Monday, April 21, 2014

From Opinion To Observation: More Evidence That Going Barefoot Is Best For Your Feet

There is a growing body of anecdotal evidence that walking and running barefoot can actually reverse some of the damage done to your feet by footwear. Specifically, several podiatrists and scientists have reported a rise in arch height due to walking and/or running barefoot (or in minimalist shoes). In this post I review the observations that have been made by others and add my own data to the mix.

Back in 2011, Dr. Nirenberg reported on his blog (www.americaspodiatrist.com) that he was seeing foot arches rise in a patient as a result of barefoot running. The 41-year old male had worn conventional shoes prior to making the switch to running barefoot. He also ditched his shoes for most daily activities and adopted a largely barefoot lifestyle. Dr. Nirenberg captured a stunning set of footprints that document the changes to his feet.

More recently, Dr. Nick Campitelli reported a similar finding on his blog. His two-year study demonstrates dramatic changes in the arch height and ankle-foot alignment of a 34-year old woman after she switched to minimalist shoes for running. Going minimalist not only raised her arches and aligned her foot and ankle bones, but it alleviated her knee pain.


In my own study, I’ve been observing a 48-year old male transition from typical shoe use to barefoot living – both for running and walking during his daily routine. At work, this individual switched to using minimalist shoes. Although he stated he had flat feet “all his life”, his feet began to change after adopting a barefoot lifestyle. Below are the footprints I acquired from this individual over a 4 ½ year period beginning with his adoption of a barefoot lifestyle in 2009.



There are several published methods to quantify arch heights, but several years ago I devised my own method called the transverse arch index (TAI). A TAI value less than 1 indicates a high arch while a TAI value greater than 1 indicates a low arch. After switching to a barefoot lifestyle, this individual’s TAI value decreased a staggering 81% from 5.2 (a very low arch) at the start of the study to 1.0 (average arch) four years later. Much of the change occurred in the first 2 ½ years.

In my opinion, and I believe Drs. Nirenberg and Campitelli would agree, shoes are casts that immobilize the foot and weaken the musculature and ligaments of the foot. Because those muscles and ligaments support the arch and properly align the 52 bones in the feet and ankles, some have speculated that the overuse of shoes – especially during exercise that involves walking or running – is a major source of many of the ailments that plague our feet. Indeed, footwear is likely responsible for more than flat feet and fallen arches, they have been implicated as a major contributor to bunions, Hallux valgus, plantar fasciitis, neuropathy, athlete’s foot, toenail fungus, ingrown toenails, and hammer toes.

Personally, I believe that simply eschewing the shoe and walking barefoot is the single best thing you can do for the health of your feet. Heretofore, that opinion was based mainly on the premise that the human foot is designed well for its functions and that man-made footwear, while useful in some situations, is largely disruptive and impedes those functions. Happily, we are now acquiring a growing body of empirical evidence that validates that opinion, such as the results presented in these three case studies.

I think it’s important to recognize two realities: 1) we typically wear shoes for cultural reasons, not physical or biomechanical reasons, often even when we think otherwise. And 2) shoes often do more harm than good to our feet. Once you become fully aware of those two points, the solution to our foot woes becomes obvious: remove the shoes and go barefoot much more often. Fortunately, more and more people are connecting the dots and kicking off their shoes in response. Going barefoot in public is becoming more common as people realize the damage that shoes can cause our feet and the healthy benefits of leaving them at home. Furthermore, going barefoot is quickly being recognized as just another individual lifestyle choice in our increasingly diverse society. So, do your feet a favor, take off your shoes and walk barefoot! Not only does it feel good, it’s good for you. And there’s science to back that up!







Daniel Howell, Ph.D.


PS. In addition to these studies, I am aware through personal communication of other studies by top-notch scientists which make the same general conclusions, but they have not at this time publicly announced their findings. 

Thursday, June 13, 2013

The Alliance Gets A Make-over


What was formerly known as The Primalfoot Alliance has now become The Barefoot Alliance. I and several others have worked closely with the alliance for years, but the organization is run primarily by its founder, Michael Buttgen. Michael has done a fantastic job using the alliance to promote barefooting to the general public, which still remains largely “podophobic” in much of the United States. We have been discussing the name change for a long time, but the time has now arrived for The Barefoot Alliance to emerge from its trans-formative cocoon as a “new creature,” as Michael puts it.

The Barefoot Alliance exists to encourage the acceptance and practice of going shoeless more often and in more places. The reasons for going barefoot include improved health, increased comfort, and expanded personal freedom. Most people really like the idea! Those of us in the barefooting community hear it frequently:

“I’d go barefoot all the time if it was socially acceptable.”

