Walking is such an integral part of our lives. Whether we need to walk to the shops, or enjoy walking around the park, once you loose the ability to walk, the world closes in on you somewhat.
Osteoarthritis is one of the main reasons people stop walking as they age. The act of loading through the ankles, knees and hips, simply becomes too painful to be worth it. As a result our older generation stop this simple pursuit and in doing so they become weaker and more isolated, exacerbating the physical condition, but also creating psychological ones.
Why is walking so painful with arthritis?
As we age, the cartilage in our knees especially, becomes thinner. This cartilage is designed to stop the bones of the lower leg rubbing on the bones of the upper leg. If the cartilage becomes damaged, the nerve endings become exposed and as they rub this can become extremely painful, especially when walking.
As the leg is straightened, in preparation for standing, the joint closes up and the bones sit closer together. Generally this doesn’t happen in a uniform manner, one side of the knee, or hip will wear at a different rate to another, due to muscle imbalances and ground reaction forces that run through your foot and leg as you walk. Therefore people tend to report pain on the inside or the outside of their knee / hip etc when they walk.
How can we improve our walking?
The first stage is to assess the legs and see whether there are muscle imbalances. We also need to see how the foot responds to standing and walking. If the foot is weak, or there are bunions present, this will affect how the ground reaction forces travel up through your knee. Often they will cause more force and therefore pain on the inside of the knee if the foot is weak.
The starting point is to try to use standard home exercises to restrengthen the foot and the leg. Balance exercises, foot scrunching exercises and leg strengthening using resistance bands are excellent for this and produce great results. They are easy to do, no gym is needed and even if you aren’t very mobile, these can be done sitting down.
If this doesn’t improve your pain, we will ask your GP for an MRI scan on the joint, if this hasn’t already been done. We can arrange for this to be done privately if you would prefer. This will tell us exactly how severe the arthritis is, and most importantly where the arthritis is, so we can modify the strengthening to accommodate this.
I have tried exercise and am still in pain.
If traditional exercise hasn’t worked and you aren’t keen on a knee or hip replacement. The next option is to try the APOS shoe. This shoe redirects the ground reaction forces we discussed above, taking the force away from the painful part of the knee.
This means that you can stand and walk, without experiencing pain. The solution to all Osteoarthritis is exercise, but if it is too painful to exercise you are a bit stuck. This is when your GP will suggest a replacement so you don’t loose your mobility.
However there is now an alternative solution as the APOS shoes will allow you to walk without pain and because the pods on the bottom of the shoes are slightly rounded, as you walk, your muscles are activated. Meaning that when you walk in the shoes, you are also strengthening your legs.
The Apos shoe program lasts around a year, which is how long you need to restrengthen the legs. After a year, the aim is that you are able to head out walking without experiencing any pain, even when you aren’t wearing the shoes. Although the APOS program is available on the NHS, only a few trusts are offering it at the moment, meaning that currently only private options are available for most people. We are the Warwickshire based provider for the APOS shoes and so can offer you a free assessment, if you fancied giving them a go. We also have regular “Come and Try” days where you can have a go quickly and easily.
To find out more about how we treat mild to moderate Osteoarthritis, take a look here.
For more information on the APOS shoe, take a look here.
