Knee Adduction Moment Reduction Strategies

Ankle-Based Interventions

The American Academy of Physical Medicine and Rehabilitation recommends using full-length laterally wedged insoles to reduce knee adduction moment in patients with mild to moderate medial compartment osteoarthritis, as they can increase foot pronation and shift the center of pressure laterally, thereby shortening the moment arm between ground reaction force and knee joint center 1, 2
The use of full-length wedged insoles has demonstrated knee adduction moment reduction immediately and at 1-3 months in some studies, although heel wedges and two-thirds length insoles have not shown consistent effects 1, 2
Patients with excessive subtalar joint valgus angle may not benefit from laterally wedged insoles, and in some cases, lateral wedges can paradoxically increase rather than decrease knee adduction moment 1, 2

The International Society of Sports Medicine recommends strengthening hip and core musculature to optimize lower extremity biomechanics and reduce knee adduction moment through improved control of the entire kinetic chain 3
Excessive hip adduction during running gait is a predictor of tibial bone stress injuries in female runners and indicates increased adduction moment, highlighting the importance of proximal control 3
The adductor muscle group plays a significant role in controlling knee alignment and moments during dynamic activities, and should be considered in knee adduction moment reduction strategies 3