Home Blog Flat Feet and Hypermobile: Okay for Barefoot Training?

Flat Feet and Hypermobile: Okay for Barefoot Training?

Written on August 23, 2010 at 4:14 am, by Eric Cressey

Q: I read with great interest your recent review of Muscle Imbalances Revealed, and in particular, your comments on Mike Robertson’s presentation that touched on factors related to excessive pronation.  I have this excessive foot pronation, plus a spondylolisthesis, a history of ankle sprains, double-jointed elbows and knees, and hips that move around like John Travolta’s in Saturday Night Fever. Basically I should have given up my career and gone into the Cirque de Soleil.

What I want to know is that specifically with my feet if wearing a supportive shoe with orthotics is such a bad thing. Everyone is on this barefoot kick, but it just doesn’t work for me. If I go barefoot my hips move out of correct position and my ankles and calves ache. In fact, when I was a child, my dad had to massage my calves and arches at night because I’d be in tears from the pain of being flat-footed. Once I got my first orthotics at age 7, I was so much more comfortable. I feel that orthotics and a nice flat shoe for me helps me use my feet correctly and allows me to stay away from internal rotation of the tibia and femur, and reduces pelvic tilt, etc.

Or, I could be mistaken? What do you think, and have you heard anyone else talk about this? Other hypermobile people and I have talked about this and we all seem to feel the same: barefoot is not the way to go for us.

A: Extensive barefoot stuff is definitely not for everyone, and if you were having issues that significant at such a young age, you’re probably just someone with a structurally different foot type.  There are definitely scenarios where orthotics are indicated, and the fact that you’ve gotten so much symptomatic relief from them tells me that they’re a good thing in your case.

That said, you might still benefit from just a bit of barefoot training – like deadlifting barefoot and doing some bowler squats and the like.  Basically, just use it for situations where foot positioning doesn’t change.  Then, you don’t have to mess around with how it affects the gait cycle.  I think you’ll get some of the benefits of strengthening the small muscles of the feet and improving proprioception (in light of your history of ankle sprains) without all the unfavorable compensations further up.  And in folks who don’t have your hypermobility, improving dorsiflexion ROM would be an added benefit.

Layout 1

I wouldn’t say that it’s specific to hypermobile individuals, though.  A lot of them probably have issues with barefoot training because they lack the strength and underlying stability required at the lower leg and hip to take the ground reaction force stress off the feet.  Remember that mobility and stability are always working at odds with one another; if you’ve got too much of one, you have to train the other one to pick up the slack.  My hunch is that most of these people don’t have structural pronation; they have excessive functional pronation because the anti-pronators – specifically the hip external rotators – aren’t strong enough to decelerate that pronation.  Check out the valgus (poor) positioning on the left here:

tuckjumplanding

Of course, in the general population, we see it for this reason, as well as the fact that most people walk around in terrible cinder blocks footwear that completely “tunes out” the joints and muscles of the feet.

A lot of the folks that try barefoot training and wind up in pain get that way because they’re idiots and jump right in full-tilt.  You can’t go from wearing cross-trainers to wearing thin pieces of cloth/rubber overnight.  And, as Nick Tumminello wisely pointed out recently, while our ancestors were barefoot all the time, they weren’t barefoot on CONCRETE for loads of mileage.  And, they weren’t as overweight as today’s society is, with such low relative strength. As always, people get hurt because they are stupid and not because a specific training modality is bad.

Typically, in a broad sense, I recommend that people do their 1-leg (pistol) squats, all deadlifting variations, and box squats without sneakers.

As long as they aren’t really overweight – or presenting with a history of foot problems – we’ll also have them do their warm-ups without sneakers.

Everything else (including more quad dominant squatting variations) are done with footwear. I’m a big fan of the New Balance Minimus; you can read my full review at the following link: The New Balance Minimus: The Best Minimalist Training Shoe on the Market.

Sign-up today for our FREE newsletter and receive a four-part video series on how to deadlift!

Name
Email
  • Joshua Richardson

    A good mention in relevance to this is an interview done with charlie weingroff the other week.
    His main point is that if your foot has an arch when its off the ground – then there’s no reason you shouldn’t be able to walk around without orthotics – its more of a neural control issue.

    For myself I’ve had success in going from using orthotics in my shoes (for the past ~15 years of my life) to barefoot or close enough.
    Some RNT training also helped – calf raises with a band to resist inversion/eversion.

    Of course you can’t apply one rule to everyone, but some good ideas to consider.

