High-Tops or Low-Tops: What does the Research Say?

By Aaron Brown, SPT, ATC, CSCS
Athletic Trainer
MUSC Health Sports Medicine

Recently I was asked the following question by a basketball player: “I know that high-top basketball shoes have better ankle support than low-tops, but does it really matter? I feel like if you land on someone else’s foot, or roll it another way it really doesn’t matter which one you’re wearing.”

Let us first breakdown the difference between a high-top and low-top shoe. A high-top shoe has a higher collar that is higher up over the ankle (figure 1), whereas a low-top shoe has a lower collar that is lower than the ankle (figure 2).

Common stigma amongst the athletic population is that high-top shoes help to prevent ankle sprains due to the collar coming up above the ankle joint. However, is this supported by the literature? A randomized study with 622 subjects was designed by Barret et al. to observe if there are any difference between high-top shoes and low-top shoes in regard to risk of ankle sprain. The results demonstrated no significant difference in ankle sprains while wearing a high-top shoe compared to a low-top shoe.¹ (Barrett et al, 1993). Additionally, Handoll et al. and Rovere et al. both demonstrated no significant differences in ankle sprains between the two types of collar height for subjects with no previous history of ankle sprains. ^2,3

Another important consideration to make when determining which collar height is superior in preventing ankle sprains is the effect on muscle activity. Research has shown that muscle activation at the ankle joint is highly influenced by collar height in the event of an inversion moment (rolling the ankle).^4,5 Fu et al. provided evidence that in certain cases, high-top shoes can delay the activation and decrease the amplitude of contraction of important ankle stabilizers in the event of rolling the ankle.⁶ Fu et al’s “main findings indicated that high-top shoes adopted in this study did not reduce ankle inversion angle, ankle inversion range of motion, and inversion angular velocity compared to low-top shoes.”⁶ Therefore, these results suggest that high-top shoes are no superior to low-top shoes in increasing ankle stability.

In a recent systematic review and meta-analysis conducted in 2019 by Ci Jiang, the findings supported no superiority of either high-top or low-top shoes in preventing ankle sprains.⁷

Now, returning back to the original question: “does it really matter?” Simply put, no. The most important factor to take into consideration is what kind of shoe does your body feel most comfortable in? Ankle sprain prevention is determined more by a proper warm up, ankle and core strengthening, and balance exercises, than collar height. Therefore, pick what your body feels best in, participate in a high-quality, dynamic warm-up prior to activity, and strengthen your core and ankle muscles.

1. Barrett, J., Tanji, J., Drake, C., Fuller, D., Kawasaki, R. and Fenton, R., 1993. High- versus low-top shoes for the prevention of ankle sprains in basketball players. The American Journal of Sports Medicine, 21(4), pp.582-585.

2. Handoll, H. H., Rowe, B. H., Quinn, K. M., & de Bie, R. (2001). Interventions for preventing ankle ligament injuries. Cochrane Database of Systematic Reviews, (3).

3. Rovere, G. D., Clarke, T. J., Yates, C. S., & Burley, K. (1988). Retrospective comparison of taping and ankle stabilizers in preventing ankle injuries. The American journal of sports medicine, 16(3), 228–233.

4. Kerr, R., Arnold, G. P., Drew, T. S., Cochrane, L. A., & Abboud, R. J. (2009). Shoes influence lower limb muscle activity and may predispose the wearer to lateral ankle ligament injury. Journal of orthopaedic research, 27(3), 318–324.

5. Ramanathan, A. K., Wallace, D. T., Arnold, G. P., Drew, T. S., Wang, W., & Abboud, R. J. (2011). The effect of varying footwear configurations on the peroneus longus muscle function following inversion. The Foot, 21(1), 31–36.

6. Fu, W., Fang, Y., Liu, Y., & Hou, J. (2014). The effect of high-top and low-top shoes on ankle inversion kinematics and muscle activation in landing on a tilted surface. Journal of foot and ankle research, 7(1), 14.

7. Jiang, C. (2020). The Effect of Basketball Shoe Collar on Ankle Stability: A Systematic Review and Meta-Analysis. Physical Activity and Health, 4(1), 11–18.