A Skeptical Look at Masai Barefoot Technology Shoes
I was at the drug store the other day waiting on a prescription, when I noticed people trying on some funny shapped shoes that had curved soles. So, I walked over to the display and took a closer look. They were called MBT shoes, which stands for Masai Barefoot Technology, and are made by the company, Swiss Masai. They had hand-out brochures, so I took one to read while I was waiting. (Note that I will refer to the company as both MBT and Swiss Masai in this essay, as it appears that the company does the same on their website.)
For some of the research for this entry, I used MBT's website. It's an annoying, flash laden site that doesn't let you just sit and read about the technology, without having some java script decide you've spent enough time on that section and then brings up something else. Also, I couldn't find some of the statements on the website that first caught my eye on that brochure - so if you go to visit the site looking for them, you may not find them, either.
Anyway, there are a couple issues I want to discuss in this entry - briefly, whether or not these shoes have anything to do with "barefoot technology," and then in more depth, whether or not these shoes might actually have some therepeutic value.
I realize now as I'm getting ready to post this entry, that it's grown longer than I'd originally anticipated, so I'll get right to the point up front, before addressing the details. MBT shoes do show promise for treating certain conditions. However, there is anecdotal evidence that they can cause significant negative side effects. Additionally, there are not enough clinical studies addressing their efficacy or possible side effects.
I suppose I'll start out by quoting a bit from that brochure, to give an idea of what these shoes are and what the company is claiming they can do. Here's an excerpt from the page of that brochure that describes the inspiration to develop this shoe:
MBTs have been available on the market since 1996. But practical proof of the effectiveness of this technology has been provided for thousands of years by the Masai, a semi-nomadic tribe from East Africa well-known for their excellent posture. joint and back pain are mostly unknown among them, they enjoy stable health and remarkable athletic ability.It was left to Swiss engineer Karl Müller to discover the secret of the Masai: the simple fact that walking barefoot on soft, natural ground means that they have to balance their bodies with each and every step.
Yes, the bold was in the brochure, as are all the other bolded sections in anything else I'll quote from them. Here's another excerpt from the brochure, from the page, "What Make MBT Different?"
Conventional shoes support and lead the foot, stabilizing the body in an unnatural way> This means that these imoprtant muscles lose their function. Like any other inactive muscel, they atrophy, which leads to many of the health problems of modern civilization, for instance joint and back pain.It is relatively easy to counteract his effect: the body must be stimulated to balance itself. This is eactly what physiological footwear does, by inducing a natural instability in the body - which must constantly be compensated by the body's supporting muscle system.
And one more excerpt from the brochure, from the page, "How Does MBT Act on my Body?"
wearing MBT physiological footwear is like walking barefoot on springy moss or a sandy beach - a very comfortable feeling, but also challenging for the whole body. Because every step is a small workout for the entire body.This training effect means that wearing MBT physiological footwear leads to a multitude of benefits: gait and posture improve significantly, relieving the pressure on the joints and back. A multitude of muscles is excercised both when walking and standing, which burns calories and stimulates the metabolism - stimulating weight loss and speeding up regeneration. MBTs also have a firming effect on abdominal, leg and buttock muscles.
So, that should give an idea of the company and its claims. Now, to address my first point, of whether this has anything to do with "barefoot technolocy," I go barefoot around the house and around my yard quite a bit, when I was a kid I used to go hiking barefoot through the woods, and I've been to the beach plenty of times. And I've gotta say, walking barefoot never seemed unstable. I mean, wearing shoes or going barefoot, you're still putting pressure on the same surface. Sand is soft if I'm barefoot or wearing shoes. And I don't see what difference this makes from the ankle up. If I stand barefoot on sand, my foot finds its equilibrium, and my body balances around my ankle. If I stand in shoes on sand, it's pretty much the same thing. So, calling this "barefoot technology," and using the Masai going barefoot as some type of validation of the technology, seems a bit silly to me.
Okay, let's just ignore the "barefoot" part. It's obvious just from one look that these shoes aren't normal. Is there something to this curved bottom sole that could have some therapeutic value?
To be fair, let's take a look at what the shoe company has to say. They have three studies listed on their website, all of which appear to have been commissioned by SwissMasai (warning - they're all pdf's):
- Changes in gait characteristics of a normal, healthy population due to an unstable shoe construction 8.1.2004 by Sheffield Hallam University
- In-Shoe Pressure Distribution in MBT shoes versus Flat-bottomed training shoes: a Preliminary Study 2.1.2005 by Laura Stuart, Edinburgh Royal Infirmary
- Effect of an unstable shoe construction on lower extremity gait characteristics 6.30.2004 by University of Calgary
The Sheffield study had 22 participants - 11 men and 11 women. To quote from the report, here is how the participants were outfitted:
On volunteering to take part in the study, each participant was provided with Masai Barefoot Technology (MBT) shoes (Figure 1.1) which were worn during the data collection sessions in the ‘MBT condition’ in addition to tight fitting shorts and vests. In the ‘normal condition’ participants were required to wear the same tight fitting clothing and their normal exercise shoes." And a little later in the report, "Prior to testing, participants were required to attend a tutorial session in which they were provided with their MBT shoes and instruction conforming to manufacturer’s specifications.
Here is the entire summary from that study:
The findings of the current study suggest that certain gait characteristics are affected during walking in a shoe of unstable construction. Although many of the kinematic variables remained unchanged, there were significant differences in both the trunk and the ankle angles. MBT shoes promote less forward lean during locomotion suggesting a more upright posture. Although not confirmed by the present study, the probable effect is a shift in the centre of mass position closer to the centre of the base of support, possibly aligning the body more optimally for locomotion. This, in conjunction with the lower hip moments experienced in the MBT condition may suggest reduced loading of the lower back. The changes in the ankle plantar flexion / dorsiflexion angle at the ankle, was primarily due to the reduced plantar flexion following initial contact during the MBT condition when compared to the normal condition. Kinetics at each of the joints of the lower limb were different between the MBT and normal conditions. The lower moments experienced at these joints suggests a resultant decrease in joint loading.The major finding from analysis of the ground reaction force data is the suggestion that there is a higher incidence of transient peaks when wearing normal shoes compared to MBTs. There is some evidence suggesting that transient forces transmitted through the skeleton are the primary aetiological factor in the development of many musculoskeletal disorders. These include, osteoarthritis, stress fractures, plantar fasciitis and achilles tendonitis and low back pain (Whittle, 1999).
Muscular recruitment during MBT gait is also altered, eliciting an increase in motor unit recruitment for Gastrocnemius, Biceps Femoris and Gluteus Maximus and a decrease in Multifidus. The increased activity in the muscles of the lower limb can be attributed to differences in the mechanics of MBT gait, i.e. more upright posture and the production of greater propulsive forces during the dragging motion of the stance limb. Although not confirmed by this study, the decrease in multifidus recruitment may suggest that MBTs reduce the possibility of fatigue in the lower back.
This initial study into the effects of an unstable shoe construction suggests that MBTs alter certain gait characteristics and that with frequent use they may reduce the incidence of some musculoskeletal problems. In those already suffering from such disorders, MBTs may allow patients to remain mobile by reducing cyclic loading of the already damaged joint.
Here are a few excerpts from the Edinburgh Study, describing how participants were chosen & outfitted, and the results.
Ten healthy adults, 4 male 6 female, took part in this study, sampled by convenience.
All the participants were fitted with MBT shoes (Fig. 1A) in the correct size. In the control condition, participants wore their own flat- bottomed sports shoe (example in Fig. 1B)
Principal Results: Standing in the MBT shoes resulted in lower peak pressure in the midfoot (21%lower) and heel (11%) compared to in the control shoe, and much increased pressure in the toes (76%). The mean pressure was also increased in the toes and forefoot in MBT’s, and decreased in the midfoot and heel. Overall, compared to the control shoe MBT’s gave a pattern of pressure distribution that was shifted towards the front of the foot. However, more research is needed to assess their clinical application.
