People with hip and knee osteoarthritis are often advised to choose appropriate footwear to help minimize their pain. But what exactly does that mean? Should you avoid wearing heels? Is it better to opt for sneakers or shoes with more support? And what about using insoles?
Research, including a recent clinical trial published in the Annals of Internal Medicine, sheds light on these questions. Contrary to popular belief, stable and supportive shoes may not always be the best option for individuals with osteoarthritis.
Osteoarthritis is a condition that affects the tissues surrounding a joint, causing pain and stiffness. It is more common in older individuals and those who are overweight. With approximately 2.35 million Australians currently living with osteoarthritis, the importance of self-management strategies, such as wearing the right shoes, cannot be overstated.
The impact of footwear on osteoarthritis symptoms is significant. Excessive force within the joint during walking is believed to contribute to the development and progression of osteoarthritis. This is where the choice of shoes becomes crucial.
High-heeled shoes, for example, can increase joint forces, putting additional strain on the knees. Supportive features in shoes, such as arch-supporting insoles or stiffer soles, are commonly thought to be beneficial for individuals with osteoarthritis. However, biomechanical research indicates that these features can actually increase knee forces by up to 15%.
So, are flat, flexible shoes without stable supportive features a better choice for individuals with knee and hip osteoarthritis? While these shoes may reduce knee forces, recent clinical trials have shown mixed results in terms of pain relief.
A study involving individuals with hip osteoarthritis found that flat flexible shoes were no more effective than stable supportive shoes in reducing hip pain. On the other hand, a separate trial with participants suffering from knee osteoarthritis showed that stable supportive shoes were more effective in reducing knee pain compared to flat flexible shoes.
The discrepancy in findings between knee and hip osteoarthritis trials may be attributed to differences in joint forces and the potential for stable supportive shoes to alleviate pain. However, both trials noted an increase in foot pain among individuals wearing flat, flexible shoes, suggesting that these styles may offer less foot protection.
Ultimately, the choice of footwear for individuals with knee or hip osteoarthritis should be based on individual needs and preferences. While stable supportive shoes may be more beneficial for knee osteoarthritis, there is no clear advantage in terms of hip pain relief. It is also advisable for all individuals, especially older adults, to avoid ill-fitting shoes and high heels to reduce the risk of falls.
If you are struggling with hip or knee osteoarthritis, consult with your healthcare provider for personalized recommendations. Non-surgical treatments, such as exercise, weight management, and pain management strategies, can also play a crucial role in managing osteoarthritis symptoms.
By Kade Paterson, Associate Professor of Musculoskeletal Health, The University of Melbourne and Rana Hinman, Professor in Physiotherapy, The University of Melbourne
This article was originally published on The Conversation and has been republished under a Creative Commons license.
