The buzzword in footwear these days is "barefoot."
Shoes as minimal as ballet slippers - and shoes with fat two-inch soles - claim to be healthy for you because they're like going barefoot.
While there are studies that support some of the purported benefits, there is also "a lot of hype," says Kendrick Whitney, a professor of podiatry and orthopedics at Temple University.
"And you have people thinking, 'I'm just going to lace up these shoes and get the same workout as going to a gym,' " he said. "Shoes should never be used as a replacement for exercising."
Whitney, who researches shoe function and design, and his Temple colleague Kathya Zinszer, a podiatrist who specializes in diabetes education, see a lot of patients whose shoe choices prove to be a step backward. The experts offered some advice for striking the right balance between innovative and sensible shoes.
Unstable shoes. For decades, doctors have been prescribing shoes with curving soles to treat gait problems, foot pain, and deformities.
But it took MBT (Masai Barefoot Technology) to convince millions of people that rocking back and forth on the two-inch-thick curved sole of an intentionally unstable shoe is like walking barefoot on sand and thus has "a positive effect on the whole body."
Since the 1996 debut of MBT, developed by a Swiss engineer, at least 15 other manufacturers have introduced their own "toning shoes," also called "wellness shoes." Supposedly, the footwear, which can cost a couple of hundred dollars, burns more calories, relieves back and joint pain, and even eliminates cellulite.
"While there are studies supporting some of these claims, toning shoes are not a panacea for gait problems or foot pain," says the American Academy of Podiatric Sports Medicine.
Whitney - who owns a pair of MBTs - says there is evidence that they improve posture and strengthen muscles that don't get worked by conventional shoes. But the rocker soles can actually be harmful for people with a history of ankle sprains, poor balance, or a foot that pronates (rolls inward) too much.
"We don't want to put an unstable foot in an unstable shoe," he said.
Roll-up shoes. Speaking of unstable, Zinszer and Whitney cringe to see women teeter down the street in platform sandals with stiletto heels.
But they also warn against the growing number of brands of slipper-thin shoes that are being marketed as a way to protect female feet from the harms of high heels: Just pull out the flimsy flats (which can be rolled up or folded and stashed in a purse), shuck your dress shoes, and you're ready to trek to work, the mall, or a nightclub.
"I saw them for sale at the airport," Zinszer said. "They look like socks. They give no support, no protection."
The lack of protection is especially risky for diabetics with foot numbness or circulation problems, Zinszer said, because they are more vulnerable to injury yet less aware of it when it happens.
Whitney calls roll-up shoes "EFCs" - excuses for foot coverings - and recommends carrying a pair of quality flip flops with good arch support to change into.
Barefoot sports shoes. It may sound contradictory, but Whitney conditionally endorses another minimalist shoe: those five-toed running shoes that look like gloves for your feet.
Vibram, the Italy-based rubber sole manufacturer, invented the funny-looking sneaker and claims it "makes feet healthier" by allowing them to move "more naturally and freely" - as if barefoot.
Several other companies have since come out with flexible, uncushioned fitness shoes.
Books, websites, and research have been devoted to examining the risks and benefits of running in bare feet.
But Whitney says the real issue is making the shoe style fit the running style. While Kenyans, who have been running barefoot for centuries, are trained to land on the balls of their feet, Western athletes are not.
Westerners' "heels hit the ground first, and we run on hard surfaces, so we've become accustomed to a rigid, supportive running shoe," Whitney said.
Barefoot shoe newbies - like those new to toning shoes - need to make a slow, careful transition from conventional athletic shoes or they may wind up with metatarsal stress fractures, not to mention irritated toes.
Zinszer and Whitney recommend consulting a doctor with a background in sports medicine before embracing any shoe or exercise program.
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