Neanderthals walked with flatter, inward-rolling feet and robust heel bones designed to handle heavy body mass and rugged terrain, according to a study published in the Journal of Human Evolution.
Researchers examined three-dimensional models of 71 adult heel bones using laser and computed tomography scans.
The study was led by Rita Sorrentino and colleagues, appearing in the October 2026 issue of the Journal of Human Evolution. To analyze the bones, the researchers used geometric methods to compare their shapes, focusing particularly on the surfaces that connect the heel with neighboring foot bones.
“The human foot is one of the anatomical structures that best demonstrate our complex evolutionary history, and among the bones it is composed of, the heel plays a crucial role: it is the first structure to touch the ground when walking, cushioning the impact and transmitting the forces to push us forward,” said Professor Maria Giovanna Belcastro, a researcher at the University of Bologna.
The analysis revealed that Neanderthal calcanei were generally shorter, wider and taller than those of modern humans, falling within the overall size range of modern human heel bones while differing distinctly in shape. Joint surfaces connecting the heel to the ankle indicated that Neanderthal feet habitually rolled inward, accompanied by a lower outer arch and a more flexible middle section of the foot.
Neanderthals are thought to have carried more body mass than Homo sapiens, including more muscle, and spent long days walking on rough ground. An earlier study by the team found that a Neanderthal midfoot bone shared features with adults diagnosed with flexible flatfoot, many of whom were overweight or obese, noting that extra body weight makes feet roll inward and flattens arches in people today.
“The robustness of the heel reflects the overall body structure of Neanderthals, which is characterized by a remarkable muscular and bone mass and an extremely intense level of physical activity,” Professor Belcastro said.
“These physical characteristics indicate an adaptation aimed at promoting a greater load-bearing capacity on the back of the foot and a high mobility on uneven ground,” she added.
Within Homo sapiens, heel shapes varied according to lifestyle and population habits. The sample included hunter-gatherers from Qafzeh and Skhul caves in Israel dated between 120,000 and 90,000 years ago, later Ice Age hunter-gatherers, Iron Age farmers from Sicily, and 46 people from a Bologna cemetery collection.
Prehistoric hunter-gatherers possessed sturdier heels with traits resembling the Neanderthal pattern—though less pronounced—while the recent urban population from the Bologna cemetery featured considerably slimmer heel bones.
The authors note that the small fossil sample serves as a reason for caution, and they inferred foot mechanics from preserved bones rather than observing living Neanderthals walk. The study did not experimentally separate the effects of shoes, activity, ancestry, and other influences on foot development, and the findings do not establish that modern flat feet always function well or that people should change footwear.
“The morphology of our skeleton is not only the product of a strict genetic program, but also the consequence of physical stimuli and our daily life habits,” Professor Belcastro said.
“The 3D analysis of the fossil heels of our ancient cousins, the Neanderthals, has therefore allowed us to highlight both an extraordinary biomechanical adaptation to withstand heavy loads and rough terrains, and the impact of modern life and footwear on our feet,” she said.
“The results of this study therefore offer a fundamental contribution to better understand how our ancestors moved in their natural environment and open fascinating prospects for dialogue between evolutionary anthropology and clinical orthopedics,” Professor Belcastro concluded.