09/01/2025    Howard E. Friedman, DPM

Barefoot Walking at Home Increases Intrinsic Muscular Strength (Michael Chin, DPM)

Regarding the recent posts about the benefits of
barefoot walking, I revisited my letter to this
forum in 2020 in which I cited two studies that
documented either improved intrinsic muscle size
or improved balance and posture in barefoot
walkers. Since then there have been further
studies that have returned the same results in
addition to previous research.

However, many things are clinically true about
barefoot walking at the same time. Yes, people can
get puncture wounds and fungal or bacterial
infections. But, it is incontrovertible that a
program of barefoot walking in a safe environment
for appropriate people can result in larger, i.e.
stronger, intrinsic foot muscles. It is also true
that barefoot walking does not result in a zero-
injury rate in feet and legs and in fact can lead
to Achilles tendonitis. However, it is also true
that one study showed that runners with fasciitis
improved from 6 weeks of barefoot running on
grass.

Podiatrists should familiarize themselves with
studies about the benefits of barefoot walking. A
regimen of barefoot walking can be a useful tool
practitioners can prescribe to help some patients
improve their long-term foot health. And it is
also true that some patients should still be told
to never walk barefoot.

1. Ridge, et al. (2020) :
This study involved daily activity in minimal
footwear over a period of six months. Using a
dynamometer, it was found that participants
experienced an average increase in foot strength
of 57.4%, which was statistically significant
(p<0.001).

2.Franklin, et al. (2022) :
This was a cross-sectional study that compared
habitual barefoot runners to those wearing
technological footwear. Using ultrasonography for
measurement, the research found a statistically
significant greater cross-sectional area or
thickness in several intrinsic foot muscles (AH,
ADM, QP, and FHL) in the barefoot runners.

3. Holowka, et al. (2016) :
This cross-sectional study of habitually barefoot
populations found that these individuals had
larger abductor hallucis and abductor digiti
minimi muscles compared to habitually shod
populations. The measurement method was not
specified.

Studies I cited in 2020: The American Journal of
Sports Medicine by Taddei, et. al: 'Foot Core
Training to Prevent Running-Related Injuries'.
This level 1 randomized controlled trial shows
that runners who performed foot core strengthening
exercises had a 2.42-fold lower rate of running
related injuries after a period of 4-8 months of
exercises.

'Foot and Ankle Strength, range of motion, posture
and deformity are associated with balance and
functional ability in older adults', Archives of
Physical Medicine and Rehabilitation in 2011
demonstrated in a cohort of adults over 65 years
of age that improving foot strength, specifically
hallux flexor and ankle inversion and eversion
strength led to an improvement in a battery of
balance, posture and sway tests.)

Howard E. Friedman, DPM, Suffern, NY

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