• 1

    Lieberman DE: What we can learn about running from barefoot running: an evolutionary medical perspective. Exerc Sport Sci Rev 40: 63, 2012.

  • 2

    Collier R: Low-tech running shoes in high demand. CMAJ 183: E20, 2011.

  • 3

    Bruggemann GP, Potthast W, Braunstein B, et al: Effect of increased mechanical stimuli on foot muscles functional capacity. In: Proceedings of the ISB XXth Congress-ASB 29th Annual Meeting ; July 31-August 5, 2005; Cleveland, OH.

    • Search Google Scholar
    • Export Citation
  • 4

    Miller EE, Whitcome KK, Lieberman DE, et al: The effect of minimal shoes on arch structure and intrinsic foot muscle strength. J Sport Health Sci 3: 74, 2014.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 5

    Angin S, Crofts G, Mickle KJ, et al: Ultrasound evaluation of foot muscles and plantar fascia in pes planus. Gait Posture 40: 48, 2014.

  • 6

    Crofts G, Angin S, Mickle KJ, et al: Reliability of ultrasound for measurement of selected foot structures. Gait Posture 39: 35, 2014.

  • 7

    Vohra PK, Kincaid BR, Japour CJ, et al: Ultrasonographic evaluation of plantar fascia bands: a retrospective study of 211 symptomatic feet. JAPMA 92: 444, 2002.

    • Search Google Scholar
    • Export Citation
  • 8

    Wong YS: Influence of the abductor hallucis muscle on the medial arch of the foot: a kinematic and anatomical cadaver study. Foot Ankle Int 28: 617, 2007.

  • 9

    Gray EG, Basmajian JV: Electromyography and cinematography of leg and foot (“normal” and flat) during walking. Anat Rec 161: 1, 1968.

  • 10

    Mann R, Inman VT: Phasic activity of intrinsic muscles of the foot. J Bone Joint Surg Am 46: 469, 1964.

  • 11

    Headlee DL, Leonard JL, Hart JM, et al: Fatigue of the plantar intrinsic foot muscles increases navicular drop. J Electromyogr Kinesiol 18: 420, 2008.

  • 12

    Mulligan EP, Cook PG: Effect of plantar intrinsic muscle training on medial longitudinal arch morphology and dynamic function. Man Ther 18: 425, 2013.

  • 13

    Jenkins DW, Cauthon DJ: Barefoot running claims and controversies a review of the literature. JAPMA 101: 231, 2011.

  • 14

    Nigg B: Biomechanical considerations on barefoot movement and barefoot shoe concepts. Footwear Sci 1: 73, 2009.

  • 15

    Ballas MT, Tytko J, Cookson D: Common overuse running injuries: diagnosis and management. Am Fam Physician 55: 2473, 1997.

  • 16

    Dalton SE: Overuse injuries in adolescent athletes. Sports Med 13: 58, 1992.

  • 17

    McLeod TCV, Decoster LC, Loud KJ, et al: National Athletic Trainers' Association position statement: prevention of pediatric overuse injuries. J Athl Train 46: 206, 2011.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 18

    Giuliani J, Masini B, Alitz C, et al: Barefoot-simulating footwear associated with metatarsal stress injury in 2 runners. Orthopedics 34: e320, 2011.

  • 19

    Robbins SE, Gouw GJ: Athletic footwear and chronic overloading: a brief review. Sports Med 9: 76, 1990.

  • 20

    Robbins SE, Gouw GJ, Hanna AM: Running-related injury prevention through innate impact-moderating behavior. Med Sci Sports Exerc 21: 130, 1989.

  • 21

    Ridge ST, Johnson AW, Mitchell UH et al: Foot bone marrow edema after 10-week transition to minimalist running shoes. Med Sci Sp Exer 45: 1363, 2013.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 22

    Franco AH: Pes cavus and pes planus analyses and treatment. Phys Ther 67: 688, 1987.

  • 23

    Tome J, Nawoczenski DA, Flemister A, et al: Comparison of foot kinematics between subjects with posterior tibialis tendon dysfunction and healthy controls. J Orthop Sports Phys Ther 36: 635, 2006.

