Podiatric Community
pfbare.gif (5853 bytes)So what do the foot doctors think about going barefoot?  Well, the podiatrists are mostly lukewarm about it. The fact is that most people (at least in the USA) don't go barefoot very much anymore. This may explain why most podiatrists seem to lack comfort with this issue. It's also worth noting that podiatrists see a surge of mishaps related to going barefoot when summer starts. This may lead them to conclude that going barefoot is just plain dangerous. However, this surge of problems are undoubtedly suffered by people who aren't used to going barefoot ... suddenly going barefoot without the subconscious care and attention developed by people (adults or children) who go barefoot on a regular basis.

Podiatrists who have traveled and worked in countries where the populace do not generally wear shoes, come back with enthusiastic reports of how amazingly free of foot problems these people are [see this article and also Medical Research].

pfshod.gif (6055 bytes)In general, most doctors will confirm that spending time barefoot is very healthy for the feet. While we agree that it's important that any shoes should be fitted and chosen very carefully, we are surprised that so many podiatrists are not promoting more barefoot activity. Since this has been proven time and again to reduce foot problems, we sometimes wonder if there is some ulterior motive. A good percentage of podiatrists make a large income from the fitting of custom "orthotics".  Orthotics seem to us to be simply putting a band-aid on a problem caused the foot being held relatively immobile in the "cast" of a shoe. On the other hand, due the wide variation in foot shape/size (sometimes even on the same person), there is no such thing as a correctly-fitting shoe. One could spend large sums of money (over and over again) using orthotics to better match each individual shoe to the shape of each foot, but the foot is still held unhealthily immobile and unventilated after such efforts. The obvious alternative is to minimize time spent in shoes.
[ for more on shoe-fitting and it's consequences, click here ]

Podiatrist Simon Wikler stated:

. . . I spent a day in such a shoe store observing the operation.

"How can you sell these corrective shoes," I asked the owner. "You insist on the necessity of 'arch cookies,' 'cuboids,' 'metatarsal supports,' and so on-yet from the continuous complaints of customers, you know that these supports are of no help to the feet. How do you justify this?"

"It's a wonderful living," the owner commented. "Besides, I always instruct them to do certain exercises. They never do them. When they complain too much about their feet, I say, 'Well, did you do the exercises?'  That usually shuts them up." . . .


There follows a sampling of statements from podiatric websites we have visited:

Overstatement

On David C. Stege's website he states:

"Going barefoot is a healthy activity for children under the right conditions. However, walking barefoot on dirty pavements exposes children's feet to the dangers of infection through accidental cuts and to severe contusions, sprains or fractures"

Please!!  ... pavements don't give you cuts ... and as for "severe contusions, sprains or fractures", we just don't know where that came from. Bare feet can go safely on hard surfaces. This kind of alarmist statement really puzzles us. It goes completely against our own experience and that of a good number of medical researchers. As for "dirt", this is pure neurosis. The world is full of compounds one could label as "dirt" and the human body is well equipped to deal with them (or we would all be dead). Unless you want to raise your children in sanitized, plastic bubbles, it would be a better idea to confine such worries to actual, describable risks rather than to anonymous risks from  so-called "dirt".

He also states:

"The components of your feet work together, sharing the tremendous pressures of daily living. An average day of walking, for example, brings a force equal to several hundred tons to bear on the feet. This helps explain why your feet are more subject to injury than any other part of your body."

This is a classic example of "How to lie with statistics."  Weight is not cumulative in this way. One could just as easily say that, since our heads bear air pressure of fourteen pounds per square inch, by the end of the day we have had several thousand tons on our scalps.


Athletes Foot

The American Podiatric Medical Association (APMA) admits that:

"The fungus most commonly attacks the feet because shoes create a warm, dark, and humid environment which encourages fungus growth."

And this is borne out by the studies referenced by the American Academy of Dermatology (see here) which states that:

"It's commonly believed that athlete's foot is highly contagious -- that you can easily catch it from walking barefoot in the locker room. This is not true. Experiments to infect healthy skin with athlete's foot have failed and often one family member may have it without infecting others living in the same house." -- American Academy of Dermatology

Yet, in the same document on athletes foot, APMA goes on to say:

"Avoid walking barefoot; use shower shoes."

This flies in the face of evidence presented by AAD. We can only assume that either the APMA  literature isn't up-to-date, or that there is a deeply embedded "don't go barefoot" philosophy in this organization. Never mind what science and logical reasoning tell us.


Warts

The American Podiatric Medical Association (APMA)  says:

"The plantar wart is often contracted by walking barefooted on dirty surfaces or littered ground where the virus is lurking."

There are no known studies that support this statement. Bandolier, a journal of evidence-based healthcare, could only find one paper which seemed to address this question. That study indicated a possibly greater risk of plantar warts due to communal shower use. In the above statement, APMA appears to be offering conjecture as fact. For our views on this matter click here.

APMA goes on to say:

"The virus is also sustained by warm, moist environments, so that warts are often associated with communal bathing facilities -- more for the wet surfaces, however, rather than for transmission in water, which probably is rare."

This is more in line with the one available study. But, once again, APMA is stating more than the available evidence suggests.


Early childhood

APMA states:

"When a child begins to walk, shoes generally are not necessary, Allowing an infant to go barefooted indoors, or to wear only a pair of socks, helps the foot grow normally and develop its musculature and strength, as well as the grasping ability of toes."

We agree, with the exception that outdoors is also fine with an initial check for any hazards.
Podiatrist Simon Wikler said:

". . . It is not enough that children's feet be free from deforming shoes - foot health also depends upon going barefoot in order to develop agility and strength in the feet   . . . For toddlers, shoes should be worn outdoors only during inclement weather and indoors only for infrequent dress-up occasions . . . "
[ see here for a larger extract of his book "Take Off Your Shoes and Walk" ]

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