Abstract

ObjectiveOur aims were to examine the effects of heeled shoes on incident knee osteoarthritis (OA) and joint pain.MethodsWe used longitudinal data from the Chingford 1000 Women Study (Chingford Study), a prospective cohort of women aged 50 years or older. Participants with musculoskeletal disorders and/or a history of knee‐related injury/surgery were excluded. Participants were followed for up to 5 years for incident outcomes including 1) radiographic knee OA (RKOA) and 2) joint pain (feet, knees, hips, and back). Footwear data, including ever worn heels of 2 inches or more and daytime/evening hours (per week) spent wearing heeled shoes over five decades (ages <20 years, 20‐30 years, 30‐40 years, and >50 years), were available at Year 10 whereas knee radiographs and joint symptom data were also collected at Year 15. Cumulative time spent wearing heeled shoes was calculated for women reporting ever‐use of heeled shoes (≥2 inches). Multiple logistic regression was used to examine the relationship between exposures and outcomes (from Year 10 to Year 15).ResultsA total of 356 women were eligible at Year 10 with a median (interquartile range) age of 60 (56‐65) years. Compared with non‐use, ever‐use of heeled shoes (≥2 inches) was not associated with incident RKOA (1.35; 95% confidence interval: 0.56‐3.27). No associations were observed between increasing cumulative time spent wearing heels and incident outcomes.ConclusionCompared with the non‐use of heeled shoes, ever‐use of heels (≥2 inches) was not associated with incident RKOA and incident joint symptoms. Further, increasing cumulative time spent wearing heels was not associated with any of our outcomes.

Highlights

  • The effect of footwear as a modifiable factor for the prevention of joint symptoms and knee osteoarthritis (OA) appears to be important; there is insufficient and often conflicting evidence regarding its efficacy [1,2]

  • Abnormal knee loading has been associated with increased risk of knee OA [6], knee torque [7] and, foot position and motion have been associated with knee load (8–1­ 0); in addition, footwear has significant effects on biomechanics [11]

  • A total of 306 (86.0%) women had positive responses to ever having worn shoes with heels of 2 inches or more; of the sites assessed, back pain was the most common type of joint pain occurring in 18.0% of participants

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Summary

Introduction

The effect of footwear as a modifiable factor for the prevention of joint symptoms and knee osteoarthritis (OA) appears to be important; there is insufficient and often conflicting evidence regarding its efficacy [1,2].

Methods
Results
Conclusion

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