Going Barefoot

[EricM]

I have a confession to make. I wear orthotics. I have worn them most of the time since I was about 11 years old. Though, I have often wondered why.

It has always seemed reasonable to me that if someone is going to wear shoes anyways they might as well wear orthotics in them. Why try to make your foot fit into something designed to accommodate a vast array of differently shaped feet? But is there something wrong with this whole picture? Maybe we shouldn’t even be wearing shoes at all?

I suppose the arguments for shoes are as follows: a) we live in a world constructed of artificial surfaces, most of which are probably harder than the natural ground our ancestors walked on, therefore we need artificial support, b) many of us live in climates where it gets too cold to expose bare skin to the elements, c) we are all victims of the shoe manufacturers marketing ploys, d) social convention tells us we should wear shoes.

In the time I spent living in New Zealand, I discovered that large numbers of people commonly go barefoot most of the time, year round. NZ has just as many artificial surfaces to walk on as anywhere else in the world and at times it gets pretty cold and wet there too. So if they can do it and seem fairly comfortable doing so, why shouldn’t I?

There is a seemingly logical argument (http://sportsci.org/jour/0103/mw.htm) that going barefoot has some advantages in terms of injury prevention. There is even a growing movement promoting barefoot running (http://en.wikipedia.org/wiki/Barefoot_running)!

In spite of this, I still find it hard to imagine going shoeless. Cognitive dissonance (http://www.somasimple.com/forums/showthread.php?t=4119) maybe? Where do you stand?

[EricM]

Every shoe tells a story (http://www7.nationalgeographic.com/ngm/0609/feature2/index.html), from National Geographic.

[Diane]

So, Eric, who put othotics under you age 11 and why?

I grew up shoeless from June to September, every year until I left home age 17. I was a farm kid - sidewalks are much kinder to bare feet than farm gravel.. (until one encounters broken glass or fresh spit or dog doo that is..)

When you think about it, we evolved without them. They have acquired much symbolic, status baggage. I saw a picture of a Sherpa guide who wanted the world to know he owned shoes, displayed them proudly by dangling them off his backpack, but his feet had at least a three inch callous all over the bottom - they would not have fit into those shoes, ever.

[nari]

I am a great fan of being shoeless. I wear them because society demands feet to be covered and it gets cold without them.

In our climate, for eight months of the year I never wear shoes at home, or outside around the yard. But as a child, I grew up in a colonial meme that shoes MUST be worn or one would get broad feet 'like a native'.

Eric, I think that constant shoe-wearing can lead to deformity and loss of proprioception, with or without orthoses. We did not evolve to wear shoes that shut the soles of the feet away from sensation.
In Tierra del Fuego, which can get pretty chilly for nine months of the year, ie snowy, the Yugans wore no clothes, no shoes, nothing. Darwin was fascinated by this and no doubt considered it for his works on evolution and adaptation.

There have been runners in the Olympics who train and run barefoot. But they have a distinct genetic advantage, with no fear avoidance.

I also avoid chairs as much as I avoid shoes. Whatever that means.

Nari

[EricM]

Diane,
I had run myself into developing a stress fracture of the head of the 2nd metatarsal. I’ll never forget the words the doctor used to describe what had happened, he told me the bone had turned to mush. Nice eh? The orthotist, a lady who seemed to me at the time to be very old, and very large, made my first orthotics in the physio clinic I went to for my 3 doses per week of ultrasound. It worked like magic, at least to clear up the pain I was in, and yes I’m referring to the orthotic. Can’t say what happened to the stress fracture, I don’t recall ever stopping running. I remember peeling the small wedge shaped orthosis off my insole and glueing onto the new insole of probably 10 consecutive pairs of shoes until it finally disintegrated during one last peel. Never had that problem with my feet again to this day.

[EricM]

Nari,
I suppose I have been wondering whether shoes/orthoses are more of a cultural manifestation than an actual need. With few exceptions, like yourself, they are just taken for granted. Imagine the difficulty convincing people to go shoeless! A similar struggle to making ideomotion acceptable and understood. Then again, maybe it might be an easier sell...??

