# Stepping Back to Minimal Footwear: How Going Barefoot-Style Could Benefit Your Feet at Every Age Modern cushioned running shoes may actually be contributing to foot problems and injuries, according to this research review by sports medicine experts from Harvard Medical School and institutions worldwide. The authors argue that our feet evolved over millions of years to function barefoot or in minimal footwear, and that heavily cushioned, supportive shoes weaken foot muscles, alter natural gait mechanics, and may increase the risk of musculoskeletal injury. The article reviews evidence across the lifespan—from children's developing feet to adult runners—suggesting that minimal footwear (shoes lacking support and cushioning) may promote stronger feet, more natural movement patterns, and potentially fewer injuries. # Stepping Back to Minimal Footwear: How Going Barefoot-Style Could Benefit Your Feet at Every Age ## Table of Contents - Key Points - Introduction: Why This Research Matters - In the Beginning: How Human Feet Evolved - How Modern Shoes May Be Causing Problems - Minimal Footwear in Children: Building Strong Feet Early - Minimal Footwear and Adult Running: A Deep Dive - Minimal Footwear and the Musculoskeletal System - Clinical Implications: What This Means for Patients - Limitations: What This Study Couldn't Prove - Recommendations: Practical Advice for Patients - Frequently Asked Questions - Source Information ## Key Points - Humans evolved to walk and run barefoot or in minimal footwear; modern cushioned shoes are a recent invention. - Cushioned shoes may weaken foot muscles, alter gait, and increase injury risk, but this is a hypothesis. - Children who grow up barefoot have higher arches and better jumping and balance skills than shod children. - Forefoot striking in minimal shoes resulted in the lowest impact loading in all directions in the reviewed evidence. - Transitioning to a forefoot strike resolved knee pain in 16 runners and avoided surgery in 10 cadets with compartment syndrome. ## Introduction: Why This Research Matters Walking barefoot is our most natural state, and the human foot is remarkably well adapted for walking and running without footwear. Although footwear was originally developed more than 10,000 years ago simply to protect the sole of the foot, the past 50–60 years have seen a dramatic shift. Most shoes today are heavily cushioned and supportive—a type of footwear that is often recommended for athletes and elderly individuals with musculoskeletal problems. But what if these very shoes are part of the problem? That's the provocative question at the heart of this review article. The researchers present a novel hypothesis: **minimal footwear may lead to improved musculoskeletal health across the lifespan**. They define minimal shoes as those lacking any support or cushioning—essentially a thin protective sole. To evaluate this hypothesis, the authors reviewed evidence regarding the relationship between minimal footwear, foot strength, mechanics, and injuries in both athletic and nonathletic populations. The topic is hotly debated in both clinical and scientific arenas, and the authors hope their perspective article will spark debate, shift how we think about footwear, and catalyze additional research. ## In the Beginning: How Human Feet Evolved Here's a fascinating fact: most mammals walk and run on their toes, but humans evolved from African great apes that have **plantigrade feet** (flat-footed walking on the entire sole), which were well adapted for climbing trees. African great apes have long, curved toes, an abducted hallux (big toe that points outward), a relatively short and flexible midfoot that lacks an arch, and a less developed calcaneus (heel bone) with a mobile ankle joint. Over the **7 million years** since the human and chimpanzee lineages diverged, hominin feet evolved substantially. This first occurred to facilitate bipedal walking (walking on two legs), and later running over longer distances than apes could manage. Human feet developed: - An **enlarged calcaneus** (heel bone) to stabilize the rearfoot and bear repeated, higher stresses during the impact phase of walking - An **elongated midfoot** stiffened by transverse and medial longitudinal arches - A **thicker plantar fascia** (the band of tissue running along the bottom of the foot) - An **elongated hallux** (big toe) with shorter, straighter toes and dorsally oriented metatarsophalangeal joints Together, these adaptations compromised our ability to climb trees, but they optimized the human foot for both walking and running. For most of the last 7 million years, humans walked and ran barefoot over a variety of surfaces—from soft grasslands to hard-packed savannah. Humans evolved the ability to adjust their overall leg stiffness to the hardness of the substrate. They increase leg stiffness on soft surfaces and reduce it on hard surfaces, a finding demonstrated in multiple modern studies. This underscores that **humans are equipped to walk and run on a wide variety of surface stiffnesses**. Until about **600 generations ago**, all humans were hunter-gatherers who walked an average of **9–15 km per day**—approximately **10,000–15,000 steps**—either barefoot or in minimal footwear. The oldest preserved sandals are about **10,000 years old**, and the oldest shoes (from Armenia) date to about **6,000 years ago**. However, researchers hypothesize that footwear was available by at least **40,000 years ago** when needles and other tailoring technologies first appear in the archaeological record. Around this time, there is also evidence of a reduction in metatarsal robusticity (the cross-sectional thickness of midfoot bones relative to bone length), indirectly suggesting that footwear use decreased bending forces on the midfoot during propulsion. ## How Modern Shoes May Be Causing Problems For most of human evolutionary history, shoes were used only occasionally—and until recently, almost all footwear was minimal, such as sandals or moccasin-like shoes. Features common in modern shoes—toe springs, stiffened midsoles, elevated heels, and arch supports—are generally quite recent inventions. **Ethylene-vinyl acetate (EVA) cushioned shoes have been available only since the 1970s.