A Surprisingly Simple Way To Relieve Knee Arthritis Pain Without Pills Or Surgery

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A randomized, placebo-controlled trial of 68 people with mild to moderate arthritis on the inner side of the knee found that personalized foot-angle walking training reduced reported pain over one year compared with sham training. The approach is not a universal walking tip: researchers measured each participant’s knee loading to select an adjustment, and the trial does not establish that it restores cartilage or replaces clinical care.

A randomized, placebo-controlled trial found that people with mild to moderate arthritis affecting the inner part of the knee reported less pain after learning a personalized foot position for walking than participants who received sham training. The study followed 68 participants for a year, offering evidence that changing walking mechanics may help some patients without medication or surgery, though the approach was tested under laboratory-guided conditions and is not a do-it-yourself prescription.

Researchers from the University of Utah, New York University and Stanford University assigned 68 participants to two groups of 34. One group practiced a foot angle selected to reduce pressure on the affected part of the knee. The comparison group took part in the same training process but was told to keep its usual foot angle, providing a sham treatment for comparison. The trial was funded by the U.S. Department of Veterans Affairs, according to the report.

Before training, participants walked on a sensor-equipped treadmill while cameras recorded their movement. The team tested small changes, with toes turned 5 or 10 degrees inward or outward, and used the measurements to identify which position reduced loading for each person. Some prospective participants were excluded because none of the tested positions lowered their knee loading. The report says the training lasted six weeks and that pain differences were reported after one year.

The researchers also observed signs consistent with slower cartilage deterioration in the personalized-training group. That finding is encouraging, but it does not show that the technique rebuilds cartilage. The report describes pain relief as comparable in magnitude to benefits reported for some commonly used medications; that is a comparison of reported effect size, not evidence that the method has been tested head-to-head against those drugs.

A Walking Strategy Tailored to the Knee

Knee osteoarthritis can make routine activities, including walking and climbing stairs, painful. The trial matters because it tested a way to alter the forces acting on the joint, rather than focusing only on symptom relief. If further studies support the results, clinicians may have another non-drug option to consider for some patients with arthritis concentrated in the knee’s inner compartment.

Personalization is central to the findings. Turning the toes inward helped some participants, while turning them outward suited others. A general instruction to change foot position could fail to reduce strain or might increase it. The researchers’ approach relied on gait measurements to select a pattern, so the results should not be taken as a recommendation for everyone with knee pain to alter their walking independently.

Why Researchers Tested Foot Angle

The knee’s inner, or medial, compartment often bears more load during ordinary walking than the outer compartment. In people with osteoarthritis in that area, researchers have investigated whether changing the direction of the toes can redistribute forces and reduce stress on vulnerable tissue.

Earlier gait-retraining studies prescribed a similar walking change to everyone and produced inconsistent results, according to the report. Scott Uhlrich, an assistant professor of mechanical engineering at the University of Utah and a co-leader of the study, said that some participants in prior trials did not reduce their joint loading, and some may have increased it. The new trial therefore used individual measurements to choose a foot angle and screened out people who did not show a lower-load option.

The study addresses a condition for which exercise, physical therapy, weight management and medications can help manage symptoms, but no established treatment reliably restores cartilage lost to osteoarthritis, according to the source report. The trial focused on mild to moderate medial knee osteoarthritis; it does not establish the same results for other patterns or more advanced disease.

“We’ve known that for people with osteoarthritis, higher loads in their knee accelerate progression, and that changing the foot angle can reduce knee load.”

— Scott Uhlrich, assistant professor of mechanical engineering at the University of Utah and study co-leader

Limits of the Trial Evidence

The trial included 68 participants with a specific form of knee osteoarthritis, and the source material does not provide detailed numerical pain scores, the size of the cartilage changes, or a full account of adverse effects. It is also not clear from the report how well participants maintained their trained walking pattern after the six-week program, or whether the benefits persist beyond the one-year follow-up.

The study does not show that gait retraining prevents surgery, works for all people with knee arthritis, or can replace medication, physical therapy or other care. The apparent cartilage benefit is described as an encouraging sign of slower deterioration, not proof of cartilage restoration. Readers with knee pain should discuss treatment choices with a qualified health professional rather than adopting a foot-angle change based on the study alone.

Testing the Approach Beyond One Trial

The next step is further research with larger and more diverse groups, longer follow-up and clearer reporting of pain scores, joint changes, adherence and possible downsides. Studies could also establish which patients are most likely to benefit and whether gait assessment can be delivered reliably outside a specialized laboratory.

For now, the findings support continued investigation of personalized gait retraining, not a universal self-treatment rule. People considering a change in walking mechanics can ask a clinician whether a supervised assessment is appropriate for their type of knee arthritis.

Key Questions

What walking change did the trial test?

Researchers tested small changes in toe direction—5 or 10 degrees inward or outward—and selected the position that reduced knee loading for each participant. It was not one fixed adjustment for everyone.

How many people took part?

The trial randomized 68 people, with 34 assigned to personalized gait training and 34 to sham training. Participants had mild to moderate osteoarthritis affecting the inner part of the knee.

Does this method rebuild knee cartilage?

No. The report describes signs of slower cartilage deterioration, but does not show that the technique restores cartilage that has already been lost.

Should people with knee pain change their foot position on their own?

The study used treadmill sensors, motion analysis and individualized testing; it does not support a single self-directed adjustment for everyone. Discuss walking changes and other care options with a qualified health professional.

Source: rss