Do shoes contribute to knee pain, joint deterioration and arthritis? According to recent research published in the medical literature by Drs. Andy Oliver Radzimski and Gisela Sole at the prestigious University of Otago, and Dr. Annegret Mundermann at the University of Constance, Germany, in most cases the answer appears to be a resounding yes.
For many barefoot runners and walkers who have avoided or alleviated their painful knees by shunning supportive shoes, arch supports, and orthotics (custom made arch supports), this research is nothing new. The barefoot community has known for years that barefoot activity is good for our knees, but now science is catching up.
Dr. Radzimski and his co-researchers reviewed the scientific literature on the effect of footwear and arch supports/orthotics on the knee. They looked at the external knee adduction moment (EKAM) when we are wearing shoes and when we are barefoot. EKAM represents knee load distribution from the inside to the outside of the knee joint. The higher the EKAM is, the greater and faster the progressions of deterioration (osteoarthritis) of the knee joint. In simple terms, a high EKAM is bad for our knee, while a low EKAM is good for the knee.
These researchers stunning findings came about after looking at a grand total of 348 scientific articles and including 33 studies in their research. In plain English: these highly educated and respected scientists evaluated all current knowledge and scientific information on the effect of footwear on the knee joint of healthy people and those with knee disorders with regard to EKAM. This impressive analysis of the literature is important because the ardent lovers of supportive shoes believe that our feet need to be encased in footwear will have a difficult time refuting the voluminous amount of scientific research analyzed.
Remarkably, these researchers found that sneakers and running shoes increased EKAM when compared to barefoot walking and barefoot running. Specifically, the knee has a greater load on the inside of the joint when wearing shoes as compared to going barefoot. In fact, the authors of this astounding research say that shoes that provide “stability” (or support) create increased load on the knee joint (again when compared to simply going barefoot).
Radzimski and his co-writers conclude by suggesting that people with knee arthritis on the inside of their knee joint should consider walking barefoot when possible. I recommend this too. Not only will your knees thank you, but your whole body will too.
This new, groundbreaking research is not proof that barefoot is better than wearing shoes, but if you will excuse the pun, it is yet one more step (in fact, a big step) in that direction. I do not expect this amazing research will convince the tiny percentage of supportive-shoe-loving zealots out there to take a step without their feet firmly encased in their thickly-padded shoes, but for the vast majority of people with an open mind, I urge them to give this research a read. More importantly, give barefoot activity a try!
Note: if you do decide to make the leap to barefoot walking or running, begin slowly, read up on the techniques of giving up your supportive footwear or shoes, and if you have any medical problems, proceed only under the care of your physician.
Radzimski AO, et al, Effect of footwear on the external knee adduction moment – A systemic review, Knee (2011), doi:10, 1016/j.knee. 2011.05.013