With osteoarthritis (OA) of the knee, choose the correct type of shoes carefully.
Here are a few tips:

• Avoid heels that are too high or too hard 
• Don’t wear sandals
• Choose shoes with low heels

Whenever possible, avoid walking up or down steep inclines or hills if you have osteoarthritis of the knee. Both put considerable strain on the knee. Walk on flat terrain, instead, whenever possible.

It is equally important to avoid uneven or very soft terrain. Walk on sidewalks rather than in the grass. Choose well-worn paths. Cobblestone roads, which unfortunately can be found in some old European cities, can be particularly unfavorable for the knees.

Cycling does not put as much stress on the knee joints as walking. This is only true, however, if you ride slowly and avoid hilly terrain. It is also necessary to keep the appropriate distance and to always ride safely. If you have gears, always use a lower gear, which does not require you to use a lot of strength. This in turn helps you to avoid situations in which you have to brake suddenly. In addition, we recommend to adjust the seat to the highest possible level. This also helps to relieve pressure, particularly on the kneecap (patella).

Every stair step puts strain on the knee. If you can use an elevator instead of taking the stairs, always take the elevator, even if you travel just one floor or if it means waiting a few minutes. With osteoarthritis of the knee, avoid stairs whenever possible.

If an elevator is not available and you have to use the stairs, you can minimize joint strain by:

• Climbing the stairs very slowly
• Using the handrail to support yourself as much as possible
• With severe osteoarthritis, allowing yourself plenty of time.

Because your knees are your biggest weight-bearing joints, every extra pound you carry increases the stress on them. Try to make sure that you do not have to carry any heavy objects or, if necessary, only very rarely. Your family will surely be glad to help you. You can also try to find someone in your neighborhood or church to help when needed.

Many people are often on their feet for many hours at a time without a break. This puts your knees under considerable strain, even if you do not feel it directly at that moment. Therefore try to follow this rule: “Never be on your feet longer than one hour at a time.” Give yourself a break after every hour, even if only for 5 or 10 minutes. This gives you renewed strength and protects your knees.

When seated, gently stretch your legs and change their position frequently. Avoid folding your legs under your chair, as many people do when sitting at a desk. This is particularly important for those who have osteoarthritis in  the anterior (patellar) part of the knee joint.

Avoid putting pressure on the flexed knee with osteoarthritis. When rising from a chair or bed, push down forcefully with both hands to minimize stress on the knees. You might do this instinctively to avoid pain, but this technique is also important when your knees don’t hurt to prevent further damage.

Choosing the correct furniture is also important. Avoid sitting on low chairs. To really take the load off  your knees, choose chairs with a  higher seat, preferably one with armrests.

Kneeling, whether at home, at work, or in church, concentrates pressure directly on your knees and should be avoided whenever possible. Many activities that require kneeling can usually be accomplished using a low stool or chair instead.

Note: In summary, one basic rule for osteoarthritis is: “Movement yes – strain no.” More information on osteoarthritis of the knee will follow in a future issue of ARTHRITIS INFO. Causes and types of therapy will then be discussed in more detail.