Dear Doc,

I decided 2013 is my year to transition to barefoot shoes. Ditching my thick, soft soles will make me faster and healthier, right?

Best, 

Carl the Caveman, N.C.

Carl,


Before you go shoe shopping, ask yourself this: Is your butt ready to go barefoot? Minimalist shoes are all the rage. People everywhere swear that running “barefoot style” eliminates injuries and increases performance. As a physical therapist, I’m skeptical. What the shoes actually do is change runners’ mechanics. 


Barefoot shoes can be great for runners who are strong. But strong feet aren’t enough. The stabilizing muscles, from the toes all the way up through the glutes and core, must balance the body. For example, if someone has a weak gluteus medius, his or her hip tends to swing to the outside. The knee compensates by dropping to the inside of the body and it leads to pronation (rolling in) of the foot, which may have been stable and neutral before switching shoes. When the body compensates, something’s bound to give.

The barefoot shoes are not stabilizing you. Nor are your glutes, which means that the IT band, medial knee and other such structures are being stressed. This can lead to injury. 

Before going barefoot, here is my advice:

  • Get your feet stronger. Can you pick up marbles and pens from the ground? Can you scrunch a towel?
  • Get evaluated. Go to your local running store and have them do an extensive evaluation to determine if your feet can structurally handle a barefoot shoe.
  • Get your butt stronger. If the stabilizing muscles can’t support you, neither can your feet. Perform a one-leg squat in the mirror. If you see your knee shift out of alignment with your feet and hips, you need to get stronger first. 
  • Practice, practice, practice. Start with low mileage. Take steps around the house and slowly increase your time just walking. Once you can do a couple of hours with no increase in symptoms anywhere (back, hip, knee or foot), start cooling down after your run in your barefoot shoes. Slowly increase the time, but carefully monitor for any symptoms. 

# # # 

Shefali Christopher PT, DPT, SCS, LAT, ATC works for Proaxis Therapy at Southpoint and Carrboro. She is a therapist, mom and competitive triathlete who loves flexing her toe muscles in the mirror. Look for her (in traditional running shoes) training on a trail near you.