Thirdly, here are some excerpts from the Calgary Study:
Eight subjects participated in this study performing tests in a control shoe (Adidas SuperNova) and the illustrated MBT shoe (Fig. 1). A first test battery was performed during quiet standing, quantifying the movement of the center of pressure and the corresponding muscle activity. A second test battery was performed during walking, quantifying kinematics, kinetics, muscle activity (EMG), soft tissue vibrations and oxygen consumption for the two shoe conditions for walking in an initial testing session at the start of the project and two weeks later in a second session. Subjects were asked to wear the unstable test shoe as much as possible for the two weeks (9.5 ± 2.1 h) as suggested by the manufacturer.
Summary
- Standing in the MBT shoe produced more movement of the center of pressure and required more muscle activity in the lower extremity to balance the body. Thus, during standing, the MBT shoe acts as a muscle training device.
- The general walking kinematics were not changed by the MBT shoe except for the landing kinematics (flat foot) and the stride frequency (higher) and stride length (shorter).
- The rotational ankle joint impulse for plantar-flexion for the first half of stance is higher for the MBT shoe. However, the actual plantar flexion moments are small during the first half of contact time. Thus, this increase should not be of any concern.
- The rotational ankle joint inversion impulse for the first half of stance is substantially higher for the MBT shoe. Small changes in shoe construction could change this situation if desired.
- The rotational ankle joint impulses for all other joints and axes are slightly decreased with the MBT shoe. The reduction is consistent for the knee joint and is on the average for all axes 19%. This result and the results for the reduced or maintained muscle activity during walking are evidence that the MBT shoe produces movement close to the preferred movement path.
- The muscle activity of the major muscle groups shortly before and after heel strike was not changed with the MBT shoe with the exception of reduction of the tibialis anterior and biceps femoris muscles.
- The MBT shoe required 2.5% more oxygen consumption for the same walking task, a difference that can be explained primarily by the additional weight of the MBT shoe.
- The onset and the frequency of the soft tissue vibrations were influenced by the MBT shoe.
- It is speculated that the MBT shoe strengthens the small muscles with small levers with respect to the rotational axes. This would reduce the joint loading which could explain some anecdotal results of less pain and discomfort.
In summary, the results of this study showed that the MBT shoe
- acts as a muscle training device during standing and quasistatic activities and
- reduces knee and hip joint loading during walking.
Okay, I think I was pretty fair in presenting the studies' findings, which do look promising. However, there are a few things about the studies which do bother me. Admittedly, I'm not a doctor or a scientist, but I still think these are valid concerns.
First of all, the studies were small. Each one only had a handful of people. Sure, it's enough for a good initial test, but not as convincing as it would be for a larger group. This, though, is my smallest complaint.
Another issue for the Sheffield and Edinburgh studies, was the manner in which participants were outfitted with shoes. For the MBT shoes, the participants were fitted and given instruction. Yet, for the control group, it was whatever old athletic shoes they happened to own. They could have been $5 Wal-Mart brand shoes for all we know. Only in the Calgary study were participants given a standardized control shoe.
The biggest issue I had, wasn't with the studies per se, but in using them as a justification for endorsing this shoe. The problem is that the studies were too focused. Let me give an (absurd) analogy to illustrate this point. Consider somebody wanted to solve the problem of saving people from burning buildings. They identified that one of the ways that fire can kill people is by burning them. They also know that the fires are caused by a combustion reaction between oxygen and and the combustible materials in the house. So, they figure, that if they can eliminate the oxygen, the fire won't be able to continue, so it won't be able to burn people to death. They invent a machine that very rapidly pumps nitrogen throughout the building, displacing all of the air, removing all of the oxygen. They run some studies, and find that their invention does indeed displace the air in the building fast enough to put out the fire. Unfortunately, they missed the fact that by displacing all of the oxygen, the people in the building wouldn't be able to breathe, and so they'd all die, anyway.
Obviously, that's much more extreme than anything that would be happening with these shoes (I said it was an absurd analogy), but it illustrates the problem with these studies. The makers of MBT shoes have identified some problems (obesity, joint pain, etc.), found some of the causes of those problems, and have built a shoe to address those causes. They ran some studies, and looked specifically at whether or not their shoes were addressing those causes. Unfortunately, they weren't looking at the big picture, or for other possible side effects. The studies were too small and too short to determine what detrimental side effects might occur from prolonged use of the shoes. For something with such big claims, such as changing your entire posture and gait, and I'd want to be sure it was changing them for the better.
Okay, so that covers the studies listed on MBT's website. I was able to find one other study that looked at these shoes, as well as a mention in the procedings of a meeting of the Physiotherapy Research Society. Let's first take a look at the Proceedings of PRS Spring Meeting (warning-pdf). Here's the relevant excerpt from that document.
The effects of Masai Barefoot technology footwear on posture: an experimental designed studyP. New, J Pearce.
School of Health Professions & Rehabilitation Sciences, University of Southampton, United Kingdom.
Introduction: This study was approved by University of Southampton ethics committee and aimed to assess the anatomical changes to upright posture that occur in the sagital plane as a result of wearing Masai Barefoot Technology (MBT) footwear during standing and walking. MBT claim that their innovative unstable shoes promote a more upright posture in which musculature is strengthened and joint wear reduced [1]. This could be helpful in the management and prevention of conditions such as osteoarthritis and back pain.
Subjects: 12 students (6 male and 6 female) at the University of Southampton aged between 18 and 40 participated in this study.
Methods: Participants attended one session at a biomechanics laboratory. The kinematics of posture wearing MBT shoes during standing and gait were examined using a twodimensional motion analysis system and compared to a control shoe.
Analysis: Statistical significance was tested using a pair ed t-test and a Wilcoxon signed ranks test.
Results: Standing in MBT footwear demonstrated a statistically significant increase in plantar flexion at the ankle joint (P = 0.025) [Mean 3.02 degrees, 95% Confidence Interval (CI) -5.6 to -0.4]. Walking in MBT’s showed a decrease in trunk flexion (P = 0.007) [Mean 1.44 degrees, 95% CI -2.4 to -0.4] and a reduction in anterior tilt of the pelvis, (P = 0.003) [Mean 3.20 degrees, CI -5.06 to -1.35] at heel strike. At toe off a significant reduction in anterior pelvic tilt (P = 0.035) was found in the MBT shoes [Mean 2.35 degrees, 95 % CI]. There was no significant difference found between the two shoe conditions at mid stance.
Conclusion: MBT footwear changes certain characteristics of posture in quiet standing and walking. These findings could have positive implications for the management of conditions such as osteoarthritis and back pain, however further research is needed.The authors acknowledge support from Masai Barefoot Technology PLC.
References:
1. Amann B, Amann F. Destabilise, sensitise, mobilise. Journal of Prevention and Rehabilitation. 2004; Special edition: 3-6.
I have the same feelings about this study as I did from ones listed on the MBT website - promising, but not in depth enough or over a long enough time interval to look for side effects.
So, let's move on to the study, Unstable Shoe Construction and Reduction of Pain in Osteoarthritis Patients, published in the October 2006 issue of Medicine & Science in Sports & Excercise Study, the official journal of the American College of Sports Medicine. I don't have access to the full text of the report, but here's the abstract:
Unstable Shoe Construction and Reduction of Pain in Osteoarthritis Patients.CLINICAL SCIENCES
Medicine & Science in Sports & Exercise. 38(10):1701-1708, October 2006.
