Thursday, May 22, 2014

Studies? We Don't Need No Stinkin' Studies (to Live Barefoot)!

One bit of opposition I keep hearing from podiatrists and other experts who oppose barefoot activity is that there isn't enough evidence to support it. Studies have not been able to show that going barefoot is better for you than wearing shoes.

Now wait just a minute.

Photo: Podiatry Today
Does anyone ever say "We don't have enough research to prove it's better to breathe environmental air rather than from an oxygen tank."

No one ever says "The evidence is inconclusive whether living without a neck brace is better than regular use of one."

Ever heard someone say, "Until we have evidence that going barehanded is more beneficial, best practice will be to recommend regular use of gloves."

See where I'm going with this?

I was in a Twitter conversation today with a barefoot supporter who said of the lifestyle, "We just need hard science to back it up, not just anecdotes." Many barefooters feel this way. My response?

No, actually we don't.

Really, since when do we need scientific evidence to use an inborn part of our bodies? How in the world did our society's thinking about feet become so "bass ackwards" that footwear supersedes our natural condition when it comes to the scientific burden of proof?

The feet we were born with are the baseline, friends. Why should we be forced to prove that we should be able use them the way they are?

We don't have studies showing why we should go barefoot, but we really don't need them. Barefoot is what we already are.

The onus is on those who claim we can't go barefoot. If footwear makes feet so much safer against injury, prove it. If arch supports improve the long-term health of the feet versus feet that never wear shoes, prove it.

This method of showing proven benefit over our innate condition has worked in other areas of the body:

  • Prescription glasses and contact lenses alter our natural condition and improve our sight.
  • Orthodontics effectively straighten the teeth and assist with their proper alignment.
  • Cochlear implants give hearing ability to those who've lost it or never had it.
  • Hip or knee replacement surgery gives pain-free mobility back to those who suffer from degeneration in these joints.
These results are proven. What's more, doctor's don't recommend those therapies above if you have 20/20 vision, straight teeth, you can hear, and/or your joints are fine.

On the flip side, listed below are a few widely-accepted results of healthy people regularly wearing footwear (and, I think, reasons that "experts" are reluctant to approach foot health from the baseline of our human condition):
  • Footwear -- even sandals -- raises the temperature of the feet, causing sweating and providing optimal conditions for fungal growth.
  • Shoes often squeeze or rub the feet in harmful ways, exacerbating or causing conditions such as bunions, hammer toes, neuromas, corns, blisters, and more.
  • The soles of footwear block the feet from feeling textures and objects on the ground below (exteroception), eliminating our natural safety mechanisms and altering our ability to sense where our feet are in space (proprioception).
So we have a good idea about why we shouldn't wear shoes. Despite those issues above and so many more, podiatrists and other experts around the world still recommend that people regularly wear shoes and "avoid going barefoot."

"BUT WAIT!," you may shout. "What if we do find a problem with the feet that needs fixing? What if someone goes barefoot all of the time and still has fallen arches, plantar fasciitis, bunions or something else that orthotics or surgery could help with?"

In those cases, yes, research to discover the best therapy would be warranted -- and those data exist. Even still, it seems to me that the goal would be to use whatever physical therapy, bracing, taping, orthotics, or even surgery that can help rehabilitate their feet so that that going barefoot can continue as the default condition.

"BUT WAIT ONE MORE TIME!," you may shout. "Those with peripheral neuropathy and Raynaud's clearly shouldn't go barefoot in certain conditions because it could create a health risk for them. Footwear is the only therapy that can't prevent serious problems."

Look, I get it that living barefoot isn't the end-all be-all for everyone. I get it that it truly isn't advisable for some select people to be barefoot in specific circumstances.

The bottom line is that the burden of proof lies with those who think footwear, orthotics, arch supports, braces, taping, etc. is inherently better for everyday living than our own two feet. While these things can provide therapeutic relief from specific medical conditions, they should not be considered for long-term, everyday use. What's more, everyday use of footwear has been shown to be detrimental and each person should think critically about whether remaining barefoot -- the human condition -- might be the best option until proven otherwise.


  1. I was that guy on Twitter. The thing is, whether you like it or not, that shoes are the default for most people in the First World. While I agree no one should dictate that we wear shoes regardless of arguments on either side (they're our feet, period!), it would be less of a hassle if we had a stronger case (although really, if it works for us, that's all they need to know). I also feel the shod world is missing out, but how do I show that to them?

    As things stands, if they even consider it they think it won't work for them. They may have heard of the Vibram lawsuit, even though that was about lack of substantiation of claims about particular minimal shoes. I've heard that 'barefooting' causes stress fractures, when it's more likely due to minimal shoes hiding people's initial vulnerability and not coercing them to adapt their form. There's also confirmation bias: each side clings to its own stories, which isn't even all that unreasonable when you suspect reporting bias on the other side.

    This is where some hard science would really help out. Both sides have claims that should be easy to test. So test them and enter a dialogue to address perceived weaknesses. We already know that people who are habitually barefoot tend to be in better shape, but what happens when people transition is less clear. Alleviate reporting bias, don't conflate minimal shoes with actual barefooting, differentiate best practice, and show that we're not the lucky ones who have successfully kicked (off) the habit but that most people used to wearing shoes can adapt.

    I see shoes as accessories that should have the burden of proof, but I'm willing to get some proof of my own anyway. I feel we can only gain ground that way, which will in turn make subsequent steps easier.

  2. This is a big, big hole in shoe-proponent expect it to be ignored and this argument dismissed! As I said on Ahcuah, I think that the next time I get in one of those shop arguments, if they are a woman, I will start with ‘I notice you aren't wearing a corset, have you got any proof you don’t need one? Really? Don't you know there was once a time when they were worn for health reasons?’ might stump them at least. It is actually a very similar situation since doctors used to design them the way they now design orthopaedics.

    You will need to explain the similarities between corsets and shoes, without befuddling them or becoming sidetracked, however. The restrictions, how doctors designed them 'for health' the same way they now design shoes based on an archaic understanding of the foot that has nothing to do with reality. This is a good metaphor but you need to be careful how you use it as they might not get it.


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