HAMBURG — What does the thought of Birkenstock sandals trigger in you? Perhaps it brings back memories of your teacher’s smelly socks. Or foot fetish fantasies. Or it triggers the desire for a pair of trendy suede slippers. Whether they are hip or horrible, one thing is certain: Everyone has an opinion about them.
The fact that the Birkenstock brand has managed to turn old slippers into a trendy item has been evident for years in commercial fashion blogs and on TikTok and Instagram. After several summers in sandals, celebrities such as Kendall Jenner, Brad Pitt and Zoë Kravitz now shuffle around Paris, Seoul and Los Angeles in their Boston clogs.
So hip, so good. Apparently the slippers are also particularly healthy for your feet. Birkenstocks are originally health shoes, right?
We talked to one of Germany’s leading experts in orthopedic shoe technology: Bernhard Greitemann, professor of Technical Orthopedics at the University of Münster. He neither owns Birkenstock shares nor earns money from the sale of the shoes. As a doctor, orthopedist and on the board of the Technical Orthopedics Association, Greitemann works with health insurance representatives to develop guidelines on which insoles, special shoes and orthoses are useful.
Right at the beginning of the phone call, he says something unexpected: “I am not aware of any reliable scientific studies that prove that Birkenstocks or similar footbed shoes are particularly healthy.” And he dispels a myth: “The term ‘healthy shoe’ does not exist among doctors. It is purely a marketing term.”
If you look more closely at the advertisements, you will notice that the manufacturers are not promising any medical effects, but are cleverly building up the vague image of a healthy shoe. For example, the Birkenstock company advertises on its website that the “well-thought-out construction” of its footbed helps “feet to endure many hours in shoes with as little strain as possible.”
“This supports health and promotes well-being,” it says.
Greitemann says that one has to differentiate between “comfortable shoes” and orthopedic shoes that are available on prescription in medical supply stores. Insoles and special shoes that are made by shoe technicians for people with misalignments or illnesses are something completely different. “Such orthopedic aids are prescribed and paid for by health insurance companies,” he says.
From Lebensreform to luxury
So are hundreds of millions of people prey to a placebo effect when they swear that Birkenstocks are good for their feet? And what about wooden shoes from Dr. Scholl’s, footbed sandals from Berkemann or barefoot shoes from Leguano, Joe Nimble or Vivobarefoot, just to name a few more brands that have the aura of being healthy shoes. Is their image also the result of marketing strategies?
Birkenstock has moved into the same league as Timberland or UGG boots.
The fact that we have associated some of these brand names with healthy shoes for generations is a legacy from the founding period. At the end of the 19th century, young shoemakers initiated a reform movement towards ergonomically shaped shoes. In Germany, this fit in with the Lebensreform movement, which sought a return to nature in response to industrialization: vegetarian food, loose clothing, outdoor sports and walking barefoot, all of this was already trendy in Germany in the late 1800s.
Inspired by these trends, Konrad Birkenstock, a shoemaker from Hesse, invented the first ergonomic shoe in 1897, adapted to the natural shape of the foot. A year later, Heinrich Adolf Berkemann, a competitor from Hamburg, presented the first mass-produced shoe insole. Shortly afterwards, William Scholl, a doctor from Chicago, patented a supportive insole called Foot-Eazer.
LVMH’s empire
The image that these fathers of insoles and footbed shoes shaped has endured to this day. With the economic miracle, some of the family businesses grew into large corporations. The most successful: the Birkenstock dynasty. Today, the brand has nothing to do with its founder.
After almost 250 years of family ownership, the company has been part of the French empire LVMH since 2021, which owns luxury brands such as Louis Vuitton, Kenzo and Moët & Chandon. According to its own info, the company sold around 30 million pairs of shoes under the traditional brand name in 2023 and expects sales of almost 2 billion euros in the year to come.
Birkenstock has thus overtaken global brands such as Dr. Martens and moved into the same league as Timberland or UGG boots. The division generates half of its sales in North and South America, followed by Europe. It was not possible to find out which model sells the most. But what do experts say about Birkenstock’s innovation of building a bed for the foot — shaped like a footprint in the sand? Is that actually healthy for our feet?
How healthy?
Even if the research is thin, there is a consensus among experts about what makes healthy shoes, says orthopedic surgeon Greitemann. “The shoe must fit comfortably from the start, be big enough and must not pinch, rub or shuffle when walking.”
The footbed must therefore fit the shape of your foot exactly. Even though Birkenstocks are available in two different widths, other footbed shoes are better suited for some people — perhaps even cheaper versions from discount stores. You have to try out what suits you. The well-known German brands are also based on our average Central European foot.
