Sheepskin boots are leading to increases in knee surgery


With winter approaching, you should be careful of potential harm when wearing certain shoes, including popular sheepskin style boots.

Sheepskin footwear can lack support for the lower limb if people purchase the wrong size or allow the boots to deteriorate, which in turn affects posture and the biomechanics of the body. As often happens, the heel can slip off to the side of the footwear, which then tends to flatten out the arch of the foot and make the foot drift into ‘planovalgus’, otherwise known as flat feet.

Planovalgus then tends to increase external rotation and valgus in the tibia, causing a knock-kneed posture, which then increases what’s referred to as the ‘Q-angle’ in the knee, meaning that more weight is put on the outer side of the knee and more strain on the inner side. It also exacerbates lateral patellar maltracking, which is where the kneecap rubs more on the outer side of the front of the knee, causing anterior knee pain and, eventually, increased wear and tear of the articular cartilage on the back of the patella (kneecap).

The risk of potential knee damage from poor footwear is significantly increased for people with existing conditions or those with naturally poor lower limb posture. If someone born with an inherently poor structure or with poor alignment then wears a poorly supported pair of shoes or boots, this can exacerbate the whole issue and this can then end up being the final straw that pushes them into developing symptoms and actual orthopaedic problems.

Avoiding such footwear is key to avoiding these issues, but working on exercising correctly and improving posture can combat this. I recommend seeking advice from a qualified physiotherapist or biomechanist to assess any posture problems, to work on gait, and to learn how best to exercise, to avoid knee and lower limb issues.

Leading Biomechanist Paul Argent from Human Movement, explains, “Footwear affects the body more than most people realise. Your feet are designed to absorb the force of you striking the ground when walking or running. Footwear can change how your body interacts with the ground, forcing you to land in a way that generates higher forces at particular joints such as the knee. Take notice of the shape and support your winter footwear gives you, as this can be the key to avoiding pain and injury.”

High heels can also often cause problems for knees, with many wearers complaining of pain at the front of the knee. This can be a sign of potential knee pathology, such as articular cartilage damage in the patellofemoral compartment at the front of the knee, which is wear and tear on the back of the kneecap. This is a bit of a ‘red flag’ and a sign that it’s potentially worth investigating the knee with X-rays and an MRI scan to check exactly what is going on inside the joint. The longer these things are left, the worse the damage can become, and the harder it can then be to fix.

Sheepskin boots and high heels may look great, but vanity may come at the cost of potential physical damage to your body. Unsculpted and flimsy footwear can mean that your feet aren’t fixed in one location as you walk, meaning that the lower limb is working harder, with a greater risk of damage. Listen to your body and make sure to not wear flimsy boots every day. Although sheepskin boots can seem like the first choice for comfort this winter, it’s sensible to opt for a sturdy pair of boots with correct arch support and greater support.




2 November 2017


Knee Surgeon London