Sport and fitness trends. 12 minute read.
Are barefoot shoes good for your feet? And how to change shoes without getting hurt
By the PocketPhysio editorial team. Published 2026-10-01.
What a barefoot shoe actually changes
A barefoot shoe changes three numbers, mostly. The heel to toe drop, which is how much higher the heel sits than the forefoot; the stack height, which is how much material sits between your foot and the ground; and the width of the toe box, which decides whether your toes can spread when you load them. Most shoes sold as barefoot or minimalist also have a bendy sole and none of the plastic or firmer foam used for motion control.
Nothing about those changes is mystical. They let the foot bend and splay, and feel more of the ground, and they ask the muscles inside the foot and the calf to do work that a stiff, cushioned, raised-heel shoe does for you.
The language is a mess, and that is a practical problem rather than a pedantic one. A 2025 systematic review notes that "phrases such as 'barefoot shoes', 'minimalist shoes', or 'no-drop shoes' are often used interchangeably in both research and practice", lists heel stack height, longitudinal flexibility, overall weight and toe box width as the design features that vary, points to a 2018 framework that classifies footwear along a minimalist index, and adds that many experimental studies still fail to report those parameters in detail (Rodriguez-Longobardo and colleagues, 2025). If a study does not say what the shoe measured, its result cannot be matched to the shoe in your hand.
So the useful question in a shop is never whether something is barefoot. It is what the drop is in millimeters, how thick the sole is, and whether your toes have room.
The case for: feet do get stronger
The clearest single study ran for six months. Twenty-two adults, mean age 27, wore a minimal shoe for at least 70% of their shod time on at least six days a week, while 24 others carried on in normal shoes. They were told about the risks of running in minimal shoes and asked not to use them for running, so this is a study of daily walking and standing, not of running. Foot strength, measured as a maximum isometric push through the joints at the base of the toes on a custom dynamometer, rose by an average of 57.4% in the minimal footwear group (p below 0.001), with no significant change in the controls. A third group who had worn minimal shoes for about 2.5 years tested at a similar level to the six-month group, which suggests the gain arrives and then plateaus (Curtis and colleagues, 2021).
That 57.4% is the figure you see quoted everywhere, usually with none of that attached. It is the average change on a laboratory rig, in 22 young adults, over six months of near-daily wear, in a study funded by the Future Footwear Foundation, with the authors declaring no competing interests. The spread around that average was enormous, a standard deviation of 68.4 percentage points, so the headline number is nobody's expected result. The same paper notes that it did not image individual muscles with MRI or ultrasound, and that arch height is only a crude measure of how stiff an arch is. Foot width did not change, which matters if you were told the shoes would reshape your feet.
A 2025 systematic review brought together 7 studies in 213 participants (72 men, 141 women) with a mean age of 27.8, mostly recreational runners, with smaller groups of sports science students, gymnasts and cheerleaders. Interventions ran from 3 weeks to 6 months. Foot muscle volume went up in most of them: by 8.8% in the intrinsic foot muscles after six months in runners who moved into minimalist shoes alongside a transition program of calf and balance work plus foot placement drills, with average compliance to the shoes of only 39.2%, and by between 8.8% and 22.3% across different muscles after eight weeks in another trial. One 12-week barefoot training program in 14 young adults reported toe flexor strength up 32.7%, with no comparison group to measure it against.
Read the title of that review before the result, though, because it is about barefoot and minimalist training rather than about shoes. Of the 7 studies, the 8-week one with the 22.3% figure was an 8-week foot muscle exercise program in 28 runners, nothing to do with footwear, and it found no improvement in toe flexor strength against its control group and no change in arch movement or foot function. The 12-week one was barefoot agility and balance drills plus calf work. Two others were training programs performed in minimal shoes, and one was a cross-sectional look at gymnasts who had always trained barefoot.
The review's own reading is that adaptations were clearest where strength, balance and agility exercises were combined over several weeks, which means it cannot separate the shoe from the exercise. The six-month study in the section above is the cleanest test of footwear on its own.
The authors put their own brake on all of it. Those gains in muscle size, they write, "may not consistently translate into proportional gains in muscle strength or functional performance, especially in short-duration or low-intensity interventions", and they list small samples and limited blinding among their limitations, along with inconsistent protocols and incomplete reporting of the footwear itself. Bigger foot muscles in a 27-year-old gymnast is a measurement, not a promise about your symptoms.
