Is there a link between athletic shoe drop and injury?

A discussion I often have, is trying to figure out if drop really is a performance and injury issue or just a way to strip weight out of the shoe?

The discussion folds nicely into that of heel lifts for conditions like Achilles tendinopathy or even Sever's disease, which is common practice, and achieves results anecdotally. But, I am interested in what the science tells us, is there a real reason to go up, or down with drop, as we look at injury?

So I guess first we talk about the theory, and then we can take a look and see if there is anything to support it.

Let's use Achille's tendinopathy as an example. Using a heel lift, or "increasing the drop", has historically been a very common treatment modality. Hell, I will go on record and say I have done it myself!

Same applies to Sever's disease, where one of the most common treatment methods is to simply get the injured child into a shoe with a much greater "drop".

The rationale behind the use of a heel lift or high drop shoe is that it will "unload" the tendon, and encourage both pain relief and repair of the damaged tissue. Seems logical right? Passively lift the heel, unload the triceps surae group and its insertion via the Achilles tendon and Bingo! We have a winner!

Appealing as this may be, it pretty much completely ignores our current understanding of not only what might cause Achilles tendinopathy, but also how, or should I say if, it repairs.

Simon Bartold
Director of Bartold Clinical