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Footwear Can Impact Knee Osteoarthritis

What Footwear Styles Are Best and Worst for Osteoarthritis?

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Updated August 22, 2014

Footwear Can Impact Knee Osteoarthritis

Flats are better for your knee joints.

Photo by Michal Koziarski (iStockphoto)

When shopping for shoes, it's not all about style -- especially if you have osteoarthritis. Your choice of footwear can affect the load or stress put on your knee joint and consequently impact knee osteoarthritis.

Researchers have analyzed high-heel shoes, moderate-heel shoes, arch supports, and walking barefoot. A specialized shoe (the Mobility shoe) has even been designed that mimics walking barefoot. Let's review some of the conclusions that were drawn from various footwear studies. Hopefully, from reading through the study conclusions, you will realize that "they're so cute" should not be the sole criteria for buying shoes.

High-heels Versus Barefoot

Knee osteoarthritis is twice as common in women as men. A decade ago, researchers investigated the force applied to the knee joint when a small group of healthy women wore high-heel shoes compared to barefoot.

The study confirmed that high-heel shoes increased the force across the patellofemoral component of the knee (behind the kneecap) and the compressive force on the medial compartment of the knee (the inside of the knee joint). Researchers concluded that the additional force from wearing high-heel shoes may result in degenerative changes to the knee.

Point you should remember: High-heel shoes may be stylish but they are not the shoe that is best for joint health. When you wear high heels, your foot is in an unnatural position. Over time that takes a toll. If you are a huge fan of high-heel shoes, the best advice is to limit the time you wear them.

Wide-heel Shoes Versus Narrow-heel Shoes

Researchers in another study compared walking in wide-heel shoes to walking in narrow-heel shoes, and determined that wide-heel shoes cause abnormal forces across the patellofemoral and medial compartments of the knee -- contributing to degenerative changes in the knee.

Moderate-heel Women's Shoes

Yet another study, involving healthy young women and healthy elderly women, evaluated women's dress shoes with moderate heel height (about 1 1/2 inches). Results showed that even shoes with a moderate heel significantly increased force across the knee joint that has been associated with the development of knee osteoarthritis.

Men's Dress Shoes Versus Men's Sneakers

Dress shoes, sneakers, and walking barefoot were evaluated in healthy men to see if knee joint torque is affected in a way similar to high-heels for women. From the analysis, researchers concluded that men's dress shoes and sneakers do not significantly affect the knee in any way that would be associated with knee osteoarthritis.

Arch Supports Can Influence Knee Torque

The addition of arch supports to the shoes of healthy, physically active adults was evaluated. It was determined that adding an arch support (under the medial aspect of the foot) increases force to the inside. The purchase or prescription of arch support cushions should be done with caution. While arch supports may help some patients, they may harm others. Discuss arch supports with your doctor before spending money on them.

Walking Barefoot Versus Walking Shoes

Gait analyses were performed on study participants who wore everyday walking shoes or walked barefoot. Joint loads at the hips and knees significantly decreased during barefoot walking. Researchers concluded that modern shoes and walking practices may need to be revisited and reevaluated based on the prevalence of knee osteoarthritis in modern society.

The Mobility Shoe

A specialized shoe -- known as the mobility shoe -- was designed to mimic barefoot walking. Researchers compared the mobility shoe to self-chosen walking shoes and to another commercially available walking shoe among knee osteoarthritis patients. Researchers concluded that the specialized mobility shoe effectively reduced joint loads in people with knee osteoarthritis.

Other Points to Consider

Footwear does make a difference -- whether you already have knee osteoarthritis or you are trying to prevent it. Appropriate footwear may actually be therapeutic for patients treating knee osteoarthritis.

When choosing shoes, consider the condition of your feet as well as the additional force moderate to high heels place on your knees. Consider toe deformities, bunions, hammertoes, or other foot problems when choosing shoes. The best choice is a shoe that has a comfortable heel and wide toe box. It's essential for you to be kind to your feet by keeping them in appropriate footwear.

Sources:

Effects of specialized footwear on joint loads in osteoarthritis of the knee. Arthritis Care and Research. Shakoor N et al. September 15, 2008.
http://www3.interscience.wiley.com/journal/121391215/abstract

Walking barefoot decreases loading on the lower extremity joints in knee osteoarthritis. Arthritis and Rheumatism. Shakoor n et al. September 2006.
http://www3.interscience.wiley.com/journal/112775868/abstract

The influence of arch supports on knee torques relevant to knee osteoarthritis. Franz JR et al. Medicine and Science in Sports and Exercise. May 2008.
http://www.ncbi.nlm.nih.gov/pubmed/18408606

Men's shoes and knee joint torques relevant to the development and progression of knee osteoarthritis. Journal of Rheumatology. Kerrigan DC et al. March 2003.
http://jrheum.com/abstracts/abstracts03/529.html

Moderate-heeled shoes and knee joint torques relevant to the development and progression of knee osteoarthritis. Kerrigan DC et al. Archives of Physical Medicine and Rehabilitation. May 2005.
http://www.archives-pmr.org/article/S0003-9993(04)01398-X/abstract

Women's shoes and knee osteoarthritis. The Lancet. Kerrigan DC et al. April 7, 2001.
http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(00)04312-9/abstract

Knee osteoarthritis and high-heeled shoes. The Lancet. Kerrigan DC et al. May 9, 1998.
http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(97)11281-8/abstract

 

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