If so many people are saying this, how can going barefoot in public not be socially acceptable? Do people say one thing in private but then behave differently in public? Maybe sometimes, but I think the barefoot-friendly majority is largely forced into shoe-compliance by a foot-phobic minority. But for a growing number of people the discomfort and health issues from constantly wearing footwear are pushing them to overcome the social resistance and simply live barefoot more often. After all, it's not illegal or unethical to simply walk around barefoot! At The Barefoot Alliance, we would like to see going barefoot as common Рand blas̩ Рas wearing shorts or a short-sleeved shirt on a warm day.

In many parts of the country things are starting to change. In my own hometown I personally experienced constant discrimination a few years ago when I first starting traipsing around barefoot in public, but after several years of confronting the discrimination much progress has been made. Indeed, I do not remember the last time I was escorted to an exit or even told I needed shoes, and I visit just as many big box stores, restaurants, and businesses as anyone else. If you try going out barefoot and meet resistance, I and The Barefoot Alliance want to encourage you to “keep on keeping on.” We want to provide you with resources to help you understand and communicate the legality and benefits of going barefoot. If you are persistent, you can change your community to make it more barefoot-friendly.

I believe strongly that the new branding for The Barefoot Alliance will greatly improve our ability to reach people about the health benefits and joys of simply living barefoot. Kick off your shoes and join us! There’s a revolution afoot.

Tuesday, September 4, 2012

Driving Barefoot


Is it illegal to drive barefoot in your home state?

I posed that question to my anatomy students at Liberty University recently and the answers were shocking but not surprising. Shocking because the vast majority of my 145 students – coming from all over the US – firmly believe a myth. Not surprising because…. well, it’s a prevalent myth.

In case you are wondering: YES, it is legal to drive without shoes in your state because it is legal to drive a car barefoot in all 50 states (and the District of Columbia). I spoke with some of those students after class. Interestingly, even though 2/3 of the class believed it was illegal to drive barefoot in their home state, they were often quick to accept that it might be legal in other states, but they were usually slow to be convinced it was legal in their state.  

The Society for Barefoot Living was formed in 1994. Other pro-barefoot organizations, like The Primalfoot Alliance and Living Barefoot Show, joined the scene more recently but have been around a few years now. Born to Run was released in 2009 and my book, The Barefoot Book, was published in 2010. Several books on barefoot running also hit the shelves in 2010-11. I would like to think that the public is becoming more informed on shoe/foot issues, but the results of my classroom poll clearly indicate that we still have a long way to go. I still have daily conversations with students who are amazed that I claim going barefoot is safe and healthier than wearing shoes, and the same old questions about germs, support, protection, etc., return afresh every semester with the sea of new faces.

But I’m encouraged. The barefooting movement is still young and many of my students are thrilled by what I say. They say they love going barefoot and they seem to love the idea of going barefoot, but unfortunately, I’ve not seen many “converts” to a barefoot lifestyle. Perhaps they are taking off their shoes more in private places, and I have seen more bare feet in public places, too. And, come to think of it, I can name a few real converts – hardcore ones that live almost entirely barefoot now. Undoubtedly, I’m just impatient. I want everyone to have that “A-ha” moment followed by a mass shoe-burning ceremony, but I’ll have to accept the baby steps. The wheels of change turn slowly. And for at least one class of 145 students, I can rest assured that they all know the truth that driving barefoot is perfectly legal!

Tuesday, July 17, 2012

My Take on the FiveFingers Lawsuit


Several people have asked me what I think of the recent Vibram FiveFingers lawsuit, so here is my brief response. First, a disclaimer: I am not privy to the details of the suit. All I know is that someone has initiated a class-action lawsuit against Vibram over “deceptive and misleading health benefit claims” and injuries. So, here is what I think.

­­­­
While I hold no love for FiveFingers or Vibram (as a company they are arrogant and aloof), I think the lawsuit is absolutely baseless. The complaint states that Vibram’s claims of “health benefits are false and deceptive because FiveFingers are not proven to provide any of the health benefits beyond what conventional running shoes provide” and “FiveFingers may increase injury risk compared to running in conventional running shoes, and even when compared to barefoot running.” Thus, the complaint has two major allegations: 1/ Vibram has not proven that their shoes are healthier to use than conventional running shoes, and 2/ FiveFingers cause injuries.

