How It Helps

View information slides in landscape mode on your mobile device. Swipe to advance slides.



  • Mechanical vibration signals need for cellular adaptation in response to activity.
  • Cellular transmembrane integrins respond to mechanical vibration created by activities.
  • Deliberate Walking, with lower loading forces, may provide a more physiological mechanical vibration, magnitude and frequency, that promotes cellular growth and adaption.
  • This effect may promote bone growth and prevent osteopenia/osteoporosis.

Adaptation (PDF)


Energy Efficiency

Energy Efficiency:

  • Deliberate walking and running is more energy efficient than heel-toe walking and running
  • Efficiency is improved by:
    • Shorter stride
    • Higher step cadence
    • Less braking
    • More gliding
    • More mechanical bounce/elasticity
    • Increased resonance
    • Less muscle work (concentric/eccentric contractions) and more isometric muscle contractions

Energy Efficiency (PDF)

Evolutionary Medicine

Evolutionary Medicine:

  • The function of the human body depends upon its genetic structure.
  • The way someone walks or runs represents a functional phenotype.
  • There is signification variation in the way people walk and run.
  • Humans adapt or change the way they walk and run to accommodate what is or is not on their feet.
  • Habitual barefoot walking and running is biomechanically completely different than walking and running with shoes.
  • There is no doubt that footwear/shoes change the way humans walk and run.
  • This difference is referred to as phenotypic variation.
  • Evolutionary medicine considers the effects of phenotypic variation on health and disease.
  • Diseases caused by using the body in a manner that it was not evolved to be used creates what are referred to as evolutionary mismatch diseases.
  • Is it possible that many if not most musculoskeletal diseases represent evolutionary mismatch diseases?

Dynamic/ Static Foot

Dynamic/Static Foot:

  • The foot/ankle and other parts of the body function best when the foot maintains a plantigrade position and posture when it is loaded.
  • A static foot refers to a foot in which the plantar fascia and intrinsic muscles of the foot are not engaged when the foot is loaded.
  • When the plantar fascia and intrinsic muscles are not active when the foot is loaded, the foot may assume a non-plantigrade or deformed position.
  • A dynamic foot refers to a foot in which the plantar fascia and intrinsic muscles of the foot are active and engaged when the foot is loaded.
  • When the plantar fascia and intrinsic muscles of the foot are engaged they function to dynamically create a plantigrade foot.
  • When the foot is loaded while heel-toe walking and running with footwear/shoes, the foot behaves like a "static foot" - the plantar fascia and intrinsic muscles of the foot are not active or engaged.
  • When the foot is loaded while deliberate walking and running (habitual barefoot walking/running) the foot behaves like a “dynamic foot” - the plantar fascia and intrinsic muscle of the foot are active and engaged.
  • The goal is to stand, walk and run with a plantigrade foot.
  • To obtain a plantigrade foot with heel-toe walking and running, specific shoes and inserts may be required.
  • Since Deliberate Walking and habitual barefoot walking create a dynamic foot for standing, walking and running specific shoes/inserts become less relevant to maintain a plantigrade foot.
  • Lee evaluates footwear/shoe wear and orthotic inserts to optimize standing, walking and running biomechanics before, during and after the transition from heel-toe walking and running to Deliberate Walking and Deliberate Running. This includes the safe transition to and use of minimalist shoes.

Dynamic/Static Foot (PDF)

Gait Control / Models

Gait Control/ Models:

  • Humans walking barefoot will walk with a shorter stride length than those walking with footwear/shoes at a given walking velocity.
  • The self-selected stride length and step cadence combination, therefore, depends upon whether footwear/shoes are worn or not.
  • This variability in the self-selected stride length and step cadence combination is controlled by the brain and central nervous system.
  • Humans adapt or change their walking and running in characteristic ways to accommodate shoes.
  • This adaptation provides insight into the mechanisms controlling how we walk and run.
  • Footwear/shoes change the walking and running gait enough that different models are necessary to describe slow locomotion (walking) and fast locomotion (running) whereas with barefoot locomotion only one model is needed to describe both fast and slow locomotion which is the situation with all other animals in the animal kingdom.

Gait Control (PDF)



  • Locomotion is movement or the ability to move from one place to another.
  • The is great variability in the way humans walk and run.
  • Footwear/shoes are the number one factor that affects how, or the quality of human locomotion.
  • Footwear/shoes may be the number one cause of many, if not most of the musculoskeletal diseases that afflict modern humans.

Locomotion (PDF)



  • Mindfulness, or “paying attention” to how one walks is necessary to perform deliberate walking and running.
  • While the for mindfulness may be viewed initially as a burden, it turns out to be a benefit.
  • Active involvement with oneself to walk and properly leads to an improvement in attitude, mood and affect which enhances one’s sense of well-being.

Mindfulness (PDF)



  • The running community completely understands the benefit of simulating a barefoot running gait with a forefoot strike more under the body’s center of mass.
  • Walking performance is no different than running.

Performance (PDF)



  • Long stride heel-toe walking creates an abnormal walking posture leading to micro-injuries and pain.
  • Heel-toe walking places the spine under tension and shear forces instead of compression forces. This contributes to abnormal disc function.
  • Deliberate Walking and running uses a shorter stride, which creates a more natural upright posture.
  • Deliberate Walking reduces cumulative spinal micro-injury and pain, providing an additional non-surgical management approach to chronic neck and back pain.

Posture (PDF)

Safety/ Injury


  • Deliberate walking and running is safer and more injury resistant than heel-toe walking and running
  • Walking and running balance is enhanced by the higher step cadence at a given velocity which creates inertial stability. This reduces falling.
  • Deliberate walking and running is less susceptible to chronic wear and tear/overuse injuries due to:
    • Lower forces (accelerations/decelerations)
    • Increased joint dynamic stability (muscle co-contractions)
    • Decreased traction and impingement forces

Safety / Injury (PDF)

Shoes / Footwear / Orthotics

Shoes / Footwear/ Orthotics:

  • Humans adapt their walking to the shoes they wear.
  • “Proper” shoes and orthotic inserts may be necessary with certain foot and ankle deformities to obtain a plantigrade foot for standing and walking
  • Alternatively, deliberate walking and running (simulating barefoot walking and running) a dynamic, plantigrade foot is created and the shoe becomes less important to control a proper foot posture.
  • Minimalist shoes in which the elevation and cushioned has been removed from the shoe facilitate proper walking and running.
  • A transition period is necessary when changing from shoes with an elevated heel to minimalist shoes.

Shoes/Inserts/Orthotics (PDF)

Walking Phases

Walking Phases:

  • The heel-toe walking gait is visually compared with Deliberate Walking (proxy for habitual barefoot walking with shoes) at significant phases in the walking gait cycle.
  • Notice that the two walking gaits are visually completely different gaits.