Footwear's Functional Deficit Undermines Health and Longevity

Key Quotes

"Original footwear is strictly for protection and then we decided to get a little fancy and it became a status of wealth socioeconomic status and things started to get pointy and they started to not look like our foot and so I think from then on it's been this big battle of fashion over function."

Dr. Conley argues that the historical evolution of footwear shifted from a primary focus on protection to one driven by aesthetics and social status. This change, beginning centuries ago, introduced shoes that did not conform to the natural shape of the foot, initiating a persistent conflict between fashion and functional design.

"Well I think if you kept it very simple the widest part of the foot should be your toes so if you were to look down at your feet the widest part of your foot should be your toes and often times most people's feet the widest part of their foot will be the ball of the foot because modern footwear tapers at the toe."

Dr. Conley explains a fundamental issue with modern shoes: their tapering toe box. She emphasizes that a healthy foot's widest point is its toes, but most contemporary footwear narrows at the front, forcing the toes into a constricted position. This design choice, she suggests, compromises natural foot function.

"So the my non negotiable for footwear is where a shoe that actually fits your foot which means it has to have a wide toe box so certain brands of shoes will offer wide options yes are you saying that we should all by default be when available purchasing the wide option yes the wide toe box so the wide toe box yes."

Dr. Conley asserts that a wide toe box is a non-negotiable feature for functional footwear. She clarifies that "wide shoe" options from manufacturers often refer to the width of the midfoot, not the toe area, and stresses the importance of a shoe that allows the toes to splay naturally.

"So when we compromise that splay it doesn't make any sense to me I'm like why would you want to do that yeah so should we all be walking around in like like barefoot or you know these new barefoot shoes that are on the market I mean my my problem with them is that they're so unstylish that like I you know living in Los Angeles I wouldn't be caught dead wearing most of them."

Dr. Conley questions the rationale behind footwear that restricts toe splay, highlighting its negative impact on natural foot mechanics. While acknowledging the potential benefits of barefoot or minimalist shoes, she humorously notes the aesthetic challenges many people face with these options, particularly in fashion-conscious environments.

"So a minimal shoe is a wide toe box zero drop which basically means that the heel and the toe sit in the same plane and a thin and flexible sole so very thin you can roll the shoe up in a ball and that type of footwear is the environment where your foot will get stronger so there's really cool research that if you wore just minimal footwear for six months you would increase your foot strength by over 50%."

Dr. Conley defines minimalist footwear as having a wide toe box, a zero heel-to-toe drop (meaning the heel and toe are at the same height), and a thin, flexible sole. She points to research indicating that consistently wearing such footwear can significantly increase foot strength over a six-month period.

"So if my toes are splayed and I have strong intrinsic function of my foot strong extrinsic function which are the muscles in the lower leg insert on the foot then no the foot does not need arch support it is well equipped to handle many times our body load when we are walking and running."

Dr. Conley argues that if a foot has proper toe splay and strong intrinsic and extrinsic muscles, it does not require artificial arch support. She explains that a well-functioning foot, when properly strengthened, is naturally capable of supporting the body's load during activities like walking and running.