The case against: injuries in people who switch fast
Bone is the tissue that complains first. Thirty-six experienced recreational runners were split into 17 who kept their usual shoes and 19 who transitioned gradually to a minimal shoe over 10 weeks, with MRI scans of the feet before and after. Afterwards, 10 of the 19 in the minimal group showed increased bone marrow swelling in at least one bone, significantly more than the control group (P = 0.009), on a scale where the top grade counted as a stress fracture. Read that as bone reacting to new load rather than as 10 injuries: the outcome was an MRI score, not a diagnosis anybody reported, and the published abstract does not say whether those runners had symptoms. The authors concluded that runners "should transition very slowly and gradually to avoid potential stress injury in the foot" (Ridge and colleagues, 2013).
Note what that study was not. It was not a group of people who bought the shoes on Friday and ran a 10 km on Sunday; it was a supervised 10-week transition, and the bones still reacted.
Across the wider literature the injury signal is genuinely unclear. A systematic review of 20 transition studies pooled injuries from 12 of them and found 17.9 injuries per 100 participants in minimal footwear, from 195 participants, against 13.4 per 100 in matched conventional shoe groups, from 187 participants. The difference was not statistically significant (p = 0.219), and the authors call the comparison equivocal. Only 5 of the 20 studies were rated high level with low risk of bias (Warne and Gruber, 2017).
So the honest version has two halves that both stay. Gradual exposure builds foot muscle. Fast exposure, and sometimes careful exposure, puts measurable load into bones that were not ready for it.
How to make the change
The best available schedule comes from that same review, and it was written for runners. Take no less than 4 to 8 weeks. Drop your overall running volume by around 10% to 20% for the first two weeks, because the loading pattern is new. Then increase the share done in the minimal shoe by about 5% to 10% per week, with a sensible cap on any single session rather than a percentage alone. Your physio will adjust all of this to your mileage, to your history and to what your own feet do.
Two extras earn their place. Only 8 of the 20 studies added strengthening work, and the review recommends strength work for the calf, balance work at the ankle, and light plyometrics alongside the transition. Nine of the 20 added gait retraining, usually a quicker cadence and a lighter, quieter footfall, which is a coaching job rather than something a shoe does for you.
For walking in minimal shoes there is no schedule to give you, and it is worth saying so plainly. The six-month strength study did not build anybody up: its participants wore the shoes for most of their shod time from the start, and nobody has published a stepped walking transition to copy. What is left is a principle rather than a number. Wear them for short periods first, keep your old shoes for the long days and the hard surfaces, and let the next morning set the pace, because a new ache in the arch, the calf or the ball of the foot that is still there the following day means you went up too fast, not that you need to push through. A physio can turn that into a schedule for your feet, which is what the research cannot do.
Keep the shoes you already run in, and use both pairs for as long as you want to. Only three of the 20 studies got anybody to 100% of their weekly running in minimal shoes by the last week, so running in a mix is what most of this research actually describes. The review adds a caveat that cuts the other way: it raises the possibility that running in both kinds of shoe interferes with learning a true minimal-shoe gait pattern, so mixing is a load management choice rather than a technique one.
Who should be careful
Reduced feeling in the feet is the one that changes the answer completely. Recommendation 12.29 of the 2023 American Diabetes Association standards of care recommends specialized therapeutic footwear for people with diabetes at high risk of ulceration, including those with loss of protective sensation, foot deformities, ulcers, callus, poor circulation or previous amputation, and grades it B. The association grades the evidence behind a recommendation with a single letter rather than publishing a strength and certainty pair, so B is the whole of it.
The same section advises that footwear habits at home are discussed, including no walking barefoot and avoiding open-toed shoes (ElSayed and colleagues, 2023). A thin, flexible sole is the opposite of protection, and a foot that cannot feel a stone cannot tell you it has been hurt. Our peripheral neuropathy page has the daily foot checks that go with this.
Current pain changes the order of operations rather than ruling anything out. Nobody has tested minimal shoes in people with current heel or Achilles pain, so this one is reasoning, not a finding: lowering the heel shifts load toward the calf, the Achilles tendon and the arch, so the middle of a flare of plantar fasciitis or Achilles tendinopathy is the worst moment to start. Heel pain that is worst in the first steps of the morning has its own page at heel pain in the morning. Settle the problem, then change footwear, and change one thing at a time so you know what did what.
Bone health matters for the same reason the MRI study does, and here too the caution is borrowed rather than tested: nobody has studied minimal footwear in people with thin bones. If you have thin bones, have had a stress fracture before, or are coming back from one, get advice before adding a new loading pattern; our osteoporosis page sets out which loads are useful and which need a conversation first.
