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How does a podiatrist help with osteoarthritis?

Did you know that osteoarthritis is the most common rheumatic condition affecting our musculoskeletal system? Approximately 1.5 million people in the Netherlands have osteoarthritis. And no, not all those people are “above a certain age”. Despite the image of osteoarthritis as a condition that commonly affects the elderly, it also frequently occurs in younger individuals. The joints most commonly affected by osteoarthritis are the knees, hips, joints in the neck and lower back, thumb, fingers, and big toe. Podiatry offers various methods to control osteoarthritis symptoms, mainly in the lower extremities such as toes, feet, ankles, knees, and hips. In this article, we delve deeper into this topic.

Healthy bone (left) en bone with osteoarthritis (right) from Artroseklienieken.nl

What is osteoarthritis? 
Osteoarthritis is a condition that affects the cartilage in your joint(s). The quality of your cartilage diminishes: it becomes thinner, softer, and more brittle, a process known as cartilage breakdown. Sometimes this is accompanied by inflammation in the joint and/or changes in the bone directly underneath it. Visible bumps may form at the edge of your joint. It is also common for the muscles around the affected area to weaken and the tendons to become irritated. Osteoarthritis mainly manifests through pain, stiffness, and difficulty moving. (ReumaNederland, n.d.)

Despite ReumaNederland’s research efforts the cause of osteoarthritis is still unknown. However, the organization has identified various factors that influence the development of osteoarthritis, such as: age, gender (osteoarthritis occurs two to three times more often in women), overweight, and joint damage in the past, for example due to trauma or injury.

Podiatry for osteoarthritis 
To date, there is no treatment that completely eliminates or slows down the effects of osteoarthritis. Academic research published in medical journals does show that podiatry can reduce pain in osteoarthritis symptoms. For example, ‘The Journal of Rheumatology’ published a study on the long-term effects of podiatry in people with knee osteoarthritis. The study found that participants who received podiatric treatments had significantly less pain and limitations in their daily activities after 18 months of treatment compared to participants who did not.

Podiatrists can help relieve pain, reduce stiffness, and restore mobility. The types of advice we can provide include:
… manual therapy to improve mobility in certain joints. 
… analysis and potential adjustment of your gait pattern and posture, which we call gait retraining
… strength and mobility exercises. 
… fitting orthotics to correct foot alignment, thereby reducing the load on the affected joint. 
… appropriate footwear with cushioning and proper support. 
… reducing pressure on bone protrusions or bumps using felt or tape. 
… collaboration with experts and healthcare providers for a holistic approach.

Gait retraining
Gait retraining involves learning a more optimal walking pattern to reduce stress on the affected joint and improve walking efficiency. Research into the effects of gait retraining on knee osteoarthritis shows that it leads to ‘significant improvements in pain and function’, suggesting that it can be a valuable intervention for managing symptoms and improving the quality of life in this population. (Shull et al., 2013) Gait retraining can even reduce the progression of knee osteoarthritis. (Parkes et al., 2016)

How does gait retraining work? 
The podiatrist conducts a gait analysis to assess your walking pattern. In our practice, we use Walk3D or Run3D technology for this analysis. Based on the analysis, the podiatrist recommends adjustments to one or more of the following factors that can improve your walking pattern:

  • Step length and frequency: Shorter and faster steps can reduce stress on the joint. 
  • Foot placement: Placing your foot(s) neutrally can relieve pressure on the affected joint. 
  • Posture and balance: Maintaining good posture and balance while walking helps distribute the load on your joints more evenly, improving stability and making you more comfortable. 
  • Muscle strengthening: Strong muscles help reduce stress on the joint and improve functionality.


Next steps
If you suspect you have osteoarthritis or another joint condition, it is beneficial to see a doctor for a diagnosis. We work closely with Artrosekliniek Amsterdam, our colleagues on the IJsbaanpad, who specialize in conservative (non-operative) treatment of osteoarthritis. As podiatrists, we mainly focus on relieving symptoms and, in collaboration with you, develop a treatment plan that suits your lifestyle.

Curious about the results of a gait analysis? Then book an appointment via the button below or visit us at the end of April during our screening day! This ‘open day’ is entirely dedicated to what we can learn about feet.

This month, we’ll be sharing exercises valuable for osteoarthritis in our mini-series. So keep an eye on our social media and website for more information.

Want to learn more? Then read the following articles:

Parkes, M.J., Callaghan, M.J., O’Neill, T.W., Forsythe, L.M., Lunt, M., Felson, D.T., & Hart, D.J. (2016). Effects of gait retraining in reducing medial compartment knee joint load – A systematic review and meta-analysis. Scientific Reports, 6, 29202.

ReumaNederland. (n.d.). Wat is artrose? Van https://reumanederland.nl/reuma/vormen-van-reuma/artrose/ 

Shull, P.B., Silder, A., Shultz, R., Dragoo, J.L., & Besier, T.F. (2013). Effects of gait retraining on pain and function in patients with knee osteoarthritis: A randomized controlled trial. Journal of Orthopaedic Research, 31(1), 36-44.

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