In 68 people with inner-knee osteoarthritis, a year of personalized foot-angle walking cut pain more than a sham program

What the research found

Study (randomized trial; the journal year is earlier than the news date). ScienceDaily carried the University of Utah account on 10 October 2026. Scott D. Uhlrich and colleagues report in The Lancet Rheumatology (2025; 7(10):e708; doi 10.1016/S2665-9913(25)00151-1). The U.S. Department of Veterans Affairs is listed as the funder. People with mild to moderate osteoarthritis of the inner knee were scanned and walked on a force-sensing treadmill. Each person tried toe-in or toe-out of 5 or 10 degrees. People for whom no angle reduced inner-knee load were excluded. Sixty-eight participants were split into two groups of 34. One group trained a personal foot angle. The other walked with the same sessions but kept their usual angle. Both did six weekly treadmill sessions with a shin device that vibrated when the foot left the assigned angle, then were asked to practice at least 20 minutes a day. A year later, pain on a 0 to 10 scale fell by 2.5 points with the personal angle and 1.3 points with the sham. An exploratory count found a clinically meaningful pain drop in about 91 percent versus 66 percent. One MRI measure of inner-knee cartilage (T1rho) worsened more slowly in the trained group. A second MRI measure did not differ. Two people in the trained group and one in the sham group stopped because pain increased. No severe adverse events were reported. The release does not give the participants' ages or sex. Uhlrich said the same toe angle is wrong for some people and that this is not a home tweak to invent without a measurement. A separate University of Bath trial in Clinical Biomechanics (2026; 134:106776) of 50 people over six weeks found pain improved in every group, including the control, while only one feedback method cut a knee-load measure by 7.6 percent at one month. That trial did not track cartilage for a year. Educational notes. This is not a prescription to turn the toes in or out.

Evidence level: Clinical trial. This is among the stronger kinds of evidence, but one study rarely settles a question.

Read the original at University of Utah / The Lancet Rheumatology