Risk Factors for Plantar Fasciitis in Physically Active Individuals: A Systematic Review and Meta-analysis

Abstract

Context: Plantar fasciitis (PF) is a common condition in active individuals. The lack of agreement on PF etiology makes treatment challenging and highlights the importance of understanding risk factors for preventive efforts. Objective: The purpose of this systematic review and meta-analysis was to determine what factors may put physically active individuals at risk of developing PF. Data Sources: CENTRAL, CINAHL, EMBASE, Gray Lit, LILACS, MEDLINE (PubMed), ProQuest, Scopus, SPORTDiscus, and Web of Science were searched through April 2018 and updated in April 2020. Study Selection: Studies were included if they were original research investigating PF risk factors, compared physically active individuals with and without PF, were written in English, and were accessible as full-length, peer-reviewed articles. Study Design: Systematic review and meta-analysis. Level of Evidence: Level 3, because of inconsistent definitions and blinding used in the included observational studies. Data Extraction: Data on sample characteristics, study design and duration, groups, PF diagnosis, and risk factors were extracted. The methodological quality of the studies was assessed using the Strengthening the Reporting of Observational Studies in Epidemiology statement. When means and standard deviations of a particular risk factor were presented 2 or more times, that risk factor was included in the meta-analysis. Results: Sixteen studies were included in the systematic review and 11 risk factors in the meta-analysis. Increased plantarflexion range of motion (weighted mean difference [MD] = 7.04°; 95% CI, 5.88-8.19; P < 0.001), body mass index (MD = 2.13 kg/m2; 95% CI, 1.40-2.86; P < 0.001; I2 = 0.00%), and body mass (MD = 4.52 kg; 95% CI, 0.55-8.49; P = 0.026) were risk factors for PF. Conclusion: Interventions focused on addressing a greater degree of plantarflexion range of motion, body mass index, and body mass and their load on the force-absorbing plantar surface structures may be a good starting point in the prevention and treatment of active individuals with PF.

The effectiveness of dextrose prolotherapy in plantar fasciitis

“…Risk factors for developing plantar fasciitis include obesity, overuse, and biomechanical factors. [ 5 , 46 ] Although traditionally thought to be an inflammatory process involving the PF, [ 1 ] Lemont et al discovered that the histopathology of plantar fasciitis is more related to a degenerative process, that is, a form of “fasciosis.” [ 4 ] Consequently, regenerative therapies like PRP injection, ESWT, and DPT have been used in the treatment of plantar fasciitis. [ 24 , 47 , 48 ] In our meta-analysis, DPT demonstrated comparable efficacy to ESWT and PRP injection.…”

“…[ 3 ] Although the etiopathogenesis of plantar fasciitis is still unclear, the degeneration of plantar fascia (PF) is considered an important mechanism. [ 4 ] One recent meta-analysis [ 5 ] found increased ankle dorsiflexion, high body mass index, and high body mass as the most significant risk factors.…”

A Systematic Review of Systematic Reviews on the Epidemiology, Evaluation, and Treatment of Plantar Fasciitis

“…Likewise, Franceschi et al reported a strong association between increased body weight and plantar fasciitis based on four observational studies [21]. These results have been supported by other reviews that specifically investigated risk factors of plantar fasciitis, especially in non-athletic population [22][23][24].…”

“…However, another review concluded that decreased ankle dorsiflexion and decreased first metatarsophalangeal joint extension were weakly associated with plantar fasciitis [22]. The most recent review by Hamstra-Wright et al investigated 16 studies focusing on physically active individuals and identified that increased plantarflexion range of motion was a risk factor [24]. Other biomechanical aspects such as ground reaction forces did not have sufficient studies to draw conclusions.…”

Non-Drug Treatment of Plantar Fasciitis

“…В 2021 г. был проведён систематический обзор и метаанализ факторов риска развития подошвенного фасциита у физически активных людей. В исследовании сравнивались физически активные люди с ПФ и без него, в результате исследования было обнаружено взаимосвязанное влияние большей степени гибкости подошвенных мышц, индекса массы тела и массы тела и их нагрузки на подошвенные поверхностные структуры при возникновении ПФ [4].…”