Barefoot/Minimalist

[Bluecollarmed]

Haven't seen anything about this for quite some time (2011 from search). Been seeing and hearing a lot lately about barefoot lifestyle/running, minimalist shoes, and the proposed benefits. Some recent studies showing morphologic changes. None have showed clinically relevant data yet but any number of reddit/youtube/whatever discussion board and comments will show people who relieved their aches and pains through a careful barefoot training protocol. No one seems to say they transitioned away from barefoot after going that way carefully. I've seen a few crossfitters/runners that have come in and are in this realm or considering it asking for recs. Obviously we follow EBM so I don't lead anyone down that route unless they specifically ask for guidance. What are your thoughts?

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[Flip-flop-flerpity]

I encourage all patients to go barefoot. Really helps my RVUs.

 

[pod squad]

Personally, I think the human foot was designed more or less perfectly for all sorts of human activities. I think if you were to grow up barefoot and go barefoot all the time, most people would be fine. But modern life necessitates shoe gear and that transition to barefoot causes problems because the foot isn't used to handling all of the forces, which can and likely will lead to injury. I don't recommend it for that reason. I don't know of any scientific protocol for transitioning to barefoot/minimalist shoes but it would be interesting to study.

 

[Podstar]

I usually just tell patients the few brands that I like and do well for me personally and that shoe gear is very individual and a lot of people like something different than the next so it’s best to physically try shoes on and test them before buying to ensure they like the fit and feel and go with that instead of initially shopping online. I’m not picky about what people wear as long as they are comfortable and functioning well.

 

[Bluecollarmed]

I think it's an interesting idea. There's a couple Peter Attia podcasts that I listened to recently which is what got me looking into it further. #128 was the main one and I see there's a new #296 that I have not listened to but would guess it delves into minimalist shoes and training. I think the biggest problem with this whole thing is inserts and/or stiff, rockerbottom, cushioned, etc shoes are easy, quick, and work for a vast majority of people we see. Whether changing gait would limit foot pathologies or decrease knee osteoarthritis and low back pain etc is yet to be scientifically studied. Also people are lazy so compliance would be abysmal if we prescribed physical therapy and gait training.

 

[dtrack22]

I think the human foot was designed more or less perfectly for all sorts of human activities. I think if you were to grow up barefoot and go barefoot all the time, most people would be fine.

I would agree with the additional caveat that we are incredibly fat as a country and the foot probably wasn’t designed to carry around a 5’2” 250 lb woman.

I think the sudden transition to barefoot/minamilst shoe gear in people who are generally overweight is the problem. Otherwise I don’t think there is anything wrong with minimalist shoes. We really should be fine walking around without inserts or supportive shoes, in theory.

 

[Bluecollarmed]

I would agree with the additional caveat that we are incredibly fat as a country and the foot probably wasn’t designed to carry around a 5’2” 250 lb woman.

I think the sudden transition to barefoot/minamilst shoe gear in people who are generally overweight is the problem. Otherwise I don’t think there is anything wrong with minimalist shoes. We really should be fine walking around without inserts or supportive shoes, in theory.

This is along my lines of thinking as well. I think most of the focus in that area is for runners which isn't terribly relevant to the general population, because as you say, most (all) runners aren't 5'2 250lbs and the consequences of sudden change can be significant.

 

[MicroPod]

I think it’s probably fine for certain fit people who don’t already have foot deformity or foot pain with a proper transition period.

I don’t really make a big deal about what shoes (or lack thereof) people want to wear unless they are having foot problems. If they do, I recommend a few good brands and tell them what to look for in a shoe.

Patients come in all the time telling me about weird stuff they are doing or applying to their feet. I just tell them that there is no scientific evidence it helps but that if they feel it is helping them then by all means they can keep doing it as long as it’s not something that I feel is actively harming them or a big waste of time/money.

 

[Sweatshirt]

I tell people it'll eventually kill your fat pad (which leads to injury) and unless you gain 200 lbs, you won't gain that fat pad back. The "stronger foot muscles" aren't worth losing your fat pad

 

[Hybrocure]

If you’re not in pain do whatever you want. Unless ur a diabetic.

