As you can see in the image, the ‘heel-toe drop’ is the colloquial term for the difference between the height of your heel in the shoe and the height of your forefoot in the shoe. The heel-toe drop is a very important factor when it comes to addressing walking and running biomechanics.

In the coming weeks, we’ll be doing some more posts on this, but today I’d like to share some information with regards to heel-toe drop and injury risk. This has been a hot topic for many years, as some individuals and companies claim there is an ideal or optimal ‘heel-toe drop’…

For anyone who understands human variation, you’ll find this difficult to accept. This notion was very big several years ago with the barefoot running movement. There was quite a push to have everyone wearing minimal (zero drop) shoes, with claims that shoes with a heel-toe drop increased injury risk… Up until the last few years, there hasn’t been much data or research on heel-toe drops and injury risk, with claims usually just being anecdotal or marketing-driven…

In 2016 Malisoux et al. published this paper in AJSM – – which concluded that overall injury risk was not modified by running shoe drop, but lower drop shoes could be more hazardous for regular runners.

Additionally, in this 2017 RCT by the same group, they looked at running injury prevention and risk, and again concluded that injury risk is not influenced by the drop of running shoes.

Again, a 2017 RCT looking at running biomechanics, suggested that shoe drop did not seem to influence long term adaptation in running biomechanics.

It is good to see some quality evidence supporting the notion that there is no such a thing as the ‘perfect heel-toe’ drop in shoes. The heel-toe drop is something very important when it comes to addressing walking and running biomechanics, but it is important for us to look at each person individually – and not make claims about needs as a whole.

Author: Ben Harwin (Podiatrist)