Do Shoes Make a Difference in Knee Osteoarthritis?

Do Shoes Make a Difference in Knee Osteoarthritis?

Osteoarthritis (OA) is a common form of joint disease affecting the neck, back, hands, hips, knees, and other areas. It is often a progressive disease: initial pain can lead to worsening symptoms with time.  Risk factors include:

  • gender (women are more likely to get knee OA)
  • age (OA affects people more often as they age)
  • obesity/being overweight (excessive loads are not healthy for joints)
  • family history (genetics increase risk of the disease)
  • previous joint injury (past damage to a joint may increase risk of developing OA)

Knee OA occurs in 13% of women and 10% of men and a variety of treatments may help relieve pain. Home treatments include skin creams, over-the-counter medications, weight loss, and exercises to improve muscle strength and aerobic fitness; medical procedures for persistent pain involve joint injections and surgery including joint replacement. Changing shoes is a simple modification everyone can make to reduce stress on painful joints.

Many people may weigh in on the process of selecting the correct shoes to reduce joint pain (as I am now). Podiatric or orthopedic medical specialists all the way to shoe outlet employees with on-the-job training probably have an opinion on the best fit for a certain individual. Tools and tests may include measurements of body parts, foot movements, muscle strength, gait tests, pressure-mapping plates, and custom molding to achieve the best fit.  Cushioned shoes, motion control shoes, stability shoes, and neutral shoes are common options to consider, but research has found pairing people with a certain shoe because of their type of foot does not prevent injury and can actually be harmful. “Motion control” shoes, with higher heels and layers of immobilizing cushion, can actually increase stress on the knee.

Research shows wearing flexible shoes without a significantly raised heel can reduce strain on a painful knee. Recently, a study found that a flexible (8mm thick), lightweight shoe without a heel helped women with knee osteoarthritis reduce knee stiffness, pain, and dependence upon medication during a six-month period compared to women using conventional shoes. Knee stress, measured with an array of cameras during walking, reduced by 21.8% at the end of six months in the women who had used the flexible shoes but not in those who had walked in conventional shoes at home. This was measured while each group wore flexible shoes. This may mean that the type of shoe a person walked in did not cushion the foot or knee, but simply changed the walker’s movement patterns in a way which reduced pressure on the knees.

Shoes, and how people walk, can change forces on joints. Physical therapists are movement experts and sometimes view shoes as one of many tools to make a positive change in the way people move. To schedule a free injury screen to talk about footwear, knee pain, or osteoarthritis, call UP Rehab Services at any of our locations or visit us online at


Knapik, J. J., Trone, D. W., Tchandja, J., & Jones, B. H. (2014). Injury-Reduction Effectiveness of Prescribing Running Shoes on the Basis of Foot Arch Height: Summary of Military Investigations. Journal of Orthopaedic & Sports Physical Therapy, 44(10), 805–812.

Trombini-Souza, F., Matias, A. B., Yokota, M., Butugan, M. K., Goldenstein-Schainberg, C., Fuller, R., & Sacco, I. C. N. (2015). Long-term use of minimal footwear on pain, self-reported function, analgesic intake, and joint loading in elderly women with knee osteoarthritis: A randomized controlled trial. Clinical Biomechanics, 30(10), 1194–1201.