How Shoes Have Deformed Our Feet: A History of Fashion Over Function

Footwear has long shaped the human foot, sometimes gently, sometimes drastically. From medieval fashion statements to modern high-tech sneakers, shoe design has impacted foot form and function throughout history. Here's a deep dive into how shoes have driven foot deformation over time and what research and firsthand accounts tell us today.

📜 Foot Deformations Across History

1. Medieval Fashion: Poulaines and Bunions

• Poulaines, the long-pointed shoes of 14th–15th century Europe, forced the toes into unnatural positions. A study of medieval burials around Cambridge showed 27% of individuals had developed bunions, compared to just 6% from earlier periods without such shoes.

• The evidence clearly links footwear trends with skeletal changes.

2. Chinese Foot Binding

• For nearly a millennium, foot binding in China reshaped the feet of young girls by forcibly breaking and bending bones to conform to a 3-inch ideal. It led to lifelong disability, chronic pain, and deformity (Wikipedia).

• Nearly 100% of upper-class Chinese women had bound feet by the 19th century.

3. Early Modern Shoes: Heels and Narrow Toe Boxes

• High heels, narrow toe boxes, and rigid construction appeared in both men’s and women’s footwear during the Renaissance and beyond. These designs contributed to hallux valgus (bunions), hammertoes, and other deformities.

• A recent study found 80% of women wearing shoes more than 0.5 cm too narrow experienced chronic foot pain and pathology (Toe Box Research).

👟 Modern Athletic Shoes: Are They Just as Harmful?

Raised Heels and Over-Cushioning

• Brands like Nike, Adidas, and HOKA design running shoes with elevated heels (up to 12mm drop), excessive arch support, and thick cushioning. While intended to absorb shock, these features discourage natural gait mechanics.

• Raised heels promote a heel-strike running style, which studies show increases joint impact forces, particularly at the knees and hips (Lieberman et al., Nature, 2010).

Born to Run: A Cautionary Tale

In Born to Run, author Christopher McDougall explores how heavily cushioned modern shoes, particularly from brands like Nike could contribute to foot weakness and running injuries. Some key insights and anecdotes:

• McDougall notes that running injuries skyrocketed after the introduction of cushioned running shoes in the 1970s:

  “No invention has hurt more runners than the modern running shoe.”

• He cites Dr. Daniel Lieberman, who explains that our ancestors ran barefoot or in thin sandals for millennia without plantar fasciitis or shin splints.

• A Nike lab researcher (anonymously) told McDougall that most injuries are caused by the shoes themselves, because cushioning causes runners to slam their heels into the ground harder without noticing due to the padding.

• The Tarahumara tribe of Mexico, who run ultra-distances in thin homemade huaraches, rarely experience the injuries common in Western runners. Their feet are wide, strong, and resilient, developed naturally from barefoot movement.

🤸 Biomechanics & Structural Changes

1. Feet “Mold” to Shoes

Modern footwear restricts natural toe splay, weakens intrinsic foot muscles, and prevents ground feel—crucial for balance and proprioception.

• A flexible foot becomes rigid.

• An adaptable arch becomes dependent on support.

2. Research on Load-induced Deformation

Studies show foot dimensions change dynamically under load. Shoes that don't account for this lead to cramping, collapse of the arch, and long-term deformities (JSTAGE, PLOS One).

3. Shoe Fit and Injury Risk

Up to 72% of people wear improperly sized shoes. This correlates strongly with bunions, corns, calluses, and neuromas (Foot and Ankle Research).
Even in athletic populations, improper fit and overbuilt shoes result in Achilles tendinopathy, plantar fasciitis, and chronic overuse injuries.

🚨 Case Against Max-Cushioned Brands (e.g. HOKA)

HOKA and similar brands are known for extreme cushioning and “rockered” soles. While they feel soft and supportive, they have drawbacks:

• Altered biomechanics: Heel-to-toe transitions are exaggerated, bypassing natural foot motion.

• Muscle atrophy: Arch and toe muscles are underused, which can destabilize the ankle and knee.

• Disconnection from ground feel: Reduced proprioceptive feedback increases missteps and reduces natural agility.

As Born to Run puts it:

“The more cushioned the shoe, the less protection you get.”

✅ What Makes a Healthy Shoe?

🔍 The Barefoot Paradigm: Data & Observation

• Populations that grow up barefoot or in minimal footwear (e.g., the Tarahumara, Maasai, or South Asian rural communities) have:

  • Lower rates of bunions, flat feet, and plantar fasciitis

  • Stronger arches

  • Greater balance and foot control
    (Appl. Sci. 2024, Health 2023)

🧭 Final Thoughts

Foot deformities aren't just relics of the past—they’re built into modern life through footwear design. From historical beauty standards to today’s performance shoes, we’ve consistently chosen fashion or marketing over function.

Born to Run reminds us that our feet evolved to run and walk without modern interventions. The key isn’t more cushioning—it’s less interference. To prevent injury, we need footwear that respects anatomy, promotes natural movement, and lets the foot do what it was born to do.