Osteoarthritis is a degenerative joint disease and the most common chronic disease of the joints. However, lifestyle measures can help reduce the effects of osteoarthritis, including footwear choice.
In the United States, according to the Arthritis Foundation, osteoarthritis (OA) occurs in about 27 million people.
OA is most common in the knees, hips, lower back, neck, small joints of the fingers, and the bases of the thumb and big toe. Cartilage provides a lubricated surface between two bones, and when this wears down, it can cause swelling, stiffness, and joint pain.
Though arthritis can occur in joints all over the body, according to the American College of Rheumatology, the lifetime risk of developing OA in the knee is about 46 percent, making it one of the most commonly affected areas.
While an individual cannot reverse the damage done by OA, physical exercise is useful for managing the progression of the disease. Exercise can help to improve muscle strength, decrease joint pain and stiffness, and also reduce the risk of disability.
However, exercising with OA can be uncomfortable. Choosing the right footwear can help ease a person with the disease into physical activity and support the joints during exercise.
In this article, we look at how to choose footwear that supports OA and the different types available.
Athletic shoes fall into two main categories: Stability shoes and neutral shoes.
These consist of a dense, cushioned midsole and heel that help control motion and prevent overpronation.
Overpronation is the tendency of the foot to roll inward more than it needs to for weight distribution and shock absorption.
Stability shoes help keep the foot in a neutral position. This is highly important for people with OA of the knee to reduce pressure and stress on the knee joint.
For people whose feet roll unevenly, stability shoes also provide good cushioning and motion control.
Neutral shoes do not correct for uneven foot rolling but offer good shock absorption and cushioning.
The neutral design also makes adding an insert or custom-molded orthotic easier. Orthopedic doctors and physical therapists often prescribe orthotic insoles to help people with OA.
Assessing normal foot movement
People may not be sure whether their feet roll normally, as they may be overcompensating in their movement or getting used to the motion of the feet.
A podiatrist, orthopedic surgeon, or physical therapist can help recognize abnormal foot motion. They can look at the distinctive wear patterns of running or walking shoes and determine if the cause relates to abnormal pronation.
The importance of shoe choice in knee OA
While the choice of shoe seems to focus on the feet rather than the knees, well-supported feet alleviate pressure from the knees and reduce the wear-and-tear that OA causes.
Elevated pressure on the joints during walking can cause OA to progress more rapidly.
As a result, people should take care to find the right type of shoe to wear, whether performing normal daily activities or walking or running to get in some exercise. However, the choice of footwear becomes especially important during physical exertion, which increases pressure on many joints, including the knee.
Wearing the wrong type of shoe might only make existing problems worse.
People with OA should keep the following factors in mind when shopping for athletic shoes:
Choose well-cushioned shoes
Shoes with plenty of cushioning help prevent shock to the knees while walking or running.
If a shoe has a lot of padding, it will absorb more impact as the foot hits the ground, reducing stress on the knees. Much of the shock never even reaches the knees.
Well-cushioned shoes also help to reduce the impact of walking and even standing on hard surfaces, such as concrete sidewalks.
Pay attention to the soles
Firm midsoles can help prevent feet from rolling inward too much.
When feet roll too far inward, the lower leg and knee rotate inward to a similar extent each time the foot hits the ground. This repetitive inward motion can lead to knee strain and pain.
Make sure they have arch support
Arch supports “build up” the arches, which helps to reduce pain and make walking or running more comfortable.
They are critical for people with extremely flat feet but can provide support for anyone looking to exercise, especially those with OA of the knee.
A lack of support can cause discomfort when walking or running, but arch supports can help alleviate this problem. They also distribute weight evenly, helping with balance.
More importantly, they provide additional shock absorption and relieve pressure from sore areas, such as the ball of the foot. If one foot becomes sore, a person may distribute more weight onto their other leg, placing more stress on that knee.
Get the right size
Many people forgo getting a shoe in the right size and shape for fashion reasons, but for walking and running, a comfortable, well-fitting shoe is vital.
People with wider feet should shop for wider shoes that leave plenty of room in the toe area. Shoes that do not provide enough space for the toes can lead to blisters and other types of foot discomfort.
Lace them up
Athletic shoes should have shoelaces. Lacing up shoes helps minimize pain and risk of injury from tripping. Tightly laced shoes cut down on uneven foot rolling and reduce the amount of impact on the feet and knees.
Lacing shoes up tightly also reduces the pressure on the outside of the foot.
Firmly anchoring the foot in the shoe reduces friction. This helps to prevent blisters. Make sure that the heel does not slip out of the shoe when walking or running.
These steps help to provide robust support for the feet, cutting down on foot, ankle, and knee injuries.
Visit a shoe store where staffers are trained to help customers choose the right athletic shoe. They can make sure that the best shoe for foot type and activity is chosen.
Some shoes are better geared toward running, and others are designed for people who prefer walking.
Be sure to ask questions and try on different types of shoes before finding the right pair. All feet are different, so a doctor might recommend shoes for low arches, unevenness, or knee support, but their suggestion may not necessarily be effective for everyone with OA of the knee.
A person should not have to “break in” shoes. If they are too tight in the store, they may never adapt to the individual’s foot size and shape. Be highly selective – the right pair can support the knee during OA degeneration, but the wrong pair can cause further damage and discomfort.
Visit a podiatrist or another specialist for information about special inserts or orthotics that may help to reduce stress on the joints.
While OA of the knee is not a reversible disease, lifestyle choices, such as exercise and shoe choice, can support the management of the OA and limit the progression of symptoms.
Effective footwear can alleviate OA symptoms in the knee, as it can help facilitate beneficial exercise and reduce stress on the knee joints.
Speak to a physical therapist, podiatrist, footwear store specialist, or orthopedic doctor about whether you should choose neutral or stability shoes. Choose well-padded shoes that are wide enough to accommodate foot shape and long enough to leave space for the toes.
When finding the best walking or running shoes for knee OA, investing in appropriate athletic shoes is important to avoid aggravating the condition further. Be sure to try on as many pairs as you need to ensure that the pair is the right fit and supports the feet well.
Can other wearable items support osteoarthritis management?
Your doctor or physical therapist may recommend a knee brace to reduce stress on the knee while exercising or walking. Many types of knee braces are available, and many people find them highly effective at reducing pain while a person is bearing weight.
Gregory Minnis, DPT Answers represent the opinions of our medical experts. All content is strictly informational and should not be considered medical advice.