Enhancing the Health of the
Everyday Athlete – Efficient
Barefoot Movement
Stephen Gangemi, DC, DIBAK
Moving - Gait
• Gait dysfunction  Health dysfunction
• Kinesthetic sense: the relationship between
the nervous system and the sensory feedback
provided by each foot – 7,000+ nerve endings
• Proprioception: sense of position, posture,
What Disrupts Gait?
• Health Problems:
– Structural (current or past injuries, posture,
excessive training – duration / intensity)
– Nutritional (diet, hormonal stress)
– Emotional
• Improper footwear
• Orthotics – a brace that supports dysfunction
• Nothing worn on the foot can improve its
• A bare foot moves in the most efficient,
natural, and healthy way (in a healthy
Modern Footwear
• Soft midsole
Elevated Heel
Line of falling weight moves
forward with heels
Motion Control
Footwear Industry Claims
Run faster
Jump higher
Be stronger
Exercise muscles not otherwise used with
competitor’s shoes or while barefoot
Yet there has never been any research to
validate such claims
Injury Prevention?
• None of which can be substantiated through
any scientific study
• Numerous studies on injury promotion:
– Journal of Injury, Function & Rehabilitation, Dec 2009: Running shoes
protect the feet at the expense of increased joint torques at the hip,
knee, and ankle
– British Journal of Sports Med 2010: Elevated heels and cushioned
shoes relationship to injuries
– Medicine & Science in Sports & Exercise 1991: Running shoes and
diminished sensory feedback and injury increase
– More: runblogger.com, naturalrunningcenter.com, philmaffetone.com
Barefoot or Shod?
• Recently, there has been a significant move
towards minimalist type shoes and barefoot
walking and running
• Experienced, habitually barefoot runners will
avoid landing on their heel.
• The natural motion during barefoot running is
to land with a midfoot, or even a somewhat
forefoot strike.
• A heel strike (while running) most often
results in a significant stress to the body,
whereas a midfoot or forefoot strike does not
• Most running shoes are developed to promote
a heel strike, and therefore an unnatural
running and gait cycle
Heel strike
Ideally the body’s
center of mass
should be over
the foot for the
lowest loading
Midfoot/forefoot strike
Healthy Footwear
• No arch support – the arch needs to flatten
upon impact to dissipate shock
• Arch supports support the arch, not the ends
of the arch  a weak and dysfunctional foot
Low Stack & Drop
• Stack Height
11mm heel
• Drop
• “Zero-Drop”
11-7=4mm drop
7mm forefoot
• No Stability or Motion Control – natural
pronation deflects shock
• Tibialis Posterior plays an important role
Toe Box
• No cramped toe box – so the toes can splay
apart to soften landing
Widest at the
Cushioning? No!
• Cushioning does not absorb shock – it tricks
the body by sending false information to the
brain – “Is this a soft surface or hard?”
The Harder the Surface the Softer the
Nice Gait Kid!!
• The harder the ground the more the
body will adjust with more knee
flexion and pronation
• Pavement is the easiest to walk/run
on barefoot
• Natural terrain is unpredictable
The Ideal Shoe?
• Depends on the individual,
• But generally:
•Roomy forefoot (1/3-1/2” in front of big toe)
•Close to the ground throughout (low to zero-drop
and a low stack height)
•Wide Toe Box
•Flexible in all directions
•Firm sole (not soft or “cushiony”)
Barefoot as much as possible, shoes
when needed
• Wear shoes that will not harm you during your daily activities
and during exercise; this includes disrupting your gait
• Notice that the word “benefit” was not used, as footwear is
not meant for this reason
• Footwear should only protect the feet from damage that may
occur from the particular environment
• There is a transition period into more barefoot walking and
minimalist-type shoes as the weakened muscles, tendons, &
ligaments regain their strength; transition as comfortably and
as safely as you can
More on Barefoot, Minimalism,
and Injury Prevention & Treatment

Check out my power point presentation on barefoot and - Sock-Doc