** These shoes provide some benefits, notably protection and comfort. However, structured shoes potentially contribute to several hypothesized **evolutionary mismatches**—conditions that are more prevalent or severe because our bodies are inadequately or imperfectly adapted for novel environmental conditions. In other words, although shoes provide advantages, they may also have drawbacks for which we are not well adapted. The evolutionary mismatches related to footwear fall into three categories: 1. **Cushioned soles slow the rate of loading at impact and decrease sensory perception.** As a result, people who habitually wear cushioned shoes experience higher ground reaction force impulses when walking, and they are more likely to be rearfoot strikers (landing on their heels) when running. This results in an abrupt impact transient (a sudden spike of force) of the vertical ground reaction force that is not seen with forefoot striking. 1. **Supportive shoes reduce the demand on foot muscles.** This can result in weaker feet, as evidenced from smaller muscle cross-sectional areas. 1. **Structured shoes alter foot mechanics.** Added sole flares increase external torques (twisting forces) to the foot, creating abnormal loading to the foot and lower extremity. Arch support reduces the longitudinal and transverse arch compression during midstance—compression that is important for elastic energy storage. All of these changes potentially lead to mismatches between the way the foot was adapted to function and how it functions in structured shoes, which can lead to dysfunction and injury. ## Minimal Footwear in Children: Building Strong Feet Early The foot undergoes crucial developmental changes during childhood and adolescence. Although several bones ossify (harden) prenatally, the main ossification period extends over the **first 10 years of life**. The epiphyseal union (fusion of the growth plates) of all long bones in the foot, as well as the talus and calcaneus, occurs throughout late adolescence or early adulthood, marking the end of foot bone growth. The foot typically achieves its final length at about **age 13 in girls and age 15 in boys**. The arch of the foot also develops during childhood. Although infants have no arch, it begins to develop once toddlers begin to walk. The shape of the arch is determined not just by the shapes of the bones, but also by the muscles and ligaments. Childhood and adolescence are **critical periods in which the developing foot is more prone to external influences**—and one of those influences is incorrectly fitted footwear. The prevalence of incorrectly fitted footwear has been estimated to be up to **66% too narrow and 72% too short** in school children. Improperly fitted footwear has been shown to increase the risk of foot deformities such as: - **Pes planus** (flat feet) - **Hallux valgus** (bunions) In contrast, children and adolescents who grow up barefoot have been shown to have **significantly higher arches** than those who have grown up shod. One large-scale study reported on **2,300 children in India between the ages of 3 and 15 years**. In one community, children were barefoot; in another, they wore sandals; and in a third, they wore closed-toe shoes. **Flat footedness was most prevalent in the group that wore shoes and least prevalent in those who were barefoot.** Low arches are associated with pathologies such as pes planus deformity, which can lead to altered function. For example, children with low arches have been shown to walk with greater foot progression angle and greater external rotation of the lower extremity. Along with higher arches, children who are habitually barefoot also demonstrate **improved jumping and balance skills**. A recent large-scale study compared Japanese children from two schools in the same city that incorporated a running program—one barefoot and one shod. Children in the barefoot program exhibited: - Significantly greater performance in jumping and sprinting - A greater proportion ran with a midfoot or forefoot strike pattern compared with the shod group Minimal footwear has been associated with the ability to mimic some of the barefoot walking characteristics in children. Hillstrom and colleagues compared the gait of toddlers with only a few months of walking experience as they walked barefoot and in minimal and structured shoes. They found **similar plantar pressure distributions between barefoot and minimal footwear** compared with more structured footwear. The authors concluded that this similarity may enhance proprioception (the body's sense of position and movement), which they suggested was important for developing gait in young children. Wolf and colleagues studied a cohort of **6- to 10-year-old children** and