These days, ultra-cushioned running sneakers with exceptionally thick soles are everywhere. The brand Hoka often gets credited with starting the trend, but even older brands like New Balance, Brooks, and Asics all now have their own versions. Podiatrists say these thick soles can provide better shock absorption and lessen the strain on your joints, making them a great choice for those with plantar fasciitis or back pain. However, new research suggests that thick-heeled sneakers are more likely to cause injuries in runners.
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Runners who wear thick-heeled sneakers may be more likely to get injured.
Published in the journal Frontiers in Sports and Active Living, a new study found that runners wearing thick-heeled sneakers were more likely to get injured than those wearing flat soles.
The researchers from the University of Florida (UF) concluded that "runners with thicker heels could not accurately identify how their foot landed with each step, a likely factor in the high injury rates," according to a press release.
To arrive at their findings, researchers pulled data from more than 700 runners who had visited UF Health’s Sports Performance Center and Running Medicine Clinic over the course of six years. They looked at the relation between foot strike pattern and shoe type.
"The shoe lies between the foot and the ground, and features like a large heel-to-toe drop make it more challenging for runners to identify how they’re striking the ground. That clouds how we retrain people or determine if someone is at risk for future injury," said Heather Vincent, PhD, a co-author of the study and the director of the UF Health Sports Performance Center. "The runners who correctly detected mid- or fore-foot striking had very different shoes: lower heel-to-toe drop; lighter; wider toe box."
It's important to note that the study did not call out any specific shoe brands, and those mentioned previously are not connected to the research.
Anecdotal insights point to these shoes' tripping hazards.
Outside of scientific studies, ordinary people have also complained about the injury risk of thick sneakers.
In a 2020 article, The Wall Street Journal refers to these shoes as "maximalist sneakers," those that have "midsole cushions that are often two or three times thicker than regular running shoes."
One person whom the Journal interviewed likened these sneakers to clown shoes and said she had difficulty driving in them. Moreover, she tripped and fell in her kitchen while wearing them, bruising her rib on the counter. "I felt like I could break an ankle in these," she said.
In a Reddit thread, a user who bought a pair of thick-soled Nike sneakers said they experienced increased tripping while trail running.
"In general, shoes with a tall stack height and a high drop are going to be easier to roll an ankle on," someone agreed.
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However, podiatrists often recommend thick-soled sneakers.
Despite the research and anecdotal claims, many podiatrists tout the benefits of thick-soled sneakers.
In previously speaking to Best Life about a specific Hoka sneaker, Ashley Lee, DPM, a podiatrist and foot and ankle surgeon who works with Northern Illinois Foot & Ankle Specialists, said they are the "ultimate cushioned shoe with a balanced support." She added that the thick sole "protects the joint," but the shoes are still "light enough to walk at a faster pace."
And while the study specifically called out the risk of a steeper heel drop, other experts say this very feature is beneficial.
For example, Milica McDowell, doctor of physical therapy and VP of operations at Gait Happens, previously told Best Life that an ultra-cushioned pair of Altra sneakers was great for those suffering from plantar fasciitis. "It has an adequate cushion to help relieve heel pain and a 4-millimeter drop where the heel is slightly higher than the toe to allow forward roll, which can take pressure off your Achilles and heel area," she explained.
There's a learning curve with thick-soled sneakers.
It's worth noting that many experts point to the learning curve that comes with switching from flat to thick-soled sneakers.
Carson Caprara, senior director of global footwear at sneaker maker Brooks Running, explained to The Wall Street Journal: "For many, it’s a very different sensation and you really have to teach your foot to relax and let the shoe sort of rock you forward. A lot of people try to fight the shoe."
"It takes a little bit of adjusting," agreed Lee Cox, vice president of global marketing and sales for Hoka One One.
In the Reddit thread, one runner spoke to a similar experience: "I know that when I switched from a low stack height shoe to one with a higher stack I had a couple weeks of tripping before my brain/body connection caught up and adjusted."
However, if you do feel unstable in a thick-heeled sneaker and want to switch to something flatter, you can also expect a transition period.
"I had to teach myself to get out of the big, high-heeled shoes down to something with more moderate cushioning and to work on foot strengthening,” shared Vincent in the study press release. "It may take up to six months for it to feel natural. It’s a process."