“People of different ethnicities have completely different foot shapes,” Greitemann says. If companies sell the same models from Rio to Tokyo to Cape Town, it is not going to be ideal for everyone.
For diabetics and people with splayed or flat feet, off-the-shelf shoes are rarely suitable. These patients need support in other parts of their feet, more lateral guidance, cushioning and relief, but also protection or support. The trendy Boston model in particular, a clog that falls off the heel with every step, could promote claw toes.
Wearing only footbed shoes all the time is not good for your feet either.
“You are constantly clinging to the slipper with your foot. That is not good at all,” says Greitemann. If the footbed presses in the wrong places, it can cause metatarsal (midfoot) pain.
Caroline Werkmeister, an orthopedist and foot surgeon at the Athleticum sports medicine center in Hamburg, sees it the same way. “Toes should have enough room to roll, to be able to spread out without hitting anything, and shoe soles should be soft and flexible,” she says. Footbed sandals meet at least part of these requirements, except that the thick cork layer is very hard and does not bend when walking, so the foot cannot roll naturally.
“A healthy foot does not need any special support from a shaped cork sole,” Werkmeister says. A few hours in Birkenstocks are definitely healthier than in 4-inch high heels, but wearing only footbed shoes all the time is not good for your feet either.
“To keep the muscles strong and the toes flexible, softer soles should also be used occasionally. And there should be times of the day without shoes at all,” the foot surgeon says.
Going barefoot
So what does science actually know about our foot health? And would it be healthier if we didn’t wear shoes at all? People have been strapping something under their feet for at least 30,000 years. This is not only proven by the oldest fossil shoes that have been excavated, which are around 10,000 years old, but also by a comparison of the toe bones on the skeletons of our ancestors from the Stone Age.
“Almost all misalignments and joint problems in adults are the result of civilization,” Werkmeister says. She estimates that around three quarters of all German feet are diseased because we rarely walk barefoot on different terrain, hardly train our muscles and toes, and our foot sensory system atrophies in shoes that are too tight and hard, or simply the wrong shape.
If you look at your own feet from above, you see a V, not an A. Human feet are wider at the front than at the back.The doctor wants to raise awareness of the fact that feet need attention and care.
“If I’ve been wearing high heels for a few hours, I treat my feet to a massage and a day’s rest in comfortable shoes,” she says. Special training for the toes or a short barefoot walk can prevent foot problems in old age. But you should start slowly.
For barefoot walking and the recently popular barefoot shoes, 15 minutes is enough to start with, Greitemann says. “Barefoot shoes are training devices. You can gradually increase the amount of walking if your feet tolerate it well.”
Kicks for kids
Unlike footbed shoes such as Birkenstocks, there are a few studies on barefoot shoes. Research shows they can be used to strengthen the foot muscles, but the risk of injury is also higher. The minimalist shoes often offer little more support than a sock with a non-slip rubber sole. If we were not exposed to cold, broken glass and hard asphalt in our civilized everyday lives, doctors believe that it would be healthier to walk barefoot.
Pediatricians therefore recommend that babies and toddlers, whose foot bones are still soft and malleable, should not wear shoes — not even socks that are too tight. Protective shoes are only necessary when children take their first steps outside.
Children’s shoes should be soft and flexible, with plenty of room for the toes. A study from Austria showed some time ago that parents often accidentally buy shoes that are too small because sizes are not clearly marked, or because children’s feet grow faster than the shoes are replaced. In a sample of 390 children examined, 65 percent wore shoes that were too short. A comparison of school children from Germany and South Africa also showed that those who wore shoes less often developed stronger arches.
You don’t have to spend a lot of money to have healthy feet.
Nobody can currently say whether the Birkenstock generation will have healthier feet than their parents and grandparents when they get older. But the shoe trend doesn’t seem to be doing much harm either, provided the footbed doesn’t pinch right from the start.
The idea that shoes have to be used for a long time before they get comfortable is also a myth, Greitemann says. He sees good progress in the development of ergonomic running shoes from the sports industry. “There are models with a kind of hinge in which the foot can roll perfectly,” he says. Cheap sneakers with light insulation could also be suitable — depending on what your own foot tolerates best.
You don’t have to spend a lot of money to have healthy feet. Quite the opposite. High heels and tight leather shoes are more harmful. Babies don’t need shoes at all, and anyone looking for comfortable sneakers can buy no-name brands. If you still want to follow the clog trend, feel free to spend 180 euros on a pair of Bostons; they won’t hurt your feet too much. But remember to change the shoes you wear every now and then.
Still, let’s be clear: They won’t have any actual therapeutic effects, and it’s better if you just take the slippers off at the end of the day.
