What are the risk factors for plantar fasciitis?

From the Guidelines

Plantar fasciitis risk factors include obesity, prolonged standing or walking, high-impact activities, improper footwear, tight calf muscles, and foot structure abnormalities, as supported by recent guidelines 1. These factors contribute to the development of plantar fasciitis by placing additional stress on the plantar fascia, altering normal foot mechanics, and creating abnormal tension. Key risk factors to consider include:

• Excess weight, which increases stress on the plantar fascia
• Occupations requiring extended periods on feet, which increase strain
• High-impact exercises, such as running, especially with sudden intensity increases, which can trigger inflammation
• Shoes with inadequate arch support or worn-out soles, which fail to properly distribute pressure
• Tight Achilles tendons and calf muscles, which limit ankle flexibility and transfer stress to the fascia
• Structural issues, such as flat feet or high arches, which alter normal foot mechanics and create abnormal tension
• Age, with plantar fasciitis most common between 40-60 years
• Previous foot injuries, which can predispose individuals to this condition by altering gait patterns Understanding these risk factors is crucial for prevention through appropriate footwear selection, gradual exercise progression, weight management, and regular stretching of calf muscles and the plantar fascia, as recommended by recent studies 1. Additionally, guidelines suggest that people with diabetes at risk of foot ulceration should receive annual foot examinations to identify high-risk foot conditions, including assessment of protective sensation, foot structure and biomechanics, vascular status, and skin integrity 1. Proper footwear, including well-fitted walking shoes or athletic shoes that cushion and redistribute pressure, is essential for managing and preventing plantar fasciitis, especially in individuals with high-risk foot conditions 1.

From the Research

Risk Factors for Plantar Fasciitis

• Increased plantarflexion range of motion, body mass index, and body mass are risk factors for plantar fasciitis, as shown in a systematic review and meta-analysis 2
• Physically active individuals with these risk factors may be more likely to develop plantar fasciitis
• Other potential risk factors, such as age and activity level, are not explicitly mentioned in the provided studies, but may be relevant based on the context of plantar fasciitis

Treatment and Prevention

• Orthotics, both prefabricated and custom fitted, can reduce pain and improve function in adults with acute plantar fasciitis 3
• Steroid injections may be effective in reducing heel pain in the short-term, but the evidence is of low quality and the effects may not last beyond one month 4, 5
• Other treatments, such as physical therapy and lifestyle modification, may also be effective in managing plantar fasciitis, but the evidence is limited

Key Findings

• A systematic review and meta-analysis found that increased plantarflexion range of motion, body mass index, and body mass are risk factors for plantar fasciitis 2
• A study on the effectiveness of corticosteroid injection in the treatment of plantar fasciitis found that it can provide short-term pain relief, but the effects may not last beyond 4-12 weeks 5
• Another study on injected corticosteroids for treating plantar heel pain in adults found that the evidence for its effectiveness is of low quality, and the risks and benefits need to be carefully considered 4