Early on in my PT career a common message I would tell runners and other patients was to not let their knee past your toes when they performed squatting exercises. We would be placing too much strain on the knee and should focus more on challenging the hip. This was a mistake.
PREPARING FOR ZERO DROP SHOES
So you have decided to try running in a lower drop shoe. Great! This can be a great way to take a little demand off the knee if we are coming back from an injury or we are just interested in incorporating some variability in our footwear rotation. I highlighted that in blog number one which you can find HERE.
We have to remember any time we change something like our running gait or footwear, we are not making forces or loads go away. We are simply shifting them around. While we are loading the knee less, we are asking more of the foot, ankle and calf complexes. With that in mind, here are some considerations before we start prescribing zero drop footwear to everyone.
DO WE HAVE THE MOTION FOR A ZERO DROP SHOE?
Wearing shoes with less drop demands more ankle dorsiflexion from the ankle. Making sure we have adequate ankle mobility is important because these tissues will have to deal with more stress in a lower drop shoe. The demands increase even more if we are trying to manage an incline. A common test we can use is a simple knee to wall test . Ideally, we are going to be able to get our knee even with the end of our toes (and maybe a little more). If we don’t have the requisite motion, improving our ankle mobility would be a good plan prior to transitioning to a more level shoe.
PREPARING THE TISSUES FOR MORE WORK
So you have the motion, but are our tissues ready for this equipment change?
Improving the resiliency of the calf, ankle and foot would be beneficial as we are going to be asking more of them. Here are two strategies we should be focusing on to help our tissues adapt to the stresses of a zero drop shoe.
Traditional Calf Strengthening
Exercises focus on ankle plantar flexion conditioning are important to build up the resilience of our calf muscle complex. Here are some of my favorites
Calf Raise Progression
Marching + OH Reach
Marching + Heel Raise
LOADING ANKLE DORSIFLEXION
We also should be focusing on loading ankle dorsiflexion with single leg drills to help our calf, ankle and foot deal with the different loading pattern. These drills cycle the runner through large ranges of ankle dorsiflexion while focusing on smooth, controlled movement.
Step Up and Over
Thanks for reading!
Nathan Carlson PT
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