Shoe Drop May Be A Significant Risk Factor For Frequent Runners


Although there is no scientific proof that clearly shows superiority of a zero-drop running shoe over one with a higher drop, there are arguments in favor of both footwear choices. Shoe retailers and experienced runners usually suggest that the right amount of drop depends on the individual, and doctors often say this as well.

Most doctors and podiatrists recommend trying on shoes before using them. With the popularity of online shopping, many people blindly pick shoes that are not the right fit for their feet. The possible health consequences of using improper footwear can range from sore feet to back problems. For those who are considering both types of shoes but have not made a choice, here are the current findings available based on a recent study.

Study Purpose

This study was a randomized and controlled trial with a 180-day follow up. Researchers looked at leisure runners using running shoes with standard cushioning. In the background section, the researchers explained that cushioning was believed to affect strike pattern. The strike pattern is the way the foot hits the ground when a person runs or walks.
For example, a person may land on their toes, flat on their feet or on their heels. The reasons for landing a certain way have remained unclear. Researchers wanted to see if injury risk was mostly related to shoe cushioning or the frequency of running sessions.

Study Methods

For the study period, some of the leisure runners used a special pair of shoes that had a drop of 10 millimeters. Some participants were given shoes with a drop of 6 millimeters, and others received shoes with no drop.
Each participant had to report running activities and any associated injuries. A special analytic algorithm was used to calculate the risk differences between the three groups, and another special tool was used to compare the risks based on shoe drop size.

Study Results

Researchers found that the risk between the three groups was not significantly different. However, they did find some differences when it came to running frequency. Participants who ran more frequently had a higher risk of injury with low-drop shoes than those who did not run as frequently with the same shoes. Researchers suggested that people who run frequently have a lower risk of injury with a high-drop shoe.

Which Shoe Is The Best?

This study shows that there is no clear shoe type winner for everyone. People who run daily may benefit more from a high-drop shoe, and people who run less frequently may minimize their injury risks with low-drop shoes. Although no-drop shoes are marketed as beneficial, there is no evidence to support that a zero-drop design prevents injury risk.

Not every person’s foot is the same. Some people have higher arches than others, and there are additional differences. The best way to find an ideal running shoe is to talk to a podiatrist. A podiatrist can suggest the right type and fit of shoe for a specific foot, and the ideal type of shoe also depends on exercise frequency.


In this instance, an athlete was originally diagnosed with minor quadriceps muscle strain and was treated for four weeks, with unsatisfactory results. When he came to our clinic, the muscle was not healing, and the patients’ muscle tissue had already begun to atrophy.

Upon examination using MSUS, we discovered that he had a full muscle thickness tear that had been overlooked by his previous provider. To mitigate damage and promote healing, surgery should have been performed immediately after the injury occurred. Because of misdiagnosis and inappropriate treatment, the patient now has permanent damage that cannot be corrected.

The most important advantage of Ultrasound over MRI imaging is its ability to zero in on the symptomatic region and obtain imaging, with active participation and feedback from the patient. Using dynamic MSUS, we can see what happens when patients contract their muscles, something that cannot be done with MRI. From a diagnostic perspective, this interaction is invaluable.

Dynamic ultrasonography examination demonstrating
the full thickness tear and already occurring muscle atrophy
due to misdiagnosis and not referring the patient
to proper diagnostic workup

Demonstration of how very small muscle defect is made and revealed
to be a complete tear with muscle contraction
under diagnostic sonography (not possible with MRI)


Complete tear of rectus femoris
with large hematoma (blood)


Separation of muscle ends due to tear elicited
on dynamic sonography examination

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