Knee Pain? It’s Gotta be the Shoes


Or does it…?  I know “It’s Gotta be the Shoes” was a popular slogan by Nike in the 90s, but I think we are all smarter than that, right?  We all know that your shoes won’t make you jump like Jordan.  But, can your shoes help eliminate your knee pain?

Honestly, I don’t think it’s that simple, but a new study was just released by the American College of Rheumatology stating that your shoes might be impacting your knee pain.

Newswise — The use of special mobility shoes can help ease knee pain and slow disease progression in people with osteoarthritis, according to research presented this week at the American College of Rheumatology Annual Scientific Meeting in Atlanta.

Osteoarthritis, or OA as it is commonly called, is the most common joint disease affecting middle-age and older people. It is characterized by progressive damage to the joint cartilage—the cushioning material at the end of long bones—and causes changes in the structures around the joint. These changes can include fluid accumulation, bony overgrowth, and loosening and weakness of muscles and tendons, all of which may limit movement and cause pain and swelling.

“Forces on the knee joint during walking have been shown to be related to pain, severity and progression of knee osteoarthritis,” explains Najia Shakoor, MD; associate professor of medicine at Rush University in Chicago and lead investigator in the study. “Therefore, researchers currently investigate strategies to reduce these forces or loads on the knee joint in hopes of preventing progression of the disease.” Dr. Shakoor’s study recently tested these strategies, more specifically, by studying how the use of mobility shoes—flat and flexible shoes, created specifically for this research, that allow natural foot mobility and provide sufficient support for the foot—can affect knee OA.

At the beginning of the study, researchers used a special camera system and a force plate to determine gait (how a person walks) in 16 participants (who were all diagnosed with knee OA through X-rays and based on symptoms) while they walked in their own shoes, in mobility shoes, and barefoot. After this initial evaluation, participants were instructed to wear the mobility shoes a minimum of six hours per day, six days a week for six months. To determine the progression of each participant, researchers performed the same gait analysis that was performed at the beginning of the study at six, 12 and 24 weeks.

Overall, researchers determined that mobility shoes, in comparison to conventional shoes, led to significantly decreased knee loads in the participants. Additionally, they found that longer-term use of the mobility shoes led to even better outcomes in participants – noting a reduction in knee load that increased from 3.7 percent at the beginning of the study to 9.4 percent after six weeks, and to 18 percent at six months. Finally, researchers found that after 24 weeks of wearing mobility shoes, participants experienced an adaptation in their gait (with a knee load reduction of 11 percent) even when wearing conventional shoes – leading researchers to believe that the use of mobility shoes could create beneficial neuromuscular and behavioral changes in how people with OA walk.

“This study showed that specialized footwear was beneficial in reducing knee loads substantially over six months,” says Dr. Shakoor. “It is also the first study to show that chronic use of a mechanical, knee-load reducing intervention could lead to favorable alterations in the way participants walk – even once the intervention is removed. “

Now, a couple things I want to point out:

1. I don’t think it’s that easy. I don’t think you can buy a new pair of shoes and eliminate why you have knee pain.  Yes, I think you can ease the pressure on the knee joint, as indicated by this study, but you aren’t eliminating the biomechanical breakdown of the knee joint and how it’s functioning.  If you want to see how your knee can change just by doing a little work, check this out.

2. Osteoarthritis isn’t a disease! Correct me if I’m wrong, but it’s not cancer, right?  I don’t believe you’re going to die because of OA.  I think it’s a condition, and conditions are changeable. You have to stay focused on why you have OA, why you have OA in one knee and not the other, or why you have it in one knee worse than the other.  Again, as proof that the knee is changeable, click here.  Also, the author states that OA is characterized by “progressive damage to the joint cartilage—the cushioning material at the end of long bones—and causes changes in the structures around the joint. These changes can include fluid accumulation, bony overgrowth, and loosening and weakness of muscles and tendons, all of which may limit movement and cause pain and swelling.”  While I agree that those can result in pain, I still want to know what caused those things to happen. Let’s get to work on that cause rather than treating the effect.

3. Less of a shoe is better than more of a shoe. I think it’s great that they tracked the progress of their patients while wearing mobility shoes.  We recommend the Vibram FiveFinger shoes.  If you haven’t seen them, check them out.  I also wrote a 4-part series (PART 1, PART 2, PART 3, PART 4) on Vibrams and how they will help with overall function, hip pain, breathing, and shoulder pain.

Are you struggling with knee pain?  What have you tried?  If you have questions about how Egoscue can help eliminate your pain and get you functional again don’t hesitate to contact us.

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