NIGG, BENNO M. 1; EMERY, CAROLYN 2; HIEMSTRA, LAURIE A. 2
Abstract:
Purpose: The purposes of this study were to assess a) the effectiveness of Masai Barefoot Technology (MBT) shoe in reducing knee pain in persons with knee osteoarthritis (OA) and (b) changes in balance, ankle and knee ROM, and ankle strength compared with a high-end walking shoe for 12 wk.Methods: The research design was a randomized controlled trial (123 subjects, knee OA). Subjects were randomized to a MBT (N = 57) or a control shoe (N = 66). A Western Ontario and McMaster Universities (WOMAC) OA index, BMI, balance, active ROM, and ankle torque were quantified at week 0, 3, 6, 9, and 12. Two-sample t-tests were done for between-group comparisons.
Results: There was no significant difference between groups in total pain score. A significant reduction over the 12-wk period was found for both shoe conditions (-42/500 or 25.6% MBT, -46.2 or 27.1% control). There was no significant group difference in pain during walking (t = -1.09, P = 0.28). Pain during walking was significantly reduced by 5.2/100 mm in the MBT and 9.7/100 mm in the control group. Total pain showed a significant reduction for the MBT -27.4/500 (-16.6%) and the control group -28.9/500 (-17.0%) between baseline and week 3. Between week 3 and 6, there was a significant reduction for the MBT group only (-27.2/500 or -20.0%). There was a significant increase in the static balance between baseline and 12 wk in the MBT group only, although the difference between groups was not significant.
Discussion: The results indicate that special shoe interventions can reduce pain in subjects with moderate knee OA.
(C)2006The American College of Sports Medicine
There is further discussion of this study at a site called Bondolier.
This is a study with a decent sized study group, a good control group, and lasted for a decent interval. I still would have liked to see more looking for side effects, but maybe that's too much for an initial study. Anyway, this study did show some good therapeutic value for the shoes, but it didn't seem to be much different from that achieved with a pair of conventional New Balance sneakers.
Finally, I was able to find a decent newspaper article that took a critical look at these shoes, Sole searching, datelined April 24, 2007, from The Guardian. The article starts off explaining the concept of the shoes, and lists the studies I've already addressed above. It then goes on to quote a few critics.
Nicki de Leon, a consultant physiotherapist at the sports and spinal clinic in Harley Street, believes that, for most wearers, MBTs can do more harm than good. "This footwear fundamentally alters the way someone walks, shifting their normal biomechanics so that instead of someone striking their heel to the floor and transferring the weight forward, they are effectively being rocked forward by their shoe." While not disputing that MBTs work some muscles harder, she argues that it is the wrong muscles that are tested. "What happens when you wear them is that the superficial muscles - such as the hamstrings, calfs and gluteal muscles in the legs and buttocks - are worked rather than the deep muscles that support the spine. When any superficial muscle is overworked, it becomes stiff and rigid, and that is precisely what I have seen happening in people wearing MBTs. I am not a fan of them at all."Noel Kingsley, a leading practitioner of the Alexander Technique in London, agrees that the shoes are overrated. "They encourage a shorter stride than most of us are accustomed to. My concern is that this type of footwear lifts you quite high off the ground and requires you to walk in a special way. Once you get used to them, you feel quite odd without them. So what happens when you take them off?"
It is a question that also concerns de Leon. "A lot of people use them to walk distances, such as to work, but when you take them off your muscles forget what they are supposed to do. When you wear them, they change your alignment, but you don't know what's happening to your posture when you take them off and it's often not good."
In the long term, she says, the rigidity and stiffness of the muscles overworked by MBT shoes can cause pain and vulnerability to other injuries. "They are particularly risky for people with an existing unstable pelvis - quite a common problem - as they compound the instability. I really hope nobody runs in them as the outcome in terms of injuries could be dire." While MBT doesn't actively encourage running in its shoes, it doesn't discourage it either.
Actually, to address that last sentence, when I read Swiss Masai's FAQ, it said:
Yes, MBTs are perfect for jogging, as demonstrated in the video/DVD. MBTs are suitable for training but not for competitions. Always make sure that you are comfortable walking in them first, starting with the recommended time.
Going back to the Guardian article, here's another quote:
Alex Hazell, 28, from London started wearing MBTs four years ago. "At first I thought they were great, but then my physiotherapist pointed out that I was getting shoulder problems as the shoe was throwing me forward posturally. In the end I ditched them for a properly fitted training shoe."
They also quoted Sammy Margo of the Chartered Society of Physiotherapists, who said that MBT shoes could be useful, but added:
However, they don't work for everyone. For people who spend a lot of time at a desk, have hypermobility in their spine and weak core stability, MBTs could make their postural problems much worse.
And then, in the closing paragraph of the article:
Margo stresses that anyone intent on wearing MBTs "should definitely be doing a Pilates class or working on their core stability. Ideally you should get them only on the recommendation of a physiotherapist and should be trained to use them properly. They are not a cure-all for modern life".
So, after looking into the claims of Swiss Masai, it does appear that these shoes do show some promise for treating certain conditions. However, these were only preliminary - more clinical studies are needed. In the meantime, there is anecdotal evidence that the shoes can cause significant negative side effects. For anyone considering using these shoes, I would suggest that they talk with a physician or a physical therapist first, and then stay in contact with them to make sure that the shoes aren't doing them any harm.
Update I wrote a letter to the pharmacy where I first found MBT shoes, which I've posted online in this blog entry. Also, I received some feedback from a vendor of MBT shoes. Read the comments of that post to see his response.
Added 2009-01-19 I continue to receive comments on this entry on a fairly regular basis, a year and a half after I first posted it. Many have related positive experiences with the MBT shoes, and many have related negative experiences. So, I feel that I need to reference the popular saying - the plural of anecdote is not data. I do not mean to discourage people from posting their anecdotes here. In fact, I welcome them, because after all, that's what blogs are for. I just want to make it clear that without a proper clinical study, there's no way to quantify the risks associated with these shoes. So, to reiterate what I wrote before, if you plan on using these shoes, be aware that they do carry a risk for negative side effects, and be sure to consult closely with a doctor or physical therapist if you do use the shoes.
Comments
Thanks for the great insights and data, Jeff!
This is excellent information! All good no nonsense facts!
For more information like this as well as expert fitting recommendations on the different MBT models... check out www.FeetFirstFitness.com
Posted by: Swiss Masai | July 26, 2007 08:01 PM
How can I purchase shoes
Posted by: Cassie | September 13, 2007 09:55 AM
Cassie-
My advice is to first go see a doctor or physical therapist, and make sure that they recommend these shoes for you. If you get that recommendation, I'd further suggest that you look for a local vendor, so that you can get a proper fitting (according to feedback I received on another blog entry, it appears that "all the MBTs run differently in width and fit and the US size converson was done incorrectly on all the women's shoes.")
If you can't find a local vendor, the feedback I've received has come from a representative of this company: Feet First Fitness, which does sell the shoes online.
Posted by: Jeff | September 13, 2007 10:07 AM
I can't find any comment on walking or stepping backward.
I stepped back off the bottom rung of a ladder, rocked on the curved sole and sat down hard, breaking my hip.
Any others?
Posted by: Alex Orr | February 20, 2008 11:40 AM
As a certified personal trainer, I have some specific concerns about the foundational logic of these claims. Humans do not typically need to activate our muscles under the condition of unstable surfaces. For example, an athlete in a game braces his/her feet against the ground to stay upright when being hit by another body or when destabilizing the body for an activity such as throwing, kicking, or swinging. Traditional weight training (bracing against the ground while handling resistance) or agility-type training (re-stabilizing during or after movement) are more "functional" than these shoes. I have used a wobble board to train ATROPHIED superficial muscles after surgery; I don't quite see why it would be a good thing to make my hamstrings work all day long to maintain stability as I walk around. It seems akin to trying to "sit up straight" all day rather than sitting in a chair with appropriate back support for relaxation. Doesn't this set a person up for unhealthy compensation for muscle fatigue?
Posted by: Barbara Saunders | March 4, 2008 05:57 PM
I wore these shoes to walk in for 2 days- They have agrivated my anterior medial knee so bad that I have been unable to straighten my knee without pain for a week now. I am not a supporter of MBT shoes.
