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Most research aimed at understanding adaptations humans possess in both maintaining stable equilibrium and mechanics and control of human mobility are irrelevant because footwear introduce massive artifact, and   subjects used in this research both either wore shoes, or usually wore shoes and resorted to barefoot weight-bearing for the experiments. It is clear that rather than being required for safe human mobility, footwear substantially alter stability and gait in humans and render hazardous these inherently.

Footwear use by a society follows either a functional or aesthetic tradition. Functional is used here to indicate advancement of health, whereas aesthetic refers body art based on any non-functional considerations, such as an individual's sense of beauty or simply a desire to conform. The only functional tradition for footwear use in large social groupings is with those inhabiting cold climates for thousands of years, where footwear would have been essential to survival, therefore used by all.[1] For example, one such kind of footwear, the kamak, has ancient origins, and impairs mobility when compared to the bare foot, but poor mobility would have been a less selective disadvantage than foot necrosis from hypothermia.[1] Aside from this group, all footwear use in early civilizations followed an aesthetic tradition.[2-7] They were used by the minority as a symbol of elevated status and probably beauty at a cost to mobility and health.[2-8]

The Domesday Book (c. 1086) is the only source of quantitative data regarding whole population composition for any pre-Renaissance society.[9] It indicates that 70 percent were serfs which were surely unshod as were probably some of slightly higher classes.[9] Similar, estimates of the unshod percentage of other early societies population that followed the aesthetic footwear tradition, whether the lowest class were slaves as with Egyptian, Roman, Greek civilizations or serfs with respect to other feudal states.[2-7]

India provides the clearest example of the transition from body decoration to shoe.[8] Foot decoration through henna painting predates human civilizations. Later, the anklet and toe ring were added.[8] The sandal subsequently appeared probably as a consequence of colonization and European cultural imperialism, with the anklet and toe loop modified to attach shoe sole material to the plantar surface.[8] The Egyptian Civilization also had an ancient henna foot aesthetic tradition.[2,7]

Examples of early Egyptian footwear were exclusively aesthetic since they were so fragile they both impaired mobility and offered no protection.[2,7,10] Even caligae - the shoes with thick soles used by Roman soldiers were of a aesthetic tradition since they were poorly functional in terms of protection and impaired mobility. It is thought that they served to impress the enemy through augmenting standing height.[7,10]. Romans introduced many currently used leather footwear construction techniques which resulted in improved footwear functionality only relative to previous ones through improved foot attachment, and improved conformation to foot contour.[7,10] Within this largely aesthetic tradition there were occasional examples of of functional footwear such as the simple foot coverings used by Greek and Roman quarry workers to avoid plantar surface damage from sharp stone fragments.[10]

Elevated narrow heels and the tapered toebox have become hallmarks of aesthetic footwear for centuries.[2-6,10] They attenuate the support base thereby impairing stability and moreover, concentrate forces involved in standing to the digits and metatarsal-phalangeal joints causing deformities and arthritis.[11-15] One author ascribes their original popularity to Tamerlane (Timur the lame - 1370-1405), because elevated heels appeared only occasionally before him, but continuously after.[10] If true, than ironically this aesthetic tradition was functional for Tamerlane. He required elevated heels to compensate for a calf muscle contracture from a war injury.[10]

The European Renaissance commenced with few wearing shoes and ended with near universal use - essentially a social norm in the cities burgeoning through international trade and nascent manufacturing.[2-7] The Renaissance also commenced with a pandemic form of bubonic plague (Yersenia pestis), the Black Death (1346-53), that de-populated countries bordering the Mediterranean Sea - the population of Venice declined by 70 percent.[16-17] It was less destructive north of the Mediterranean, however even England suffered population decline from non-pandemic bubonic plague and other infectious diseases over two centuries.[16] De-population changed societies from having excess labor consisting of unpaid serfs existing in marginal agricultural settings, to labor scarcity with ex-serfs migrating to urban centers for paid employment.[16] Footwear cost plummeted due decline in leather price following massive culling of herds - the plague killed humans but not animals. With both money and low cost, and perhaps with pseudo-science attributing bare feet to disease transmission, the lowest class majority started wearing shoes for the first time in human history.[2-7]

European Renaissance shoe design varied by region, however essentially all were of the aesthetic tradition.[2-7] Examination of foot bones from hundreds of peri-Renaissance skeletons reveals a high frequency of hallus valgus in men, but less in women - the opposite of contemporary observations.[15] Extant footwear examples explain these anatomical abnormalities.[2-7] Men's shoes were mainly of leather, with less ornate examples possessing relatively thick, modestly flexible soles that were less wide than the bare weight-bearing foot, and heel height greatly exceeding contemporary fashion and particularly narrow at the toe box.[2-7] Shoes worn by females were less robust with lower heels and wider toe box.[2-7]

It is clear that footwear use in general follows the esthetic tradition of body art through foot decoration. The use of shoes generally has historically always come at a cost in terms of health and mobility.

[1] Kobayashi Issenman B. Sinews of Survival: Living Legacy of Inuit Clothing, Vancouver: UBC Presss 1997.

[2] Bronwyn C. The Complete History of Costume and Fashion: From Ancient Egypt to the Present Day. New York: Checkmark Books, 2000.

[3] Rosenthal M, Jones A, ed. and trans, Habiti Antichi et Moderni: The Clothing of the Renaissance World. London: Thames & Hudson 2008.

[4] Welch E. Shopping in the Renaissance: Consumer Cultures in Italy 1400-1600. New Haven:Yale University Press, 2005.

[5] Rublack U. Dressing Up. Cultural Identity in Renaissance Europe. London:Oxford University Press 2010.

[6] Gröning, K. Body Decoration: A World Survey of Body Art. Munich: Vendome Press 1997.

[7] Goubitz, O., van Driel-Murray C, Groenman-van Waateringe W. 2001. Stepping through Time. Archaeological Footwear from Prehistoric Times until 1800. Dulles Va: The David Brown Book Company 2007.

[8] Mohapatra R. Fashion Styles of Ancient India: A Study of Kalinga from Earliest Times to Sixteenth Century A.D. Delhi, India: B. R. Publishing 1992.

[9] Harvey S. Domesday: Book of Judgement. Oxford: Oxford University Press 2014.

[10] Stewart S. Physiology of the unshod and shod foot with an evolutionary history of footgear. Am J Surg 1945;68:127-138.

[11] Zipfel B, Berger L. Shod versus unshod: the emergence of forefoot pathology in modern humans. The Foot 2007;17:205-213.

[12] Engle E, Morton D. Notes on foot disorders among natives of the Belgian Congo. J Bone Joint Surg 1931;13:311-318.

[13] Hoffman P. Conclusions drawn from a comparative study of the feet of barefooted and shoe- wearing peoples. Am J Orthop Surg 1905;3:105-136.

[14] Sim-Fook L, Hodgson A. A comparison of foot forms among the non-shoe and shoe-wearing Chinese population. J Bone Joint Surg Am 1958;40A(5):1058-1062.

[15] Mafart B. Hallux valgus in the historical French population: paleopathological study of 605 first metatarsal bones. Bone Join Spine 2007;74:166-170.

[16] Herlihy D. The Black Death and the Transformation of the West. Cambridge, Mass. Harvard University Press 1997.

[17] Diehl C. La Republica di Venezia. Roma: Newton Compton 2004.