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Shoe-Shopping Tips For Your Osteoarthritis

24th May 2021

We explain why footwear is super-important for managing OA and give tips for buying the best footwear.

With a healthy nutrition and exercise routine, osteoarthritis can become a lot easier to manage. That said, your lifestyle can have a massive impact on the symptoms and severity of your condition. Footwear is particularly important, and uncomfortable shoes you wear with the motto beauty is pain can have significant consequences on your foot, knee, and hip joints. Besides accelerating the development of OA, the wrong shoes can exacerbate existing syndromes.

Keep reading to find out more about the importance of footwear in managing knee OA.

Why Does Footwear Affect The Upper Joints?

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Just because a pair of shoes is designed to provide maximum comfort for your foot doesn’t mean it is comfortable for your entire lower body. Sometimes, the alterations made on shoes to enhance foot comfort can impact the distant parts of your legs, such as your knees or even hips. Because the nerves, muscles, and bones in your legs are all interrelated, shoes that change the feet’ alignment and posture can transmit the extra load to your knee and hip joints. For example, an average pair of walking shoes can result in a 14% increase in the knee load than walking barefoot [1].

The main idea is that you should consider several factors when buying footwear as an OA patient, not only the stylish look or the cozy feeling.

Things to Consider When Buying Footwear for OA

Choosing the Proper Size

Whether you want to relieve your symptoms or prevent further injuries, choosing the right shoe-size can go a long way. Obviously, the first thing to check is whether or not the shoe provides enough room in the toe box, as an overly tight toe box can disrupt the integration in your entire leg.

That said, the shoe length and width are also crucial. A rule of thumb is to bring a paper tracing of the sole of your feet and compare it to the shoe soles.

You might assume that buying an extra-large shoe will get you the much-needed extra space, but that could have a reverse effect. In extra-large shoes, the soles will not bend where they are supposed to, which is the line across your toe joints. This leads to an unequal distribution of the body weight throughout the feet, creating added pressure on your knees.

Avoid Heels

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Regardless of the type of arthritis you have, heels are your worst enemy. Research suggests that heels higher than 1 inch create an extra burden on your forefoot, increasing the risk of foot problems from bunions to hammertoes [2]. However, their impact goes beyond the foot. Studies found that high heels increased the tension across the patellofemoral region behind the knee-cap while also compressing the knee joint and opening the gates to knee degeneration [3].

Removable Insoles

If you are suffering from foot deformities and subsequent problems throughout your leg, your doctor might prescribe you orthotics, inserts tailored to treat the specific issues in your feet. Besides, having the right kind of orthotics in your footwear can positively impact your knee OA by reducing the knee load and the pain.

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However, the only way you can use them in your footwear is if your shoes have removable insoles. This can also allow your foot to go deeper in the shoe, which can benefit you if you are particularly suffering from hammertoes.

Material

The material of the shoe is another factor when deciding what the best footwear for osteoarthritis is. If your feet constantly swell up from inflammation, a rigid material will make it worse by exerting more pressure on the deformed areas. That’s why you should opt for flexible shoes that can stretch and adjust to deformities and swelling. In clinical trials for knee OA, flexible shoes decreased the knee-load by 15% compared to stable shoes [4].

The flexibility should also apply to the laces. Tying-shoes are not a great choice simply because you have to kneel every time you want to tie your shoes or adjust the knot tightness. On the other hand, shoes with elastic laces, Velcro closings, or zippers are more user-friendly, as they allow your foot to slip into the shoe even if it is already tied.

Minimalist/Barefoot

Minimalist natural shoes are becoming more and more popular with the growing body of evidence supporting their role in joint pain relief. With flexible soles and the absence of arch support, these shoes were designed to mimic barefoot walking, which many researchers considered the optimum condition for minimum knee-load [5].

A study with elderly women showed that minimalist shoes caused the minimum knee adduction moment (KAM) and alleviated pain similarly to barefoot walking [6].

The best type of shoe for knee OA depends on your specific conditions and symptoms. One shoe type that works perfectly for one patient can worsen the symptoms in another. So, you should always consult with your practitioner before making any purchase attempts.

[1] Shakoor, Najia et al. “Effects of common footwear on joint loading in osteoarthritis of the knee.” Arthritis care & research vol. 62,7 (2010): 917-23. doi:10.1002/acr.20165

[2] Puszczałowska-Lizis, Ewa, et al. "Foot deformities in women are associated with wearing high-heeled shoes." Medical science monitor: international medical journal of experimental and clinical research 25 (2019): 7746.

[3] Ho, Kai-Yu, Mark G. Blanchette, and Christopher M. Powers. "The influence of heel height on patellofemoral joint kinetics during walking." Gait & posture 36.2 (2012): 271-275.

[4] Paterson, K. L., et al. "Effects of footwear on the knee adduction moment in medial knee osteoarthritis: classification criteria for flat flexible vs stable supportive shoes." Osteoarthritis and cartilage 25.2 (2017): 234-241.

[5] Shakoor, Najia, and Joel A. Block. "Walking barefoot decreases loading on the lower extremity joints in knee osteoarthritis." Arthritis & Rheumatism 54.9 (2006): 2923-2927.

[6] Sacco, IdCN, et al. "Joint loading decreased by inexpensive and minimalist footwear in elderly women with knee osteoarthritis during stair descent." Arthritis care & research 64.3 (2012): 368-374.

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