Body weight belongs in this section, and it comes from the running literature rather than from a guideline. In a six-month transition trial in 61 male runners, inside the review of 20 transition studies, runners over a body mass of 71.4 kg (157 lb) had double the risk of developing an injury in minimal footwear compared with conventional shoes (hazard ratio 2.00, 95% confidence interval 1.10 to 3.66), and the same trial recorded more knee and calf pain in the minimal group (Warne and Gruber, 2017). That is one trial in male runners, not a cut-off for anybody walking. It is a reason to go slower and to keep your mileage down while you change, rather than a reason not to.
Falls change the answer too, and this is the one place where our own advice points the other way. None of the studies on this page included older adults, and nobody has tested minimal shoes for falls risk in either direction. What the falls literature does say is about bare feet and about footwear that is wrong for the person: the 2022 World Falls Guidelines list footwear and foot problems as a domain of a falls risk assessment, and say to screen for inappropriate footwear, including bare footedness (Montero-Odasso and colleagues, 2022), and Age UK advises against walking around the house in bare feet, socks or tights.
Every balance page on this site asks for flat shoes that fit well and grip the floor, not socks, tights or bare feet. A minimal shoe that fits and grips can meet that description; going barefoot indoors does not. So if you have fallen in the past year or feel unsteady on your feet, treat footwear as part of the falls conversation rather than as a training tool: work through the balance and falls prevention program with a physio, and ask them about your shoes while you are there.
And if your feet are structurally different from the ones in these studies, the evidence simply does not cover you. Every group quoted on this page was healthy and mostly athletic, and in the strength studies the participants were young. That includes people with a painful flat foot, a stiff or painful big toe, or pain under the ball of the foot, which are covered by our flat feet and metatarsalgia pages, and all of them deserve an individual answer rather than a trend.
What this research never tested, and one thing it did
Knees and back are the two things people ask about most, and no study used on this page set out to measure either as an outcome. What these trials and reviews measured was foot muscle size, foot strength, arch height, balance, running mechanics and the injuries described above. That is an absence of evidence rather than evidence of absence, and it is a reason to be suspicious of any confident claim that a shoe fixed someone's knee or back.
One finding does bear on the knee, and it does not favor the shoes. Inside the review of 20 transition studies, a six-month trial in 61 male runners found that training in minimal footwear increased knee and calf pain, more so above about 35 km (22 miles) of running a week. In that trial 16 of 30 runners in minimal shoes became injured against 11 of 30 in conventional shoes, although time to injury did not differ by shoe type (Warne and Gruber, 2017). One trial is not a conclusion. It is enough to retire the idea that this research has nothing to say about knees.
Posture and alignment, and anything described as natural movement, fall into the same gap. What has been measured is a stronger foot in a lab, and that is a reasonable thing to want. It is not a treatment for a painful joint somewhere else.
When to see a physio (physical therapist)
Go before you change shoes if your feet already hurt, if you have diabetes or reduced feeling in your feet, or if you have had a stress fracture. Twenty minutes of assessment will tell you whether your calf has the length and strength to cope with a lower heel, which is the single thing that decides how this goes for most people.
Go afterwards if something has started to hurt since you switched, especially pain in one spot on a bone, pain that is worse the morning after, or pain in the calf or Achilles that is getting worse week by week. Bring both pairs of shoes to the appointment. The warning list below comes first, at the speed each line sets.
See a doctor promptly if
- Emergency: part of your foot or a toe turns cold, pale, blue or black. Call emergency services or go to an emergency department straight away, and do not drive yourself, as the blood supply to the foot may be blocked.
- Same day: a sudden pop or snap at the back of your ankle or heel, a feeling that someone kicked you there, or sudden pain there after which you cannot push off or rise onto your toes on that leg. Stop, take the weight off that leg carefully and go to an urgent care center or emergency department the same day, even if you can still walk, as this can be a torn Achilles tendon.
- Same day: you cannot put weight on the foot, or the pain started with a fall or a landing from height. Get it checked the same day.
- Same day: the foot is hot, red and swollen, or you have a fever or feel unwell. Get medical help the same day, and go to an emergency department if you feel very unwell. If you have a very high or very low temperature, shivering you cannot control, you are breathing very fast or finding it hard to breathe, you are confused or your speech is slurred, your skin, lips or tongue look blue, gray, pale or blotchy (on brown or black skin this can be easier to see on the palms of the hands or soles of the feet), or you have a rash that does not fade when you press it, call emergency services, as this can be sepsis.
- Same day: you have diabetes or numb feet, and one foot becomes hot, swollen or red, or changes color or shape, with or without pain. Take your weight off that foot straight away and get advice the same day from your doctor or your diabetes foot team. This can be Charcot foot, where the bones and joints of the foot are damaged and the foot can collapse. Do not exercise that foot until it has been checked. If you also have a fever or feel very unwell, or redness is spreading up your foot or leg, go to an emergency department.
