Foot developmental and bio-mechanical aspects throughout childhood - part 5 of 7

Development of the foot is ongoing throughout childhood and time spent barefoot helps to increase neuroplasticity in the brain, and bring about clear benefits in stability, posture, balance, gait, and movement. Morrison, Price, McClymont, and Nester (2018) discuss foot development as a complex interplay of inherent biological variables as well as external factors such as footwear and mechanical forces. In a study of 2300 children aged between 4-13 years, Rao and Joseph (1992) reported that flat footedness was more common in children who wore closed toe footwear than in children who remained unshod. Since then many other studies have challenged the findings of Rao and Joseph, however, much evidence points to stronger foot structure and function, and ability to spend more hours in a day engaged in physical activity in habitually unshod children. In another study by Hollander et al. (2016) researchers performed an observational study across binational, multicenter, and cross-sectional cohorts to pinpoint the differences in foot mechanics and motor performance in habitually barefoot children (South African cohort in which barefootedness prevails) versus habitually shod children (German cohort which obliges the use of footwear in all educational institutions) aged 6-18 years. The general consensus indicates that habitually barefoot children have stronger feet and less foot and toe deformities (Hollander et al., 2016). Further, unshod children presented a wider forefoot region, a higher and more pliable arch, and a reduced hallux angle, than shod children. The study by Hollander et al. (2016) was very precise in comparing geometric parameters of forefoot, midfoot, and hindfoot, with special focus on detecting the medial longitudinal arch development over age. Most studies conclude that development of the medial longitudinal arch occurs until 6-8 years of age, with possible changes to arch morphology still possible through adolescence, with footwear as the greatest influencer in arch morphology. Evidence exists attesting to diminished flexibility, mobility and foot pliability overall in individuals who habitually wear shoes, and consistently shod feet showed an increase in foot deformities such as hallux valgus, hallux rigidus, and pes planus (Hollander et al., 2016). Further, Soysa (2012) notes that because intrinsic foot muscles have both their origin and insertion within the foot, a range of foot disorders and deformities are the result of intrinsic foot muscle weakness. Soysa compares shod wearing modern humans to primates, noting the morphological adaptation of much shorter phalanges in the human foot, and other adaptations of intrinsic muscles with specialized functions that may have evolved for bipedal ambulation. It appears conclusively that barefoot locomotion has long term effects on foot mechanics and motor performance.

It was determined over 30 years ago in a study by Greer, Hamill, and Campbell (1989) that barefoot walking children ages 3-4, produced ground reaction vertical forces much greater than adults, and with notably higher anteroposterior braking, propulsion forces, and mediolateral average force. Children at this age are still developing proprioception, and learning how to move in space. The movement of this age group strives to hone balance, control and stability, while developing gait pattern. Bare feet are essential in establishing the foot-brain connection to diminish strike force, develop ease of movement, gain postural stability, and evolve gait pattern.