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DOI: 10.1055/a-1908-8867
The Effects of Minimalist Shoes on Plantar Intrinsic Foot Muscle Size and Strength: A Systematic Review

Abstract
Minimalist shoes are proposed to prevent injury and enhance performance by strengthening intrinsic foot muscles, yet there is little consensus on the effectiveness of minimalist shoes in increasing muscle strength or size. This systematic review assesses using minimalist shoes as an intervention on changes in plantar intrinsic foot muscle size and strength. PubMed, CINHAL, Scopus, and SPORT Discus were systematically searched for articles from January 2000 to March 2022. Studies were included if they had an intervention of at least 2 weeks with a control group and examined the effect of minimalist shoes on plantar intrinsic foot strength or size (either volume, cross-sectional area, or thickness). Nine studies were included. There were significant increases and percent changes in foot muscle strength, volume, cross-sectional area, and thickness. Strength increased between 9–57%, and size increased between 7.05–10.6%. Minimalist shoes may effectively increase intrinsic foot muscle size and strength in healthy individuals, and they may also be more convenient than implementing time-intensive physical therapy programs. Future research is needed to explore using minimalist shoes as an intervention in clinical populations who would benefit from increased IFM strength and function. It will also be vital to improve upon IFM assessment methods.
Publication History
Received: 24 March 2022
Accepted: 20 July 2022
Accepted Manuscript online:
25 July 2022
Article published online:
11 November 2022
© 2022. Thieme. All rights reserved.
Georg Thieme Verlag
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Germany
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References
- 1 Goldmann J-P, Potthast W, Brüggemann G-P. Athletic training with minimal footwear strengthens toe flexor muscles. Footwear Sci 2013; 5: 19-25
- 2 Esculier J-F, Dubois B, Dionne CE. et al. A consensus definition and rating scale for minimalist shoes. J Foot Ankle Res 2015; 8: 42
- 3 Azeem Z, Rathod P, Palekar TJ. Barefoot running: myths and realities of barefoot and shod mechanics towards implicating running related injuries. J Clin Diagn Res 2021; 15: YE01-YE03
- 4 Lohman EB, Balan Sackiriyas KS, Swen RW. A comparison of the spatiotemporal parameters, kinematics, and biomechanics between shod, unshod, and minimally supported running as compared to walking. Phys Ther Sport 2011; 12: 151-163
- 5 Rixe JA, Gallo RA, Silvis ML. The barefoot debate: can minimalist shoes reduce running-related injuries. Curr Sports Med Rep 2012; 11: 6
- 6 Frey C. Foot health and shoewear for women. Clin Orthop Relat Res 2000; 372: 32-44
- 7 Squadrone R, Gallozzi C. Biomechanical and physiological comparison of barefoot and two shod conditions in experienced barefoot runners. J Sports Med Phys Fitness 2009; 49: 6-13
- 8 Goss LDL, Gross MT. Relationships among self-reported shoe type, footstrike pattern, and injury incidence. US Army Med Dep J 2012; 25-30
- 9 Hall JPL, Barton C, Jones PR. et al. The biomechanical differences between barefoot and shod distance running: a systematic review and preliminary meta-analysis. Sports Med 2013; 43: 1335-1353
- 10 Anderson LM, Bonanno DR, Hart HF. et al. What are the benefits and risks associated with changing foot strike pattern during running? A systematic review and meta-analysis of injury, running economy, and biomechanics. Sports Med 2020; 50: 885-917
- 11 Willy RW, Davis IS. Kinematic and kinetic comparison of running in standard and minimalist shoes. Med Sci Sports Exerc 2014; 46: 318-323