noted that walking kinematics (movement patterns) in minimal footwear were closer to the barefoot condition than in structured footwear in **12 of 15 parameters tested**. They also noted that minimal footwear allowed the medial longitudinal arch to deform more naturally than traditional stiff footwear. Running mechanics in children are also influenced by minimal footwear. Hollander and colleagues conducted a comparison of minimal and cushioned footwear with barefoot running in **6–9-year-old children**. The greatest differences in mechanics were found between the cushioned and barefoot conditions, and the most similarities were noted between the minimal and barefoot conditions. For example, the rate of rearfoot strikes was highest for cushioned shod running and lower but similar for barefoot and minimally shod running. This pattern held for other variables: impact force and step length were higher, and cadence was lowest in the cushioned shoe, but similar between the barefoot and minimal shoe conditions. Based on these collective studies, **minimal shoes may be optimal for the developing feet of children**. These shoes are designed to better match the natural shape of the foot, with additional width in the forefoot. This helps overcome the issue of improper shoe fit, which is especially important for the developing foot. Despite these potential benefits, the authors note that recommendations for youth footwear, to date, still do not address minimal shoes. ## Minimal Footwear and Adult Running: A Deep Dive Up until **60 years ago**, running shoes were quite minimal—typically consisting of a thin rubber sole and a canvas or leather top. These shoes were flexible and lacked any midsole cushioning, arch supports, or heel counter stiffeners. Although running injuries likely occurred in those days, they were not reported in the literature until the **1970s**, suggesting that this may have been when they began to become more prevalent. This coincided with the **running boom** as millions of untrained people started running. Unfortunately, researchers lack the data necessary to explore the causes of this apparent uptick in injuries. However, a number of sports medicine professionals at that time attributed the injuries to untrained runners landing too hard and without adequate foot control. The authors of this review hypothesize that, instead of these new runners developing the ability and strength to cushion and control their landings, **footwear was adapted to do this passively for them**. Shoe companies added midsole cushioning, arch support, and heel counter supports to address these deficiencies. Elevated heels were added to reduce the load on the **Achilles tendon**, and toe springs were added to reduce the work of the toe flexors. These changes were made with the goal of increasing comfort and reducing injury risk—but the authors postulate that these changes, intended to assist the runner, may actually be **increasing injury risk**. ### Foot Strike Patterns: Heel vs. Forefoot As humans evolved to run without footwear, barefoot running provides a reference for our most natural running gait. Strike patterns of barefoot runners are variable, depending on running speed and the hardness of the surface. On softer surfaces, there is a greater tendency to land on the heel (rearfoot strike, or **RFS**). However, habitual barefoot running is mostly associated with landing on the ball of the foot—referred to as a **forefoot strike (FFS)** pattern. Those who are habituated to cushioned running shoes tend to land consistently on their heels (RFS). A recent study demonstrated that **the more time individuals spend running in cushioned shoes, the more likely they will be a rearfoot striker**. This is because the cushioning allows landing on the heel without the pain that would be experienced if landing on it barefoot. An RFS places less demand on the calf musculature, which must contract eccentrically (lengthening while contracting) at the onset of stance in an FFS to control the heel's descent. However, there are consequences of the RFS landing style: - It results in an abrupt, characteristic **impact transient** in the vertical ground reaction force that is typically missing in FFS landings - Impact loads have been shown to produce damage to both cartilage and bone in animal studies - The impact transient is associated with a steep rise to its peak, leading to a **significantly increased loading rate** compared with an FFS pattern Increased loading rates have been associated with some of the most common running injuries, including: - **Tibial stress fractures** (hairline cracks in the shin bone) - **Patellofemoral pain** (pain around or behind the kneecap) - **Plantar fasciitis** (inflammation of the tissue along the bottom of the foot) ### The Rise of Modern Minimal Shoes In an attempt to mimic barefoot running, the first modern, widely available minimal running shoe was introduced by **Nike in 2005**. Like many racing flats, the **Nike Free** lacked arch support and heel counter stiffness, and it had a flexible sole. However, it had a cushioned midsole, which still permitted an RFS pattern. In the same year, the **Vibram FiveFingers** shoe also became available. This shoe had five pockets for the toes, allowing them to move independently from each other. The shoe was extremely flexible and had no midsole or heel counter. It was originally designed for boating but quickly was adopted by the barefoot running community who wanted a shoe that was