[nari]

Eric,

It may well be just a cultural manifestation that developed for shoe-wearing along the way. As for orthoses - maybe they are an attempt to correct this cramping of feet into shoes 16 hours a day every day. Some of us probably needed correction, maybe most did not, but gait analysis ruled.

I have a feeling it would be harder to convince folk to go barefooted than to elicit ideomotion as a therapy. Women in general seem devoted to shoes; men are less culturally bound. In a country where the ground is generally safe for walking, it would be easier. In the tropics, where parasites and ground-walking feet chewers and stingers abound - maybe not.

Nari

[BB]

Hi Eric,

I'm an orthotic wearer also. I've worn them for around 7 years. I wore shoes 1-1.5 sizes too small until I was in PT school. I didn't know any better. Also, I can remember always being a soft foot. I always wore shoes. It would take me a 1/2 hour to walk across a gravel lane barefoot.

Now, I try to go barefoot more often, but orthotics allowed me to tolerate walking and hiking and running further. I think my adaptive potential was too low and the orthotics were a way to cheat my way to better adaptive potential.

[EricM]

I wore shoes 1-1.5 sizes too small until I was in PT school.
Does it feel good to get this off your chest? :D

[Diane]

Think of what women in China had to endure for a 1000 years with feetbinding. It was deliberate crippling for a social notion of "beauty", right up there with genital mutilation. Foot binding not only divided women into different classes, it divided classes from each other based on how incapacitated their women were obliged to become.

When you think about it, shoes are functional prostheses.

I recall a slide show given at a foot course by a PT who worked for a time in Papua New Guinea. (This was a long time ago.) She had made a study of peoples' feet, had lots of slides. It's a rainy and mountainous country, with muddy trails, had no paved roads at the time. For some weird reason she and her husband drove a land rover, which got stuck on a regular basis. Out of the forest would melt a bunch of people, who would tow the car with ropes, and nothing but the traction they got by digging their toes into the mud. She was in awe. Feet were very broad and strong, the toes were strong and capable with wide spaces in between, like fingers, and thick soles. Probably the way all feet would look, used unhindered by shoes through a lifetime.

She told the story of a woman whose baby daughter was born with club feet - not good in a society that relies on feet the way this one did. The baby was about to start walking; the PT couldn't do much, showed the mom some stretches to try, decided casts would be useless in the mud, asked her to come back in 6 months.

When the mom brought the baby back, the baby was walking normally. The PT was in awe once again. The mom had taken matters into her own hands - had begun to burn the outside edges of the baby's feet so the baby would avoid walking on them. When the burns healed the mom would burn the feet again. The baby trained itself to walk on the bottoms of its feet where there were no burns.

People in this shoe bound culture have very little foot awareness. I spend quite a bit of time working with feet, actually.

[Luke Rickards]

Perhaps its an Aussie thing, but I also have my shoes off most of the year when appropriate. It takes a little while to work up to the hot tarmac each summer but once I've built up a coating for this I can even go bushwalking barefoot.

Eric,
Soft or hard?

[BB]

Eric,

Your courage will allow other embarrassed orthotic wearers and shoe size morons to come out of our shells. Thank you so much for blazing the trail and providing me with a means to unload this painful memory I've been carrying around for so long.:teeth:

[Randy Dixon]

This is something I've wanted to bring up and probably have before, but now it is too late at night to go much into it. I remember reading about how our fingerprints served a purpose for improving feeling and enhancing grip but that it worked in conjunction with the sweat glands. The moisture made for a better grip and more sensitivity. I don't think it is a coincidence that our feet and toes have prints as well, as well as a large number of sweat glands. They don't do much to cool our bodies there. We weren't made to wear shoes and there are studies showing that simply adding stimulus to the bottom of the foot improves balance, particularly in the elderly. To keep it short, the homunculus of most people today probably has huge hands, enormous fingers, but two stubs below our ankles where the feet and toes should be. This can't be a good thing. Perhaps something as simple as getting people to try to identify objects with their toes may lead to something good. I will probably write more later, but for now, for those who are interested maybe you can consider a pair of these:
http://www.vibramfivefingers.com/

Contradicting myself somewhat I have found several people, including my wife, that have found great relief from Plantar fasciitis/tarsal tunnel with a pair of these:
http://www.zcoil.com/

In fact, I have a pair, and while I don't usually wear them, sometimes after a hard weeks running my feet feel like they are on the road to injury and I wear them and I can at least attest to them making my feet feel much better.