- Same day: you have diabetes or numb feet and find a new blister, cut or sore on your foot, especially one you did not feel, a wound that smells or is leaking, or new pain in your foot that you cannot explain. Get it seen by your doctor or foot team the same day. If you also have a fever or feel very unwell, redness is spreading up your foot or leg, or part of your foot or a toe turns black, go to an emergency department.
- Within a few days: the pain sits at one spot over one of the long bones that lead to the toes, and that spot is tender or swollen, especially after a sudden increase in walking, running or standing, or if you have thin bones (osteoporosis). Stop running and jumping, cut down on walking and standing, and see a doctor within a few days, as this can be a stress fracture. An X-ray can look normal for the first 2 to 3 weeks, so a normal early X-ray does not rule it out.
- Within a few days: the pain is there at night or at rest as well as when you stand and walk, and it is getting worse. See your doctor within a few days. If you have had cancer, now or in the past, or are losing weight without trying, see your doctor sooner, within a day or two, and mention it. This applies even if the pain is not getting worse. If you are being treated for cancer now, contact your cancer team the same day.
- Within a week or two: you have numbness, tingling, burning or loss of feeling in the foot. Book an assessment with a doctor or physio in the next week or two.
Common questions
Do barefoot shoes actually strengthen your feet?
The best single study says yes, with limits attached. Twenty-two adults with a mean age of 27 wore a minimal shoe for at least 70% of their shod time, at least six days a week, for six months. Their foot strength, measured as maximum isometric push through the joints at the base of the toes on a custom laboratory dynamometer, rose by an average of 57.4% (p below 0.001), while 24 people who kept their usual shoes showed no significant change; a separate group with about 2.5 years of minimal footwear use scored about the same as the six-month group, which suggests the gain plateaus (Curtis and colleagues, 2021); foot width did not increase. A 2025 systematic review of 7 studies in 213 mostly young and athletic participants found consistent increases in foot muscle volume, from 8.8% after six months in one study to between 8.8% and 22.3% across different muscles after eight weeks in another, while cautioning that "morphological adaptations may not consistently translate into proportional gains in muscle strength or functional performance" (Rodriguez-Longobardo and colleagues, 2025). Stronger on a rig is not the same as fewer symptoms, and nobody has shown that these changes prevent injuries.
How long does it take to transition to barefoot shoes?
A systematic review of 20 transition studies recommends a transition period of "no less than 4 to 8 weeks" for runners, with running volume cut by roughly 10% to 20% in the first two weeks and exposure to the minimal shoe increased by about 5% to 10% of your running volume per week (Warne and Gruber, 2017); across the studies it reviewed, first-week exposure varied from 0% to 24% of normal running volume, so there is no single protocol. The same review notes that only 8 of its 20 studies added strengthening work, and recommends calf strength and balance work plus light plyometrics alongside the change. For walking rather than running there is nothing equivalent: no study we found tested a stepped walking transition, and the six-month foot strength study that people quote had its participants in minimal shoes for most of their shod time from the start rather than building up (Curtis and colleagues, 2021). So any walking schedule, including the short periods first and the old shoes kept for long days and hard surfaces, is practice rather than published, and the next morning is the measure. Your physio will adjust all of it to your mileage and to anything in your feet that already hurts.
Can barefoot shoes cause injuries?
Injuries have been recorded in people switching, which is why every careful source says go slowly. In a trial of 36 experienced recreational runners, 19 of whom transitioned gradually to a minimal shoe over 10 weeks while 17 stayed in their usual shoes, MRI showed that 10 of the 19 in the minimal group developed increased bone marrow swelling in at least one foot bone, significantly more than the control group (P = 0.009), and the scoring system used counted the most severe grade as a stress fracture. What was counted was a scan finding rather than a reported injury, and the published abstract does not say whether those runners had any symptoms; the authors concluded that runners "should transition very slowly and gradually to avoid potential stress injury in the foot" (Ridge and colleagues, 2013). Pooled across 12 studies, injury rates during transition were 17.9 per 100 participants in minimal footwear (195 people) against 13.4 per 100 in conventional shoes (187 people), a difference that was not statistically significant (p = 0.219), so the overall picture is unsettled rather than alarming (Warne and Gruber, 2017). Stop and see a doctor within a few days if one spot on a long bone of the foot becomes tender or swollen after more walking or running.
Are barefoot shoes good for your knees or your back?
