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A randomized, placebo-controlled trial found that people with mild to moderate arthritis on the inner side of the knee reported less pain after learning a personalized walking pattern. The 68-person study also reported encouraging cartilage findings, but it does not show that the approach works for everyone or restores damaged cartilage.
A randomized, placebo-controlled trial found that people with mild to moderate osteoarthritis on the inner side of the knee reported less pain after training to walk with an individually selected foot angle. The study followed 68 participants for one year and also reported signs of slower cartilage deterioration, though the findings do not establish that the method works for all people with knee arthritis.
Researchers from the University of Utah, New York University and Stanford University tested personalized gait retraining, a method that changes walking mechanics in an effort to reduce pressure on the affected part of the knee. The trial was published in The Lancet Rheumatology in August 2025, according to the supplied report. The U.S. Department of Veterans Affairs was listed as the trial’s funder.
Participants had MRI scans and walked on a sensor-equipped treadmill while motion-capture cameras recorded their movements. They tested changes that turned the toes 5 or 10 degrees inward or outward. Researchers selected the foot position that reduced loading on each participant’s inner knee most effectively. People for whom none of the tested adjustments reduced knee loading were excluded.
After assessment, 34 participants received individualized walking instructions and 34 received a sham program that involved training but asked them to keep their natural foot angle. At one year, the personalized-training group reported significantly less pain than the sham group. The report says the pain reduction was comparable in magnitude to benefits reported for some commonly used medications; it does not provide the trial’s pain scores or a direct medication comparison. It also describes cartilage results as encouraging signs of slower deterioration, not cartilage restoration.
A Walking Strategy, Not a Cure
The finding matters because gait retraining aims to change the forces placed on the knee, rather than only reducing the sensation of pain. Osteoarthritis can damage cartilage over time, and current treatments can help manage symptoms, but the supplied report says no established treatment reliably restores cartilage already lost to the disease. A non-drug approach that may reduce joint loading could offer another option for some patients.
That possibility comes with limits. The trial studied a small, selected group with mild to moderate disease in a particular part of the knee, and participants were screened to confirm that a tested walking adjustment reduced their knee loading. Its results should not be read as evidence that people can safely choose a toe angle on their own, or that the approach prevents arthritis progression. The findings support further study, not a replacement for clinician-guided care.
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Why Foot Position Was Personalized
The knee’s inner, or medial, compartment often bears more load during ordinary walking than the outer compartment. In people with arthritis affecting that inner region, researchers reasoned that shifting how forces pass through the knee might reduce stress on the vulnerable area. Changing toe direction can alter those forces, but the useful direction varies: one person may benefit from turning the foot inward, another from turning it outward.
Earlier gait-retraining studies prescribed a similar walking change to everyone and produced inconsistent results, according to the report. The investigators said some people in those studies may not have reduced joint loading and may even have increased it. The newer trial’s approach used laboratory measurements to select a pattern for each participant. It was described as the first randomized, placebo-controlled trial to show the effectiveness of personalized gait retraining for knee osteoarthritis over a full year.
“We’ve known that for people with osteoarthritis, higher loads in their knee accelerate progression, and that changing the foot angle can reduce knee load.”
— Scott Uhlrich, assistant professor of mechanical engineering at the University of Utah
Who May Benefit Remains Unclear
The supplied report does not give detailed pain scores, the size of the difference between groups, or the full results for cartilage measurements. It also does not specify how durable the effects are beyond the one-year follow-up, whether participants kept using the walking pattern, or how the method compares directly with medication or physical therapy.
The study included only people whose knee loading could be reduced by one of the tested adjustments. That selection means the results may not apply to everyone with osteoarthritis, including people with disease in other parts of the knee or more advanced disease. The report does not establish whether gait retraining prevents joint replacement or changes the long-term course of arthritis. The proper foot angle is individual, and the study does not support trying to alter walking mechanics without assessment.
Further Testing Is Needed
The trial provides a basis for additional research into how clinicians could identify suitable patients and deliver gait retraining outside a motion-analysis laboratory. Future studies could test the method in larger and more varied groups, report the magnitude and clinical relevance of pain and cartilage changes, and follow participants for longer than a year.
For now, the reported results describe a research intervention, not a universal self-help instruction. Anyone considering changes to walking because of knee pain should discuss them with a qualified health professional, who can help assess the cause of symptoms and appropriate care options.
Key Questions
What did the trial find?
Participants assigned personalized foot-angle training reported significantly less knee pain after one year than participants in a sham-training group. Researchers also reported encouraging signs related to cartilage deterioration, but the supplied report does not give detailed measurements.
What does personalized gait retraining involve?
In the trial, researchers measured participants’ walking and tested small toe-angle changes, turning the feet 5 or 10 degrees inward or outward. Each person received instructions based on which tested position reduced loading on the inner knee.
Can everyone with knee arthritis use this method?
The study does not show that it works for everyone. It focused on people with mild to moderate arthritis on the inner side of the knee, and excluded prospective participants when none of the tested adjustments reduced knee loading.
Does walking training restore cartilage?
No. The report describes signs of slower cartilage deterioration, not cartilage regrowth or restoration. It does not establish that gait retraining reverses damage or prevents the need for surgery.
Should I change my foot angle on my own?
The trial used laboratory measurements to choose a pattern for each participant, and the report says the wrong adjustment could fail to help or increase loading. People with knee pain should discuss walking changes with a qualified health professional rather than treating the study as a do-it-yourself prescription.
Source: rss
