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 Osteoarthritis?
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 or walking, the joint closes up and the bones sit closer together. Ideally we should load the knee in a uniform manner, with the forces running centrally through the knee or hip. However, this rarely happens. Often one side of the knee, or hip will take more force and will therefore wear at a different rate to the other. This could be due to muscle imbalances affecting the ground reaction forces that run through your foot, leg and hip as you walk. As a result people tend to report Osteoarthritis pain on one side of their knee / hip etc when they walk and more often than not, the inside is the more painful area.
How can we improve our walking?
In order to improve walking, we first need to assess the legs to see whether there are muscle imbalances. We also need to see how the foot responds to the forces of both standing and walking. If the foot is weak, or there are bunions present, this will often affect how the ground reaction forces travel up through your knee and hip. A weak foot will cause more force to travel through the inside of the knee area, creating pain in this area when standing.
The first treatment option for Osteoarthritis 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 write your your GP to request this, or arrange for this to be done privately if you would prefer. This will tell us exactly how severe the Osteoarthritis is and, most importantly where the Osteoarthritis 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 you will often be offered a knee or hip replacement. However, many people aren’t keen on this and now there is an alternative treatment option in the form of the APOS shoe. This treatment involves using a shoe that is designed to redirect 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 which is why your GP will suggest a replacement so you don’t loose your mobility.
The APOS shoe treatment plan utilises a shoe that has pods on the bottom. Specially trained therapists calibrate these pods to redirect the forces that travel up the legs. This means the APOS shoes will allow you to stand and walk without pain, however, the real magic of these shoes is that the pods on the bottom of the shoes are slightly rounded. This creates a slight wobble in your legs, which activates the muscles of your leg. Meaning that when you walk in the shoes, you are also strengthening your legs, this allows you to exercise without pain.
The Apos shoe program lasts around a year, which is how long you need to restrengthen your 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. The APOS program is fully researched and has received NICE approval, meaning it 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 to see whether they can help your Osteoarthritis. 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.