Unraveling the impact of “shoe drop”: Biomechanical and clinical perspectives in running

Context “Shoe drop” refers to the height difference between the heel and forefoot of a shoe, a concept increasingly important in sports shoe design. This systematic literature review synthesizes the biomechanical effects of “shoe drop” and its clinical implications. Methods Research included major academic databases like MEDLINE, Cochrane Central, Scopus, and PEDro, using specific keywords. Inclusion criteria focused on studies involving adult runners of various levels, examining the effects of “shoe drop” on aspects such as injuries and biomechanics, conducted in controlled environments such as laboratories or real-world scenarios and following a randomized controlled trial design. Studies not meeting these specific criteria were excluded. Results Of 113 initially identified articles, 4 were included for analysis. These studies examined the effect of “shoe drop” on running biomechanics, suggesting that low “shoe drop” shoes might improve running mechanics by reducing heel acceleration. However, their impact on overall injury risk remained uncertain. The studies highlighted differences between occasional and regular runners, and among young athletes, indicating variable biomechanical responses. Conclusion This review explored the impact of “shoe drop” on running biomechanics and injury risk. Findings suggest that low “shoe drop” shoes may improve running mechanics by reducing heel acceleration, though their effect on injury risk is unclear. Differences were noted between occasional and regular runners. The results underscore the importance of customized shoe prescriptions, patient education, and injury prevention, while calling for further research for stronger clinical evidence.