- 12 Daoud AI, Geissler GJ, Wang F. et al. Foot strike and injury rates in endurance runners: a retrospective study. Med Sci Sports Exerc 2012; 44: 1325-1334
- 13 Warne JP, Gruber AH. Transitioning to minimal footwear: a systematic review of methods and future clinical recommendations. Sports Med Open 2017; 3: 33
- 14 Johnson A, Myrer J, Mitchell U. et al. The effects of a transition to minimalist shoe running on intrinsic foot muscle size. Int J Sports Med 2015; 37: 154-158
- 15 Lieberman DE, Venkadesan M, Werbel WA. et al. Foot strike patterns and collision forces in habitually barefoot versus shod runners. Nature 2010; 463: 531-535
- 16 Miller EE, Whitcome KK, Lieberman DE. et al. The effect of minimal shoes on arch structure and intrinsic foot muscle strength. J Sport Health Sci 2014; 3: 74-85
- 17 Chen TL-W, Sze LKY, Davis IS. et al. Effects of training in minimalist shoes on the intrinsic and extrinsic foot muscle volume. Clin Biomech 2016; 36: 8-13
- 18 Kelly LA, Cresswell AG, Racinais S. et al. Intrinsic foot muscles have the capacity to control deformation of the longitudinal arch. J R Soc Interface 2014; 11: 20131188
- 19 Robbins SE, Hanna AM. Running-related injury prevention through barefoot adaptations. Med Sci Sports Exerc 1987; 19: 148-156
- 20 McKeon PO, Hertel J, Bramble D. et al. The foot core system: a new paradigm for understanding intrinsic foot muscle function. Br J Sports Med 2015; 49: 290-290
- 21 Kelly LA, Kuitunen S, Racinais S. et al. Recruitment of the plantar intrinsic foot muscles with increasing postural demand. Clin Biomech 2012; 27: 46-51
- 22 Quinlan S, Fong Yan A, Sinclair P. et al. The evidence for improving balance by strengthening the toe flexor muscles: a systematic review. Gait Posture 2020; 81: 56-66
- 23 Lee E, Cho J, Lee S. Short-foot exercise promotes quantitative somatosensory function in ankle instability: a randomized controlled trial. Med Sci Monit 2019; 25: 618-626
- 24 Menz HB, Morris ME, Lord SR. Foot and ankle characteristics associated with impaired balance and functional ability in older people. J Gerontol A Biol Sci Med Sci 2005; 60: 1546-1552
- 25 Mickle KJ, Munro BJ, Lord SR. et al. Toe weakness and deformity increase the risk of falls in older people. Clin Biomech 2009; 24: 787-791
- 26 Henderson AD, Johnson AW, Rasmussen LG. et al. Early-stage diabetic neuropathy reduces foot strength and intrinsic but not extrinsic foot muscle size. J Diabetes Res 2020; 2020: 9536362
- 27 Arulsingh W, Pai GS. A study of foot defects, deformities and diseases among shod and barefoot middle and long distance runners - cross sectional study. Int J Curr Res Rev 2015; 7: 15-23
- 28 Hollander K, Hamacher D, Zech A. Running barefoot leads to lower running stability compared to shod running - results from a randomized controlled study. Sci Rep 2021; 11: 4376
- 29 Holowka NB, Wallace IJ, Lieberman DE. Foot strength and stiffness are related to footwear use in a comparison of minimally- vs. conventionally-shod populations. Sci Rep 2018; 8: 3679
- 30 Curtis R, Willems C, Paoletti P. et al. Daily activity in minimal footwear increases foot strength. Sci Rep 2021; 11: 18648
- 31 Ridge ST, Olsen MT, Bruening DA. et al. Walking in minimalist shoes is effective for strengthening foot muscles. Med Sci Sports Exerc 2019; 51: 104-113
- 32 Campitelli NA, Spencer SA, Bernhard K. et al. Effect of Vibram FiveFingers minimalist shoes on the abductor hallucis muscle. J Am Podiatr Med Assoc 2016; 106: 8
- 33 Cashin AG, McAuley JH. Clinimetrics: Physiotherapy Evidence Database (PEDro) Scale. J Physiother 2020; 66: 59
- 34 Page MJ, McKenzie JE, Bossuyt PM. et al. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ 2021; 372: n71