[Luke Rickards]

I wouldn't wear them often either. I'd be to self-conscious.:D

[nari]

Diane,

You elaborated on my phrase '..like a native'. Their feet are broad, flat with widely separated toes and strong abductors on the great toe and little toe. This, of course, is an antithesis to modern society.

By the end of summer here I can walk quite happily on hot bitumen and sand. But I haven't gone bushwalking barefoot - too many brown snakes around in my territory. :) The interesting thing is that without shoes, the entire foot is active and working hard, and the sensation of grass, mud, sticks and pebbles is really quite nice.

So I untrained myself from the rules of my childhood; and today I can still separate all ten toes enough for a finger to easily slide through. Plus 40 degrees of abduction on both little toes. I think my homunculus would have a fair display of the foot....

There's hope for you young shoebound folk yet!! ;)

Nari

[ian s]

http://janeygodley.bravejournal.com/archive/05/25/2005

here is a good take on novel footwear from this scottish comedy artist!
Masai warrior shoes are real middle class trend to 'cure' back pain ...you could probably feed a whole masai town for the price of a pair !
Great news about your feet nari !

[nari]

I don't think I will embark on the masai shoe.
Actually, a shoe that is built so that one is consistently in a state of pertubation is an interesting consideration. The sole is slightly curved, so when one stands still, there is slight movement all the time, an unstable base. I have a pair of trainers/runners which do just this. Once you get over the instability feeling while hiking, they feel just great. Like walking on air.....effortless.
Good thing is, they cost about $AU50.

Nari

[Diane]

I remember that effortless feeling the first time I ever wore Birkenstock sandles, 1982. I think it must have just been the novel input.

They certainly were no good for an 80 km. walk I did in 1988, however. Thought my legs were going to need to be amputated about two days in, and for three weeks after. That was when I learned how tape could hold things together - it was just horrid white adhesive, but I doubt I could have functioned without it.

[nari]

I am wondering if the constant 'instability' factor contributes to effortless walking and keeping the nervous system happy, rather than have feet locked in a stable embrace with shoes. Dunno...but it's worth a think or two.
My hiking boots are excellent, but they have no steel support in the sole - and as they are men's boots, the feet get to move a little while encased. The offside is callouses; but the benefits may outweigh that problem.

I wonder if graded exposure to life without orthoses is worth considering, Eric? And life without shoes on the weekend, again graded? If the weather turns chilly, put on some warm socks??

Nari

[Diane]

I foresee someone making $ by selling people gravel footbaths designed to "toughen" feet. A new slant on spa treatment. :D

[Bas]

Grew up in Indonesia and Singapore outskirts - only wore shoes to school and they were off immediately after. Even at the "Hollandse Club" (Dutch Club) in Singapore - as soon as we had arrived and looked our best for the other colonials, we took off our shoes behind the tennis courts and played...Mostly in jungle, on sand, gravel, grass etc etc. Ashfalt was hot but feet were used to it. Playing with the natives deeper in the jungle also exposed us early to ...well, exposed other body parts.... Hence my still present preference for barefeet as well as bare-ass (esp. when swimming).
After all, clothes are the MOST opressive cultural items.....Only in cold or bad circumstances do they really serve a purpose.
Our city has now got a bylaw that, since men can walk with bare upper body in the hot summer, women can too.
So, my adolescent and young adult life on holidays in Europe were blissfully without shoes, speedos or shirts - on the beaches of the Netherlands and France (no, NOT on the bikes).
Both countries are especially happy now that I am in Canada - in view of my age, and the unbeatable laws of gravity...