as close to barefoot as possible. Other minimal shoes also began to emerge. However, traditionally shod runners who wanted the "barefoot experience" began running in these shoes without proper preparation. Many simply replaced their cushioned shoes with minimal shoes **without reducing their running mileage**. These runners lacked the benefit of adaptation that experienced barefoot runners had. Therefore, many sustained injuries to the foot and ankle due to the lack of cushioning and support that their traditional shoes offered. Reports of **Achilles tendinitis, plantar fasciitis, and metatarsal stress fractures** appeared in the literature. The authors emphasize that this was unfortunate, as it may not have been the shoe itself but rather the **lack of appropriate transition to it** that led to the injuries. Although there continued to be steadfast believers in the minimal shoe, these injury reports led to reduced enthusiasm for this type of footwear. As a result of the reported injuries, some footwear companies decided to retreat from minimal shoes. Instead, they produced shoes with less cushioning and support than their traditional running shoes as a compromise—sometimes classified as **"partial minimal" shoes**, such as the **New Balance Minimus** and **Saucony Kinvara**. However, studies have suggested that mechanics while running in partial minimal shoes are similar to those while running in traditional shoes and statistically different from running barefoot. **Only when running in shoes with little or no cushioning are mechanics similar to barefoot running.** ### Can Changing Your Foot Strike Resolve Injuries? Minimal footwear promotes an FFS pattern, and this pattern has been shown to actually resolve some injuries: **Case Series 1: Anterior Compartment Syndrome.** A case series of **10 West Point cadets** diagnosed with anterior compartment syndrome (a painful condition caused by increased pressure within the front of the lower leg) and recommended for fasciotomy surgery (a surgical procedure to relieve that pressure). The cadets underwent a **6-week training intervention** to transition from an RFS to an FFS, shifting the load from the anterior lower leg musculature to the larger, posterior musculature. After the training: - All compartment pressures returned to normal - Significant improvements in pain and function were noted - Their 2-mile run times improved - **Most importantly, surgery was avoided in all cases** **Case Series 2: Patellofemoral Pain.** Another study involved **16 runners with patellofemoral pain** (knee pain around the kneecap) who were randomized into a retraining group to transition to an FFS pattern or a control group. Those who transitioned to the FFS pattern had **near complete resolution of their knee pain**. In addition, the patellofemoral contact stresses (the pressure between the kneecap and the thigh bone)—which have been associated with this pain—were **reduced by 50%**. This is likely due to two factors. First, there is greater knee flexion (bending) at foot strike with an FFS pattern, which increases the contact area between the patella and femur. Second, forces at the knee during early stance are lower due to the decreased slope of the vertical ground reaction force typically seen in an FFS pattern. Lower forces and greater contact areas lead to lower patellofemoral contact stresses and likely reduced pain. ### The Critical Interaction Between Shoes and Foot Strike There is an important interaction between footwear and foot strike patterns that must be considered. An FFS runner in cushioned shoes demonstrates a **lower vertical ground reaction force loading rate** compared with an RFS runner in cushioned shoes. However, the **mediolateral (side-to-side) and anteroposterior (front-to-back) loading rates** of an FFS runner in cushioned shoes are increased above those of an RFS runner. This is likely due to the elevated heel and lateral flare of a cushioned shoe. These structural features often place the foot in greater plantarflexion (pointing downward) at foot strike—which is coupled with inversion (rolling inward)—than when running in a minimal shoe. This is associated with greater posterior and medial ground reaction force loading rates at foot strike. These increased posterior and medial loading rates, coupled with the decreased vertical loading rate in FFS runners habituated to conventional shoes, result in **similar resultant loading rates** between them and RFS runners habituated to conventional shoes. However, **when forefoot striking in minimal shoes, all components of the ground reaction force loading rates are significantly lower** than when either rearfoot or forefoot striking in traditional shoes. Thus, **forefoot striking in minimal shoes results in the lowest impact loading in all directions**. The clinical relevance of this is significant: reducing impacts in the vertical direction has been shown to prospectively lead to a **62% reduction in running injuries over the course of a year**. Reducing impacts in all three directions may potentially lead to even fewer injuries, but this needs to be examined further. ## Minimal Footwear and the Musculoskeletal System The human musculoskeletal system normally adapts to the mechanical loads it experiences. As proposed by **Frost's mechanostat model**, tissues respond to the mechanical demands placed on them by altering their mechanical properties to better meet the new demands. This is a fundamental principle: **our bones, muscles, tendons, and ligaments are dynamic tissues that strengthen in response to appropriate loading—and weaken when that loading is removed.