Zero Drop Shoes Lead to Injuries

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.

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 this link on 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.