What are the risk factors for plantar fasciitis?

Risk Factors for Plantar Fasciitis

The primary risk factors for plantar fasciitis include obesity, foot deformities, limited ankle dorsiflexion, excessive foot pronation, and prolonged standing or walking on hard surfaces, particularly in individuals with diabetes or those engaged in high-impact activities. 1, 2

Biomechanical Risk Factors

Foot and ankle biomechanical abnormalities significantly contribute to plantar fasciitis development:

• Foot structure abnormalities:

  • Forefoot pronation 3
  • High metatarsal pressure during gait 3
  • Flat feet (pes planus) 1
  • High-arched feet (pes cavus) 1
  • Limited ankle dorsiflexion 1

• Foot deformities:

  • Bunions (hallux valgus) 4
  • Hammertoes or claw toes 4
  • Charcot foot deformities 4

Activity-Related Risk Factors

Certain activities and occupational factors increase plantar fasciitis risk:

• Standing/walking patterns:

  • Prolonged standing on hard surfaces 3
  • Increased walking duration 3
  • Repetitive impact activities 5
  • Excessive running 5

• Footwear issues:

  • Inadequate footwear support 1
  • Lack of shoe rotation during work week 3
  • High-heeled shoes 4

Individual Risk Factors

Personal characteristics that increase susceptibility:

• Physical attributes:

  • Obesity/increased BMI 5, 1
  • Age (most common in fourth and fifth decades) 2

• Health conditions:

  • Diabetes 4, 2
  • Peripheral neuropathy 4
  • Peripheral vascular disease 4

Occupational Risk Factors

Work-related factors contributing to plantar fasciitis:

• Medium tenure at manufacturing plants 3
• Frequent ingress/egress from vehicles (truck/forklift drivers) 3
• Jobs requiring prolonged standing 1
• Inadequate supervisor support (trend) 3

Sport-Specific Risk Factors

Athletes face unique risk factors:

• Playing soccer on natural grass (vs. artificial turf) 4
• Defensive position in soccer 4
• Landing after jumps in volleyball 4
• Competitive level sports participation 4

Prevention Strategies

Understanding these risk factors enables targeted prevention:

• Rotate shoes during work week 3
• Use orthoses with medial longitudinal arch support and metatarsal pad 3
• Alternate between sitting and standing postures 3
• Use cushioning mats on concrete surfaces 3
• Implement proper stretching and strengthening exercises 6
• Maintain appropriate body weight 1

Early identification of these risk factors allows for timely intervention to prevent the development of plantar fasciitis, reducing morbidity and improving quality of life for affected individuals.