Joint Load and Osteoarthritis

Joint load is a term that often appears in osteoarthritis studies, especially those pertaining to knee osteoarthritis. Joint load refers to the force put on a weight-bearing or load-bearing joint during activity. Researchers are trying to determine the impact of joint load on the pathology or progression of osteoarthritis. In other words, does decreasing joint load slow the progression of osteoarthritis? What can help to decrease joint load?

Joint Load and Knee Osteoarthritis

Let's look at knee osteoarthritis since the knee is the joint most commonly affected by the disease; it's also a weight-bearing joint. Your knee, if aligned perfectly, has its load-bearing axis in a straight line that runs through the hip, knee and ankle joints. If your knee is mal-aligned because of deformity associated with cartilage damage, abnormal force is applied to specific areas of the knee.

The abnormal force applied to the knee can cause increased pain and other symptoms. Researchers also have linked increased joint loading of the knee to the progression of osteoarthritis. Something called the knee adduction moment (torque) is a factor related to the distribution of load between the medial (inner) and lateral (outer) plateaus of the knee joint. The peak knee adduction moment, which is the maximum medial joint load incurred during walking (through gait analysis), is greater in people with knee osteoarthritis than in those without the disease.

Mechanical measures determined by gait analysis, such as moments and forces, vary depending on the activity performed. Studies have consistently estimated maximum compressive forces of the knee joint to be four to 4.5 times body weight during daily activities. During level walking, some studies have even estimated a higher number. Descending stairs hikes the force to six times body weight, downhill walking hikes the force to eight times body weight, and jumping adds joint load at 20 times body weight. Suffice to say, the knee takes a beating over time. These estimates not only point out the need for reducing joint load, but they also are factored into designing long-lasting knee prostheses.

Decreasing Joint Load

Researchers have evaluated the effect of footwear, cane use, and weight loss on joint load in knee osteoarthritis. Each factor made a difference.

The shoes you choose can impact the joint load on your knee. For example, after comparing high-heel shoes, moderate-heel shoes, arch supports, and walking barefoot, researchers cast a definite vote against high-heels and even moderate heels.

Being overweight adds stress to weight-bearing joints. Did you know that people who are overweight have about four times the risk of developing knee osteoarthritis?

Lateral-wedge insoles and knee braces are additional options for reducing the joint load of the knee. Lateral-wedge insoles change the mechanics of the knee by reducing the varus torque (twisting the knee inward when walking). Regarding knee braces, an "unloader" knee brace is specifically designed to unload stress from the knee.

Bottom Line

It makes common sense that decreasing joint load is beneficial for osteoarthritis patients. Depending on the joints affected in your individual case, discuss your options with a healthcare provider.