•  
  •  
 

Keywords

Minimalist footwear, Barefoot running, Stress fracture, Metatarsal, Intrinsic foot muscles, North Karnataka

Abstract

Background: Minimalist footwear (MF) and barefoot walking and running are increasingly adopted in India, often using low-cost flat shoes or no footwear at all. However, abrupt transition on hard urban surfaces (concrete, marble, tile) may predispose to metatarsal stress fractures, plantar fasciopathy, and Achilles' tendinopathy. Objective: To synthesize current biomechanical and physiological evidence on MF transition and present clinical case data from a single centre in North Karnataka. Methods: We reviewed published studies examining bony strain, intrinsic foot muscle adaptation, and injury rates following MF use. Additionally, we present representative clinical cases from combined Orthopaedics and Physiology outpatient services (January 2024 – March 2026). Key Findings: Peak metatarsal strain increases by 15–25% when running in MF compared to conventional cushioned shoes. Intrinsic foot muscle cross-sectional area requires 12–16 weeks of progressive loading to hypertrophy significantly. Bone remodelling at the metatarsal necks requires up to 16 weeks. Across our eight illustrative cases from North Karnataka, mean transition duration was 18 days; seven of eight patients transitioned in <4 weeks. High BMI (>27), pes planus, and prolonged standing on hard floors were common contributory factors. Conclusion: The paradox of MF is that it unloads the foot's artificial supports while overloading the skeleton. Graduated transition over 4–6 months, preparatory foot-ankle strengthening, and public health messaging for high-risk occupational groups are essential in the Indian context.

Pages

52

Last Page

56

Download

Share

COinS