- 35 Quinlan S, Sinclair P, Hunt A. et al. The long-term effects of wearing moderate minimalist shoes on a child’s foot strength, muscle structure and balance: a randomised controlled trial. Gait Posture 2022; 92: 371-377
- 36 Ebrecht F, Sichting F. Does neuromuscular electrostimulation have the potential to increase intrinsic foot muscle strength?. Foot (Edinb) 2018; 35: 56-62
- 37 Quinlan S, Sinclair P, Hunt A. et al. Excellent reliability of toe strength measurements in children aged ten to twelve years achieved with a novel fixed dynamometer. Gait Posture 2021; 85: 20-24
- 38 Goldmann J-P, Sanno M, Willwacher S. et al. The potential of toe flexor muscles to enhance performance. J Sports Sci 2013; 31: 424-433
- 39 Ridge ST, Myrer JW, Olsen MT. et al. Reliability of doming and toe flexion testing to quantify foot muscle strength. J Foot Ankle Res 2017; 10: 55
- 40 Kelly L, Lichtwark G, Cresswell A. Dynamic function of the plantar intrinsic foot muscles during walking and running. J Sci Med Sport 2013; 16: e4
- 41 Rodgers MM. Dynamic biomechanics of the normal foot and ankle during walking and running. Phys Ther 1988; 68: 1822-1830
- 42 Cudejko T, Gardiner J, Akpan A. et al. Minimal shoes improve stability and mobility in persons with a history of falls. Sci Rep 2020; 10: 21755
- 43 Cheung RTH, Sze LKY, Mok NW. et al. Intrinsic foot muscle volume in experienced runners with and without chronic plantar fasciitis. J Sci Med Sport 2016; 19: 713-715
- 44 Baellow A, Jaffri AH, Hertel J. et al. Intrinsic foot muscle size and quality in a single leg weight bearing position across foot posture types in individuals with patellofemoral pain compared to healthy. Phys Ther Sport 2022; 54: 58-64
- 45 Taddei UT, Matias AB, Duarte M. et al. Foot core training to prevent running-related injuries: a survival analysis of a single-blind, randomized controlled trial. Am J Sports Med 2020; 48: 3610-3619
- 46 Jaffri AH, Hertel J, Saliba S. Ultrasound examination of intrinsic foot muscles in patients with 1st metatarsophalangeal joint arthrodesis. Foot (Edinb) 2019; 41: 79-84
- 47 Okamura K, Egawa K, Okii A. et al. Intrinsic foot muscle strengthening exercises with electromyographic biofeedback achieve increased toe flexor strength in older adults: a pilot randomized controlled trial. Clin Biomech 2020; 80: 105187
- 48 Newsham K. Exploring workload associated with learning foot core exercises. Int J Athl Ther Train 2022; 27: 120-128
- 49 Trombini-Souza F, Matias AB, Yokota M. et al. Long-term use of minimal footwear on pain, self-reported function, analgesic intake, and joint loading in elderly women with knee osteoarthritis: a randomized controlled trial. Clin Biomech 2015; 30: 1194-1201
- 50 Trombini-Souza F, Kimura A, Ribeiro AP. et al. Inexpensive footwear decreases joint loading in elderly women with knee osteoarthritis. Gait Amp Posture 2011; 34: 126-130
- 51 Hsu TC, Wang CL, Tsai WC. et al. Comparison of the mechanical properties of the heel pad between young and elderly adults. Arch Phys Med Rehabil 1998; 79: 1101-1104
- 52 Soysa A, Hiller C, Refshauge K. et al. Importance and challenges of measuring intrinsic foot muscle strength. J Foot Ankle Res 2012; 5: 29
- 53 Battaglia PJ, Mattox R, Winchester B. et al. Non-weight-bearing and weight-bearing ultrasonography of select foot muscles in young, asymptomatic participants: a descriptive and reliability study. J Manipulative Physiol Ther 2016; 39: 655-661
- 54 Fukunaga T, Miyatani M, Tachi M. et al. Muscle volume is a major determinant of joint torque in humans: muscle volume and joint torque. Acta Physiol Scand 2001; 172: 249-255
- 55 Jaffri A, Koldenhoven R, Saliba S. et al. Evidence of intrinsic foot muscle training in improving foot function: a systematic review and meta-analysis. J Athl Train 2022;