How Runners Can Deal with Knee OA

Many runners are unfamiliar with treatments of knee OA (osteoarthritis), a risk factor in heel strike running. We now know that forefoot running is a great way to reduce knee-joint loading. A new report however, found that long-term use of minimalist footwear improves symptoms of OA of the knees, suggesting that wearing minimalist shoes while forefoot running can bring knee osteoarthritis to a screeching halt.

How Minimalist Shoes Help Knee OA

How Runners Can Deal with Knee OA

A study by Souza-Trombini et al. 2015 examined the effects of zero drop, flexible minimalist shoes on knee joint loading, biomechanics and knee pain improvements in knee osteoarthritis sufferers. The control group was asked to wear their own standard running shoes which were inflexible and thickly cushioned. The experiment lasted 6 months where patients were ask to carry out their everyday activities.

The researchers found that minimalist footwear was an effective strategy for pain management of OA knee-related pain because the shoes significantly reduced knee external adduction moment by 22% as compared with standard running shoes.

In contrast, high knee external adduction moments increase loading on the knee-joint and is involved in the development and progression of knee osteoarthritis (Sharma et al. 1998). Heel strike running in cushioned running shoes prolongs knee-joint loading, therefore your knees are asking for trouble if you run this way in these shoes.

Footwear, and running style of course, plays a vital role in maintaining healthy knees. For instance, pain reduction was 2.5 times greater in minimalist shoes than in cushioned running shoes, suggesting that minimalist running shoes brings about greater functional improvements in the knee and that cushioned running shoes dismantle mechanical parameters that sheds loading off the knee.

And consider this an astonishing piece of advice: the researchers stated that to successfully maintain low knee-joint loading, knee OA sufferers should wear minimalist shoes as much as possible to acquire and sustain knee-friendly neuromuscular gait patterns. As for cushioned running shoes,  there are plenty more injuries they cause. Take a stroll through my articles on the dangers of cushioned running shoes.

More From Run Forefoot:

Why Running Barefoot is Good for You

Why Some Forefoot Runners End Up with Sore Calves

Natural Remedies for Muscle Soreness

Factors that Influence Nerve Communication in the Feet

Vibram FiveFingers KMD Sport LS Not For Running

How Cushioned Running Shoes Instantly Impairs Your Forefoot Strike


Sharma, L., Hurwitz, D.E., Thonar, E.J., Sum, J.A., Lenz, M.E., Dunlop, D.D., Schnitzer, T.J., Kirwan-Mellis, G., Andriacchi, T.P., 1998. Knee adduction moment, serum hyaluronan level, and disease severity in medial tibiofemoral osteoarthritis. Arthritis Rheum. 41,

Souza-Trombini et al. Long-term use of minimalist footwear on pain, self-reported function, analgesic intake, and joint loading in elderly women with knee osteoarthritis: a randomized controlled trial.  Clin Biomech, 2015.

Bretta Riches

"I believe the forefoot strike is the engine of endurance running..."

BSc Neurobiology; MSc Biomechanics candidate, ultra minimalist runner & founder of RunForefoot. I was a heel striker, always injured. I was inspired by the great Tirunesh Dibaba to try forefoot running. Now, I'm injury free. This is why I launched Run Forefoot, to advocate the health & performance benefits of forefoot running and to raise awareness on the dangers of heel striking, because the world needs to know.
Bretta Riches

P.S. Don't forget to check out the Run Forefoot Facebook Page, it's a terrific place to ask questions about forefoot running, barefoot running and injury. I'm always happy to help!