Achilles tendonitis is one of the most frustrating injuries a runner can face. That nagging pain at the back of your heel can sideline you for weeks—or longer if not managed properly. While rest and rehabilitation are essential, your choice of running shoes can play a significant role in both recovery and prevention.
Here's what the research says about finding the right running shoes when dealing with Achilles tendon issues.
In This Guide
What Is Achilles Tendonitis?
The Achilles tendon connects your calf muscles to your heel bone. It's the largest and strongest tendon in your body, but it's also one of the most commonly injured structures in runners. Achilles tendonitis (or tendinopathy) refers to inflammation, irritation, or degeneration of this tendon.
Symptoms typically include pain and stiffness along the tendon (especially in the morning), thickening of the tendon, and pain that worsens with activity. The condition often develops gradually from repetitive stress rather than a single acute injury.
The Achilles tendon transmits force from the calf muscles to the heel, enabling push-off during running
Why Heel Drop Matters for Your Achilles
Heel drop (or heel-to-toe drop) is the difference in height between the heel and forefoot of a shoe, measured in millimeters. This specification has a direct impact on how much your Achilles tendon has to stretch and work during running.
Think of it this way: when you wear shoes with some heel elevation, your calf muscles start in a slightly shortened position. This means they don't have to lengthen as much during the stance phase of running, which reduces the eccentric load on your Achilles tendon.
Heel drop affects ankle angle and Achilles tendon stretch during the stance phase of running
What the Research Shows
Multiple studies have examined the relationship between heel drop and lower leg loading. The findings consistently point in the same direction:
Research Summary
A 2021 study in Applied Sciences found that running in shoes with larger heel-to-toe drops decreases loading of the Achilles tendon and calf muscles by minimizing the net ankle moment during running.3
Additional research using musculoskeletal modeling showed that minimalist (low-drop) shoes are associated with higher muscle forces in the gastrocnemius, Achilles tendon, and flexor hallucis longus compared to traditional shoes.4
The data on injury patterns supports these biomechanical findings. One study found that while zero-drop shoes showed a lower rate of knee injuries (15% vs. 26%), they were associated with a higher rate of ankle and foot injuries (41% vs. 31%) compared to shoes with a 10mm drop.5
| Heel Drop | Achilles/Calf Load | Knee Load | Best For |
|---|---|---|---|
| 0-4mm (Minimal) | Higher | Lower | Runners with knee issues; requires gradual transition |
| 5-8mm (Low) | Moderate | Moderate | Experienced runners seeking balance |
| 8-12mm (Traditional) | Lower | Higher | Runners with Achilles/calf issues; most recreational runners |
Key Shoe Features for Achilles Protection
Based on the available research and clinical guidance, here are the shoe characteristics that may help runners dealing with Achilles issues:
What to Look For
- Heel drop of 8-12mm — Reduces stretch on the Achilles tendon by positioning the heel higher than the forefoot
- Adequate cushioning — Absorbs impact forces that would otherwise be transmitted through the tendon
- Firm heel counter — Provides stability and prevents excessive heel movement that can irritate the tendon
- Appropriate stack height — Enough material underfoot to attenuate ground reaction forces
- Room in the toe box — Allows natural foot function without compensation patterns that stress the Achilles
- Gradual rocker geometry — Some shoes include a mild rocker that assists with toe-off, reducing push-off demands
What to Avoid When You Have Achilles Issues
Zero-drop or minimalist shoes — While these shoes have benefits for some runners, research indicates they increase loading on the posterior lower leg structures, including the Achilles tendon.4 Transitioning to them too quickly is a common cause of Achilles problems.
Worn-out shoes — As midsole foam breaks down, it loses its ability to absorb impact. Most running shoes should be replaced every 300-500 miles, and runners with Achilles issues may benefit from erring on the earlier side.
Racing flats — These lightweight shoes typically have minimal cushioning and lower heel drops, both of which increase Achilles stress.
Sudden changes in heel drop — Switching from a 12mm drop shoe to a 4mm drop shoe (or vice versa) forces rapid adaptation that can trigger or worsen Achilles problems. Any changes should be gradual.
Clinical Recommendations
Sports medicine professionals often provide the following guidance for runners with Achilles tendonitis:
Podiatrists frequently recommend that runners with chronic calf or Achilles problems may benefit from shoes with a greater heel-to-toe differential, which can reduce strain on those structures.6
For those also dealing with plantar fasciitis (which often accompanies Achilles issues), a heel drop in the 7-12mm range is often suggested.7
The Bottom Line
While no shoe can cure Achilles tendonitis—proper rest, physical therapy, and sometimes medical intervention are essential—your footwear choice can meaningfully affect the load placed on your Achilles tendon with every step.
The research points to a moderate heel drop (8-12mm) as potentially beneficial for runners dealing with Achilles issues. This positions the heel higher than the forefoot, reducing the stretch and eccentric load on the calf-Achilles complex during running.
Designed with Your Achilles in Mind
10mm drop to reduce lower leg strain. Wide toe box for natural function.
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References
- Lopes AD, et al. "What are the Main Running-Related Musculoskeletal Injuries?" Sports Medicine. 2012. PubMed
- Kujala UM, et al. "Cumulative incidence of Achilles tendon rupture and tendinopathy in male former elite athletes." Clin J Sport Med. 2005. PubMed
- Xu D, et al. "Biomechanical Analysis of Running in Shoes with Different Heel-to-Toe Drops." Applied Sciences. 2021. MDPI
- Li J, et al. "Simulation of Lower Limb Muscle Activation Using Running Shoes with Different Heel-to-Toe Drops Using Opensim." Bioengineering. 2023. PMC
- Research data as cited in RunRepeat. "Heel to Toe Drop: The Ultimate Guide." runrepeat.com
- Podiatry Today. "How Does Heel-to-Toe Drop in Running Shoes Impact Heel Pain?" hmpgloballearningnetwork.com
- Bayshore Podiatry Center. "Best Running Shoes for Plantar Fasciitis 2025." bayshorepodiatry.com
This article is for informational purposes only and does not constitute medical advice. Achilles tendonitis is a medical condition that may require professional treatment. If you have Achilles pain or any injury, please consult a qualified healthcare provider before making changes to your footwear or training.