Posted by: Chantal | June 4, 2008 04:27 PM
Just met a woman who swears by her sandles and says she won't wear any other kind of shoe shince she broke an ankle.
I'm interested in learning more as someone in the family is having foot problems. Thanks for your research!
Posted by: Harbot | June 9, 2008 09:47 PM
I have had a pair of MBT shoes for about a year----and at first they really hurt my feet and I was very sore muscularly after wearing them all day. Now, I am having some sort of lower back problem in which I have cold tingles going down the back of my leg to my foot-possibly the L4-L5 lumbar??? MBT's fault??? Possibly---but extremely hard to find any critical info on MBT......
Posted by: ktb | July 11, 2008 01:22 PM
I have been wearing the MBT shoes for over a year. I did notice it caused me to use different muscles, which is always great. After about 13mos wearing them, I developed extreme knee injury to both knees! I am now preparing for knee surgery.
Posted by: Rhonda | July 15, 2008 08:46 AM
A shoe that corrects certain muscle, joint and/or posture problems would be great. So, on the tenative advise of my knowledgable friend, I bought a pair of MBTs. I only went to this site after wearing them for 2 days.
I now am more informed and can relate more analytically. So, here's my take. The only advantage that I see is in standing, they do help my posture. When I walk they put pressure on the wrong part of the foot and are very unstable. My lower back area is aching from the use of these poorly designed shoes. And running is ridiculus in these shoes. Thick-soled,air based sports shoes are very comfortable and put the MBT to shame.
In conclsion, I challenge the shoe manufactures to take the one great thing about the MBT shoes, that is, better posture when standing, and dynamically redistribute the shape of the shoe for walking and running. Also, I want royality rights for the idea: 0.1% is just fine.
Posted by: dr.gil | July 26, 2008 06:32 AM
To answer the concern about MBT's link to walking barefoot and the need to stabilise, the shoe is designed to create slight instability between the foot and the ground. When you stand in sand the ground will be moving slightly underneath you causing stabilising muscles to continually make slight adjustments in order to maintain balance.On initial strike when walking in sand this will be occurring even more as the sand doesnt have time to compact and harden. Obviously this does not happen on the hard flat surfaces we often walk on. MBT's are serving to recreate that slight instability underfoot that we do not often get these days.
Posted by: Kyle | August 10, 2008 07:03 PM
In answer to the query on side effects of MBT i would like to say that the footwear does alter the gait pattern slightly in that it promotes a slightly shorter stride length with a resultant upright posture. I would argue that Biomechanically this is the most efficient way to walk, reducing shock and rotational torque forces to joints, and allowing the body to rotate naturally therefore making it the most efficient natural shock absorber. I think that this coupled with the slight instability and resultant increase in muscle activity meaning that postural stabilising muscles are more active is the most efficient way for humans to walk. The big thing for me is that by reducing stride length you can reduce heel strike force on initial contact (reducing the lever for over pronators) and you spend a lower amount of time with full body weight on 1 leg. So for me if there are any abnormalities in the gait pattern MBT could help to reduce the negative impacts of this. From my study in Exercise Science and gait analysis I see MBT as an excellent tool for promoting efficient gait. I think there will always be those not suited to MBT but i think on the whole many can benefit. I havent seen too much evidence so far on the side effects of MBT
Posted by: Kyle | August 12, 2008 10:02 PM
What an informative blog. Have been searching all morning for pros and cons on MBT's. Just cannot decide whether or not they are worth the money. I am on my feet a lot. Most days standing over 5 hours a day and on weekends can be on my feet for 10-12 hours a day. Wish I knew if the MBT's would help with the burning neck and back pain from standing for so long. My job requires me to work outside so the ground is not always smooth, flat and dry either.
Posted by: Lorr | August 25, 2008 11:13 AM
Kyle,
In response to your first comment, I still don't see what this instability has to do with simulating going barefoot? How is standing on sand barefoot versus in shoes any more or less stable? How about on pavement? Our ankles already act like a pin joint. Our legs are naturally unstable about our ankles, anyway. These shoes may make you even more unstable, but I fail to see how that can be referred to as "barefoot" technology. Nevertheless, as I said in the main post, I'm not going to dwell on the semantics of their name, since it's obvious the shoes are doing something.
Regarding your second comment, you make some valid points, but how do you quantify the negative consequences? How many people will experience negative side effects? Just how bad will those side effects be? Is it just minor irritation that will go away when the person quits using the shoe, or could a person actually become crippled? These are the types of questions I would like to see addressed. I think they are very relevant as to whether or not people should be using these shoes, especially as studies such as the one by Nigg et. al. from Medicine & Science in Sports & Excercise Study indicated that these shoes didn't really help any more than a properly fitted New Balance walking shoe.
I'm not saying these shoes won't be beneficial to some people. I'm just questioning how many, and wondering how safe they are. At the time I wrote the article, I didn't see any studies to reassure me. If there are newer studies tracking the long term side effects of these shoes, I'd certainly be interested in seeing them.
Posted by: Jeff | August 26, 2008 03:58 PM
Lorr,
I'm no doctor, so you certainly shouldn't put much stock in my opinion. However, my gut feel is that if you're going to be spending a lot of time on uneven ground, these shoes probably aren't the way to go. However, you'd probably be best to go to a doctor or physical therapist and get their advice. (Personally, I'd avoid chiropractors. Even though they may have some techniques that work, the field is based on some pretty wacky ideas, and has some techniques that certainly don't work. Granted, not all chiropractors believe all of the mystical mumbo jumbo, but my personal opinion is that if somebody wants to go into that type of work, why would they even enter the field associated with woo, when they could just become a physical therapist and use evidence based treatments.)
Posted by: Jeff | August 26, 2008 04:20 PM
I have psoriatic arthritis in my feet and hips. The MBT shoes have helped me very much by making sure my weight is distributed across my feet, rather than thrown forward on the ball of the foot the way ordinary shoes do. The straightened posture also helps relieve hip pain. I think the shoes are great for walkign and every day use, but I doubt they are the best for ahtletics.
Posted by: Gayle | August 27, 2008 05:18 PM
The reference to barefoot comes from the fact that basically the aim of MBT is to simulate a softer, uneven terrain and therefore challenge the foots proprioceptive abilities. A Flat soled stable shoe does not challenge the foot and proprioceptive abilities can be lost. So the use of 'Barefoot' in the name is referring to the increased challenge to the foots intrinsic musculature. I think where MBT is coming from is that most of our time is spent on hard, flat surfaces in flat shoes, we never need to stabilise as we used to when walking and standing on uneven terrain. Obviously in this day and age we all need to wear shoes but the aim is to recreate the instability our ancestors encountered.
In terms of the walking pattern in MBT i see no negative to walking with a reduced stride length, reduced shock to joints and a more even gait. It is the way the human body is designed to walk. For those with existing conditions these can be increased by lengthening the stride, increasing shock, rotational torque and overloading to other areas as compensation. Im sure there will always be some that do not get along with MBT, I really do think they would be a minority. In saying this it would be great to see more research and I am aware that they are always doing more. I know they have currently done around 26 studies on the various effects.
Posted by: Kyle | September 10, 2008 12:30 AM
I would like to hear from someone that has wore these shoes if they received any weight loss benefits from wearing them. I have to stand on my feet alot at work and other times I have to walk alot(i'm a surgical nurse)did anyone see a significant change in their glutes muscle tone?
Posted by: sadie | October 11, 2008 10:06 PM
hiya,
so i bought MBT's and have been wearing them daily for around 2 months.
i am only 28 have a pretty healthy life style, but was suffering massively from hip joint pain, lower back pain, on and off neck pain and constantly hurting legs.
i go to the chiro weekly, do pilates twice a week, stretch daily, ride a bike, walk alot etc... all in order to try to lessen my pain and improve my wellbeing.
my problems were effecting my daily life extensively and made me worry about my future and ageing.
i have also worn orthodics for the past 8 years and usually wore a nike shoe.
about 3 months ago, my heel got very swolen and my feet were cramping up during walking or pilates, so i saw a podiatrist, she went through a few options for me, but felt due to my feet rolling in so much, that was a huge part of all of my problems.
she suggested MBT's. i felt like i had no options left so thought why not?
