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  1. Laurent Malisoux1,
  2. Nicolas Chambon2,
  3. Axel Urhausen1,3,4,
  4. Daniel Theisen1
  1. 1Sports Medicine Research Laboratory, Luxembourg Institute of Health, Luxembourg, Luxembourg
  2. 2Decathlon, Movement Sciences Laboratory, Villeneuve d'Ascq, France
  3. 3Sports Clinique, Centre Hospitalier de Luxembourg, Luxembourg, Luxembourg
  4. 4International University of Health, Exercise and Sports, Luxembourg, Luxembourg


    Background Modern running shoes come in variable heel-to-toe drops, but it is currently unknown if this feature plays a role in the prevention of injuries.

    Objective To determine if the drop of conventional cushioned running shoes influences injury risk and whether running regularity (>6 months of regular practice over the previous year) modifies this association.

    Design Double-blind randomised controlled trial, with a 6-month follow-up.

    Setting Leisure-time distance runners.

    Participants Study participants (n=553) were recruited via advertisements in local newspapers. They were required to report any running activity, sport practice and injury using a dedicated internet platform.

    Intervention Running shoes with a drop of 10 mm (D10, n=176), 6 mm (D6, n=190) or 0 mm (D0, n=187). Apart from the shoe drop, the 3 versions were strictly identical. A stratified analysis was conducted according to the participants' running regularity.

    Main Outcome Measurements First running-related injury self-reported by the participants, and systematically verified by email or phone call. Cox regression analyses were used to compare injury risk between exposure groups.

    Results 136 of the participants (25%) sustained at least one injury. The proportion of injured participants were 21.6%, 27.4% and 24.6% in the D10, D6 and D0 groups, respectively. The overall injury risk was not different among the participants who had received the D6 version (hazard rate ratios – HR=1.30; 95% confidence intervals −95% CI=0.86–1.98) or the D0 version (HR=1.17; 95% CI=0.76–1.80) when compared to the conventional D10 version. The stratified analysis revealed that low drop shoes (D6 and D0 grouped together) were associated with a lower injury risk in occasional runners (HR=0.48; 95% CI=0.23–0.98), and with a higher injury risk in regular runners (HR=1.67; 95% CI=1.07–2.62).

    Conclusions Overall, injury risk was not influenced by the drop of conventional cushioned running shoes, yet this association may be modified by the runner's profile.

    • Injury

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