Beyond what conventional running shoes provide?
The first allegation is laughable since consumers have spent billions of dollars on traditional running shoes in the past five decades and received untold numbers of injuries in exchange. The conventional shoe makers have spent virtually zero dollars on any research beyond marketing, and the independent scientists actually investigating the relationship between your body and running shoes have solid evidence that those traditional running shoes are the cause of many running injuries. Certainly, no major running shoe company has ever demonstrated scientifically that their shoes are “proven to provide health benefits,” so why is Vibram now being held to a higher standard? (In fact, there’s not even a single orthotic that has been proven to live up to its claims; podiatrists be warned). The filing continues: “false and misleading advertising campaign has allowed them to reap millions of dollars of profit at the expense of consumers they misled.” Again, laughable in light of the half-century of reaping by motion-controlled, ultra-padded, microchip-embedded shoe makers.

FiveFingers cause injuries
The second allegation has some merit in that FiveFingers can lead to injury, but Vibram has been careful to warn people of the risks so I doubt they can be held culpable. Experienced barefoot runners have from the beginning also cautioned people about the potential injures from using Vibram FiveFingers and other minimalist shoes:

“I recommend all runners learn to run barefoot prior to adding minimalist shoes to their training routine. Learning to run barefoot first will allow you to learn good form and strenghthen yoru feet, legs, and other anatomy to help prevent injuries. While it is possible to learn to run in minimalist shoes first, the lack of tactile sensation with the ground will interfere with the process.”[emphasis added].  – Jason Robillad, The Barefoot Running Book

“The biggest challenge with FiveFingers is that you still don’t feel the ground nearly as much as you do when barefoot, so it’s easy to overdo it.” [emphasis added]. – Michael Sandler, Barefoot Running

“The Vibram FiveFingers is praised by many runners tired of traditional athletic trainers… However, some barefoot running experts warn that minimalist shoes may cause overuse injuries in new barefoot runners since they encourage a barefoot-type gait but reduce biofeedback from the foot sole.” [emphasis added]. – Daniel Howell, The Barefoot Book

In the above statement I was referring primarily to Barefoot Ken Bob, who says it saliently in his book, Barefoot Running Step-by-Step:

“Vibram FiveFingers… can be dangerous if not used properly. I am not totally against Vibrams… but beginning barefoot runners should simply not use them.” [emphasis in original]. – Barefoot Ken Bob Saxton, Barefoot Running Step-by-Step

Again, Vibram has always concurred with these experts and cautioned new FiveFingers users accordingly, so I can’t see how Vibram is liable. So, the way I see it, shoes companies that have for decades promised the moon to runners with high-tech devices that alter gait and cause injuries are guiltless, while the company that tries to keep runners moving naturally and clearly warned customers of the hazards is culpable.

The most common injury I've seen from FiveFingers (and barefoot running), is TOFP ("Top Of Foot Pain"), or metatarsalgia. The pain seems to originate from microfractures in metatarsal bones and, if you keep running, can lead to a full-blown metatarsal break. Ironically, I do not blame Vibram (or barefoot running) on this injury, but the traditional shoe we've been wearing since childhood that has weakened our bones nearly to the point of debilitation. It takes years for those bones to strengthen after adopting barefoot or minimalist running. Not coincidentally, TOFP and metatarsal breaks usually occur after 1-2 years of barefoot running.

Hopefully, the end result of this lawsuit will be a more educated public with respect to their feet.


Thursday, July 12, 2012

Top 10 Reasons Why You Must Wear Shoes


1.  Shoes protect your feet from germs.
Actually, although many people believe that the world is full of germs just waiting to make your bare feet fall off, this is a myth. Well, the world is full of bacteria, but most of those bacteria are perfectly harmless and some are even beneficial. The nasty germs, like Pseudomonas, actually live inside shoes and are otherwise not present on your skin. Same goes for the fungus that causes athlete’s foot (Tinea pedis). In truth, the shoe is a warm, moist, hotbed for microbial growth and is the leading cause of foot infections. Going barefoot exposes the skin of your feet to refreshing air and sunshine, which inhibit microbial growth and infection. Need proof that shoes are germ factories? Wear your shoes all day and then smell them and your feet (if you dare), then go barefoot for a day… no stinky feet. You could try the same experiment with gloves.

