This topic comes up for me a lot when discussing shoe choices with runners. Right now, it feels particularly relevant. The brand Altra, who is known for their zero to low drop models, recently came out with a shoe that is not zero drop and I, for one, applaud their choice.
Low drop and zero drop shoes have been around for almost two decades now, and like most shoes, seem to work well for some and not so well for others. To be clear, this isn’t a rant against low drop shoes. I have run in them off and on over the years, and have had many athletes do well with them. However, I have also had to work with the problems they can cause, and get frustrated with the lack of choices in higher drop shoes.
When these shoes first started coming to market, there was an interesting phenomenon that PTs started to see in the clinic. Injuries to the Achilles, deep posterior compartment and bottom of the foot that we used to only see in competitive athletes transitioning from their off-season road shoes to racing flats started happening in the general running population. The claims of the shoe industry that low drop and zero drop shoes would fix everyone’s running woes were simply not true. There has been a lot of research done on shoes and orthotics over the years, and for the most part, there is no consensus that any particular shoe or insert really has an effect on anything. However, clinically, I see a different picture. The runners I help who have lower leg and foot injuries (which I discussed in a previous column, Managing Achilles and Calf Issues) almost exclusively run in low drop shoes with bad running mechanics. After changing how they run and recommending a higher drop shoe, many are able to get back to running pain-free quite quickly, or with vastly reduced symptoms.
To further add to my point, I was thinking about backcountry skiing the other day. For those of us who transition to ski mountaineering (skimo) in the winter, there is an essential piece of equipment that we use when going uphill: the heel riser. For those of you who don’t backcountry ski, a heel riser is a piece of your binding that rotates to various heights under your heel when you are going uphill to offload your calves and Achilles during long ascents. Most skiers say that you are crazy for not using them when going uphill. Wearing a zero drop or low drop shoe, especially in our vert-obsessed community of runners, is akin to skiing uphill all day without a heel riser. Why would we want to do that?
Of course, my mind started to go down a rabbit hole, thinking about the retail world and their whole purpose: to sell stuff. Why are some shoe companies pigeonholing themselves with offering one or a limited number of shoes that only work for a small segment of the running population? Of course, there are some bigger companies that offer a lot of shoes with different drops, shapes and cushion, but I feel like some companies are missing out on sales and an opportunity to gain a wider following just because of being committed to low drop shoes.
The bottom line with shoes is, why not make people’s running experience as efficient and pain-free as possible? Running, especially trail running, is hard enough as it is. I’m going to go out on a limb and say that trail running shoes should all be 10–12mm drop. Give people a heel lift. Give me a shoe with an Altra toe box and a Brooks Cascadia drop and I’d wear and recommend that thing all day long. All of our bodies will thank us for it. See you on the trails!
Medical disclaimer. What I write here in no way substitutes for an in-person, thorough evaluation by a licensed Physical Therapist. As with many body issues, there can be multiple factors involved with your aches and pains, and, in some cases, more serious underlying conditions that can be manifesting as physical symptoms. It is always best to have a PT that you can see when you have concerns, so that you can make sure your personal situation is being addressed appropriately and safely. This column should, in no way, serve as a substitute for seeing a licensed medical practitioner.