$360 - (AUD) later and a couple of months in... i am SO happy and relieved that i tried them.
first week the muscle behind my knee was sore but its because i wasnt walking correctly in them. (big steps)
i went to a MBT walking class and the main thing i had to change is taking much smaller steps, which im now in the habit off.
so... near to ALL of my pain has GONE. my lower back is still slightly unsettled, but it does not affect me to the degree it did daily like before and my partner and colleagues have noticed me complaining alot less.
all of my hip joint pain is gone and i no longer have to wear orthodics AT ALL.
I find that incredible, i wore those things in my shoes all the time and still experienced sore arches, shin splints and jarred ankle joints.
A few weeks back i was going to a dance party and wore my older nikes for fashion reasons and i wasnt so confident i could dance to techno in my MBTs (also didnt wanna get them filthy) this was the first time i wore my nikes since i got the MBTS - biggest MISTAKE ever. I walked less than 1 km to the party, and felt my lower back jamming up, each step was like a impact of tension. throughout the night my legs began killing me and my feet cramped up.
I dont know about the long term possible negative affects. but for someone as young as myself, i am so thrilled with the effect MBT's have had on my life.. and this is only 2 months in!
Everyone keeps telling me too that i look great and have lost weight... (im around 70kg's so pretty average) i havent noticed the loss, but if so i bet its the MBTs!
the only small thing i noticed is when im really trying to hold my shoulders back to fully instigate my core and work my stomach, it can make my shoulders achy the next day. but i think this is just the body adjusting and once i strengthen my posture even more that will decrease.
If your going to get them.
MAKE sure they FIT!
Ensure to take the walking class - TINY steps are an absolute must.
and GOOD LUCK!
Posted by: alysha | November 11, 2008 09:05 PM
Hi, I have been seeing a physical therapist due to an unfortunate sciatica problem. I have asked her about MBT. She says i could use them if i believe that they work. She does not think that there is a real proof of evidence that they work nor she takes them seriously. I find them ugly and eyewateringly expensive. So i have to let them go anyway.
Posted by: A | January 3, 2009 05:28 PM
Here's something to think about before you buy MBTs. Your WEIGHT. Yes. You're too little - they do too little.
I bought some. I'd been eyeing them off for a while but at $360 AU... nup. $180 on special, I'd give em a go. I now realise that if you are light, they don't do all they are meant to. The soft 'unstable' bit has the same PSI resistance in all sizes. I weigh possibly half that of a man and they don't squish under my weight. That means they don't give way and throw me off, forcing me to compensate as is supposed to happen.
There was a crowd in the shop that day and I spent a long time in there. I noticed that other bigger people trying them for the first time, were more wobbly and really going on about how about how "different" they felt. Not me. They didn't feel unstable at all. I thought maybe I just have better balance. The only difference was the centre of gravity, but I wear lots of spongy platforms with the backs worn down (bad girl) so it was no biggy. My old high rise thongs do pretty much the same. Maybe even more if the whole concept is lack of support, because the MBTs certainly don't collapse under me in any greater way than those. To test, I carried a 15kg weight in the MBTs and ah ha!, I started to get it.
So, in all, I think the real key is to keep your body thinking. Scholls sandal's claimed that the exercise was in the toe clenching required to keep them on. Then there are the heel-lower-than-ball shoes that give your calves a right bollocking. I have a pair of knobbly massage thongs that are a dream when I'm tired or my feet are achey. Not to mention the hundreds of sports and walking shoes that say their benefit is in the very support that MBTs eschew (or antishoe should I say).
Over and out. Hope this was useful to somebody.
Posted by: Lisa | January 9, 2009 10:46 PM
I've been wearing MBT's for about two years and just love them - I have 4 pairs!
I have MS and resultant "foot-drop" which led to many falls over the prior few years. During the previous 2 summers I wore knee braces all the time because I'd fallen so often & injured my knees so severely.
When a close friend, who also has MS, recommend that I try MBT's I figured I didn't have anything to lose. The owners of Total Body Solutions in Framingham, MAss, where I bought the shoes gave me a a lesson on how to balance myself before I started walking in them - they wouldn't let me leave the store until I knew how to walk in them properly!
I accommodated to the new gait so quickly that I didn't need to slowly increase my wearing time over the course of the first week... I wore them full-time within 3 days.
1 - I no longer stumble and trip over uneven pavement he way I used to - I can walk longer and farther, without foot, knee, hip or back pain (which were constant problems in the past, really inhibiting my ability to get out and walk - I also have a Morton's Neuroma on the soles of both feet which was often excruciating if I walked more than 1/2 mile!)!
Since walking is my main form of exercise and I used to walk at least 3 miles a day, having to give that up was depressing.
2 - People started commenting on my improved posture within days.
3 - People are (still) constantly asking me if I've lost weight -(maybe 4-5 pounds over the past two years) but I am fitting into smaller clothes - especially pants and shorts.
4 - My tush and thighs are visibly smaller and less "jiggly".
When I'm able to walk at least 3 times/week there's no jiggle at all!
5 - My tummy is tighter (maybe from the extra effort to balance).
6 - My overall balance is better - wonderful news for anyone with MS, or anyone, for that matter
When I got my first pair of MBTs, I asked my Podiatrist his opinion, and he was quite skeptical ... however he said to
try them out and keep him posted on how I was doing with them - I could be a "guinea pig" to see how well they worked.
At my next appointment, he was amazed at the difference in my posture and balance and has started recommending them to specific patients.
The only bad news - They did NOT prevent a slip on black ice which resulted in knee surgery after 18 months of physical therapy! ;-)
So call me one big MBT fan for giving me back my mobility and lessening my foot, knee, hip, and back pain.
Karin
Posted by: KJ Sprecher | January 17, 2009 02:11 PM
One point (a friendly piece of advice) I forgot to make earlier:
Do NOT get MBTs on-line ... buy in a good shoe store with knowledgeable personnel:
1 - it took at least 4 pairs for me to find the best fit for me. The same went for my very petite friend (size 0 - 2, 5'2") who introduced me to MBTs. (My friend only weighs about 95 lbs., and she loves MBTs, so I am surprised by the comment about weight.
2 - We both found that different styles of MBTs required different shoe sizes.
3 - In addition, you really do want the lessons on how to change your stance and gait before you start wearing them .. it makes it a lot easier to get used to them.
As did an early blogger, after wearing MBTs for several months, I had to wear more "elegant" shoes to a wedding - low heeled sandals which were definitely the correct fit. I could barely the few blocks from the car to the hotel, and immediately took them off when we reached to reception room. Wearing the "elegant" shoes from the reception room to the front entrance of the hotel was excruciating. My feet, calves and back remained sore for several days after-wards.
MBTs may not be fancy but I won't wear anything else.
All the best,
Karin
Posted by: KJSprecher | January 17, 2009 02:43 PM
I have been wearing MBT's for 2.5 years and have a bad hip flexor injury.
I have have proof that they caused it but I have been doing everything else about the same.
LVR
Posted by: Lisa Van Raalte | January 19, 2009 01:20 PM
I never had any problem with my knees but after I used MBT shoes for a month I started feeling feeling pain for the first time. Now pain is still with me even when I quit wearing them.
