You’ve heard the phrase: if you don’t use it, you lose it, right?!  Well, you do stand to lose some important things if you don’t spend time barefoot. Here at Beacon Physical Therapy, we care a lot about all of the connections your brain and body are making, many of which intimately involve your (bare) feet. Read on as we cover some fun foot information and hopefully convince you that going barefoot is totally worth devoting some time to!

The homunculus is a big word, but in simple terms it is a body map of the brain for both the motor and sensory cortex. The size of each body part on the homunculus is represented based upon the percentage of use with functional tasks. For example, the hands are about 25% of the homunculus, and the feet represent about 10-15%. Does this mean that our hands are more dexterous than our feet? Well, yes and no. Because we use our hands more than our feet with fine motor skills such as eating, writing, typing and playing the piano, the function of our hands become heightened on cortical brain maps. If we looked at the homunculus of human feet in Western cultures today, they would likely represent 0.01% because of how much time we spend in shoes that limit our foot movement.

If we stop using a body part, the companion cortical area in the brain will shrink and we will lose function in that body part. Some research has shown that immobilizing the hands and arms for only 2.5 weeks significantly reduced hand use and impaired tactile acuity. Similarly, when we immobilize our feet by wearing shoes that keep our toes bound up together, we are shutting down these cortical pathways. Consequently, the intrinsic and extrinsic muscles of the feet atrophy, which can lead to plantar fasciitis, hammer toe, bunions, posterior tibialis or Achilles tendinopathy, etc., not to mention create negative impact up the kinetic chain (i.e., knees, hips and back).

Many of the options we have when we buy shoes these days include extra padding and support. Interestingly, this actually sets our foot health back! Research by Petersen et. al. (2020) found that permanent support of the foot (permanent arch supports, stability and motion-control shoes) can decrease the efficiency of the activity and sensitivity of the muscles of the foot. In contrast, walking barefoot can increase the sensitivity of the feet which promotes proprioception, and increases the activation of the intrinsic and extrinsic foot muscles. Both of these beneficial actions related to walking barefoot have been shown to improve balance in older adults.

In order to walk or run, we need the leverage and stability that intrinsic foot muscle strength provide (Holowka et al., 2018); Sichting et al.,2020). Not to keep harping on modern shoes, but most have restrictive toe boxes, and raised arch supports that passively support and stiffen the longitudinal arch of the foot, which can decrease the strength of the intrinsic and extrinsic foot muscles. Overuse injuries are sure to follow, including plantar fasciitis, posterior tibialis tendinopathy, knee osteoarthritis, bunions, metatarsal stress fractures, and tibial stress fractures.

Most modern shoes have what is called toe spring (the upward curve of the front of the toe box at the front of the shoe). This shoe shape seems like a great idea in theory, but it has also been shown to alter the natural biomechanics of the foot during walking, decreasing the activation of the intrinsic foot muscles. Among runners, Ridge et. al. (2018) demonstrated how simply wearing minimalist shoes for everyday use (shoes for work and walking around town) while continuing to run in traditional running shoes was just as effective as performing foot exercises to develop strength in the intrinsic and extrinsic muscles of the feet. We can easily postulate that walking barefoot would produce the same results.

There is some good news here: our brain has plasticity, or the ability to change and adapt as a result of experience. Research has shown that individuals who lack hands and must use their feet to replace this function can develop cortical toe representation that mimics that of a typical hand. We’re not saying you should go drive your car or eat dinner with your feet but try to decrease the time you spend in shoes. Opt for a shoes-free household (that means no slippers), and if you have outdoor space where it’s appropriate to do so, go barefoot. Your feet may be a bit sensitive at first, but they will adapt. While modern shoes may increase comfort and give you style points, going barefoot even if only around the house can help strengthen your feet and decrease your risk of foot-related issues – and also decrease your risk of knee, hip and low back pain.

At Beacon Physical Therapy, we support our patients in making small changes that make a big difference. That includes giving your feet some room to breathe! Come in for a session soon and bring your foot-related questions. We’d love to meet you and get you back to doing what you love.