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Negative Heel Shoes Reduce Peak Forces at the Knee While Running




What running shoes should I be wearing? This is a frequent question we get as physical therapists. This is a heated discussion in the research and one where the pendulum has swung to extremes multiple times over the past few decades. In the 2000s anti-pronation motion control shoes were the must have. In the 2010s you were absolutely foolish to run in anything other than minimalist zero drop footwear. The most current recommendation is as general as it gets: lightweight, comfortable, and minimal motion control showing the lowest rates of running related injuries. As of 2024 we have a new contender, the negative heel shoe???


Gu et al1 recently published a study investigating the acute effects of negative heel shoes on perceived pain and biomechanical characteristics of the knee in runners with patellofemoral pain (PFP). The study compared runners with PFP wearing shoes with a -11mm heel drop (i.e. heel lower than toe) to those wearing shoes with a 5mm heel drop (i.e. heel higher than toe). They found that patellofemoral joint reaction force, peak patellofemoral joint stress, knee extension moment, quadriceps force at time of peak patellofemoral joint stress, and foot inclination angle were all significantly lower when wearing negative heel shoes. Although these objective measurements were all significantly decreased, the runners did not report any change in self-reported pain experienced during the runs. The authors conclude that negative heel shoes may be beneficial in reducing further development of PFP.


If you are a runner in the Denver area experiencing knee pain, book an appointment with one of the expert physical therapists at RISE for a comprehensive evaluation to get you back tearing up the miles without pain!


Citations:

Gu Y, Zheng Z, Zeng Q, Yang C, Song Y, Wan X. Acute effects of negative heel shoes on perceived pain and knee biomechanical characteristics of runners with patellofemoral pain. J Foot Ankle Res. 2024 Mar;17(1):e12001. doi: 10.1002/jfa2.12001. PMID: 38551203; PMCID: PMC11296720.

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