If you’re in pain, change your shoes.

The problem w barefoot shoes is that they’re generally for athletes. Not elderly, obese, handicapped etc

 

[Hybrocure]

Personally, I think the human foot was designed more or less perfectly for all sorts of human activities. I think if you were to grow up barefoot and go barefoot all the time, most people would be fine. But modern life necessitates shoe gear and that transition to barefoot causes problems because the foot isn't used to handling all of the forces, which can and likely will lead to injury. I don't recommend it for that reason. I don't know of any scientific protocol for transitioning to barefoot/minimalist shoes but it would be interesting to study.

Guys he said shoe gear 🤣

 

[Feli]

The issue is not the feet; the issue is the surfaces we walk on.

Barefoot was surely awesome when we were cavemen who were in shape and walking on dirt, grass, sand... natural, fairly soft surfaces. Add sandals or mukluks prn for rugged or very cold terrains.

Now, in 2025, we are mostly fat and we walk on flat manmade rock (sidewalks, parking lots, hard floors, stairs). Barefoot is not the way to go. Hard calcaneus + overweight human walking on flat rock = ends badly. It's a safety issue more than anything. Anyone working in a warehouse or post office or parking lot and standing on concrete for 12+ hours a day is going to need serious cushion to the feet, ankles, knees, back... whole kinetic chain. World of Warcraft and TikTok and Slurpees and McD have also seen to it that America is fat AF... so that compounds the issue.

We can use common sense and the fact we see 100+ feet every day over EBM (which, for this topic, is basically all anecdotes from podcasters anyways).

Imo, 90% of people will now do best in a solid running type shoe with a thick EVA cushion midsole (Brooks, Altra, Hoka, Asics, Saucony, NB, etc... take your pick), and it helps to have a PowerStep or SOLE or similar type of prefab in there too... in order to spread the pressure, give even more cushion, and support the PT+PF. Young people or people who don't stand/walk a lot can do the shoes without a good midsole (Cons, Pumas, skate shoes, slip, etc), but it tends to catch up with them as they age/fatten. The other 10% of people with the real outlier foot types (and/or BMI) probably need CFOs of one sort or another and/or Wegovy.

...if patients want to wear barefoot/minimalist shoes, I suggest everything in moderation. Have them do the thin/flex shoes on treadmill or just on rubberized gym floor, for crossfit workout, etc.

 

[heybrother]

People get such interesting ideas from podcasts. My dad recently found a podcast advocating putting his feet into soil so that he could experience some sort of beneficial transfer of electrical charge from the earth. Make sure to explain the benefits of this to your truly minimalist patients.

 

[Retrograde_Nail]

Vibram five fingers for the win. RVU heaven. My bank account is thankful.

Thank you CrossFit, pickleball and sky zone/air madness trampoline parks as well.

 

[Feli]

People get such interesting ideas from podcasts. My dad recently found a podcast advocating putting his feet into soil so that he could experience some sort of beneficial transfer of electrical charge from the earth. Make sure to explain the benefits of this to your truly minimalist patients.

Yes, exactly.

I think a lot of podcast and YouTubers start out fine enough. Peter Attia knows about nutrition or working out... Logan Paul knows Pokemon cards... Joe Rogan knows MMA or maybe weed... Jordan Peterson knows picking up girls or making friends... etc. But then, they launch their show and rapidly run out of stuff to talk about or run out of quality guests, and they start going waaaaay out of their lane. They talk just to talk. They become a expert on everything. They start talking about whatever their listeners ask for. And sadly, people eat it up like it's some good info.

That's not to say there can't be bad info in a book or even a journal, but the podcasts and social media and talk shows are just horrible, though. They are entertainment... not real info to base your life on. That's why FB shouldn't need "fact checking"... it's mindless entertainment to begin with; it's not a reputable or reliable source. It was never created that way, and the content is just made by randoms.

