Minimalist footwear reduces patellofemoral joint loads during running

1. In this systematic review and meta-analysis, it was found that minimalist footwear reduced the load experienced by the patellofemoral joint during running more than conventional footwear.

2. In addition, medial support insoles and rocker-soled shoes did not impact patellofemoral joint loads while walking or running.

Evidence Rating Level: 1 (Excellent)

Symptoms associated with patellofemoral pain and patellofemoral osteoarthritis may be persistent even several years after diagnosis. Strategies that alter joint biomechanics (e.g., through footwear and insoles) have therapeutic potential but have not been studied extensively. As a result, the objective of the present study was to evaluate the efficacy of footwear interventions on the biomechanical load experienced while running, and/or walking in individuals with and without patellofemoral pain or osteoarthritis.

Of 11,953 identified records, 33 studies (22 footwear studies, 11 insole studies, n= 578 total participants) were included from various databases from inception to October 2022. Studies were included if they investigated either healthy adults or those diagnosed with patellofemoral pain or arthritis, used a biomechanical foot-based intervention, had a control group that received either no intervention or another eligible biomechanical foot intervention, and measured patellofemoral loads during walking and/or running. Grey literature was excluded. The review was performed using PRISMA guidelines. The risk of bias was assessed using the Revised Cochrane Risk of Bias 2 tool for randomized cross-over trials. The primary outcome was patellofemoral joint load during walking and/or running.

The results demonstrated that only minimalist footwear showed a reduction in patellofemoral joint loads during running compared to conventional footwear. Furthermore, medial support insoles and rocker-soled shoes did not impact joint loads during running or walking. However, no studies examined the effects of foot taping or bracing on joint loads. Despite these results, the study was limited by the use of only one author to conduct data extraction, which may have affected the accuracy of the results. Nonetheless, the findings of the present study suggested that minimalist footwear may have a therapeutic benefit by reducing joint loads in those with patellofemoral pain or osteoarthritis.

Click to read the study in British Journal of Sports Medicine

Image: PD

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