Zero Drop Shoes Lead to Injuries - Functional Performance Physical Therapy (2024)

Zero Drop Shoes Lead to Injuries

Zero Drop Shoes Lead to Injuries - Functional Performance Physical Therapy (1)

For the past decade, the hottest trend in the running community is the “zero-drop” shoe. Basically, it’s any shoe where the heel and the ball of the foot are the same height – just like there is no drop when you are barefoot. On the contrary, traditional running shoes feature a heel that is slightly elevated (approximately 12mm); therefore, the foot is tilted.

The fad started in 2009 when Born to Run hit bookstore shelves. It caused a cascade of events including shoe manufactures developing zero drop and minimalist shoes to keep up with competition and demand, runners changing their form to a “natural” running style, researchers investigating injuries and ground reaction force on humans running with various shoes, and most importantly, runners experiencing injuries in different areas.

Benefits of Zero Drop Shoes

Because your heel and forefoot are equal in height, it promotes a natural alignment between your foot and the rest of your body. It allows the intrinsic muscles of the foot to act as a shock absorber so it can distribute the forces that are being transfered to the knee, hip, pelvis and back when you land. When “natural” running is performed correctly, the center of your mass (hip) is directly over your foot when it lands. Numerous biomechanical tests have shown that the ground reaction force is less; ultimately putting less stress on your joints and thus reducing injuries.

Zero Drop Shoes Lead to Injuries - Functional Performance Physical Therapy (2)

What runner doesn’t want to run faster, more efficient, and be injury free? Many runners talk to other runners, read the internet, and watch videos on the benefits of switching to a zero-drop shoe. However, research studies are consistently reporting that injury rates are not dependent on changing the drop of the shoes. Meaning, there’s still high level of injury rates among runners even if they change shoes from traditional to zero drop. But, there’s a trend to the location of pain. Zero drop shoes have a higher correlation to injuries that occur in the lower leg and foot, while traditional running shoes cause more injuries to the hip and knee. So, based on the research, there is no golden shoe that’s going to make you faster and injury free. This is very consistent among the healthcare professional that specialize in treating runners.

Over the past half a decade, there has been an increase in prevalence of tendonitis of the Achillies, calf strain, and metatarsalgia among runners that have switched shoes from traditional to zero drop shoes. There are a few main reasons why people end up with these injuries.

Lack of Professional Care

Due to the abundance amount of free information on the internet, runners will make the switch without any professional guidance because we all think that we should and know how to run. And there are many people that claim to be running specialists, but you have to do the research to find out who really specializes in running biomechanics. Based on the research and in the clinical setting, it’s not the type of shoes you wear that leads to injuries, it’s all about the mechanics. The right professional should be full of knowledge and have worked with many runners so they can identify your weaknesses and strengths immediately to adjust their teaching methods accordingly to your personality and physical abilities. They should have various methods of teaching so running becomes more efficient and injury free. You should be getting one on one feedback to develop proper mechanical habits, and be taught how to self-assess, as you will be running by yourself. And finally, you should not be overloaded with information during a session.

Transitioning Too Fast

A detailed history, physical examination, and biomechanical examination of running should be performed prior to initiating your transition. It is imperative to determine if your joints and muscles have the flexibility and strength to run properly. If there are impairments, address it prior to starting the transition. Otherwise, it is almost guaranteed that you will have an injury. Our body does an excellent job of compensation to execute a movement.

Going from a 12 mm wedge to a no wedge shoe is going to impact the level of support on our foot, knees, and hips. In addition, your brain, nerves, tendons, ligaments, and muscles need rewiring – compare it to writing with your right hand your whole life and then being forced to write with your left. To minimize the stress to your body, try a 8 mm drop shoe and then to a 4mm drop shoe. You may find that a 4mm drop rather than a zero drop shoe may give you the right balance between efficient running form and being injury free. It is recommended that you start with a track workout, such as 50 -100 meter intervals focusing on one running form tip at a time. Avoid back to back days to allow your muscles and tendon to rest and recover. And don’t forget to foam roll and stretch the calf muscles (click on thislinkon instructions). This journey may take 3 months to a year to fully grasp the proper technique.

Ignoring Body’s Response

There’s a difference between muscle pain and delayed onset muscle soreness. If you have pain over a joint, tendon, and/or muscle for days, take a break and reassess your form. Do not push through pain as it may take longer for recovery. If the pain doesn’t go away after adjusting your form and rest, seek advice from a professional. Sometimes, it maybe a simple modification in your running biomechanics or a shoe insert that may solve the root cause of the pain.

Summary

There are many options out there in running shoes and running style. As there’s no such thing as the “best shoes”, same principle applies for running style and form. Based on the current knowledge, there is an important role of improving the form and efficiency of running, and reducing injuries with proper shoes among runners. Having the right professional that has both the medical knowledge of treating the root of pain and teaching the proper biomechanics of running is imperative to avoid injuries when transitioning from a traditional running shoes to a lower drop shoe.

If you are suffering from pain and want immediate relief and/or want help running faster, efficient, and injury free, visit us at www.fpphysicaltherapy.com.