[nari]

In the north, Queensland kids never wore shoes to primary school; I think that hasn't changed much. All events in school sport were done barefooted, no matter what the sport, on or off asphalt. Perhaps the warmer the climate, the less inhibited the brain.

I grew up in the Pacific, and admittedly going barefoot had great risks: centipedes up to 10 inches long, and lethal to small animals; scorpions (also highly toxic); stingray barbs with neurotoxins; burrs in grass. But I survived, as long as my mother never found out I was barefooted.

There is something delicious about trampling through five inches of mud in banana trenches, or climbing prickly trees barefoot. I don't do it anymore, and Bas, ageing probably has something to do with that....

Nari

[EricM]

Apart from personal preference, would there be any significant benefit to going barefoot? Is this going to change lives enough to make it a worthwhile pursuit? So what if my toes develop the ability to pick up and manipulate objects? So what if the skin on the bottom of my feet toughens up? Is anyone really going to be that much better off?
Really interesting discussion everyone!

[Diane]

Is anyone really going to be that much better off?
Maybe just you, and your sensory homunculus... :D:D:D

[BB]

Nari,

I've often thought I could kick my orthotic habit in the way you described. I have awful toe proprioception. If anything ever hurts on me it usually starts at my feet. I used to sprain my ankles in basketball constantly.

If I try to abduct my little toe, the whole foot splays uncontrollably. I have pretty much zero control of my toes except the gross movements of flex and extend.

Interestingly, I recently became determined to go barefoot more often. Everyone I have ever lived with, parents, roommates, and now my wife, have commented on how weird it is that I always have my shoes on. Sometimes even when I take a nap.

Weirdo.....I know, I know.

[EricM]

Ok, so maybe it might help Cory out.

[nari]

Eric, it may be that your sensory homunculus would improve, as Diane suggested, and this could have roll-on benefits. Puts you in better contact with the environment; increases awareness of textures etc, and improves balance. These are only guesstimates, but there could only be benefits, no downsides.
Think of how things change when gloves are worn - they can decrease proprioception and coordination.
On the other hand, it is a personal choice. Prehensile toes aren't really of benefit unless you plan a lot of tree-climbing.

Nari

[nari]

Addendum:

I have just googled 'barefoot advantages' and came up with a gamut of reasons for bare feet, with the risks and advantages. Some of the advantages include an improvement in OA of the lower limbs, risk of tinea reduced; risks include trauma, bites, parasitic invasions. Apparently there are groups in developed countries who practise barefooting, and a search for OH&S issues came up with no health risk of having bare feet in restaurants, etc. It seems it is very much a social thingy - barefeet suggest poverty, hooliganism and low socio-economic values.

One more social construct to deconstruct?

Nari

PS My current avatar indicates these Canadians enjoy barefootedness!

[bernard]

Nari,
I think your Canadians are cheating with these kind of shoes. :angel:

[nari]

Bernard, that is quite funny. :D Maybe they are, but Coast Guarders are a tough bunch....

Nari

[Randy Dixon]

I was a fan of Dune, and I still am of the original book. I remember when one of the characters talks about being able to move the pinky toe of her left foot while all the others remain completely still. I practiced that for quite awhile and finally was able to do it. It is more like twitching than smooth movement, but I can do it. The interesting thing is that I couldn't do it really consciously, or my whole foot moved with it. I had to "think" about moving my pinky toe while not actually trying to do it, then at some point it would move all by itself, surprising me as to the timing.

I have some studies somewhere about balance being improved in older adults simply by adding stimulus to the sole while standing. I'll see if I can dig them up.

[nari]

Good example of nonconscious movement and imagery, Randy. Your pinky representation in the brain just got bigger.
Now for the great toe abduction...I can manage about 10 degrees.
A follow-up from this is ear wiggling....but I can't crack that at present.

