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What's the Right Choice of Footwear for Those with Knee Arthritis? Experts are Flipped and Flopped on the Issue!

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Bones & Joints related image Photo: Getty Images

Nothing beats warm spring and summer days that just beg you to sit back, relax, and ditch the heels and uncomfortable career footwear in favor of the barefoot look or at least a pair of fashionable flip flops. This time of year all but requires the ceremonial unveiling of those casual shoes of summer that almost make you feel as if you are going barefoot. Nothing feels better than wearing, well, almost nothing on your feet! However, while those “non-shoes” as I call them are most definitely comfy, how do they measure up as practical foot wear? After all, they don’t seem to offer much in the way of support and stability.

Contrary to popular opinion, flip flops may actually be of some benefit to your skeletal structure, especially if you suffer from knee pain related to arthritis. Studies have shown that wearing flat, flexible shoes may actually reduce the stress placed upon the joints, keeping you more comfortable than the typical clogs or athletic shoes that tout stability features.

In a 2010 study, experts at Rush Medical College in Chicago have suggested that going barefoot is actually good for the knee load, and an in effort to determine if different shoes have varying effects on the knees, this group of researchers compared four types of shoes with going barefoot.

What surprised them is that the shoes typically recommended for patients with knee arthritis, like the stability shoes and clogs, actually produce the highest load on the knees.

The four types of shoes studied were clogs, an athletic shoe, flat walking shoes, and flip-flops. This study was supported by the National Institutes of Health. The researchers measured what is referred to as a knee adduction moment, which essentially measures the extent of the force on the knee as you walk.

The results indicated that while flat walking shoes, going barefoot or wearing flip-flops all produced the same load on the knee, the clogs and stability shoes had a 15 percent greater load.

While these results are preliminary in nature, they do suggest that the flatter, more flexible footwear may decrease loads on the knee compared to shoes that are less flexible and have higher heels. Overall, flatness and flexibility seem to have the greatest impact in the reduction of load on the knees.

The researchers do not intend to advocate continual use of flip-flops, citing that a flat walking shoe would be a better choice, as those do provide more walking stability and minimize the risk of falling.

Other researchers found these results to be surprising. Jeffrey A. Ross, DPM, MD, spokesperson for the American College of Sports Medicine and chief of the diabetic foot clinic at Ben Taub Hospital in Houston, Texas, actually expected the running shoe to be the best option for those suffering from knee arthritis.

In spite of the study results, this podiatrist is still inclined to recommend a low heel running shoe with a flexible sole to his patients as opposed to flip flops as well as flat footwear, noting that individuals who do suffer from arthritis in the knees should wear shoes that bend easily, resulting on reduced stress at the front of the foot. Even a neutral athletic shoe, one without the added features of motion control or stability, might also lighten the load on the knees.

Footwear choices for individuals struggling with knee arthritis are essentially one of trial and error. What works for one person might not produce the same results for another person, and even though flip flops tend to reduce the overall load on the knee, they offer little in the way of support, and for an older person with knee arthritis, this could result in a loss of balance and could increase the risk of falling down, resulting in further injury.

As for me, flip flops will never be an option. Why? As a lifelong runner, I have the most hideous feet. The miles I have logged on the roads have resulted in lost toe nails and a couple of hammer toes. Not even the most competent pedicure specialist could make my feet look good in flip flops. Therefore, I am the one in the summer with the tan line right above the ankle.

(Information for this article was found at http://arthritis.webmd.com/news/20100329/flip-flops-flat-shoes-best-for-arthritic-knees and at http://www.medicinenet.com/script/main/art.asp?articlekey=114828)

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We value and respect our HERWriters' experiences, but everyone is different. Many of our writers are speaking from personal experience, and what's worked for them may not work for you. Their articles are not a substitute for medical advice, although we hope you can gain knowledge from their insight.