High Top vs Low Top Sneakers and Ankle Sprains
by ACE Physical Therapy and Sports Medicine Institute

One of the longest lasting debates in shoe wear involves high top vs low top sneakers. Does one shoe provide better protection from ankle sprains? Millions of dollars are spent to research and design the “ultimate” shoe that provides ideal comfort, support, and improves performance for a given sport. Each day Physical Therapists help athletes to recover from injuries and prevent injuries. They are often asked whether the high top or the low top sneaker does a better job of protection. It might help to clarify the nature of the foot and ankle complex and the unique contribution of high top and low tops.

The Foot and Ankle Complex

There are 20 bones involved in every movement of the foot and ankle complex. These bones are held together statically by bands of leather- like soft tissue called ligaments, and the ankle and foot complex are “dynamically stabilized” by the surrounding musculature.  Some healthcare professionals believe that too much external support of a joint can lead to instability due to weakening of the surrounding muscles.  If the joint has the external support, then the muscles don’t have to be ready to be active and help to dynamically support the joint.

High Tops

High top sneakers are thought to give a lot more ankle support because they are laced up above the “ankle” bones.  The foot and ankle complex functions together as a unit to move and support the body, and it has to be able to perform motions and movements in all directions and at all speeds.  Stopping and starting and changing directions at high speeds can lead to ankle injuries if the ankle and foot complex is not supported adequately.   The use of a high top sneaker or athletic shoe can aid the support of the complex by being a mechanical buttress to motion.  In theory, if the joints in the complex are supported and have limited in motion they less likely to be injured.

There are many healthcare professionals that debunk that theory and believe that these shoes might actually cause more injuries with prolonged use.  The shoe might inhibit the muscles from doing their job as dynamic supporters of the ankle and foot complex.  The use of high top sneakers on a daily basis as part of every-day fashion might predispose the ankle to injury.

Low Tops

Low top athletic shoes provide a lighter, less supportive shoe. The low top lacks the mechanical support and buttressing action that comes with high tops. As a result, the muscles of the foot and ankle complex must be more active.  Muscles that are more active are capable of providing dynamic support to the structures of the joint that are injured most frequently.   When wearing a low top sneaker, the muscles of the foot and ankle complex are more active and suited to dynamically stabilize the joints of the complex.

When wearing low tops or high tops, you may still get injured. If you sustain an injury to your ankle and foot complex, begin to treat it with RICE (Rest, Ice, Compression and Elevation) protocols of acute injury treatment.  If the injury does not respond quickly and the symptoms do not resolve, then you should seek advice and treatment from a Physical Therapist.  You can visit a Physical Therapist without seeing your doctor first and they will be able to evaluate and treat you beginning on your first appointment.  This will speed up your recovery.

Ultimately, the decision to wear high or low top sneakers often comes down to the individual preference.   There has not been any significant research that supports the use of one or the other.   It would be wise to perform an exercise routine that will facilitate the activity of the ankle muscles in an attempt to have them prepared to contract and help stabilize the foot and ankle complex.