Mississauga Pain Clinic offering chiropractic, physiotherapy, massage therapy and orthotic services to residents of Churchill Meadows InMississauga
Mississauga Pain Clinic offering chiropractic, physiotherapy, massage therapy and orthotic services to residents of Churchill Meadows InMississauga
When it comes to running shoes, one often-overlooked yet critical feature is the “drop” which is the difference in cushioning height between the heel and the forefoot. This measurement, usually expressed in millimeters, plays a significant role in determining how your foot interacts with the ground, how your weight is distributed during each step, and ultimately, how stress is transferred through your muscles and joints.
A high-drop shoe, typically 10–12 mm, raises the heel significantly higher than the toes. This type of shoe tends to encourage a heel-first landing, which can shift more of the impact load to the knees and hips. For runners who naturally land on their heels or who have tight calf muscles or Achilles tendon issues, a higher drop can provide more comfort and may reduce stress in the lower leg. On the other hand, low-drop shoes, usually between 0–6 mm, keep the heel and toes closer to the same level. These shoes promote a midfoot or forefoot strike and generally encourage shorter strides and higher cadence. While low-drop shoes may reduce stress on the knee joint, they increase the demands on the calf muscles and Achilles tendon, which can lead to soreness or injury if not transitioned into carefully.
Zero-drop shoes, where the heel and forefoot are level, aim to mimic barefoot running. These shoes require a strong and well-conditioned foot, ankle, and calf complex, as they remove any artificial support and place the responsibility of stability and shock absorption squarely on your body. While some runners report improved foot strength and running economy with minimalist or zero-drop shoes, others experience an increase in overuse injuries, particularly in the Achilles tendon or plantar fascia, due to the sudden increase in loading
Research has shown that the heel-to-toe drop of a shoe can influence biomechanics significantly. For example, increasing drop from zero to 15 mm has been associated with over 15% higher peak stress at the patellofemoral joint (the front of the knee), which is a common site for running-related knee pain. In contrast, lower-drop shoes shift the mechanical load downward to the ankle and foot, making them potentially beneficial for runners with knee issues but more challenging for those with Achilles or calf problems.
There is no universally “correct” shoe drop for all runners. The ideal drop depends on several factors, including your natural foot strike pattern, injury history, foot shape, mileage, and even your running surfaces. For heel strikers or those transitioning from walking to running, a moderate to high drop may be more comfortable. For experienced runners with strong lower limbs and a preference for a forefoot strike, lower-drop shoes may feel more natural and efficient.
Choosing a new drop level should be done gradually. Abrupt changes in drop, especially moving to a lower or zero drop, can lead to significant soreness and increase injury risk. A safe transition strategy includes replacing just one run per week in the new shoe initially, incorporating calf and foot strengthening exercises, and increasing usage incrementally. Paying attention to signs like morning Achilles stiffness, persistent calf tightness, or sharp heel pain can help prevent long-term issues.
At home, certain strategies can be helpful for managing discomfort associated with inappropriate shoe drop. For example, if you’re experiencing Achilles or calf soreness, applying ice, stretching the calf muscles, and performing isometric heel raises may help. For knee pain, strengthening the quadriceps and glutes while avoiding prolonged sitting or stairs may reduce symptoms. For plantar fasciitis or arch pain, rolling the foot with a frozen water bottle and performing towel curls can relieve tension in the fascia.
At the Muscle and Joint Clinic, we offer a variety of services to help runners and walkers optimize their shoe choice and address pain caused by improper footwear. Our team provides gait analysis to identify your running style, custom orthotics to support specific foot mechanics, and therapy modalities such as Class 3B Laser and shockwave therapy to address chronic pain conditions. We also offer rehabilitation programs tailored to your needs, helping you transition safely to different shoe types and prevent injury.
Understanding your ideal shoe drop is not just about comfort—it’s about optimizing your biomechanics, reducing your injury risk, and enhancing performance. Whether you’re recovering from an injury or training for your next race, making an informed decision about shoe drop can make all the difference.
Altman, A. R., & Davis, I. S. (2012). Barefoot running: Biomechanics and implications for running injuries. Current Sports Medicine Reports, 11(5), 244–250. https://doi.org/10.1249/JSR.0b013e31826c9bb9
Lieberman, D. E. (2012). What we can learn about running from barefoot running: An evolutionary medical perspective. Exercise and Sport Sciences Reviews, 40(2), 63–72. https://doi.org/10.1097/JES.0b013e31824ab210
Malisoux, L., Chambon, N., Urhausen, A., & Theisen, D. (2016). Influence of the heel-to-toe drop of standard cushioned running shoes on injury risk in leisure-time runners: A randomized controlled trial with 6-month follow-up. The American Journal of Sports Medicine, 44(11), 2933–2940. https://doi.org/10.1177/0363546516654690
Sun, X., Lam, W. K., Zhang, X., Wang, J., & Fu, W. (2020). Systematic review of the role of footwear constructions in running biomechanics: Implications for running-related injury and performance. Journal of Sports Science and Medicine, 19, 20–37. https://pmc.ncbi.nlm.nih.gov/articles/PMC7039038/
Wearing, S. C., Reed, L., Hooper, S. L., Bartold, S., Smeathers, J. E., & Brauner, T. (2014). Running shoes increase Achilles tendon load in walking: An acoustic propagation study. Medicine & Science in Sports & Exercise, 46(8), 1604–1609. https://doi.org/10.1249/MSS.0000000000000256
Yu, P., He, Y., Gu, Y., Liu, Y., & Xuan, R. (2022). Acute effects of heel-to-toe drop and speed on running biomechanics and strike pattern in male recreational runners: Application of statistical nonparametric mapping in lower limb biomechanics. Frontiers in Bioengineering and Biotechnology, 9, Article 821530. https://doi.org/10.3389/fbioe.2021.821530
Zhang, M., Zhou, X., Zhang, L., Liu, H., & Yu, B. (2022). The effect of heel-to-toe drop of running shoes on patellofemoral joint stress during running. Gait & Posture, 93, 230–234. https://doi.org/10.1016/j.gaitpost.2022.02.008
