Footware Matters
Footwear Matters: Sandals, Barefoot Walking & Support
A Physical Therapist’s Guide to Summer Foot Health
Summer often brings a shift in footwear habits—sandals, flip-flops, barefoot walking at the beach, and more time spent in minimal shoes. While this can feel freeing, it meaningfully changes how the foot absorbs load and stabilizes the body. As physical therapists, we frequently see an increase in plantar fasciitis, Achilles irritation, and foot fatigue during warmer months, often tied to sudden changes in footwear and activity volume.
The goal is not to avoid sandals or barefoot time, but to use them in a way that matches your tissue capacity and includes gradual adaptation.
Flip-Flops and Sandals: Why They Can Contribute to Pain
Most flip-flops and unsupportive sandals have limited arch support, minimal rearfoot stability, and no secure mechanism to keep the foot stable without toe gripping. This combination increases demand on the intrinsic foot muscles and plantar fascia while reducing external support.
Over time, this can contribute to plantar fascia overload, calf tightness, and generalized foot fatigue. These effects are more likely when people suddenly increase walking volume in these shoes or wear them for long durations on hard surfaces.
Barefoot and Minimalist Walking: What the Evidence Suggests
Research supports the idea that gradual exposure to barefoot or minimalist footwear can improve intrinsic foot muscle strength over time. Systematic reviews show improvements in foot muscle size and strength when minimalist footwear is paired with progressive loading and strengthening programs over weeks to months. However, rapid transitions increase the risk of overuse symptoms such as plantar fascia irritation or calf strain.
The key clinical takeaway is that barefoot exposure can be beneficial, but only when it is progressed gradually and treated as a training stimulus rather than an immediate full-time change.
Safe Transition Guidelines for Barefoot or Minimal Shoes
A safe progression involves short, low-demand exposure at first, followed by gradual increases based on symptom response. In early stages, 10 to 20 minutes per day of barefoot walking indoors on softer surfaces is typically appropriate. Over time, this can increase by approximately 10 to 15 percent per week as tolerated.
Monitoring response is essential. Mild muscular fatigue is expected, but increased heel pain in the morning, persistent arch soreness, or next-day stiffness indicates that the load is increasing too quickly and should be reduced.
Plantar Fasciitis Prevention During Summer
Plantar fasciitis often develops when tissue load exceeds tissue capacity, particularly when activity levels increase quickly while support decreases. Common summer triggers include increased walking during travel, long periods of standing, and sudden shifts from supportive shoes to barefoot or sandals.
Prevention focuses on managing load progression and improving tissue capacity. Calf flexibility plays an important role, as calf tightness increases strain on the plantar fascia. Gradual exposure to barefoot walking, rather than abrupt change, is also important.
Strengthening the foot and calf consistently has strong support in the literature as a way to improve load tolerance and reduce recurrence risk.
When Supportive Shoes Are the Better Choice
Barefoot and minimalist footwear are useful tools, but they are not appropriate for every situation. Supportive shoes are often more appropriate during longer walking sessions, travel days with high step counts, prolonged standing, or during an active flare of foot or heel pain.
From a clinical perspective, minimalist footwear is best viewed as a training stimulus, while supportive shoes serve as load management. Both have a role depending on the demands of the day and the current condition of the tissue.
Foot Strengthening Program
A simple, consistent strengthening program is one of the most effective ways to improve foot resilience.
Short foot exercise, or arch doming, is performed by gently lifting the arch without curling the toes. This can be done for 3 sets of 8 to 12 repetitions with holds of 5 to 10 seconds.
Toe coordination exercises, often called toe yoga, help improve motor control by isolating movement of the big toe and smaller toes. This can be performed for 1 to 2 minutes.
Slow calf raises are another key component. These should be performed for 2 to 3 sets of 10 to 15 repetitions with a slow controlled tempo. As strength improves, progression to single-leg calf raises is appropriate.
Balance training, such as single-leg stance for 30 to 45 seconds, can also be added to improve foot and ankle stability.
This program is most effective when performed 3 to 5 times per week.
Clinical Bottom Line
Foot symptoms that appear during summer are often related to a mismatch between increased activity and insufficient tissue preparation, rather than footwear alone. Barefoot walking and minimalist shoes can be beneficial when introduced gradually, but sudden changes in support or activity volume commonly lead to overload symptoms.
If heel pain, arch fatigue, or morning stiffness develops, it is usually a sign that the load is exceeding the current capacity of the foot and should be adjusted.
When to Consider a Physical Therapy Evaluation
A foot and gait evaluation is appropriate if heel pain persists for more than a few weeks, if symptoms recur each summer, or if foot fatigue begins to limit walking or daily activity. Evaluation can help identify movement patterns, assess load tolerance, and provide individualized recommendations for footwear, strengthening, and progression into barefoot or minimalist activity.
A targeted approach can also help determine whether plantar fascia irritation, calf dysfunction, or foot mechanics are contributing to symptoms and guide a structured plan for recovery and prevention.
References
Ridge ST, Johnson AW, Mitchell UH, Hunter I, Robinson E, Rich BS, Brown CN. Foot muscle size and strength are associated with improved function in minimal footwear runners. Med Sci Sports Exerc. 2019.
Miller EE, Whitcome KK, Lieberman DE, et al. The effects of minimal footwear and foot strengthening on foot morphology and function. J Foot Ankle Res. 2014.
McKeon PO, Hertel J, Bramble D, Davis I. The foot core system: a new paradigm for understanding intrinsic foot muscle function. Br J Sports Med. 2015.
