Last Thursday, researchers at Wits University announced the results of a study on the health
of human feet published in the November issue of the prestigious journal The Foot. The study demonstrates that people had healthier feet prior to the invention of the shoes.
The study conducted by Wits academics Dr Bernhard Zipfel, a Podiatrist and University Curator of Fossil Collections and Prof. Lee Berger of the Institute for Human Evolution and the Bernard Price Institute, reveals that early humans who did not wear shoes had healthier feet with fewer pathologies than modern groups of humans who wear shoes. The research was conducted on over 180 modern humans from three different population groups (Sotho, Zulu and European) and on skeletons of humans more than 2000 years old.
The study challenges the widely held belief that habitually wearing shoes is good for your feet and suggests that going “barefoot” results in fewer bony pathologies, particularly in the metatarsal (mid-foot) region. The study also highlights the damage done to female feet by the wearing of high-heel shoes. “In almost every case, women show a higher frequency of fore-foot pathologies and bony damage to the foot. This is almost certainly due to the constraining nature of fashionable female footwear and the wearing of high 
heels in particular,” says Berger.
The one exception to this is in Zulu males where surprisingly, the study shows that they have more foot pathologies than Zulu females. “The surprising reversal in this global trend may be due to the history of manual labour in South African mines where these men were forced to wear ill-fitting footwear and stand on their feet for long hours,” adds Zipfel, lead author on the paper.
Berger is quick to point out however that statistically the Zulu population group in the study “have the healthiest feet overall. This was followed by Sotho people, with people of European decent having the most unhealthy feet.” Zipfel explains that “our study suggests that the reason Africans have generally healthier feet is probably due to the fact that the mid-twentieth century Africans examined probably came from rural areas and thus may have been barefoot as children - a much healthier situation for their feet than the European group which probably wore shoes from an early age.”
“Prehistoric humans had it right – bare is best – at least when it comes to feet!” says Berger.
Zipfel notes that while the American Podiatric Medical Association (APMA), the largest organisation in the world representing podiatric medicine, justifiably instructs people with diabetes who have lost protective sensation not to go barefoot, “they, however, unfortunately also do not actively encourage outdoor barefoot walking for healthy individuals. This flies in the face of the increasing scientific 
evidence, including our study, that most of the commercially available footwear is not good for the feet.”
Both authors agree that the results of the study indicate that if one’s goal is to have fewer foot problems then going without shoes is the healthier option. But Zipfel, is quick to point out that there are some situation where wearing shoes is mandatory. “For hygienic reasons shoes should be worn in public areas, restaurants and toilets and situations where there might be the danger of stepping on sharp objects,” he says.
The research was supported by grants from the Palaeontological Scientific Trust and Wits University.
The article is citable as: Zipfel, B. and Berger, L.R. (2007) Shod versus unshod: The emergence of forefoot pathology in modern humans? The Foot, 17, 205 – 213.
For information or interviews, contact Dr Bernhard Zipfel on (011) 717-6683 or 083 779 3394 or Prof. Lee Berger on 083 454 6309. Reprints of the article are available on request.