Are There Any Benefits In Running With Zero Drop Shoes?

My wife's zero drop running shoes

Although you don't see it as much now, the minimalist type running shoes were the rage all few seasons ago. These minimalist type (and not the barefoot type) usually have a relatively low heel to toe drop. Meaning the height in the midsole and the outsole at the back of the shoe is almost level and/or no difference in height.

One proposed benefit of zero drop running shoes is that it may reduce injury. Shoes with a large drop encourage severe heel striking which can contribute to knee injuries. With zero drop shoes, it may also allow your feet to land as if you were not wearing shoes which helps to distribute impact forces.

Shoes with a high drop may also tilt you forward too much and contribute to alignment and compensatory discrepancies.

If you visit the running section of most running stores now, most midsoles of current running shoes are almost back to before when they were much thicker. But many manufacturers have retained the zero drop while offering plenty of cushioning like the Hokas and Altras.

A recent study however found that a shoe's heel to toe drop may not have have anything to do with running injuries.

The researchers studied 533 non elite runners wearing running shoes with 0, 6 or 10 millimetres (mm) drop for six months. The running shoes were 2l mm in the heel and forefoot, 21 mm in heel and 15 mm in forefoot and 24 mm in heel and 14 mm in forefoot respectively. The shoes were otherwise similar.

25 percent of the runners reported being injured during the six month study period. An injury was defined as leg or lower back pain that resulted from running and prevented planned running for at least one day.

The main finding of the study was that injury rates among the three groups were similar, regardless whether their shoes had a heel to toe drop of 0, 6 or 10 mm.

However, among the runners who ran more frequently, those in the 0 or 6 mm drop shoes had a higher injury rate than the frequent runners with a 10 mm drop.

The researchers suggested that that this may be due to the runners transitioning to fast from their regular running shoes to zero drop shoes leading to increased injury rates as 78 percent of the runners recruited in the study hadn't run in zero drop shoes before.

I remember when I was racing cross country races as a kid we used to train in heavier cushioning shoes and then switched to racing flats for the race. It was very common to have sore calves after the first few races of the season as I've not done enough running in the racing shoes (which had lower drop than the training shoes). Yes, racing flats back then were very similar to the zero drop shoes now.

It was more apparent (sore calves) switching to racing spikes for the track training and track meets when cross country season ended and I raced in track events.

As I always tell my patients, their running technique is much more important than their running shoes. Be sure to rotate your running shoes to minimise injuries too.

Reference

Malisoux L, Chambon N et al (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. AJSM. 44(11): 2933-2940. DOI: 10.1177/0363546516654690.

Now, this is what I'll call a racing flat