...The town I live is very smart on average (lab/science town, obviously). Ergo, I'm one of the dumber people, but I saw a cool bumper sticker on the way to my office: "ESCHEW FACTLESS THOUGHT DRIVEL." When you think about it, that's basically summing up 80% of social media and the internet right there. 🙂

 

[AttackNME]

This started cus of the book Born to Run, talking about the author’s experience spending time with the Tarahumara Indians and how they run forever barefoot fueled by their diluted beer made from their special corn. It got me to try the VFF running around and concrete and it sucked so I stopped, clearly it was a fad. Those Indians had a lifetime to adapt to barefoot life doesn’t mean it’s better for our feet to do the same.

 

[DYK343]

They talk just to talk. They become a expert on everything.

This has been driving me crazy lately listening to patients rants. Your comments sums up American culture. Were full of BS and experts in everything we know nothing about. Social media is a demise of our culture and happiness. Patients just want to get it out. They saw something on FB and are convinced XYZ is now happening. I dont ask or want to know but they have to tell me their dumb opinions. Its becoming a revolving door and worsening over the last 4-6 years.

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I always felt people that can tolerate them can tolerate them. But most of us in this country are not 90-150lbs and fit. We walk on concrete or stand on hard floors all day. They can lead to stress fractures. They were a fad and the fad died off because too many injuries. Some love them and are very vocal about them. But they are not for everyone.

They would be a disaster in cavus feet.

 

[Hybrocure]

This has been driving me crazy lately listening to patients rants. Your comments sums up American culture. Were full of BS and experts in everything we know nothing about. Social media is a demise of our culture and happiness. Patients just want to get it out. They saw something on FB and are convinced XYZ is now happening. I dont ask or want to know but they have to tell me their dumb opinions. Its becoming a revolving door and worsening over the last 4-6 years.

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I always felt people that can tolerate them can tolerate them. But most of us in this country are not 90-150lbs and fit. We walk on concrete or stand on hard floors all day. They can lead to stress fractures. They were a fad and the fad died off because too many injuries. Some love them and are very vocal about them. But they are not for everyone.

They would be a disaster in cavus feet.

“I cold plunge every day and sauna. Why do my feet still hurt after 20,000 steps?”

 

[air bud]

People get such interesting ideas from podcasts. My dad recently found a podcast advocating putting his feet into soil so that he could experience some sort of beneficial transfer of electrical charge from the earth. Make sure to explain the benefits of this to your truly minimalist patients.

Grounding bro.

 

[heybrother]

Grounding bro.

 

[MicroPod]

Cold plunging has got to be one of the dumbest fads I have heard of. I feel that most people do it so they can tell others about it or post it on social media to look tough or cool or something.

 

[Feli]

Cold plunging has got to be one of the dumbest fads I have heard of. I feel that most people do it so they can tell others about it or post it on social media to look tough or cool or something.

Whatever, brah... I'm gettin one of dem Chilly Goat Phelps tubs for myself as a retire present in a few years. (there should be cheap used ones by then?)

 

[GreenHousePub]

Cold plunging has got to be one of the dumbest fads I have heard of. I feel that most people do it so they can tell others about it or post it on social media to look tough or cool or something.

I do it after a really hard workout to recover, and I found it help tremendously.

I'm talking like a 18 mile ruck with a 28 pound pack though, not a 30 min trip to the gym.

 

[billBOB213]

Years back I saw a guy (older, looked like Larry David actually) who was running barefoot when it was getting kinda trendy, his stride was so long-he was a calc stress fracture waiting to happen.
If anyone wants to do that you gotta go with the short choppy steps and lay off the heel contact otherwise it’ll end in disaster. Give me hokas or Brooks all day for running. I wish Hoka had an ambassador program like Brooks, someone make that happen.

 

[Feli]

I've seen a couple pretty young pts this week already who had real bad sub 2nd overload (meta/PDS/plantar plate/etc) with these thin flexible shoes.

They just don't work for 95% of the modern world.
One dude even told me he took the minimalist shoe's liners out "to be closer to the ground."
People walk on linoleum, wood floors, tile, hard hospital floors, parking lots, sidewalks, etc with basically just 2mm fabric and 5mm of rubber.

I don't understand the trend.