** This principle has direct implications for footwear. When structured shoes provide passive support and cushioning, the foot muscles are not required to work as hard. The evidence reviewed in this article suggests this can result in weaker feet, with smaller muscle cross-sectional areas. By contrast, minimal footwear requires the foot to engage its natural support systems—actively using both the **intrinsic foot muscles** (the small muscles within the foot itself) and the **extrinsic foot muscles** (the larger muscles in the lower leg that control foot movement). This increased demand may strengthen these muscles, potentially improving foot function and reducing injury risk. The article's key points summarize this concept directly: - Minimal footwear promotes strengthening of both the intrinsic and extrinsic foot muscles - Minimal footwear promotes walking and running gait patterns more similar to our natural barefoot gait - Minimal footwear is beneficial to healthy older adults and those with some pathologic conditions such as knee osteoarthritis ## Clinical Implications: What This Means for Patients This review has several important implications for patients and clinicians alike: 1. **For parents:** The type of footwear your children wear matters. Shoes that are too narrow or too short (up to 66% and 72% of school children, respectively) may increase the risk of foot deformities such as bunions (hallux valgus) and flat feet (pes planus). Minimal shoes with a wide forefoot may better support natural foot development. 1. **For runners:** If you run in heavily cushioned shoes, you are more likely to land on your heel, which produces an abrupt impact transient and higher loading rates associated with common running injuries. Forefoot striking in minimal shoes results in the lowest impact loading in all directions. However, transitioning to minimal footwear must be done **slowly and gradually**—the injury reports in the literature largely involved runners who switched too quickly without reducing mileage. 1. **For people with knee pain:** The evidence that transitioning to a forefoot strike pattern resolved patellofemoral pain—with a 50% reduction in patellofemoral contact stresses—is promising. This may be relevant for patients seeking non-surgical approaches to knee pain management. 1. **For patients with lower leg conditions:** The West Point cadet study, in which all 10 cadets avoided compartment syndrome surgery through gait retraining, suggests that modifying foot strike can shift loads between muscle groups in the lower leg, potentially resolving some conditions without surgery. 1. **For older adults and those with chronic conditions:** The article notes that minimal footwear may be beneficial for healthy older adults and those with knee osteoarthritis (OA) and diabetes, though the specific recommendations for these populations are detailed further in the full text. ## Limitations: What This Study Couldn't Prove It's important to understand the limitations of this review: - **This is a perspective/hypothesis article, not a clinical trial.** The authors are presenting a novel hypothesis and reviewing existing evidence, rather than providing definitive proof. - **Much of the evidence is observational or from small case series.** The West Point cadet study involved only 10 individuals, and the patellofemoral pain study involved only 16 runners. - **The authors acknowledge gaps in the data.** For example, they note that "we lack the data necessary to explore the causes of this apparent uptick in injuries" that coincided with the running boom. - **Causation cannot be firmly established.** While cushioned shoes are associated with certain injury patterns and foot deformities, association does not prove causation. - **Individual responses vary.** What works for one person may not work for another. Some runners thrive in traditional cushioned shoes, and some people with existing foot conditions may not be appropriate candidates for minimal footwear. - **The article is a review of selected evidence**, not a systematic review or meta-analysis. The authors have chosen studies that support their hypothesis. ## Recommendations: Practical Advice for Patients Based on the evidence reviewed in this article, here are practical recommendations: ### For Parents of Young Children - Allow children to spend time barefoot in safe environments to promote natural foot development - When shoes are needed, consider minimal footwear with a wide forefoot that matches the natural shape of the foot - Ensure proper fit—the studies showed up to 66% of children wear shoes that are too narrow and 72% wear shoes that are too short - Be aware that current youth footwear recommendations do not yet address minimal shoes, so you may need to seek this information independently ### For Runners - If you are interested in minimal footwear, **transition slowly**. The research suggests that injuries occurred when runners switched from cushioned to minimal shoes without reducing their mileage, giving their tissues no time to adapt - Consider working with a physical therapist or running coach on retraining to a forefoot strike pattern if you are experiencing repeated injuries - Be aware that partial minimal shoes (like the New Balance Minimus or Saucony Kinvara) produce mechanics similar to traditional shoes—only true minimal shoes (little or