2.  Shoes protect your feet from injury.
Wrong again (sort of). Shoes can protect your feet from some acute injuries, but I’ve noticed that people step on nails with or without shoes. Many people fear broken glass, but broken glass is rather rare these days (“plastics make it possible”) and is actually not that dangerous anyway. While stepping blindly and forcefully on a huge shard of glass can cause a severe cut, that kind of thing is not likely to happen on the sidewalk. (Ironically, it is likely to happen while wading in a littered river, which lots of people do, barefoot). On the sidewalk, most broken glass is small and lies flat. As for nails, it turns out that it’s better to actually step on a nail barefoot than while wearing shoes. Why? Because the shoe is a hotbed for bacteria (remember that Pseudomonas?) and the likelihood of a dangerous bacterial infection skyrockets from your shoe. Lastly, while shoes may offer some protection against acute injuries, they are responsible for most of our chronic foot injuries, like bunions, Hallux valgus, hammer toe, over-pronation, fallen arches, etc. etc.

3.  Shoes give you better grip on car pedals.
I’m not aware of a study that demonstrates this declaration. In fact, a strong argument can be made that shoes reduce your grip on car pedals. The skin on your feet is well-designed for traction, you even have skin prints on your soles and toes just like you do on your fingers for improved grip. You can also hold the pedal with your toes. Shoes, on the other hand, often have slick, slippery soles (especially when wet). Flip flops are notoriously dangerous for getting caught in pedals and high heels limit your ankle’s range of motion. Experienced barefoot drivers compare driving barefoot to driving bare handed, which is also arguably safer than driving with stiff, bulky gloves. Of course, you should keep your car floors clean of debris, but you should do that whether you drive barefoot or in shoes.

4.  Shoes improve your gait.
Shoes definitely seem to change your gait, but those changes are likely not improvements to the barefoot style. The higher the heel, the more the shoe will modify your gait (alter stride length, weight distribution in your feet, which muscles are active and when, etc.).  Other shoe features will impact your gait, as well, such as the toe spring, arch supports, motion control, side panels, and so on. Probably you have heard about the barefoot running debate. There is a lot of research being done these days that indicate running barefoot is healthier than running in shoes. Logically, the same goes for walking.

5.  Shoes correct bad posture.
Again, no. Indeed, shoes create bad posture and, once again, the higher the heel, the greater the impact of the shoe. If your body was rigid, only a 1-inch heel would suffice to tip you over (and virtually every shoe has at least a 1-inch heel). You do not tip over because you make postural adjustments to remain upright. In 3-inch heels, your pelvis tilts about 15 degrees and this puts strain your back and hip joints. In heels, more of your body weight is carried by the front of your knee and this may be why women suffer from knee osteoarthritis 4x more often than men. Also in 3-inch heels, about 90% of your body weight is supported by your forefoot and the weight-distributing arches are rendered useless. Back pain, hip pain, knee pain, and foot pain can all be traced back to your shoe and bad posture.

6.  Shoes are required by health codes.
This is widely believed, but it’s another myth. Health departments regulate eateries, not their customers. The health department is concerned primarily with three things: how the restaurant stores their food, how the restaurant handles their food, and how the restaurant cooks their food. Health departments exist to protect the customer from the restaurant, not to regulate customer behavior. Health departments do not require customers to wash their hands, take a bath, brush their teeth, or wear clean clothing (or any clothing at all) in a restaurant. Nor do they require shoes.

7.  Shoes are required by OSHA.
Yes and no. The Occupational Safety & Health Administration (OSHA) does require footwear for some occupations, but shockingly few. Indeed, OSHA is one of the last government agencies which gives wide discretion to the business owner / manager to decide what is best for the employee (in this case, whether shoes should be required or not). And certainly, OSHA regulations pertain only to employees, never to customers.

8.  Shoes are required for reasons of liability.
Not usually. Most retail stores have nothing to fear from bare feet. A shopping mall and its stores, for example, is probably a very safe place for feet. Lawsuits from a barefoot patron due to a foot injury are exceedingly rare, and judicial victory even more rare (I found two in the past 50 years). On the other hand, 20,000 women per year go to the hospital from high-heel injuries, and lawsuits involving shoe-related falls and injuries are too numerous to count (well, there’s a lot). To my knowledge, there are no insurance riders or other requirements for customers to wear shoes for any business, not even car shops (though customers are often not allowed in a commercial garage without an escort). Bottom line, shoes are more of a liability than bare feet.

9.  My boss requires it.
Okay, that’s a valid reason if you want to keep your job, but be aware that this is a cultural reason, not a legal, physical or health reason. Shoes are unhealthy and are not required by law or health codes. Given the health benefits of going barefoot, our culture should ease up when it comes to shoe rules. If you are the boss, please let your employees work barefoot!

10. Shoes make the outfit.
Well, maybe they do sometimes. But in my opinion, bare feet go with everything!

*There are references for all my claims in The Barefoot Book. I was too lazy to pull them out again for this blog post. :)

Wednesday, June 27, 2012

Is The Tide Turning For Barefooters? REI Stores Set The Example.


