Thursday, May 12, 2011

Barefoot Likely Better Than Shoes If You Step on a Nail

A common argument against going barefoot is that one might step on a nail and it could go straight into the sole of your foot. By wearing shoes, many people believe, you can protect your soles from such puncture injuries. On the surface this seems like sound advice, but when you look more closely at the issue you'll discover that it's probably just best to take your chances barefoot.

Some "protection."
(Image: Cirris Systems)
Before I write any further, it's important to remember that nails can pierce into the feet even if someone is wearing footwear. Construction workers experience this a lot - especially those involved in demolition work. Closer to home, I recently had a friend post on Facebook the following status: "How worried should I be that my 5 year old stepped on a nail outside? Went through his flip flop and made him bleed. Says it's still hurting this morning..." The flip flop was likely intended as a protection for his feet but failed at its job. Some people might say that if he'd gone barefoot the injury could have been even worse. I disagree and here's why:

First, stepping on a nail while barefoot does not automatically mean you'll get a puncture wound. Because each foot has 200,000 nerve endings in its sole, our bodies are exceptional at reacting to painful stimuli beneath us and reacting accordingly. It's like pulling your hand away from a hot pan on the stove. Almost before we can realize it our body's natural systems have kicked in to protect us from harm. If we begin to step on a nail or other sharp object while barefoot, our feet - if flexible enough - can mold around the offending item and/or pull away before much damage is done. I'm not saying that a puncture wound won't happen, but it could be far less deep and serious without shoes.

Keep in mind that when we wear shoes, almost all sensation of the ground below us is blocked. Our bodies cannot react until the offending object has already pierced through the layer(s) of sole material in the shoe and by then it's too late. We've already begun to put so much force down that a puncture is all but guaranteed. Likewise, the material of the shoe holds the nail or other object in place! We can't take the foot out of the shoe until we've pulled out the nail or destroyed the shoe. If, while stepping down, we sense that the nail is there and then try to step away from it we can't.

Shoe material partially
removed from around a nail
in boy's foot.
Image: Cline's Family Blog
Secondly, a nail that is stepped on barefoot is likely to be less harmful than one stepped on with shoes due to a lack of additional foreign material that can enter the wound. If a person does puncture the foot with a nail while unshod, pretty much the only thing going into the foot is the nail. On the flip side, a nail that has already punctured through a shoe's material(s) may end up depositing fragments of that material inside the foot. Depending on the shoes, this may include rubber, foam, fabric and/or glue. What's more, any contamination that has occurred to that material via mud, animal excrement, foot sweat or various forms of bacteria may also go inside the foot as well. If foreign contaminants are left inside the foot and the wound heals around them, it could cause infection and other problems long into the future. For diabetics or others who have difficulty with wounds healing, this can be especially bad.

Let's be clear: I'm not saying that going barefoot keeps you from stepping on sharp objects like nails. I'm also not saying that shoes won't protect against such objects -- they obviously will to some extent. What I am saying is that my chances while barefoot seem no worse than with shoes. In fact, I feel like there's a better chance of avoiding some puncture wounds and further complications by going barefoot instead of wearing shoes. All things considered, I'll just go barefoot, be careful and let the chips fall as they may. I'm up to date on my tetanus shot, and that's what's really important. It's a good idea for anyone.

We should remember that for most people, stepping on a nail is not a risk to life or limb* and doesn't prevent you from going barefoot again in the future. Stuff happens. I stepped on a nail while barefoot in our house as a kid. It hurt. There was a lot of drama around the experience. I moved on, though. I grew up and became a barefooter who realizes that risks are out there, but the rewards of living unshod are so much greater.

What do you think? Have you ever stepped on a nail, whether barefoot or shod? If so, do you think the situation would have been worse if you'd had your feet the other way? Has some past injury made you skiddish about going barefoot more often? Please leave any and all comments you have in the section below.


* - People with difficulty healing wounds or with peripheral neuropathy should take extra caution to keep floors clear of debris and clean as a way to prevent potentially-catastrophic injury. Always consult with your doctor about the wisdom of barefoot activity in relation to your condition(s).

3 comments:

  1. Like I said earlier on twitter, I can remember 4 distinct instances of me stepping on a nail. 3 were shod, one was just a few weeks ago, barefoot. All of these puncture wounds were extremely serious... except the barefoot one. All of them also occured on job sites. Three times I have been moving around quickly not looking where I was going, why would I? I have protection! And then an awful feeling. One time it was so serious that i lt went through my foot and just barely poked out the upper of my shoe.

    The time just the other day was going down a loading ramp, the nail was a finish nail, and it was propped up on the treads of the ramp. I stepped into it and I immediately jerked backwards. I brought my foot to view and a nail was sticking just inside the skin, I plucked it out and went about my business. No pain. No blood.

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  2. I've been running barefoot for 1 year, and just going barefoot nearly fulltime, meaning college, shopping, and at home. For the 5 years I've been running, I've only punctured my foot with glass once, when wearing a heavily cushioned shoe, two years ago.

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  3. You mentioned shoe fragments getting deposited into a puncture wound as well as various forms of bacteria that may get in. Various pathogens do indeed live inside dirty, dark, moist shoes and can easily enter the wound as a nail passes through the shoe and into a foot. This was shown to be the case in a 1997 study entitled, "Soft Tissue and Bone Infections from Puncture Wounds in Children" by Terese J. Laughlin, DPM, and others (See http://tinyurl.com/3vnfkwa ). They reported on 44 children admitted to a hospital with infected foot puncture wounds during a 7-year period. Of the 44 children injured, 17 had been barefoot. And as you can read in the study, those that were barefoot had significantly less soft tissue or bone infections than those who had been shod. The study supports the theory that infections in foot puncture wounds are much less likely when barefoot than when wearing shoes.

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