Greater first metatarsophalangeal joint range is associated with less pain in female patients with plantar fasciitis

Abstract

Introduction: Deficit in the first metatarsophalangeal joint (MTPJ) extension range is suggested as one of the intrinsic risk factors for Plantar fasciitis. However, the relationship between MTPJ range and intensity of pain and dysfunction has not been explored. The purpose of this study was to determine if a difference exists in extension Range of Motion (ROM) of the first MTPJ between PF sufferers and healthy controls; and to explore its association with intensity of pain and dysfunction.Methods: Thirty-six patients (22 female) with unilateral plantar fasciitis (19 on the dominant foot) and 21 healthy controls were recruited. Active and passive ROM of first MTPJ extension were assessed. In the healthy control, side-to-side difference on the joint range was compared using repeated measure analysis of variates with gender as a factor. Multivariate analysis of variates was used to compare MTPJ extension range between patients and healthy control matched with leg dominance, and with gender and body mass index as covariates. Partial correlation coefficient tests were conducted to assess relationships between MTPJ extension range and intensity of pain and dysfunction controlled with BMI, activity level and affected side. Results:The active and passive MTPJ range was significantly greater in the dominant than non-dominant feet (all p < 0.05) in the healthy controls. Female patients had significantly larger passive MTPJ extension range (p = 0.034 and 0.006) for patients with the dominant and non-dominant feet being affected, respectively). Significant correlation was detected between the passive MTPJ extension range and intensity of pain (r = -0.54, p = 0.017) and pain score of foot functional index (r = -0.47, p = 0.042) in the female patients. Conclusions:In female patients with plantar fasciitis, increased passive metatarsal phalangeal joint extension range is detected, and a larger extension range is associated with less pain.