Nothing on this page supports that, and one trial points the other way. No study used here set out to test minimal footwear as a treatment for knee or back pain; what these trials and reviews measured was foot muscle size and strength, arch height, balance, the mechanics of running and the injuries recorded during the switch. Where knee symptoms were recorded, they went against the shoes: in a six-month transition trial in 61 male runners, inside a systematic review of 20 transition studies, training in minimal footwear increased knee and calf pain, more so above about 35 km (22 miles) of running a week, and above a body mass of 71.4 kg (157 lb) the risk of developing an injury in minimal footwear was double that of conventional shoes (hazard ratio 2.00, 95% confidence interval 1.10 to 3.66). In the same trial 16 of 30 in minimal shoes and 11 of 30 in conventional shoes became injured, and time to injury did not differ by shoe type, so that trial is one signal rather than a verdict (Warne and Gruber, 2017). If your knee or back is the problem you are trying to solve, a change of shoe is a long way down the list, and an assessment is the thing that sorts out which structure is sore.
Can you wear barefoot shoes if you have plantar fasciitis?
Nobody has tested that properly, so this is caution rather than a finding. The studies behind the strength benefits were run in young, mostly athletic people without current foot pain, and a lower heel puts more of the load through the arch and through the calf and Achilles tendon, which is exactly where plantar heel pain and Achilles pain sit. If you have heel pain now, the sensible order is to settle the pain first with a program that has evidence behind it, then change footwear slowly if you still want to, and not both at once. Our plantar fasciitis and Achilles tendinopathy programs are the places to start. Get it looked at first if the pain is severe, if it followed an injury, or if you have diabetes or reduced feeling in your feet.
Who should not wear barefoot shoes?
Anyone whose feet cannot feel what they are standing on should take advice before going thin-soled. Recommendation 12.29 of the 2023 American Diabetes Association standards of care recommends specialized therapeutic footwear for people with diabetes at high risk of ulceration, including those with loss of protective sensation, foot deformities, ulcers, callus, poor circulation or a previous amputation, and grades it B; the association grades the evidence behind each recommendation with a letter and does not publish a separate strength and certainty pair, so B is the whole grading. The same section advises discussing footwear habits at home, including no walking barefoot, and a thin, flexible sole with little protection under it is the wrong direction for a foot that cannot feel a stone or a drawing pin. The same caution applies if reduced feeling in your feet comes from any other cause, and our peripheral neuropathy page sets out the foot checks that go with it; if you have thin bones, a foot that has already had a stress fracture, or a structural difference in your feet, ask a physio or podiatrist before changing, because the published evidence does not come from feet like yours. The same goes if you have fallen in the past year or feel unsteady: the 2022 World Falls Guidelines count unsuitable footwear, including going barefoot, as part of a falls assessment, and every balance program on this site asks for flat shoes that fit well and grip the floor rather than bare feet.
References
- Curtis R, Willems C, Paoletti P, D'Aout K. Daily activity in minimal footwear increases foot strength. Scientific Reports. 2021;11:18648. doi:10.1038/s41598-021-98070-0
- Rodriguez-Longobardo C, Gomez-Ruano MA, Canosa-Carro L. Effects of barefoot and minimalist footwear strength-oriented training on foot structure and function in athletic populations: a systematic review. Journal of Clinical Medicine. 2025;14(21):7629. doi:10.3390/jcm14217629
- Ridge ST, Johnson AW, Mitchell UH, et al. Foot bone marrow edema after a 10-week transition to minimalist running shoes. Medicine and Science in Sports and Exercise. 2013;45(7):1363-1368. doi:10.1249/MSS.0b013e3182874769. Abstract read 1 October 2026 at https://pubmed.ncbi.nlm.nih.gov/23439417/
- Warne JP, Gruber AH. Transitioning to minimal footwear: a systematic review of methods and future clinical recommendations. Sports Medicine Open. 2017. doi:10.1186/s40798-017-0096-x
- Montero-Odasso M, van der Velde N, Martin FC, et al. World guidelines for falls prevention and management for older adults: a global initiative. Age and Ageing. 2022;51(9):afac205. doi:10.1093/ageing/afac205
- Age UK. Fall prevention for the elderly. Read 1 October 2026. https://www.ageuk.org.uk/information-advice/health-wellbeing/exercise/falls-prevention/
- ElSayed NA, et al. 12. Retinopathy, neuropathy, and foot care: Standards of Care in Diabetes 2023. Diabetes Care. 2023;46(Suppl 1):S203-S215. Read 1 October 2026 at https://pmc.ncbi.nlm.nih.gov/articles/PMC9810462/
Written and checked by the PocketPhysio editorial team. Last updated 2026-10-01.
This page is general education, not a diagnosis or a personal treatment plan. See a physiotherapist or doctor for advice about your own situation.