Systematic Review of the Role of Footwear Constructions in Running Biomechanics: Implications for Running-Related Injury and Performance.

Running shoes are built from many parts, laces, midsoles, heel flares, heel-toe drop, minimalist designs, heel cups, uppers, and bending stiffness, and each could influence how the body moves and absorbs impact during running. This review searched five databases plus the journal Footwear Science from 1994 to 2018, screening 1260 articles down to 63 studies examining how these shoe construction features relate to running biomechanics, injury risk, and performance. The authors grouped findings by construction type rather than pooling data statistically. Across these studies, some patterns emerged: shoe stiffness within an optimal range appeared linked to better performance-related variables, softer midsoles were associated with reduced impact forces and loading rates, thicker midsoles seemed to improve cushioning and shock absorption but reduced plantar foot sensation, and minimalist shoes were associated with improved running economy and changes in Achilles tendon stiffness alongside increased loading at the foot and ankle joints.

Evidence on laces, heel flare, heel-toe drop, Masai Barefoot Technology, heel cups, and uppers remained too limited to draw firm conclusions, and the review noted a lack of standardized testing protocols across studies.

If you've ever wondered whether the type of running shoe you wear actually changes how your body moves or your risk of injury, this review looked at exactly that question. Researchers combined findings from 63 studies (out of 1260 screened) that examined different shoe features, things like laces, cushioning (midsole), heel height difference (heel-toe drop), minimalist designs, and shoe stiffness, and how they affected running mechanics, injury risk, and performance. The review found some patterns worth knowing about, though not definitive answers.

Shoes with stiffness in a certain optimal range seemed linked to better performance measures. Softer cushioning was associated with lower impact forces on landing, and thicker cushioning seemed to absorb more shock but reduced how much the foot could feel the ground.

Minimalist shoes were linked to improved running efficiency and stronger Achilles tendons, but also more stress on the front of the foot and ankle joint. For several other shoe features, including laces, heel cups, and heel flare, the evidence was too limited to draw clear conclusions. The studies used different methods, so a standardized way of testing shoes still doesn't exist.

This is a summary of research, not medical advice. Talk to your own healthcare provider about anything affecting your care.

This systematic review synthesized 63 biomechanical studies (from an initial pool of 1260) on running shoe construction features, categorized into nine domains: lace, midsole, heel flare, heel-toe drop, minimalist shoes, Masai Barefoot Technology, heel cup, upper, and bending stiffness. No meta-analysis or pooled participant count was reported, and the review appears organized narratively by construction type rather than through quantitative synthesis, which limits the strength of conclusions that can be drawn about magnitude or consistency of effects. Reported patterns included stiffness within an unspecified optimal range being associated with improved performance-related variables, softer midsoles correlating with reduced impact forces and loading rates, and thicker midsoles improving cushioning at the cost of plantar sensory feedback.

Minimalist shoe use was associated with improved running economy and increased Achilles tendon cross-sectional area and stiffness, alongside increased metatarsophalangeal and ankle joint loading relative to conventional shoes. The authors explicitly flagged that evidence for lace, heel flare, heel-toe drop, Masai Barefoot Technology, heel cup, and upper constructions remains insufficient for firm guidance, and they called for standardized testing protocols to establish optimal stiffness, thickness, and drop parameters. Heterogeneity in methodology across the 63 studies and absence of formal risk-of-bias grading constrain confidence in these associations.