Zero Drop Shoes Lead to Injuries - Functional Performance Physical Therapy (2024)

FAQs

Can zero drop shoes cause problems? ›

Do zero-drop shoes cause Achilles tendonitis? Yes, zero-drop shoes can cause Achilles tendonitis when they are used incorrectly. But just because you're wearing them, does not mean that they are definitely to blame for your pain. Let's look at two scenarios we often see in runners; the same principles apply to walkers.

Why do podiatrists not like zero drop shoes? ›

"Although not everyone with flat feet suffers from foot pain, people with flat feet overpronate, which means their arch collapses for abnormally long periods of time during the gait cycle." Thanks to the lack of support their arches are getting from zero drop shoes, this prolonged overpronation can lead to plantar ...

Do zero drop shoes prevent injury? ›

Switching to a zero drop or minimalist shoe will not automatically stop you from heel striking or overstriding! It will lead to injuries if you are overstriding regardless of the shoe, but even more quickly with these shoes. However, there are benefits for some runners who transition to a shoe like Altra Zero Drop.

Who shouldn't wear zero drop shoes? ›

Unlike standard sneakers, zero-drop shoes are flat, with little to no cushioning. They may strengthen foot muscles and improve your balance and walking stride. But they might not be suitable for people with certain conditions, including Achilles tendonitis, plantar fasciitis, or flat feet.

Are zero drop shoes bad for the knees? ›

Zero drop shoes have a higher correlation to injuries that occur in the lower leg and foot, while traditional running shoes cause more injuries to the hip and knee. So, based on the research, there is no golden shoe that's going to make you faster and injury free.

Are zero drop shoes bad for your back? ›

A zero-drop shoe is simply one that doesn't have a variance in height between your heel to your toe. Again, there may still be cushioning around your foot to give you support, but your heel-to-toe ratio is protected. These are both great shoe options that won't aggravate your back pain further.

Do orthopedists recommend barefoot shoes? ›

Although advancements in running shoe technology during the last 40 years has not reduced injuries, a literature review published in the Journal of the American Academy of Orthopaedic Surgeons suggests that running “barefoot” in shoes with minimal cushioning may help alter the strides and landing patterns of runners ...

Are Hokas zero drop? ›

They aren't complete opposites however: Hokas aren't zero drop but do tend to be very low drop (4mm for Speedgoats, 5mm for Cliftons), they are neutral shoes too with less structuring than other models and both brands started off in the ultra trail running world.

Can zero drop shoes cause metatarsalgia? ›

Forefoot pain, also known as “Metatarsalgia,” is a condition indicated by pain and inflammation under the ball of the foot. This is increasingly prevalent in runners who are making a change to minimal footwear, barefoot running and Newton Running Shoes.

What heel drop is best for the knees? ›

A low heel drop, which is less than 6 mm, is particularly suitable for forefoot runners. In addition, the load on the knee and hip joints is significantly reduced. Similarly, a zero drop can also be advantageous, as a shoe without a heel can strengthen the calf muscles and counteract muscle shortening.

Do zero drop shoes strengthen ankles? ›

Another benefit of zero drop shoes is improving balance and alignment. Increasing the strength in the legs, ankles and feet will help increase balance and keep the body in its natural alignment.

Can zero drop shoes cause shin splints? ›

Zero-drop shoes allow your foot to strike the ground with less impact. Reducing the impact will not only help prevent shin splints, but can also help to prevent and repair other injuries. This might seem like a no-brainer, but you'd be surprised by the frequency of shin splints among people who wear ill-fitting shoes.

Can zero drop shoes cause hip pain? ›

For one, the use of an elevated heel can wreak havoc on your posture and your alignment. Because it's an unnatural stance, it can cause pain all the way up through your legs, hips and into your lower back. The extra cushioning in the heel can also ruin your running form.

What do podiatrists say about barefoot shoes? ›

However, he notes that “many feet are so unstable that it is hard to recommend such an activity.” Dr. Romansky says he rarely recommends barefoot running or minimalist shoes for patients or athletes starting to exercise or restarting an exercise program after a layoff.

Do zero drop shoes cause Achilles tendonitis? ›

Zero-drop or minimalist shoes vs.

The amount of heel-to-toe drop is relevant for Achilles problems, because biomechanical research has shown that the flatter the drop, the more stress and load the Achilles tendon – and to some degree the plantar fascia, the metatarsals, and your calf muscles – have to endure.

Why do my feet hurt after switching to zero drop shoes? ›

Your legs and feet will need to adapt to wearing a zero-drop shoe. Many people notice soreness in their calf muscles, Achilles and feet at first. This is usually because your legs are used to wearing shoes with a large heel-to-toe drop.

Are shoes with a drop bad? ›

Lower-drop shoes will place more of a load on your ankles and Achilles, while a higher heel drop places more pressure on your knees and hips. So, is either type of offset "better" than the other? No. You may find, however, that a higher or lower-drop shoe is better for you.

Are zero drop shoes bad for high arches? ›

HOW you walk (and run) is more important than how high your arches are. Wearing barefoot shoes can help develop a better walking and running gait, as your feet cannot land out in front of you in a crushing heel-strike. (Particularly bad for high arches). Better gait also means stronger feet – and body!

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