  • Joshua Richardson
  • Paul M

    Eric – this is a really great post! Your answer is great and illustrates why it’s important to assess each individual’s situation. Especially in light of the latest barefoot running craze. Speaking of which, you inserted a pic of your ‘Assess and Correct’ program into this post. I’m wondering if you cover foot assessments in your A & C program? Thanks!

  • Ben McLellan

    Paul- feet are well covered in A&C. I Highly recommend it as a resource. I have used it for myself and my clients.

  • Short and sweet! Great explanation….
    There was a post on Yahoo about Vibrams and the hater were out. Something like 2,100 posted comments in the morning with most talking trash.

  • I agree with Eric!

    I also think that the intrinsic muscles of the feet can be strengthened over time which is something people rarely consider before getting into orthotics. Using an orthotic to mechanically support the arch can further accentuate the problem by not allowing them the muscles to work.

    A two part strategy might be temporary use of supports while working to strengthen the intrinsic muscles. During this time shoes can be left off during warm ups and DLs as Eric mentioned. Hip external rotators should be investigated as well.

    Over time, the supports can gradually be phased out as the muscles gain strength/control.

  • I recently walked around in nothing but my Vibrams while I was on vacation. Long treks on the concrete were the toughest.

    I wear them routinely and had previously, but walking/running on the concrete is definitely something people don’t think about.

  • Giovanni

    Good video, I find single leg deadlifts realy difficult, harder than pistols to me.

  • Ben M

    What about someone with high arches who uses orthotics to alleviate foot and ankle pain?

  • Paul M

    Thanks, Ben!!!

  • Paul M

    Joshua – can you please tell us more about RNT training? Thanks

  • Joshua

    Paul – Sorry I am not an expert on RNT only recently having been introduced to it – it’s a training methodology idea by Gray Cook I believe.

    Using it on calf raises for example the band is around your ankle and will roll the ankle either in, or out (inversion/eversion). The idea is to resist this action while performing the calf raises, with the expectation that you will build stability in the ankle.

  • Joshua

    Paul – Or another example I can think of is if you have issues with say glute activation and knee/s caving in on the squat. You could use a band around your knees so you have to resist the caving for the whole movement.
    I used this on my front squat, really helped me in learning to force my knees out throughout the entire lift.

  • Travis

    Great article but I like that you are using a picture of a valgus position that I took at the place I used to work. Its nice to see that a coach in your position would use something that I was involved in. Thanks alot for that, it made my day.

  • Very cool, Travis; thanks for your help! And, thanks to Google Images for connecting us! Haha

  • Andrew Barker

    Eric,

    Would you recommend doing some myofacial release on the feet to help a person with flat feet? And the valgus picture was really intense…a little scary since people don’t really understand the effects of the valgus position. Great post.

  • Just like anything else, progression needs to be in place. It’s no different in strengthening the feet as in working with the rest of the body. If someone just came to train with you and we put them on a high intensity, high volume program, they hurt because their body wouldn’t be ready for it.

    Common sense.

  • Fabian

    You need length training for the toe flexors, so that you can drag yourself over the floor with your toes, then you can run barefoot. Only then you calw muscles will work right. If you cannot use your toes to propel your gait you are using only ankle joint muscles made for jumping.

    And with the concrete: it stimulates bone growth. Ancestors also ran on rock or wet sand, so that arguement doesn’t count.

  • Some great information and appreciate your addressing the need to take each person/program individually. My concern lately with the barefoot training debate is that people hear chatter about barefoot training and running and jump right in. As a PT working with general orthopedics I certainly use barefoot activities for training balance and proprioception but find in the general population few have the mechanics that would allow much participation in more dynamic barefoot training/lifting/running without risking injury. Thanks for the great commentary on the debate.

  • Great post Eric. I love barefoot running and training, and I’m so glad that I took the time to read ‘born to run’ by Christopher McDougall

  • Great article and great SLDL you are doing.

  • catherine mallorie

    Thanks for your post Eric. I’m over in the UK, where there seems to be little understanding of sensory motor work among the professionals I’ve contacted about the ankle/knee/hip pain I have and accompanying hypermoblity. My own instinct is that the problem overall is, as you put it, neural rather than functional and I’ve been trying to avoid use of orthotics with a lot of short foot work and a barefoot approach. Other solutions – that involve use of supports inside shoes that actually prevent optimum functioning of the gait cycle – simply don’t make sense to me. However, after a really encouraging start without pain for four weeks, I’m now getting aching through my leg and into my hip. Can you advise on the pacing of a rehab programme: how much to do over what period of time and a good exercise for strengthening the hip external rotators? All the best to you…


LEARN HOW TO DEADLIFT
  • Avoid the most common deadlifting mistakes
  • 9 - minute instructional video
  • 3 part follow up series