Osteoarthritis affects nearly one in four adults over age 40 and ranks among the leading causes of adult disability. The condition erodes cartilage in the joints, and current treatments focus mainly on pain management since damage cannot be reversed. Joint replacement is considered only in advanced cases.
A year-long randomized controlled trial conducted by researchers at the University of Utah, New York University, and Stanford University tested whether a minor, individualized change in foot angle during walking could ease symptoms. Participants with medial knee osteoarthritis received training to adjust their gait. Those who adopted the modified walking pattern reported pain reduction similar to medication effects. MRI scans also indicated slower cartilage loss compared with a placebo group.
The study, published in The Lancet Rheumatology, was the first placebo-controlled trial to demonstrate that a biomechanical approach can both relieve symptoms and potentially limit joint damage. Lead researcher Scott Uhlrich noted that while altering foot angle to reduce knee load is not a new concept, prior studies lacked rigorous controls.
Because the optimal foot adjustment varies by individual, researchers screened participants to identify whether an inward or outward toe rotation of 5 or 10 degrees would best lower knee stress. People unlikely to benefit were excluded. In the trial, 68 participants were split evenly between the active retraining group and a sham group that maintained their natural gait.
Both groups completed six weekly lab sessions using vibration feedback on the shin to reinforce the assigned foot position. After training, participants practiced the pattern daily. Early follow-up data suggested sustained benefits in pain and joint loading for those who received the personalized intervention.
