Minimalist Shoes for Treatment of Achilles Tendon Injury

Minimalist shoes were found to provide better ankle stability in runners with an Achilles tendon injury.

Achilles Tendon Injury in Forefoot Runners

In forefoot running, Achilles tendon injury arises only if forceful toe-propulsion is used to initiate flight. Aside from that, Achilles tendon injuries are lower in habitual forefoot runners than heel strike runners.

New research however, offers insight into a simple means for a permanent depletion of Achilles tendon injury in forefoot running, and that is to run in zero drop minimalist shoes as opposed to the standard running shoe.

  • A study by Baur et al. found that running with Achilles tendon injury reduces amplitudes in weight-acceptance in the peroneal muscle, indicating reduced stability in the subtalar joint –the peroneal muscle controls the motion of the subtalar joint during the stance phase of running.

The results were clear that running with Achilles tendon injury may increase eversion of the subtalar joint. Likewise, runners with an Achilles tendon injury may be sapped of neuromuscular control of the foot/ankle complex due to structural changes within the injured tendon.

Overwhelming evidence points to thick shoe cushioning for inducing deficits in neuromuscular control that are difficult to overcome, leading to destructive impulsive movements to compensate for sensory-motor impairments during running.

Ankle Stability Dependent on Proprioception

Using Minimalist Shoes to Treat Achilles Tendon Injury

Of course, zero drop minimalist shoes are a good proxy for better ankle stability because they enhance the processing of sensory-motor information with high proprioceptive resolution. Therefore, it’s plausible that runners with an Achilles tendon injury would benefit from running in these shoes.

As predicted, the researchers suggested that enhanced sensory-motor commands is essential to improve neuromuscular control of the subtalar joint thereby reducing and preventing Achilles tendinopathies in runners.

Granted, previous reports imply that motor-control deficits of the calf musculature contribute to running-related Achilles injuries, suggesting that calf strengthening exercises should be the main therapeutic approach. The runners in the study however, did not seem to have the same powerful need for stronger calves, but the need for stronger ankles by wearing better shoes.

More From Run Forefoot:


Baur et al. Comparison in lower leg neuromuscular activity between runners with unilateral mid-portion Achilles tendinopathy and healthy individuals. J Electromyo Kin, 2011;21:499-505.

Ryan M, Grau S, Krauss I, Maiwald C, Taunton J, Horstmann T. Kinematic analysis of runners with Achilles mid-portion tendinopathy. Foot Ankle Int 2009;30:1190–5.

Bretta Riches

Bretta Riches

"I believe the forefoot strike is the engine of endurance running..."

BSc Neurobiology; MSc Biomechanics candidate, ultra minimalist runner & founder of RunForefoot. I was a heel striker, always injured. I was inspired by the great Tirunesh Dibaba to try forefoot running. Now, I'm injury free. This is why I launched Run Forefoot, to advocate the health & performance benefits of forefoot running and to raise awareness on the dangers of heel striking, because the world needs to know.
Bretta Riches

P.S. Don't forget to check out the Run Forefoot Facebook Page, it's a terrific place to ask questions about forefoot running, barefoot running and injury. I'm always happy to help!

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