requiring high levels of dexterity: painting, playing musical instruments or completing many activities of daily living (such as brushing teeth, changing nappies, making food)!
So what happens when we wear shoes?
Many of us put on our shoes every day without ever really thinking about an alternative. In the Western world, as babies start to learn to walk (sometimes even before) they are placed into shoes, and barefoot time isn’t routinely encouraged. In Australia due to our climate and our love of the outdoors, we do tend to spend more time in minimalist shoes, but even our favoured Aussie thongs can have some disadvantages compared to simply going barefoot.
Interestingly, research has shown that the walking in shoes actually increases the load through our joints, which over time leads to increased wear and tear (usually noticed in our knees and hips).
Why does something that is supposed to protect our joints from impact actually increase it? This increase in load is assumed to be largely attributed to the changes in gait (the way we walk) that occur when we put shoes on. People tend to take longer strides, have their foot in a more out-toed position and land more firmly on their heel with in-shoe walking. This is because we are less cautious of injury to the soles of our feet (from sharp objects) and often believe that the padding in our shoes will absorb the impact on foot landing. We are no longer carefully scanning the ground ahead for danger and landing lightly in case we need to withdraw our foot again quickly. In addition, when we walk barefoot, the nerve endings in our feet give us accurate feedback on exactly how hard we are landing on the ground. This feedback becomes disrupted when another surface (ie. a shoe) is placed between our feet and the ground.
There is no denying that shoes change the natural shape of our feet. Studies have shown that people who wear shoes the majority of the time from a young age tend to have narrower, less flexible feet and toes. Most shoes also have a raised heel of some degree (even our everyday school, athletic or work shoes) and a stiff sole, compared to the flexibility of our own foot. This changes the way our foot can react and adapt to ground forces and similarly, has been shown to increase loads further up the chain (into our knees, hips and back). On top of this we have a host of conditions that commonly develop because of poorly fitting footwear and the way shoes limit our natural foot movement: blisters, bunions, hammertoes, ingrown toenails and corns to name a few!
As an obvious follow on, strength in our feet decreases with the habitual use of shoes over a long period of time. While it has been shown that problems such as flat feet and plantar fasciitis (largely caused by weakness in the feet) occur worldwide, they are found to be much more prevalent in habitually shod populations.
What happens when we go barefoot?
When we allow ourselves to go barefoot and rediscover our natural stride we tend to have much healthier feet. With the increased sensation and movement the circulation to our feet increases and they become stronger and more flexible. As a result, issues such as plantar fasciitis, foot neuromas and bunions often start to heal. Even an arthritic foot can improve.
Having our feet directly in contact with the ground stimulates the proprioceptive and vestibular systems which improves our overall balance system. We also receive better internal feedback on our posture, which coupled with returning to a smaller stride and losing the anterior pelvic tilt (encouraged by the added heel height in our shoes), makes it easier to stay in natural alignment.
Several studies have also looked at a “grounding” effect that occurs when we are barefoot on a natural surface. When we are in direct contact with the Earth our bodies draw in negatively charged electrons and discharge positively charged ones (free radicals). This can change electrical activity in our bodies and brain. Research shows that it may affect us in a number of ways including: reducing pain and inflammation throughout our whole body; lowering stress; improving sleep and energy levels; shortening recovery time from injuries and relieving muscle tension; normalising biological rhythms and improving blood pressure and flow.
Last, but not least, by stimulating nerves on the bottom of our feet we may also receive many benefits from reflexology points. Similar to grounding, these comprise of a boosted immune system, faster healing processes and reduced stress and tension.
Transitioning to barefoot
The fantastic thing about going barefoot is that it doesn’t have to be an all or nothing decision. In fact, for most of us that have been in shoes for many years, it is recommended to start with only small amounts of barefoot time on relatively gentle surfaces (grass or sand).
It’s important to keep in mind that shoes do have a role in protecting us from direct injury to the soles of our feet, keeping us warmer, and reducing the risk of invading parasites or viruses (such as plantar warts). Furthermore, extra caution should be taken for those that are overweight, overly pronated, have intrinsic instability and are prone to stress fractures or suffer from fat pad atrophy.
So, how do we safely start reaping the benefits of barefoot time?
Just like starting out at the gym or in a new sport etc. I would recommend seeking some professional guidance to help get you started correctly and avoid potential problems down the track. There are specific exercises that can help you regain foot and leg mobility and strength to help with the transition (I will cover some of these in a blog post in a few weeks!).
General guidelines however, are:
• Start slow and gentle – soft surfaces and short time periods. Even simply standing outside barefoot will start to give you some benefits.
• Do your barefoot walking first before your legs become tired (especially as you start to build up onto trickier surfaces). Carry your shoes with you if you are completing a longer walk and put them on when you need to.
• Give your soles a chance to toughen up and your feet and legs the opportunity to strengthen. Slowly progress to longer walks, include uphill and downhill areas, and as many different natural surfaces as possible (smooth pebbles, rocks, leaves and sticks, muddy areas).
• Don’t walk barefoot if you have an open cut or an injury that makes it painful at the time!
Getting out into nature benefits us all emotionally, physically and mentally. Encourage your kids outside to play (and join them!), take walks, find a way to incorporate some movement into your day and reap the benefits of letting our body work as nature intended it!
NOTE: I will be doing a future blog on barefoot running as well. The training to start transitioning to barefoot running should be far more involved process for most people and there are other considerations to be factored in as well. If you would like further information on transitioning to barefoot walking or running please feel free to contact us at Two Bears Physiotherapy and Health Services.