Wearing shoes with thick heels can make runners more prone to injury, new research suggests.
People who wear flatter shoes can better understand how their feet move during running, which could lead to fewer injuries, researchers from the University of Florida Sports Performance Center report. Limits in sport and active life paper published in December.
Researchers examined more than six years of data on injury history and characteristics of shoe type—weight, cushioning, and heel height—for more than 700 racially and ethnically diverse endurance runners ages 12 to 77. They also used special treadmills and videos to record the movements. to analyze the running gait and ask participants to identify their particular “kick”, which refers to the way the foot first touches the ground.
Those who wore sneakers with a thick heel while running had a higher injury rate. Runners with thicker heels were also not as accurate in identifying their foot strike as runners with flatter shoes, which is likely a factor in the high injury rate.
The scientists reached those conclusions after controlling for age, weight, running volume and competitiveness.
“We have noticed that when runners are already running with their heels raised higher, they can have a false sense of the front foot striking first and often believe they are ‘forefoot strikers.’ Dr. Heather K. Vincentsaid director of the UF Health Sports Performance Center and lead author of the study Health. “In fact, they’re clearly the back hitters, and the heel of the shoe strikes first.”
This confusion about foot movement can lead to injury, Lori Diamos, PT, functional movement specialist, he said Health.
“Just as standing on a foam surface challenges your balance and control, these shoes dampen your body’s ability to sense and respond to the ground,” she said. “This forces you to rely more on the shoe for stability instead of your muscles and joints, increasing the risk of injuries such as a sprained ankle or knee pain.”
Despite the link between high-heeled shoes and injuries, researchers stress that they still don’t know if this type of shoe is really causes injuries. Although other studies—albeit smaller ones—have also shown that heel height and foot movement can affect running injuries, more research would be needed to establish a potential causal relationship.
Regardless of the ambiguity, if the study has you scrambling for a flatter running shoe—or any kind of new running shoe, for that matter—it’s best to take certain precautions to avoid injury.
First, look for shoes that fit your foot type but don’t force you to change your natural running style. Emma Andersoncertified personal trainer and exercise science coach at Fit Athletic Club, he said Health.
“Running shoes should be comfortable, durable, but also breathable and flexible,” she said. “Make sure your feet have plenty of room and your toes aren’t crowded together.”
You also want to make sure the shoes are designed for the terrain you intend to run on, whether it’s a treadmill, track, trail or street, she added.
In general, experts recommend starting slowly. Go on shorter runs with new shoes and store the old ones so you can change them for a few weeks.
“Not every shoe can be right for you,” added Anderson, “so if you experience pain or discomfort when transitioning to a new running shoe, stop and look for another shoe that might be a better fit.”