A member of The Society for Barefoot Living, John, from the Boston area, just had an amazing victory at REI stores (outdoor recreational supplies). He had been declined service due to being barefoot at an REI store and then sent a letter to the president of the company. It's kind of long, but I wanted to copy his entire report, which is well worth reading:

Hello Everyone,

As some of you may know I sent a letter to the president of REI and within a few weeks got a phone message from the Mountain\Eastern territory Retail Director.

I have called the director back several times over the last couple of weeks (leaving messages) and also sent her two emails. As of yesterday morning I had heard nothing and just hoped that she was busy.

Well, at around lunchtime, she called me back. She apologized, saying that she was on a trip. I'll need to paraphrase most of this because I can only remember her exact words in a few places. My head is still spinning.

First she apologized for my treatment in the store. I thanked her and assured her that I was not upset, just disappointed since I really like the store. I also assured her that the store manager was polite and professional with me at all times. Then she said, "You really got us all thinking here". and continued to explain that they are aware of the barefoot running and hiking movements and they know some people go barefoot for health reasons. OK, so far so good.

The director said that she asked store managers how many barefoot customers they see come through the stores. Sure enough, some managers reported barefoot customers. The store with the most barefooters seemed to be one in Colorado, right in the same state as her office.

She then said that they looked through the company policies and, although many in upper management THOUGHT bare feet would be excluded from the stores, they found no such statement. She called it a "phantom policy which only existed people's minds".

She said the next worry they addressed was, "You know, we sell food... and you've got the whole health code thing". I asked her what they found. She said, "Well, we found that there are no health codes out there that would stop a customer with bare feet". Wow, this was starting to sound pretty good. Maybe they found that info on our site :)

She said that next they considered liability issues. She said that just like "our phantom dress policy", which so many people thought existed, "we had people worrying about phantom injuries, things people thought could happen but really probably wouldn't".

I would guess the ice axe fits this category pretty well :)

She said they sorted out the things that really could happen and little by little realized that the stores were actually pretty safe. She said they researched old records looking for customer injuries as related to what might happen to a bare foot. They found one real injury in the records. Someone stepped on an inventory control pin and put it into their foot. And, she said, "that guy was wearing flip flops... and he still got stuck". She said the store personnel already know to keep them off the floor.

[Note: Inventory control pins are those plastic mushroom heads with a sharp nail about an inch long sticking out. They stick through garments and lock into the electronic alarm tags. I HAVE seen them on the floor in stores, pin facing up, but it's not too common. They are a bad design. We know why the guy got stuck. he was wearing sh@@s, was careless, and couldn't feel the pin until it was too late.]

The lady then said that they reached the conclusion that it is not necessary to prohibit barefoot shoppers and that they notified the managers of the stores, telling them to instruct the workers as such. Wow, I still can't believe this...

The lady said, "We want you back as a customer and you are welcome to shop barefoot".

She then asked that I stop by the counter and ask for the manager on my next visit to the store. If it's not the same guy, she wants me to introduce myself and tell him that I'm a barefooter. She wants the managers to get to know me. The manager that I already met should be expecting me and the staff should have already been instructed. She said, "You won't have any more trouble.”

And THAT, my friends, is how it should be. If there is an REI near you, Go There! And Go Barefoot!

Barefoot Running Movie From RunBare


Almost everyone in the barefoot running community has heard of Michael Sandler. He has shared his inspiring story with us through his book, Barefoot Running (published by his company RunBare) and his whirlwind running clinic tours over the past few years. Today, Michael and Jessica released a trailer for their upcoming movie on barefoot running. That’s right. Barefoot Running, the movie.

To be clear, this is not a movie for the cinema. It is not a documentary of the barefooting movement (we’re still waiting for that). It is primarily an instructional “how-to” film, though Michael and Jessica do spend quite some time simply celebrating barefoot freedom.

Several barefoot running enthusiasts have already produced short video clips, both humorous and instructional, but what RunBare has coming out this Fall is on a whole new level. Their DVD is a full-length, professional quality film, as entertaining as it is educational. I have had the pleasure of previewing several chapters and the quality of the film is spectacular. It is exactly as they describe: “Seventy minutes, 17 chapters filled with amazing running, scenery, and entertaining lessons about barefoot running.” The film is stunning for no other reason than the running footage through the breathtaking Maui scenery and the National Geographic quality music. Seriously, the folks at RunBare have outdone themselves with this one!

Catch the trailer here, and then be sure to get the full-length film in August.