Posted by: F.Farraj | March 14, 2009 12:40 PM
I earlier posted about being too light for MBTs. Just thought I'd report back after 4 mths of wear. I do love wearing them, but wish they were really 'unstable' to match my weight even more, now that I'm used to them. I notice that the fact they don't flatten out as much under me means the rocker sole remains more curved, so on that count it's a bonus. I think I'm right about this, because the new model MBTs have a much more curved sole than mine, probably to conpensate for the flattening of the squishy middle bit. Now, if they'd just make the smaller sizes with softer middle bits, we'd all get to have the same experience with the shoes. For something that claims it's all about technology and charges so much for it, I think this oversight of of basic physics is pretty poor. I bought a weight belt which I use when I can and can feel they are more effective. I don't regret buying them, in fact they are my favourite shoes but I won't get another pair while I have to bulk up like a deep sea diver to make them really work.
Posted by: A | April 18, 2009 07:48 AM
I think it would be a bad idea to wear MBTs all the time. But they have made a huge difference to me in the short term.
I have had a hammer toe straightened (which sounds like nothing if you have never experienced having a toe joint removed!) and was given a surgical shoe to wear for six weeks, making me a good inch higher on one side than the other. As a result I had a limp and pain in my hip.
Now I am wearing MBTs instead, and they are wonderful. But I shan't want to wear them again once my six weeks of recovery are up.
Query: why do hospitals only provide one shoe to patients with foot injuries? I would have gladly paid for a matching shoe.
Posted by: Stephanie | April 25, 2009 02:07 AM
i have been wearing mbts for 3 years now. I initially bought them for my mum as she has hip problems. She is 50 and I am 34. As soon as she put them on she was able to walk a lot more, normally when we go shopping she has to sit down after 20 mins, but in these shoes she was up for 3 hrs and felt great! I asked if they could be used for running. I run 45 mins to 1 hr, covering between 8 to 10 Km..She said yes. Now when I ran before I had terrible knee and back pain. With these I have no problem at all! Whoever said its difficult to go back to walking normal is stupid. I wear stilletoes most days and have no trouble changing from both. My posture is so much better and I can run longer with no problems. I did go back to a cushioned running trainer, and my back problems started again. So I have to say, each to their own, I for one am a great fan!
Posted by: s khan | April 29, 2009 03:56 AM
This has been quite a good site for discussing the pro's and cons of the MBT's.
So for what it's worth here's my tuppence worth! As a corrective exercise specialist I have always been skeptical of the claims of MBT and most research that backs up their claims has probably been subsidised by MBT in the first place? The foot is an amazing piece of work and shutting it off in any shoe causes inherent problems, the reason that some people on here have had negative effects from going back to old style running shoes may be because for each inch of heel you have in a shoe in creates 11 degrees of postural tilt that the body has to compensate for. that's why women in high heeled shoes look so unstable. most shoes like nike, NB etc have an inch and a half of heel or at least 15 degrees for the body to adjust to.
Yep it would also appear that MBT's can decrease some impact that could cause some pain experienced by people with faulty mechanics but if you look at why people have dysfunction it is not placed solely (no pun intended!) at what footwear they are wearing.
Foot dysfunction is, in my experience not a primary cause of pain, whereas breathing pattern disorders, jaw alignment, eyesight, neck, organ referral, emotional stress, sacro-illiac joint pain and many more are the causes of modern pain syndromes. Footwear is a potential cause but a very small part of the equation.
My biggest criticism of MBT's and this is just an observation, is that the instability is created in a sagittal plane (forwards/backwards) a plane where most people have considerable problems anyway from seated at a desk, completing too many exercises like press ups and sit ups, running etc. not completing functional movement patterns that twist, side bend, pull and the like. Wearing shoes that continue to exacerbate this problem would compound any painful conditions.
I recommend and sell my clients a shoe called vibram 5 fingers because it is the closest thing to bare foot. I run in mine and I get clients to train in them also. I don't sell anything to my clients that is gimmicky or that would be the source of dysfunction. Besides Masai mechanics are a very different from white european mechanics. Most clients of mine from african and eastern descendants have increased pronation and flattening of the foot that is hereditary. it's a bit like nutrition one man's food is another man's poison.
My advice to anyone is sure if these MBT's help you out in the short term by all means use them as pain can be a burden but clarify the source of your pain, is it structural, hormonal or emotional.
Think to yourself can I run in these shoes, as we are all designed to run. Most force attenuation shoes designed by manufacturers are marketed to create doubt in your mind that impact is bad but we need impact to be stored in the deep longitudinal sling to provide energy for the next stride. Impact is good. Most Masai warriors spent hours on endurance hunts on baked sand that is as hard has concrete.
Have you noticed that Nike hasn't lost this concept by producing the nike free which heel size is being reduced each new model?
So there's my input, I could go on, but I may have bored you long enough.
Cheers
Tommo
Posted by: keith littlewood | May 3, 2009 06:56 AM
Hi Jeff,
Interesting stuff, and thanks for taking the time to review. Home many of the different shoes did you try yourself?
Here are the points I find interesting in your report and responses.
1, You seem a little concerned regards the reports being sponsored by the manufacturer, and I agree it would be much much better to see independent reports - but seems difficult to find anybody to conduct reports unless somebody pays.
Perhaps a Consumer reports study would be a good place.
Similarly, most of the prescription drugs that are brought to market are usually sponsored by the for-profit (I only mention the for-profit because many seem to feel that the pharmaceutical industry is "for health" which it is not) pharmaceutical company. And as we know, many many cases of only the good results being used to approve drugs which later turn out to be deadly. So evaluation is a problem.
2, I noticed in one of your responses you recommended that a Doctor be asked for advice before purchase.
I feel that this may be a little misguided advice. The Doctor is often positioned as the know all, when in effect, the majority of doctors don't even know about nutrition and how the body functions. Try this next time you visit your family doctor, ask him/her how much nutritional training they have taken? So to expect them to provide any valid advice on a non drug product is ludicrous.
Going to somebody that looks at the person holistically would likely provide better advise, or try them yourself, form your own opinion.
I think what would be very helpful would be a database of experience with these shoes - over a long term.
I'd be very interested to hear what your experience has been with the different types of shoes, and also it would be good to know how to decide what is a bad shoe (ie is a shoe from Walmart automatically a bad shoe?) and only expensive shoes good?
Don't get me wrong, I would not buy a Walmart show as I don't believe in their business practices, I only mention this to illustrate a point.
Thanks again for your report. I guess we all have to take responsibility for being our own best second opinion in anything we see or hear.
Interesting, just tried to post and seems my comments have been listed as junk!
I don't appear to have a single link? Curious.
Posted by: Raid | May 28, 2009 08:07 AM
Hello people interested in this MBT blog. This is my third post. Last report was at 4 mths wear. It's now been 7 mths and I'm a complete convert. Having said I wouldn't buy a second pair, I'm now up to my seventh. What a tragic. I've averaged about a quarter price for them (on special, online and even secondhand - get em wherever I can find em)
I guess, whatever theories people have about why they they should or shouldn't work, the proof is in the wearing. Some have had injuries but many many more have had good results as testified to by the fact they can keep selling thousands of these expensive things to return customers - like me for instance.
The renovations to my body shape have been worth it. The improvement in my posture add to it. The total lack of previous back aches absolutely seals the deal for me.
All the talk focuses on walking, but frankly, I think much of the benefit comes from standing still and being full of micro-twitches from the waist down the whole time. (To those who haven't tried them, don't worry, you don't notice the twitches unless you think about it) This must be hugely effective when you consider how much standing you do in a given day, when normally you would be using few muscles at all. This may be why some of us have such noticeable results from seemingly a simple walking shoe with just a slightly different sole. Wear them for everyday things like doing dishes and prepping food. Free exercise! No extra time. No gym. Wear them shopping and at least standing in a queue becomes something more than a total waste of life.
Cheers
Posted by: Lisa | June 25, 2009 07:36 PM
I have worn nothing but my MBT's since I got them three years ago. I wasn't able to stand or wear any pair of shoes, even those with my orthotics for more than 30 minutes. My MBT's have given me my life back. I can walk and lead a normal life. They have relieved the pain from my feet knees and hips. I praise God for these wonderful shoes!
