Knee injuries are the most common reason for consulting an orthopaedic surgeon. This largest joints in the body, knees are vulnerable because they are hinge joints rather than ball-and-socket joints. Wear and tear, joint disease and inborn irregularities of gait take their toll on the knee components of cartilage, bones, tendons, ligaments and muscles. Proper shoes help prevent excessive load to knee structures under various conditions.
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Osteoarthritis places a higher load on knees when walking. A study headed by Dr. Najia Shakoor of Rush University in 2010 found the best shoes for lessening knee joint loads have flat, flexible soles which allow natural foot movement. Knee loading was 15 per cent less in flat walking shoes or flip-flops than in clogs or stability shoes. The study recommended flat walking shoes rather than flip-flops for safety reasons.
In 2004, a study published in "The International Journal of Clinical Practice" indicated that wedged insole orthotics inserted into shoes showed promise in reducing knee pain from osteoarthritis.
Pronation is the natural sequence of foot bending and flexing that occurs during walking. The foot rolls slightly inward as the arch absorbs the shock of impact. A problem occurs if this inward rotation is excessive, called overpronation, which causes abnormal stress on lower body joints, including knees.
Check shoe soles for noticeable wear on the inner sides. If you have overpronation, motion-control shoes and stability shoes will help normalise the inner roll. Shoe shape is straight, midsoles are firm with denser material on the inner sides, and heel supports are incorporated. Stability shoes are lighter weight for mild overpronation and motion-control shoes are heavier to help severe overpronation. Orthotic supports can be helpful.
Avoid overly padded shoes, since these can worsen overpronation. It may be necessary to seek professional evaluation.
If your foot does not roll inward sufficiently, it means a bigger load on your knee joints. Usually this happens in those with high inflexible arches. Choose walking shoes that have good cushioning, curved shapes and flexibility.
Regular Wear and Tear
Even if you don't have joint disease or gait problems, it is still important to minimise stress to your knees during walking. A good walking shoe has flexibility through the ball of the foot to allow normal foot movement, adequate arch support and sufficient cushioning to absorb the weight load of one to two times your body weight. Running shoes are built differently and should not be used for walking.
Dr. D. Casey Kerrigan, lead investigator of a 2010 study of the effect of running shoes on lower extremity joints, reported a 36 to 38 per cent increase in knee torque while using them, greater than that recorded while walking in high-heeled shoes.
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