The Center for Podiatric Care and Sports Medicine

What Do NYC Podiatrists Say About Negative Heel Shoes Benefits?

Posted by on Monday, June 11th, 2018


Who wouldn’t wear a pair of shoes that is said to improve posture, help you breathe better, strengthen core muscles, and tighten up your thighs? Could getting your entire body into shape be as simple as footwear selection? NYC podiatrists from The Center for Podiatric Care and Sports Medicine explore the concept of negative heel shoes popularized by brands like Kalso and Earth Shoe in the 1950s.

negative heel shoes benefits
Negative heel shoes are said to improve posture, help you breathe better, strengthen core muscles, and tighten up your thighs. [Image Source: Unsplash user Jez Timms]

What are Negative Heel Shoes?

Negative heel shoes were designed by Danish yoga instructor Ann Kalso in the 1950s and marketed to Americans as “Earth Shoes” in the 1970s. It was thought by placing the heel slightly lower than the forefoot, the spine would fall into proper alignment and reduce stress on the hips and knees. Most shoes do just the opposite—elevating and cushioning the heel to shift the center of balance forward during propulsion. The shoes exhibit greater width in the toe box and narrow at the heel to support the foot’s natural shape and avoid toe-crowding. Walking in negative heel shoes should feel like walking up a slight 3.7-degree incline, which stretches calf muscles, burns calories, and engages different muscle sets.

Negative Heel Shoes Benefits

Fans of negative heel shoes say:

“They fit perfect in every way.”

“I have had chronic plantar fasciitis for 20 years. These shoes prevent it so long as I wear these every other day or so.”

“I have high arches and these are the only shoes I have ever had in which I can actually feel the arches.”

“Anyone with plantar fasciitis knows that Kalso Earth is the perfect shoe to be able to walk in comfort. They have saved me!”

“For anyone with back problems, the reverse sole is the way to go.”

” I bought them for a trip to San Francisco and just walked miles and miles in them.”

” I have hallux limitus, so my big toes hurt if I walk too much. I found that I didn’t notice that I was walking a lot… no more foot pain!”

“They have great arch support and plenty of toe room. I may even cancel my appointment with the foot doctor scheduled next week.”

Some claims go so far as to say these shoes help with calorie burning, toning, cellulite, and weight loss.

Drawbacks of Negative Heel Shoes

Some groups of patients may experience greater pain and problems with negative heel shoes—notably those with:

  • Short calf muscles
  • Flat feet
  • Achilles tendon problems
  • Chronic back pain
  • Diabetes
  • Arthritis
  • Balance issues

The modern podiatric community seems to be split on the use of rocker bottom or negative heel shoes. Indeed, the American Podiatric Medical Association has approved some shoes for toning—models by American Sporting Goods (Aviva and Ryka), FitFlop Limited, Keds, and Reebok, for instance. Some foot doctors put patients with bunions, plantar fasciitis, and metatarsalgia in these shoes for years with good results. Others argue that negative heels are not good for use in anything other than walking, and add that these shoes are more likely to hurt patients with underlying biomechanical pathology.

According to a 1975 article from the NY Times“A survey of the authorities most familiar with foot care—orthopedic foot specialists, podiatrists, and a body movement teacher—showed that they view it with everything from alarm to caution. And even those who approve of it are quick to point out that it cannot be worn by everyone.”

What Science Says

One study by the California College of Pediatric Medicine in San Francisco came to a slightly favorable conclusion but did not verify all of the manufacturer’s claims. In the study, 157 men and women with a variety of foot problems, ages 22 to 41, wore Earth Shoes for 10 weeks.

“The most significant contribution of the Earth Shoe [the only brand studied] is that it is as wide as the foot and relieves many symptoms related to pressure on the foot,” lead author Dr. Paul Scherer explained. He concluded 70% of the population would find negative-heel technology allowed them to walk better. Those with hallux valgus (bunions), hammer toes, tailor’s bunions, corns, Haglund’s deformity, and planta metatarsal saw the most benefits.

However, those with plantar heel pain and shortened heel cords experienced no relief, with 30% of people—those with flat feet, very high arches, and short calf muscles—experiencing discomfort. The report also found that the shoes could be “harmful to diabetic patients who have the potential to develop ulcerous conditions on the bottom of their feet.”

Dr. Scherer was careful to note: “It’s not curing the disease, it’s taking away the negative factors that seem to make the problems more painful.”

Another 1978 survey done at Toronto Western Hospital looked at 96 walkers—none of which had previous foot problems—who wore the shoes for 18 months. Within the first three weeks, 45% of study participants complained of calf pain and difficulty with balance. Another 25% experienced arch pain, sole pain, and blistered heels. After the first month, 26% continued to experience calf pain and 20% said their knees felt hyperextended, but 39% of wearers said they felt their posture and walking tolerance improved.

The Bottom Line

Here at The Center for Podiatric Care and Sports Medicine in NYC, we are happy to examine your feet and make custom footwear recommendations. Negative heel shoes are not something we would market, based on the lack of credible science backing the claims. Wider toe boxes and custom orthotics can improve many of the same ills without having potentially deleterious effects. No shoe will ever replace the expertise of a foot and ankle specialist. We offer advanced therapies to address the root cause of your pain right away. Come see us! We accept all major insurance.


If you have any foot problems or pain, contact The Center for Podiatric Care and Sports MedicineDr. Josef J. GeldwertDr. Katherine Lai, Dr. Ryan Minara and Dr. Mariola Rivera have helped thousands of people get back on their feet. Unfortunately, we cannot give diagnoses or treatment advice online. Please make an appointment to see us if you live in the NY metropolitan area or seek out a podiatrist in your area.