Every now and then I am asked the same question: so what do you think about those “insert name of barefoot running shoe here”.

MBT shoes are the original unstable or “barefoot” shoe design, named so after “Masai Barefoot Technology”. The shoe has a rounded sole in the anterior-posterior direction and a cushioned sensor under the heel that creates a degree of instability in both the anterior-posterior and medial-lateral directions. The idea is that this provides some of the benefits attributed to barefoot motion, to help facilitate smaller intrinsic as well as the extrinsic muscles of the foot and ankle to work. This has the potential to assist in reducing joint stress of the foot and ankle and higher, improve balance/posture, and encourage lesser used muscles to work.

There is some anecdotal and scientific research to support and negate the proposed benefits of the MBT shoe, some of which is in peer-reviewed journals; however many are studies conducted by the manufacturers themselves. There is little known of the long-term effect of wearing such a shoe.

So what is my answer?

As with anybody who presents for physiotherapy, the estimated benefit from an MBT shoe must be considered by a case-by-case basis. A person who has reduced stability through foot/ankle, or higher up the limb/pelvis/trunk, in concurrence with a specific injury, may have their problem significantly exacerbated by putting them into a more unstable position. Furthermore, if there is a specific biomechanical fault which is the cause/contributor of the problem (e.g. a pelvic malalignment), changing the footwear won’t correct the problem!

The amount of time of wear of such as shoe needs also to be evaluated. To go from wearing shoes for one’s whole life for activity/sport to wearing an unstable shoe has the potential for stressing structures not used to the reduced support. Monitoring training/wear time in such a situation needs to be considered.

Finally, even in appropriate situations where the shoe may hold some benefit, whether the wear of such a shoe is better than other approaches in the way of exercise, balance/proprioceptive retraining etc. for similar issues, is unknown. It is unlikely to be as specific as targeted exercises/treatment for a complaint.

There certainly many proposed benefits of MBTs in some situations – have a chat to your physio or podiatrist about whether they might be appropriate for you.