Barefoot Shoes & Foot Strength: A Podiatrist’s Perspective on Real Foot Health - Helen Halkias

Functional podiatrist Helen Halkias on pronation myths, orthotics, barefoot shoes and the paradox of making life easy

TL;DR

• Pronation isn't the enemy. A healthy foot needs to move in and out of every direction, and the goal is to restore that function.
• Cushioned shoes, orthotics and other aids are tools. Rely on them every day and your feet can get weaker through disuse.
• Transition to barefoot shoes gradually, starting with a foot-shaped toe box, and strengthen as you go.
• Helen's one thing for everyone: find one thing every day that you're grateful for.

Introduction

Helen Halkias has been a podiatrist for about 28 years. For most of that time, she practised the way she was taught at uni: identify the problem, then control it with footwear, orthotics or both. She wore orthotics herself because she believed they would protect her feet.

Around five or six years ago, that changed. Her own on-and-off forefoot pain wasn't improving, no matter how many orthotics and metatarsal domes she tried. She started questioning everything, and it led her to functional podiatry. She describes it as a scary and lonely time, which ended with a rebrand, a new location and a very different approach.

We had a lot of listener questions for this one, and Helen answered most of them along the way. We covered pronation, how shoes and modern life make us weaker, transitioning to barefoot shoes, plantar fasciitis, and what keeps her going on hard days.

A quick note: this is general education, not medical advice. If you have ongoing foot pain, see a qualified professional before changing your footwear or training.

Lesson 1: Pronation isn't a problem to fix

Insight: Helen says many people, and even some sports shops, still label feet as overpronating, high-arched or flat. But pronation is normal. It unlocks your foot so it can absorb shock when you land. Supination locks it up again so you can push off. It only becomes a problem, she says, if your foot gets stuck in one position.

Functional podiatry focuses on how the foot functions rather than its shape. Helen pointed out that some of the greatest athletes, Usain Bolt among them, have what we'd call poor foot posture, yet they move beautifully. The goal is to give the foot access to its full range of movement. Where that's been lost, such as a big toe that no longer bends, you make the most of what's left. Movement is medicine.

Action: Stop thinking of your foot type as a diagnosis. Instead, ask whether your feet can move freely: can you bend your big toe, spread your toes and balance on one leg?

Outcome: You focus on what your feet can do, not on a label.

Lesson 2: Making life easy can make us weaker

Insight: Helen talked about a paradox I see all the time as a PT. Cars now have motion sensors, cameras and lane assist. Shoes are designed so you roll forward without bending your big toe. Everything is built for ease, so our bodies get lazy. Then we pay for a gym membership or Pilates class to learn how to get up off the floor again.

She noticed it in her clinic. People were wearing highly cushioned, high-stack shoes just to walk around the local shopping centre, then asking which shoe they needed for the Camino in two months. If you need maximum support for the bare minimum, there's nowhere left to go when you want to do more.

When she travelled through Europe, she saw older people walking on cobblestones and hills every day. In Australia, by contrast, people around 65 are often told to pack up the rugs and stop climbing ladders.

Action: Build movement back into your day. Get up from a chair without using your hands, sit on the floor and get up again, and take the stairs.

Outcome: You maintain strength and balance without needing extra time or a special gym.

Lesson 3: Your feet are built to feel

Insight: Helen says we've become scared to feel the ground. When a cushioned shoe makes us feel nothing, we assume that must be a good thing. But your feet have thousands of receptors for a reason. Feeling the ground is how your body gets feedback for balance, and she's seen research suggesting it even links to pelvic floor function.

Narrow, tight shoes don't make you more stable either. Plenty of young soccer players size down because they think a snug shoe feels secure. Helen's comparison: when you do a handstand, you spread your fingers as wide as possible for stability. Your feet are no different. When balancing clients splay their toes and press them into the ground, they're often instantly steadier. And that matters, because weak toes are linked to a higher risk of falls as we age.

Action: Practise balancing on one leg barefoot. Spread your toes, press them into the ground and notice the difference.

Outcome: You build the balance and toe strength that protect you as you get older.

Lesson 4: Use orthotics as a tool, not a crutch

Insight: Helen still prescribes orthotics, just far less than she used to. She uses them when someone has lost function, such as a dropped foot after a stroke or a fused joint. Her concern is dependency. She sees young people who are scared to go a week without their orthotics while they're being adjusted.

She explained what often happens when the root cause isn't addressed. People get more orthotics, then more cushioning. When that stops working, they're offered anti-inflammatories, cortisone and sometimes surgery, without anyone suggesting they try strengthening first. Her son does speed skating, and she's been struck by how many cortisone injections young athletes in that world have had in their feet. Those options have their place, she says, but they should come after the basics.

I use the same language with my clients about knee braces. Wanting a brace for a certain movement is fine. Needing it to exercise at all is a sign something needs work.

Action: If you rely on orthotics, a brace or another support every day, ask your practitioner what you can do to build strength alongside it.