Posted by: Caroline Goering | July 3, 2009 10:37 AM
Raid,
I apologize for taking so long to respond to your comments, but I've been very busy over the past month. However, I felt like I must respond to your comments, because, quite frankly, some of your attitudes seem a bit dangerous. I guess the easiest way is to address your comments point by point.
But first, let me say that Swiss Masai now has a list of studies on their website. I haven't yet had a chance to review these studies, but I hope to in the near future. Okay, on to your points...
I haven't used the shoes at all. Like I wrote originally, I first saw them in a drugstore and considered them a curiosity, so I decided to investigate them a bit further. I don't currently have any back pain or foot pain that I would need any treatment for (I did have a bit of foot pain once, but I'll address that a little later).
Just to be sure that my memory wasn't faulty, I went back and skimmed through both this entry and my follow up entry, Letter to Pharmacy about MBT Shoes. As I thought, conflict of interest was the least of my concerns with the studies. My major concerns were that studies were too limited, and didn't do enough to address possible negative side effects.
I cannot stress enough how much I disagree with this comment. This is one your attitudes that I considered dangerous. A good family doctor should be your starting point for any medical treatment (other than emergencies, obviously). Family practice doctors may not be specialists in nutrition, but they do know quite a bit about how the body works - why do you think they take all those anatomy and physiology classes? And as far as having a regular family doctor, it is invaluable to have a consistent point of contact, who knows your history and who knows you personally, and can judge your condition far more accurately than a stranger, before referring you on to specialists.
In the past few years since I've met my wife, I've come to know many people in the medical field, considering MDs, NPs, RNs, and various others in the field as friends. I've learned a lot more how the field works in this time. There's an old joke, that a patient goes to the doctor and says, "Hey Doc, it hurts when I bend my arm like this." The doctor responds, "Well then don't bend your arm like that." This common sense approach to medicine is a common theme I hear from my medical friends, where drugs and pills are not the first course of action, and more invasive treatments are even further down the list.
For example, when I had some foot pain a few years ago, I mentioned it to one of my friends who happens to be an NP. What was her advice? To lose the extra pounds I'd recently put on. No drugs, no special therapy - just a slight lifestyle change. Similarly, when I complained to her about elbow pain, she told me to use ice packs and heat compresses - old fashioned, traditional therapies.
Granted, there are times when the use of drugs is merited, but that should hardly be a surprise. And it's nothing new. Our species has been using drugs since before we realized that chewing on willow bark would ease our pain. Modern pills are mostly just a way to isolate the useful chemicals and administer them in controlled doses, but many of those useful chemicals originally came from natural sources (and whether you ingest a drug in a pill or a plant leaf, the chemical still behaves the same in your body).
All that being said, not all doctors are created equal. I'm glad that I now know enough about the medical field in my town to know which doctors to go to, and which to steer clear of. I even knew of a provider who would prescribe antibiotics for viral infections! I don't know you so I don't know your history, but if your experiences with doctors have been to jump to drugs as the first line of treatment for every ailment, then I'd say that you need to find a new doctor.
Well, here I agree with you. This was kind of the whole point of my post - more data is needed on these shoes. Considering the comment you made on my other post (which I'll address in a bit), how would you propose gathering this data in any meaningful manner if not through clinical studies?
If only expensive shoes were good, then MBTs would be among the best. Personally, I've found over the years that Asics, Avia, Adidas, and Reebok are all very comfortable for me, while Nikes are a bit uncomfortable on my feet. I've never actually worn New Balance or many of the other brands of sneakers. Since I don't like shopping and don't feel like hunting out a new brand that works well for me, my sneaker shopping has basically become a search for the cheapest pair of Adidas I can find, hopefully on sale (I don't like to spend over $40, and refuse to spend more than $50). Other than comfort, the main reason I stick to Adidas is that I've found they're built well and last a while (I get more use out of a $50 pair of Adidas than I would out of 2 pairs of $25 Walmart sneakers).
Reading back over this entry, my comment about "$5 Wal-Mart brand shoes" was meant more as an indication that the control group in those studies wasn't very controlled. We don't know what the variability was in the control shoes.
You left another comment in my follow up entry, Letter to Pharmacy about MBT Shoes. I'll address that here, as well.
This is another of your comments that I must strongly disagree with because I consider it a dangerous attitude. As Richard Feynman once said, "The first rule of science is not to fool yourself—and you are the easiest person to fool." One of the primary purposes of clinical trials is to avoid self deception. This is a topic that deserves more than I can write in a short response, so I'll recommend a very good article from the winter 2005 issue of Skeptic Magazine, The double-blind gaze: how the double-blind experimental protocol changed science. In short, there are countless ways that we can convince ourselves that a treatment works, even when it's no better than a placebo, and the double blind clinical trial is the best method we've found to get around our own self deception.
Another important factor of large clinical trials is that they can find the negative side effects. Every drug or treatment will have positive and negative effects, and the strength of these effects will vary from person to person. What may be a miracle drug that saves the life of one person, could cause a fatal allergic reaction in another. Obviously, treatments aren't ruled out for the entire population if they have negative side effects in some (millions have been saved by penicillin even though people like me can't take it) - but doctors and patients must be aware of the side effects so they can keep a look out for them. This is one of the major points I have tried to make with this blog entry. MBT shoes may work great for some people. The benefits may be real, and not just placebo, confirmation bias, or any other self delusion. But there may still be a substantial number of people who experience negative side effects. Just exercise some caution if you're going to use these shoes, and consult with a medical professional before and while using them.
Posted by: Jeff | July 8, 2009 12:39 PM
I bought a pair of MBT sandals from Zappo's in June. On July 1st I was startled while in my recliner and attempted to run towards the stairs in the hallway. I must emphasize "attempted" because the shoes threw me off balance and propelled me down the hallway where I stopped by my heading hitting the metal front door. I broke both my arms and hurt my neck, back and knee and leg. I have no history of falling or any condition that compromises my balance. Until the accident occured, I loved the shoes and felt that they were helping my plantar facitis. Now, I would really like to caution people about the possibility of serious injury when wearing these shoes. We never know when we might have to hurry across busy street or be startled by something and lose the concentration necessary to keep balanced in these shoes. I just want people to be extra cautious when wearing the MBT's.
Posted by: Linda | August 22, 2009 12:39 AM
Marketing hype is a wonderful thing. In truth the shoe has little to do with bare-footedness, perhaps it should just be called the "rocking shoe" or the "unstable shoe". But "Masai barefoot" sounds so much better! ... but that is just marketing, and I can't comment on whether the foot instability is good for us or not. ...
However, I do know a lot about bare-footedness, having spent 12 years in an earlier part of my life roaming barefooted in rough country, through heavy timber (sticks and stones!) and rocky creeks and hard gravel roads, and dusty cowpads. What is different is how carefully and automatically we placed our feet in that situation, our peripheral vision selects the spot, and our eye is already choosing the next spot before the foot is placed! Walking quickly across stony creek beds was effortless, but now I find (after years of being shod and walking flat pavements) that a return to my old haunts is a dicey and precarious balancing act.
With that bare-footedness came great balance (and very tough soles! ... I could run barefoot for 5 miles on tarmac with no problems).
But I have no doubt the benefits were a function of the terrain, and allowing the foot to grip the ground. I guess this can be replicated to some extent by a very thin sole, but the toes don't get to do their thing quite so freely.
Posted by: Mark Eastaugh | August 23, 2009 09:02 AM
Avon has the same type of shoe for $40.00. I got some 3 weeks ago and wear them to work. (9 hours a day) and love them. And will continue to wear them at this point.
Posted by: Jenifer Pace | September 5, 2009 12:08 PM
Hi Jeff, great information! I was considering these shoes for orthopaedic benefit and I'm glad I got both sides... I think it's interesting, I've been wearing converse (no support) for years and everyone always says so bad that is. Based on the barefoot theory you'd think they'd be promoting that benefit. Personally I do think having some support is necessary to assist with your posture. Mine sucks.
