Arthritis? Wear light, flat shoes!
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with more flexible soles are easier on the knees than clogs or walking shoes,
and may offer relief to people with osteoarthritis, says a new study.
Loading on the knee joints is a key factor in the development of osteoarthritis.
"Traditionally, footwear has been engineered to provide maximum support and
comfort for the foot, with little attention paid to the biomechanical effects on
the rest of the leg," said Dr. Najia Shakoor, a rheumatologist at Rush and the
primary author of the study. "But the shoes we wear have a substantial impact on
the load on the knee joints, particularly when we walk."
"Our study demonstrated that flat, flexible footwear significantly reduces the
load on the knee joints compared with supportive, stable shoes with less
Osteoarthritis is the most common form of arthritis and a significant source of
disability and impaired quality of life. A higher-than-normal load on the knees
during walking is a hallmark of the disease, associated with both the severity
of osteoarthritis and its progression.
To reach the conclusion, Shakoor and her colleagues analyzed the gait of 31
patients with symptoms of osteoarthritis in the Rush Motion Analysis Lab while
they walked barefoot and with four popular shoe types: Dansko clogs, which are
often worn by healthcare professionals who have to be on their feet much of the
day; Brooks Addiction stability shoes, which are prescribed for foot comfort and
stability; Puma H-Street shoes, a flat athletic shoe with flexible soles; and
The loads on the knee joints differed significantly depending on the footwear.
For the clogs and stability shoes, the loads on the knee joints were up to 15
percent greater than with the flat walking shoes, flip-flops or barefoot
walking. Knee loading was roughly the same whether the subject wore flips-flops
or walked barefoot.
"Currently, knee braces and wedged orthotic shoe inserts are used to relieve the
load on the knee joints of patients with osteoarthritis, but everyday footwear
is also a factor to consider. The results in our study demonstrate that the
reduction in load achieved with different footwear, from 11 to 15 percent, is
certainly comparable to reduction in load with braces and shoe inserts," Shakoor
According to Shakoor, several aspects of footwear affect the joint loading.
"Heel height is one factor, and may explain why the stability shoes and clogs in
our study, both of which had higher heels, produced greater knee loads," Shakoor
"Stiffness is also a factor. We've shown in earlier studies that barefoot
walking is associated with lower knee loads than walking with conventional
footwear. It may be that the flexible movement of the bare foot is mechanically
advantageous. The natural flex of the foot when it contacts the ground probably
attenuates the impact on the joint, compared to the artificial 'stomping'
movement created by a stiff-soled shoe."
In the present study, Shakoor said, flip-flops and the walking shoe were flat,
flexible and lightweight and seemed to mimic the mechanics when walking with
"Clogs and stability shoes, conventionally believed to provide appropriate
cushioning and support, actually increased the loading on the knee joints, as
opposed to shoes with less 'support,' flatter heels and more flexibility,"
ANI / Times of India