• Joanna Riley, PT, DPT

Shoes or No Shoes, what's the difference?

The last decade brought much attention to barefoot running versus using a traditional shoe. There are pro’s and con’s to both. What it comes down to is the individual. I have gathered information from what Runners World and the Postural Restoration Institute are saying about this topic to hope guide our readers to find what works best for them!

First off, here is a little background on barefoot running. From 2009-2010 barefoot runners drastically increased. Vibram’s five finger shoes doubled every year and they were hard to keep in stock. However, in 2012 Vibram sales began to decline. This was for several reasons. One, more companies started to make minimalist type shoes so there were more choices and two, a lot of runners went back to their traditional sneaker. Currently, “minimalist shoes only account for 11 percent of the U.S. market for running shoes” (Douglas, 2018). The Nike Free makes up 7 of the 11 percent (Douglas, 2018). The question is why is the trend changing again? Was “barefoot running” that was supposed to be more natural and reduce risk of injury not doing what it said it would do? Or is there more to it than jumping into a pair of flat shoes and calling yourself a natural runner?

The idea of barefoot running is to allow your foot to be able to naturally hit and push off the ground and to let your muscles control the movements as they were meant to. You get the best feedback/ proprioception when there are less barriers between your foot and the surface below. While these are all good things many runners found that barefoot running was not for them. They loved the idea of it but needed more control and support than shoes such as the Vibram’s five finger offered.

When you run the foot moves into a position of supination and pronation. You can also think of this as a locked and unlocked position respectively. When you push off the ground your foot is more rigid to create power and when you land the foot needs to accept weight and serve as a shock absorbers.

Firm surfaces give the foot the best feedback when it comes in contact with the ground whereas, cushioned shoes reduce that feedback. “Someone running at 7.2 mph is only in contact with the ground for about 0.17 seconds each step. Overbuilt shoes impair the function of the foot on any one run--over time… feet lose sensitivity and have to relearn these specific reactions” (Cucuzella, 2018).

Barefoot running will create the best feedback however, other issues can occur. Achilles tendinitis and other calf injuries are common in barefoot runners due to overstretching the tendon and the increased demand required in the calf to produce force. When you’re in a traditional shoe the heel tends to be elevated putting your Achilles, Gastroc, and Plantar Fascia in a shortened position. It is a difficult transition from running in this shortened position, possibly for decades, and then transitioning to working in a lengthened position. Improper shoes can lead to many issues. They can create injuries and deformities including stress fractures, ingrown nails, bunions, blisters and other skin irritations, and hammer toes. Improper footwear can also change your entire lower extremity alignment creating problems more proximate like in your hips and low back.

The Postural Restoration Institute has found that many people are unable to maintain a neutral pelvis and thoracic position and that it’s directly related to your footwear. When there is a lack of support/ control in the right arch of the foot one will overuse their right adductor, or inner thigh muscle, further pulling the pelvis out of alignment. The left adductor is rarely an issue. (This is beyond this papers discussion and for more information please refer to the postural restoration institute website.) With the proper footwear this can be negated and facilitate in maintaining the proper pelvic position which is necessary for optimal running mechanics.

Many of you may be asking if barefoot running is not appropriate for me then what is? I as well as many others trained or certified through the Postural Restoration Institute recommend the 2018 Hruska Clinic shoe list. The Postural Restoration Institute has done extensive research for shoes that promote a neutral pelvis. They focus on establishing the proper shoe for the individual who has a high arch, low arch, average arch, sensory issues requiring increased cushion, heel stability, and limited first ray mobility. I hope this information helps guide you to appropriate footwear!

Please click the link below and the Summer 2018 Updated shoe list


Cucuzzella, Mark. “Are You Ready To Go Minimal?” Runner's World, Runner's World, 1 July 2018,

Douglas, Scott. “Minimalism in The Long Run.” Runner's World, Runner's World, 25 May 2018,

Hruska, Ron, et al. “Home.” Hruska Clinic, 2014,

“Postural Restoration Information.” Physical Therapy in Omaha : Specialized Physical Therapy, Specialized Physical Therapy in Omaha., 2016,

“Shoe List.” Hruska Clinic, 2014,


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