Thanks for the blog!
Posted by: Kate | September 18, 2009 10:12 AM
Hi Jeff,
I'm glad you started this discussion. I think it is important that people know the pros and cons of MBTs. I'm a fitness trainer and have 47 clients wearing the shoes. Everyone has been happy with them so far. I've been wearing them for almost a year with nothing but positive results.
Almost all of the negative reviews I've read online are from people who don't actually own the shoes (and may have never worn them).
One person talked about getting blisters when wearing the shoes. I have tried many MBTs on, and found they fit true to size. I believe in supporting local businesses, but I have found most local show stores carry limited sizes and syles. They typically don't carry half sizes. I was put into a shoe that was a half size too large. As I walked, my heel practically came out of the shoe, but I was told that is how they are supposed to fit (which just is not true). I would suggest getting your foot measured locally, and then only buying a shoe that fits like your other shoes. If they don't have a shoe in stock that fits, then order it. If you can't order it, then go online.
The rocker bottom shoe is gaining popularity. Other mainstream shoe manufacturers are coming out with their own version of the rocker bottom shoe. Some less expensive, and others more expensive than MBTs. Nothing works for everyone. I believe there are more people benefiting from this type of shoe than there are having problems with them.
Posted by: Courtney Miles | September 21, 2009 07:59 PM
I love your extensive post about mbt. I have worn them since 2004, and love them. But I like your unbiased look at the pros and cons of these shoes. I wonder why no studies have been done in the United States? One would think that a college would do a study of them. Anyway, just my thoughts.
Posted by: Janet Davis | October 11, 2009 09:18 AM
I purchased a pair of mary janes and used them for about 2 months and actually loved them. I found my vulnerable knees didn't hurt after long walks in them..so I felt I was set. I didn't have any balance problem at all with them.
(I haven't really seen anything written up about this, but I haven't spent hours on end reading about them. I have done my fair share of research through.)
The problem I DID have with them is this. I walk on the outside of my foot generally and have a high arch. Because of that, I didn't realize, but learned the hard way, when I stepped off a 12" step onto a welcome mat outside someone's home, carrying a few pieces of luggage, the foot I stepped out with, inverted inward and I BROKE MY ANKLE!!!! It was the oddest thing.
I am not going to use the shoes again. I know if I had worn a flat, not rounded bottom shoes, this would not have happened.
Just my two cents which cost me alot more than that from this experience.
Judith
Posted by: Judith | November 21, 2009 11:40 PM
623793
Your site is of great importance. here is my story:
I have been slightly kyphotic and scoliotic for as long as I can remember, so the chance of improving my posture with MBT's was approached by me with great enthusiasm. I purchased a pair last August - the shoes felt comfortable and I followed the instructions stringently. After about 3-4 weeks of wearing them I thought my posture had improved, but at the same time I began to feel strange pains in my thoracic spine - a pain which I never experienced before. I did not attribute this to MBT's as a physiotherapist I went to see reccommended them to me. After about 2 months tthe pain in the spine - which I will describe below - intensified to such an extent that I decided to take a break from wearing MBT's. For the last 4-6 weeks I have suffered from sudden (caused by a wrong turn/movement, especially when sliding down in bed from sitting to lying position), most excruciating pain, which lasts about 10 seconds and feels as if a tree trunk is breaking in the storm - there is a huge crack and my muscles go into spasm, I cannot breath and the pain persists until I find, ever so carefully, a different position. I have had the ambulance here twice, as the shock of this pain is so huge that I cannot recover for a few hours. I have had x-rays and a DEXA scan and all show just a normal thinning of the bones (I am 59). I am yet to see a consultant to give me the full verdict. I have claimed all along, and tried to explain this to the consultant I saw in the Royal Free, that this pain is due to MBT's, but he took my opinion with a pinch of salt, not being able, nevertheless, to attribute the pain to anything else!
AND TODAY I HAVE HAD A HUGE BREAKTHROUGH WITH MY ANALYSIS OF MY CASE!
My son's mother in law came today to see me and asked me what is the matter with my spine. when I told her, somewhat hesitantly, not expecting to be believed, that I think my problem started with wearing MBT's she said that her daughter, who is 17 years old and has a slight scoliosis and kyphosis, like myself, was told by Great Ormond Street consultant(s) never to wear MBT shoes as they will cause her damage!!!!!!! SO THERE YOU HAVE IT FROM THE MOUTH OF EXPERTS: MBT'S CAN CAUSE DAMAGE!
You cannot imagine my relief when I heard this, as at long last there was some credence to my perception of what was happening to my body as a result of wearing MBT's.
I would love to know if this damage is reversible, because if it is not I am in for a life of pain which, I fear, will impact on my heart etc. It is a pain that on a scale of 0-100 is 120!
AND LASTLY, i FEEL THERE IS NOW ENOUGH GROUNDS TO SUE MBT MAKERS WHO SELL THESE SHOES WITHOUT A HEALTH WARNING. IF OTHERS WOULD LIKE TO JOIN ME - WE SHOULD GO FOR IT. I have been incapacitated now for 6 weeks, my life had turned upside down and I am fearful of making any movement. By the end of the day I cannot sit/stand/lie down/walk.
Eda
Posted by: Eda spinka | November 29, 2009 08:27 AM
I really love MBT shoes. It feels like you're walking on a cloud. I love that you can get them occasionally on a discounted price on discontinued items.
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Posted by: mabel | December 11, 2009 09:08 PM
I bought some of these shoes due to the agony i had been experiencing while on Holidays and my habit of walking for days on end in Art Galleries and Museums. And they are brilliant my feet no longer feel like they are burning and I can walk and stand in them for hours on end. I must stress though i am usually walking on reasonably flat surfaces here. Im not sure how these shoes would measure up on very uneven surfaces, and I always take extra care when using stairs in them. But for day after day on your feet and standing they are bliss.
Posted by: jenny | December 13, 2009 12:06 AM
i have not tried these shoes yet, but i have something to tell ya all. i have had numerous accidents, eventually leading to deterioration of C-5, then C-3 too. also, i broke my ankle, which really counts here. i had learned that the best way to walk to relieve pain in your back and neck was to walk barefoot in the sand. because sand is so soft, it makes it so that your vertebra move and then new, oxygenated blood flows through and around, reducing back pain. i learned that it was true, and now i can't do it because of the ankle break (that happened 4 years ago, but still i can't walk barefoot in sand, dammit)!
next, walk barefoot on the earth. next, walk barefoot on hard surfaces. the worst thing you can do, especially if you suffer from hip arthritis, is to walk in any fashion, shoeless or not, on a cold concrete floor. even those covered with linoleum, like in stores, are bad for you.
another shoe that works for ME, are negative heel technology "earth shoes," which are patented by Ann Kalso. don't confuse them with any other shoes that start with the word "earth," like "earth spirit," which give you no benefit.
i will try out these shoes on the city streets and in stores, but i may revert to wearing my earth sandles with socks, even in the winter! (they sell boots too--see my epinion published about them on epinion.com in the winter of last year, either december 2008 or january/february 2009). the cost a lot, but they feel so good!
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Posted by: snow | December 13, 2009 08:57 PM
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Posted by: snow | December 15, 2009 09:40 PM
All I know is that walking on white sand is the greatest stabilizing factor for my feet,legs and back, even thugh it seems a bit awkward while you are doing it. I did it and hope for that same effect from a shoe.If anything can simulate that ,I need it.
Posted by: Len Trankina | January 23, 2010 01:55 PM
If you want to simulate being barefoot, get a pair of Virbram FiveFingers. These MBT shoes are crap. My sister pulled her hamstring in these things. Your foot works best when its forced to support itself without technology. If the Masai saw these things, they would laugh their asses off.
Posted by: JP Kab | January 30, 2010 06:53 PM