Nari

[Diane]

Here's a post (http://www.somasimple.com/forums/showpost.php?p=36655&postcount=16) on the skin sense thread that mentions barefoot walking specifically. It talks about WDR fibres: With purely mechanical stimuli, provided they are large enough, the effects of centre and surround will cancel each other out, and an erroneous pain message will not be transmitted. So what we have is a kind of lateral inhibition, used not to reduce the effects of spatial overlap, but rather to reduce overlap between modalities. In addition, it also means that a mechanical stimulus that is sufficiently small in extent will stimulate the central area but not the periphery. As a result, it will also cause pain, before it actually causes tissue damage. It is a matter of common experience that such stimulus - a thorn, the point of a drawing pin - do, indeed, cause pain without damaging the skin in the slightest; the advantage of responding in this way when walking barefoot is obvious enough.

;)

[Sarah]

All this talk of going barefoot makes me think of Hobbitts. Those shoes Bernard posted were certainly the closest thing to Hobbitt feet I've seen in a while.

Diane's post made me think of something I used to wonder about as a kid running barefoot through our yard. If I walked slowly and didn't watch where I was going, I would inevitably step on a "pricker" plant which is a very unpleasant sensation. But if I ran, I never seemed to notice the prickers. I used to imagine that it was my cheetah-like speed that allowed me to just skim over them like the Flash, barely touching the ground. More likely it was lateral inhibition. Shucks.

As a dancer, I have quite well-developed foot muscles, including an abnormally large extensor digitorum brevis. Or it could be due to my forefoot varus. I also remember learning about the abductor hallucis muscle in anatomy class and staring at my foot like Randy to will it to move. I finally mastered the great toe abduction isolation. Who knows, it may come in handy if I ever need to toe wrestle.

Anyway, Janda describes a "short foot" position that promotes activation of the intrinsic musculature including the toes to lift the longitudinal arch and respond better to uneven ground. I try to teach this to my patients and I'm always amazed by how many people do not use their toes with they walk. I think this is because of wearing shoes too much and never practicing dance, martial arts, yoga or any other activity which requires one to go barefoot.

Feet are fascinating though often neglected and unfairly shunned. ;)

[EricM]

Bernard, do those come in different sizes?

Consider this, more from the pro (http://www.symbioseweb.de/barefoot.html) side.

[nari]

Sarah, great post. After decades of seeing patients' feet both in weightbearing and NWB, I have come to the conclusion most feet are clinically inactive, rather like ducks' feet, especially in the older person. I blame compulsory shoe-wearing, but it may be more complex. As a friend of mine, who is a podiatrist said once: People care more about their eyebrows or moustache than their feet. True.

Nari

[Anne Bower]

This is quite an interesting topic. I must admit I wear shoes almost all the time at home. Mainly as a hazard of having 100+ year old wood floors with "character" (read: splinters). Guess I just need to toughen those babies up a bit.

Anyway, my husband's doctor has just recommended orthotics to him. He has a pretty funky right foot. When he was born, his toes were curled under to his heel and he was braced as a child to straighten his foot out. His right foot basically stopped growing when he was 10 and so it is a good 4 sizes smaller than his left. He also has an extremely high rigid arch. Basically, his foot looks exactly like Netter's illustration of cavovarus foot. He had a Jones fracture while playing soccer in April. The surgeon wanted to do a foot reconstruction but he was not too keen, as his foot had never given him problems before this break. The fracture is still not healed on X-ray, although clinically it is testing fine. He also had back surgery when he was 21. I have often wondered if the imbalance in his feet was a factor.

Any thoughts?

[EricM]

Hi Anne,
In my first post I reflected on whether if one was going to be wearing shoes anyways, why not wear orthotics in them? An orthotic after all is really no more than a insole molded to more closely match the contours of your foot compared with the insole provided by the shoe company. The real question might be whether your husband would benefit from going barefoot? Let his tissues adapt to most efficiently transmit the load on them through to the ground.

[ian s]

http://www.sandrablakeslee.com/articles2.php#

8th article down --interesting article on proprioception and random buzzing insoles!
In the book Blakeslee mentions areas in Chinese parks which have cobbles to improve balance and proprioception . I am not sure if this is true or not.