Outcome: You use support when it helps, without losing the strength to cope without it.

Lesson 5: Transition to barefoot shoes gradually

Insight: When Helen first understood the barefoot approach, she went straight from orthotics and technical shoes into Vivobarefoot shoes. Her feet and lower back were weak, and she was in a lot of pain. She had to go back to the drawing board and do it gradually while strengthening.

Her advice now:

• Know the 3Fs. A barefoot shoe is flat, flexible and foot-shaped. As a bare minimum, start with a foot-shaped shoe with a wide toe box.
• Take the insole out. Stand on it and check whether your big toe can point straight ahead. Most traditional shoes taper at the front, squeezing your big toe and sometimes your little toe.
• Go less where you can. Less cushioning for everyday wear means more feedback and better balance.
• Bring your orthotics with you. If you use them, put them into a foot-shaped shoe with less cushioning as your first step.
• Meet yourself where you are. If you're sensitive to sensation (some people can't handle the fold of a sock), there are plenty of functional shoes with a wider toe box and more cushioning. Go barefoot in short bursts at first, because your brain may overreact to new sensations.

Helen herself hiked up mountains and volcanoes in the Greek islands in Earth Runners while everyone around her wore boots and carried poles. As she told them, you need a boot or a support if you're not strong enough. And how do you make your feet strong? The same way you make anything strong: you move them.

Action: Pull the insole out of your everyday shoes and stand on it. If your big toe hangs off the edge or gets pushed sideways, start looking for a shoe with a wider toe box.

Outcome: You give your toes room to work and set yourself up for a safe transition.

Lesson 6: Strengthen your feet like any other body part

Insight: If someone has a sore shoulder, nobody suggests immobilising it forever. You get it moving and build strength. Helen asks why we treat feet any differently. They have muscles, tendons, nerves and bones like everything else.

Some of her older clients can't move their big toe at all and insist it's impossible. Two months later, they come back excited that they can. For my own plantar fasciitis, which came from rolling an ankle I've injured many times, Helen shared three big priorities:

• Calf raises with your toes lifted. This mimics pushing off. Go slowly on a single leg, aiming for 15 to 20 reps for three sets, then progressively load it over about three months.
• Peroneal strength. Use a resistance band to work the muscles on the outside of the ankle, which are often weak after ankle sprains.
• Toe strength. Use a band under your toes to lift them and push down against it.

She likes toe spacers and toe socks as tools for waking up the toes. But she doesn't want people relying on them all the time, because you still need to actively spread your toes using your own muscles. She also cautioned against getting overwhelmed by gear. Some people buy so many products that they never start.

Action: Add slow single-leg calf raises and band work for your ankles and toes to your routine two or three times a week, starting at a level that suits you.

Outcome: You build the strength that supports your feet, knees and hips.

Lesson 7: Bravery is acting in spite of fear

Insight: Helen is a mum of three, two of them now adults, and spent years as a single parent. She admits she still gets burnt out. What's changed is that she's learned to be less rigid, prioritise what feels important at the time and forgive herself for not being perfect.

Earlier in her career, she said yes to everything, including community health, aged care and psychiatric facilities, which was far outside her comfort zone. Later, a life coach had her write down the negative beliefs she held about herself, then look for evidence against them. When Helen said she didn't feel strong, the coach pointed out that she was raising three kids and running a business. Bravery, the coach said, isn't the absence of fear. It's doing it anyway.

More recently, Helen worked with a psychotherapist using EMDR and neurofeedback. She'd put it off for years because survival mode meant she couldn't afford to fall apart. Learning how her brain followed old patterns empowered her in the same way she tries to empower her clients with awareness of their bodies.

Action: Write down three negative beliefs you hold about yourself. Next to each, write one piece of evidence that proves it wrong.

Outcome: You start seeing yourself through what you actually do, not what that inner voice says.

Quick wins

• Get out of a chair without using your hands, every time.
• Spend 10 minutes barefoot at home today.
• Pull the insoles out of your shoes and check the shape.
• Balance on one leg while brushing your teeth.
• Name one thing you're grateful for before bed.

Closing insight

What I loved most about this conversation is how simple Helen makes it. Your feet are designed to do everything they need to do. We've just made them weaker by trying to make everything easier. Give them a chance to feel, move and get stronger, and many problems can improve.

Helen's motivation on hard days is the same approach. She knows that if she gets up and shows up, she'll feel better, and at some point someone will thank her for helping. So when I asked what one thing she'd get everyone to do, her answer was gratitude. Even in the worst of times, find one thing each day you're grateful for.

Connect with Helen

Visit Helen Halkias Podiatrist or follow her on Instagram.

Listen to the full episode

The full conversation is on Spotify, Apple Podcasts and YouTube, or press play at the top of this page.

Related episodes: Strong Feet, Strong Life with Thien Trinh and From Pain to Performance with Tom Swales