no cushioning) produce barefoot-like running mechanics - If you have a history of knee pain, patellofemoral pain, or lower leg conditions, discuss foot strike modification with your healthcare provider ### For Older Adults - The article suggests minimal footwear may be beneficial for healthy older adults and those with knee osteoarthritis - Consult with your physician or physical therapist before making footwear changes, particularly if you have diabetes or other conditions affecting foot sensation ### For Everyone - Your feet are adapted to function with active muscles and natural arches—shoes that do all the work for your feet may leave them weaker over time - Listen to your body: if you experience pain when trying minimal footwear, it may be a sign you are transitioning too quickly, or that this footwear style is not right for you ## Frequently Asked Questions ### Are cushioned running shoes actually bad for my feet? The review suggests heavily cushioned shoes may weaken foot muscles, alter natural gait, and increase injury risk. However, this is a hypothesis based on review of evidence, not definitive proof. Individual responses vary, and some runners thrive in traditional cushioned shoes. The authors argue minimal footwear may promote stronger feet and more natural movement. ### Should I let my child walk barefoot or wear minimal shoes? The article suggests children who grow up barefoot have higher arches and better jumping and balance skills. Improperly fitted shoes are common and may increase risk of flat feet and bunions. Minimal shoes with a wide forefoot may support natural foot development, but current youth footwear recommendations do not yet address minimal shoes. ### How should I transition to minimal running shoes? Transition slowly and gradually. Injury reports largely involved runners who switched from cushioned to minimal shoes without reducing mileage, giving tissues no time to adapt. Consider working with a physical therapist or running coach on retraining to a forefoot strike pattern. If you feel pain, you may be transitioning too quickly. ### Can changing my foot strike help knee pain? In a study of 16 runners with patellofemoral pain, those who transitioned to a forefoot strike pattern had near complete resolution of knee pain, and patellofemoral contact stresses were reduced by 50%. This may be relevant for patients seeking non-surgical approaches to knee pain management. ### What did the West Point cadet study show about compartment syndrome? A case series of 10 West Point cadets with anterior compartment syndrome, recommended for surgery, underwent 6 weeks of training to transition from a rearfoot to a forefoot strike. All compartment pressures returned to normal, pain and function improved, and surgery was avoided in all cases. ### Is minimal footwear beneficial for older adults? The article notes that minimal footwear may be beneficial for healthy older adults and those with knee osteoarthritis and diabetes, though specific recommendations are detailed further in the full text. Consult your physician or physical therapist before making footwear changes, particularly if you have diabetes or conditions affecting foot sensation. ### What are the limitations of this research on minimal footwear? This is a perspective article, not a clinical trial, so it presents a hypothesis rather than definitive proof. Much evidence is observational or from small case series (e.g., 10 cadets, 16 runners). Causation cannot be firmly established, and individual responses vary. The authors selected studies supporting their hypothesis. ### Should I get a second opinion before switching to minimal footwear or changing my running style? A second opinion can help you decide if transitioning to minimal shoes or altering your foot strike is right for you, especially if you have knee pain, lower leg conditions, or a history of running injuries. The evidence shows that forefoot striking in minimal shoes reduces impact loading, and gait retraining resolved knee pain in 16 runners and avoided surgery in 10 cadets with compartment syndrome. However, individual responses vary, and a slow transition is critical. Diagnostic Detectives Network provides independent expert second opinions. ## Source Information **Original Article Title:** Davis-2021-Stepping Back to Minimal Footwear 1 **Authors:** Irene S. Davis (Harvard Medical School, Spaulding National Running Center), Karsten Hollander (MSH Medical School Hamburg, Germany), Daniel E. Lieberman (Harvard University), Sarah T. Ridge (Brigham Young University), Isabel C.N. Sacco (University of São Paulo, Brazil), and Scott C. Wearing (Queensland University of Technology, Australia / Technical University of Munich, Germany). **Journal:** Exercise and Sport Sciences Reviews, Vol. 49, No. 4, pp. 228–243, 2021. Published by the American College of Sports Medicine. DOI: 10.1249/JES.0000000000000263 **Article Type:** Perspective for Progress (peer-reviewed perspective/review article) *This patient-friendly article is based on peer-reviewed research. It is intended for educational purposes and is not a* --- Publisher: Diagnostic Detectives Network (https://diagnosticdetectives.com) — independent multi-expert medical second opinions, worldwide, private-pay. Author byline: Anton Titov, MD, PhD. Contact: https://diagnosticdetectives.com/pages/contact Canonical page: https://diagnosticdetectives.com/products/stepping-back-to-minimal-footwear-how-going-barefoot-style-could-benefit-your-feet-at-every-age