Unlocking the Power of Barefoot Shoes

In this episode of the Align Podcast, the following topics were discussed:

• Exploring movement in spirals, emphasizing non-textbook approaches.
• Athletes prioritizing performance over health risks in their busy lives.
• The importance of maintaining natural movement patterns for structural integrity.
• Challenges in physical therapy and techniques for improvement.
• The impact of connective tissue on the entire body.
• The story of how back pain from rollerblading kick-started David’s career.
• The discussion of why walking on flat surfaces may not be healthy.
• The concept of strengthening the foot by embracing discomfort.
• How limb position affects movement and efficiency.
• The use of tools for survival and creativity.
• The importance of not neglecting strength training.
• The advice to test yourself, avoid harm, and study wisely.
• The significance of pain in protecting oneself and adapting.
• Learning rope tricks for both enjoyment and practicality.

Much of the conversation centers on the idea that modern footwear and flat, uniform surfaces have weakened our feet, and that restoring natural movement patterns can improve how the whole body works. That is an appealing story, and part of it is supported by research. Other parts are still open questions. Here is what the evidence says.

What barefoot and minimalist shoes are

Barefoot or minimalist shoes have thin, flexible soles, little or no cushioning, a flat profile (often called zero drop) and a roomy toe box. The idea is that thick, supportive shoes reduce how much the small muscles inside the foot have to work, much as a brace can reduce the work of the muscles it supports.

Do they strengthen the feet?

This is the best-supported claim. In a randomized trial of 57 runners, those who spent eight weeks gradually increasing the number of steps they walked in minimalist shoes gained foot muscle size and strength, about as much as a group doing progressive foot-strengthening exercises, while the control group saw no change (Ridge et al., 2019). A systematic review of nine studies reported strength gains between 9 and 57 percent and size gains between roughly 7 and 11 percent in healthy people (Xu et al., 2023).

A larger 2025 review and meta-analysis of 28 randomized trials (1,399 participants) found that minimalist shoes improved the strength of toes 2 to 5, but the authors rated the certainty of the evidence as low to very low because there were few studies and many had a high risk of bias. Muscle size results were conflicting (Peters-Dickie et al., 2025).

In short: foot strength likely improves with minimalist footwear, but the trials are small and short, and we do not know how much that strength matters for everyday health.

Do they prevent injury or improve running?

The popular claim that barefoot shoes prevent injuries is not established. A systematic review of 23 studies found moderate evidence for biomechanical differences when running barefoot, such as lower peak vertical ground reaction forces, shorter strides and a higher step rate. However, because of the lack of high-quality evidence, it concluded that no definitive conclusions could be drawn about specific risks or benefits (Perkins et al., 2014).

Changing how the foot lands moves load around, and it does not simply remove it. In one MRI study, 10 of 19 experienced runners who transitioned to minimalist running shoes over 10 weeks showed increased bone marrow edema (a sign of stress on bone) in at least one foot bone, compared with a significantly smaller number of runners who stayed in their usual shoes. On the study’s 0 to 4 scale a score of 4 represented a stress fracture, and the authors advised that runners transition very slowly and gradually (Ridge et al., 2013).

What about walking on flat surfaces?

The episode raises the idea that walking on flat surfaces may not be healthy and that strengthening the foot by embracing discomfort is useful. We did not find direct trials testing either idea. Uneven ground does ask more of the foot and ankle, so it is a reasonable thing to include, but it is an idea about training variety and not a proven requirement. On the discomfort point, aches from unfamiliar load are normal, while sharp or persistent pain is a signal to back off, which fits the episode’s own advice to test yourself and avoid harm.

A cautious way to try them

• Start small. Wear them for short walks or around the house first, and add time over weeks, not days.
• Keep your regular shoes for most activity while your feet adapt, and avoid switching your running to minimalist shoes overnight.
• Add strength work. Foot strength is one piece of a bigger picture. Our articles on resistance training after 40 and mobility work versus stretching cover the rest of the body, and daily walking is the easiest way to build up time on your feet.
• Stop and get checked if pain in the foot or shin is sharp, localized, getting worse or keeps you awake at night, since that can mean a stress injury.

Who should be careful

Diabetes or neuropathy. Reduced feeling in the feet means you may not notice a cut, blister or pressure point. The National Institute of Diabetes and Digestive and Kidney Diseases advises people with diabetes not to walk barefoot, even indoors, and to wear shoes and socks at all times (NIDDK). Thin soles offer less protection, so talk with a clinician or podiatrist before changing footwear.

Poor circulation, foot deformities, recent foot or ankle injury, or pain you cannot explain. Get advice before switching.

The honest takeaway

Barefoot shoes are a reasonable tool for building foot strength if you move into them gradually, and the best evidence supports that benefit. Claims that they prevent injury or restore “natural” function across the whole body are not established, and a too-fast transition can cause injury. Treat the episode’s ideas as a good prompt to give your feet more to do, and let comfort, history and a slow progression guide how far you take it.

References

• Ridge, S. T., et al. (2019). Walking in minimalist shoes is effective for strengthening foot muscles. Medicine & Science in Sports & Exercise, 51(1), 104–113. PubMed
• Xu, J., Saliba, S. A., & Jaffri, A. H. (2023). The effects of minimalist shoes on plantar intrinsic foot muscle size and strength: a systematic review. International Journal of Sports Medicine, 44(5), 320–328. PubMed
• Peters-Dickie, J. L., et al. (2025). The effects of foot core exercises and minimalist footwear on foot muscle sizes, foot strength, and biomechanics: a systematic review and meta-analysis. Clinical Biomechanics, 122, 106417. PubMed
• Perkins, K. P., Hanney, W. J., & Rothschild, C. E. (2014). The risks and benefits of running barefoot or in minimalist shoes: a systematic review. Sports Health, 6(6), 475–480. PubMed
• Ridge, S. T., et al. (2013). Foot bone marrow edema after a 10-wk transition to minimalist running shoes. Medicine & Science in Sports & Exercise, 45(7), 1363–1368. PubMed
• National Institute of Diabetes and Digestive and Kidney Diseases. Diabetes and foot problems: do not walk barefoot, wear shoes and socks, check feet daily. NIDDK

Related reading

• Walking as Medicine: Daily Steps, NEAT, and Longevity
• Mobility Work vs. Stretching: What’s the Actual Difference (and Which Do You Need)?
• Resistance Training After 40: Why Strength Becomes the Priority

This article is for general educational purposes and is not a substitute for personalized medical advice. Anyone with diabetes, neuropathy or persistent foot pain should speak with a clinician or podiatrist.