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 24

    Sherman KP: The foot in sport. Br J Sports Med 33: 6, 1999.

  • 25

    Bahram J: Evaluation and retraining of the intrinsic foot muscles for pain syndromes related to abnormal control of pronation Advanced Physical Therapy Education Institute Web site. Available at: http://www.aptei.com/articles/pdf/IntrinsicMuscles.pdf. Accessed March 20, 2014.

    • Search Google Scholar
    • Export Citation
  • 26

    Jung DY, Koh EK, Kwon OY: Effect of foot orthoses and short-foot exercise on the cross-sectional area of the abductor hallucis muscle in subjects with pes planus: a randomized controlled trial. J Back Musculoskelet Rehabil 24: 225, 2011.

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 27

    Fiolkowski P, Brunt D, Bishop M, et al: Intrinsic pedal musculature support of the medial longitudinal arch: an electromyography study. J Foot Ankle Surg 42: 327, 2003.

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 28

    Healey K, Chen K: Plantar fasciitis: current diagnostic modalities and treatments. Clin Podiatr Med Surg 27: 369, 2010.

  • 29

    Yong JR, Silder A, Delp SL: Differences in muscle activity between natural forefoot and rearfoot strikers during running. J Biomech 47: 3593, 2014.

  • 30

    Goss DL, Gross MT: Relationships among self-reported shoe type, footstrike pattern, and injury incidence. US Army Med Dep J Oct-Dec, 25, 2012.

  • 31

    Daoud AI, Geissler GJ, Wang F, et al: Foot strike and injury rates in endurance runners: a retrospective study. Med Sci Sports Exerc 44: 1325, 2012.

  • 32

    Yanagisawa O, Kurihara T: Intramuscular water movement during and after isometric muscle contraction: evaluation at different exercise intensities. Clin Physiol Funct Imaging [Published online ahead of print July 3, 2015; doi ].

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation

Effect of Vibram FiveFingers Minimalist Shoes on the Abductor Hallucis Muscle

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  • 1 Kent State University College of Podiatric Medicine, Independence, OH. Dr. Bernhard is now with Highlands-Presbyterian/St. Luke's Podiatric Medicine and Surgery Residency Program, Denver, CO. Dr. Heard is now with Millcreek Community Hospital Residency Program, Erie, PA. Dr. Kidon is now with St. John Macomb Oakland Hospital, Warren, MI.
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This study investigated the effect of Vibram FiveFingers Bikila minimalist shoes on intrinsic foot musculature. We hypothesized that a gradual transition into minimalist shoes will increase the thickness of the abductor hallucis muscle.


Forty-one individuals were divided into four groups: control (traditional shod) (n = 9), restricted walking in Vibram FiveFingers (n = 11), running in Vibram FiveFingers (n = 10), and unlimited walking in Vibram FiveFingers (n = 11). At baseline, 12 weeks, and 24 weeks, the thickness of the abductor hallucis muscle was determined using ultrasound. Statistical analysis was performed to determine the significance of differences in muscle thickness at the three different time points.


The mean thickness of the abductor hallucis muscle at 24 weeks was significantly greater than that at baseline for the restricted walking (P = .005) and running (P < .001) groups. In the unlimited walking group, the mean thickness of the muscle at 12 weeks was significantly greater than that at baseline (P < .05) but not at 24 weeks. There were no significant differences in muscle thickness among the three time points for the control group (P = .432).


This study demonstrated that wearing Vibram FiveFinger Bikila footwear over a controlled period of time, an unlimited amount of time, as well as transitioning runners over a 6-month period of time using the 10% philosophy for increasing mileage, significantly increases intrinsic muscle thickness of the abductor hallucis. The abductor hallucis muscle aids in support of the medial longitudinal arch, and an increase in this muscle thickness may help reduce running-related injuries thought to arise from arch weakness.

Corresponding author: Nicholas Campitelli, DPM, 2660 West Market Street, Fairlawn, OH 44333. (E-mail: feet@me.com)