Highlights
- •Altered foot mechanics exist in runners with plantar fasciitis.
- •Differences in mechanics were noted between current and resolved plantar fasciitis.
- •A lowered arch during running may cause or prolong plantar fasciitis symptoms.
Abstract
Background
The biomechanical factors related to plantar fasciitis are not well understood. A
history of injury is considered a risk factor for subsequent injury, but it is unknown
if differences in mechanics exist before, during, and after injury. This study compared
gait mechanics among individuals with plantar fasciitis, resolved plantar fasciitis,
and uninjured controls.
Methods
Thirty male and female runners were divided into three groups: 1) plantar fasciitis
(n = 10, age 43 ± 11 years); 2) resolved plantar fasciitis (n = 10, age 43 ± 13 years); and 3) control (n = 10, age 38 ± 11 years). Participants ran at preferred velocity and 3.3 m/s while
kinematics and kinetics were collected. Variables of interest include vertical loading
rate, foot, ankle, knee, and hip kinematics, arch height index, arch rigidity index,
and arch drop. Group differences were analyzed at each velocity using one-way analysis
of variance.
Findings
The plantar fasciitis group exhibited less forefoot extension (P = 0.02), more midfoot inversion (P < 0.01), and more midfoot extension (P < 0.01) than the resolved plantar fasciitis group. Foot mechanics in controls did not
differ. Sagittal knee range of motion was greater in the plantar fasciitis group than
resolved or control (P = 0.01). No other variables were significantly different among groups.
Interpretation
The plantar fasciitis group exhibited dynamic foot mechanics which suggest a lower,
more flexible arch compared to the resolved group, although static measures of foot
structure and ankle motion did not differ. The differences between these groups indicate
that the motion of the forefoot and midfoot during gait are important to consider
for plantar fasciitis.
Keywords
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References
- Plantar fasciitis and the windlass mechanism: a biomechanical link to clinical practice.J. Athl. Train. 2004; 39: 77-82
- Arch height index measurement system: establishment of reliability and normative values.J. Am. Podiatr. Med. Assoc. 2008; 98: 102-106https://doi.org/10.7547/0980102
- Multi-segment foot kinematics and ground reaction forces during gait of individuals with plantar fasciitis.J. Biomech. 2014; 47: 2571-2577https://doi.org/10.1016/j.jbiomech.2014.06.003
- Reliability of a Multisegment Foot Model in Shod Running.([Unpublished masters thesis]) University of Nevada, Las Vegas2015
- Proximal and distal influences on hip and knee kinematics in runners with patellofemoral pain during a prolonged run.J. Ortho. Sports Phys. Ther. 2008; 38: 448-456https://doi.org/10.2519/jospt.2008.2490
- The mechanics of the foot. II. The plantar aponeurosis and the arch.J. Anat. 1953; 88: 25-31https://doi.org/10.1159/000141121
- The arch-height-index measurement system: a new method of foot classification.Athl. Ther. Today. 2006; 11: 56-57https://doi.org/10.1093/eurheartj/ehq023
- Current concepts review: plantar fasciitis.Foot Ankle Int. 2008; 29: 358-366
- Rear-foot, mid-foot and fore-foot motion during the stance phase of gait.Gait Posture. 2007; 25: 453-462https://doi.org/10.1016/j.gaitpost.2006.05.017
- What are the main running related musculoskeletal injuries? A systematic review.Sports Med. 2012; 42: 892-905https://doi.org/10.2165/11631170-000000000-00000
- Load analysis and sports injuries in the lower extremities.Sports Med. 1985; 2: 367-379https://doi.org/10.2165/00007256-198502050-00005
- Plantar fasciitis in athletes: diagnostic and treatment strategies. A systematic review.Muscl. Ligam. Tend. J. 2017; 7: 107-118https://doi.org/10.11138/mltj/2017.7.1.107
- Biomechanical and anatomical factors associated with a history of plantar fasciitis in female runners.Clin. J. Sport Med. 2009; 19: 372-376
- Frontal plane multi-segment foot kinematics in high- and low-arched females during dynamic loading tasks.Human Mvmt. Sci. 2011; 30: 105-114https://doi.org/10.1016/j.humov.2010.08.015
- Weekly running volume and risk of running-related injuries among marathon runners.Int. J. Sports Phys. Ther. 2013; 8: 111-120https://doi.org/10.1016/j.orthres.2003.12.011
- The effects of plantar fasciitis and pain on plantar pressure distribution of recreational runners.Clin. Biomech. 2011; 26: 194-199https://doi.org/10.1016/j.clinbiomech.2010.08.004
- Rearfoot alignment and medial longitudinal arch configurations of runners with syptoms and histories of plantar fasciitis.Clinics. 2011; 66: 1027-1033https://doi.org/10.1590/S1807-59322011000600018
- Dynamic patterns of forces and loading rate in runners with unilateral plantar fasciitis: a cross-sectional study.PLoS One. 2015; 10: 1-9https://doi.org/10.1371/journal.pone.0136971
- Risk factors associated with the development of plantar heel pain in athletes.Foot. 2001; 11: 119-125
- What are the main risk factors for running-related injuries?.Sports Med. 2014; 44: 1153-1163https://doi.org/10.1007/s40279-014-0194-6
- Epidemiology of ankle and foot overuse injuries in sports: a systematic review.Scand. J. Med. Sci. Sports. 2013; 23: 669-686https://doi.org/10.1111/j.1600-0838.2012.01509.x
- A prospective study of running injuries: the Vancouver sun run “in training” clinics.Brit. J. Sports Med. 2003; 37: 239-244https://doi.org/10.1136/bjsm.37.3.239
- A retrospective case-control analysis of 2002 running injuries.Brit. J. Sports Med. 2002; 36: 95-102https://doi.org/10.1136/bjsm.36.2.95
- Comparison of three methods for computing loading rate during running.Int. J. Sports Med. 2016; 37: 1087-1090https://doi.org/10.1055/s-0042-107248
- Injuries in runners: a systematic review on risk factors and sex differences.PLoS One. 2015; 10e0114937https://doi.org/10.1371/journal.pone.0114937
- Incidence and determinants of lower extremity running injuries in long distance runners: a systematic review.Sport En Geneeskunde. 2007; 40: 16-29https://doi.org/10.1136/bjsm.2006.033548
- Sagittal movement of the medial longitudinal arch is unchanged in plantar fasciitis.Med. Sci. Sports Exerc. 2004; 36: 1761-1767https://doi.org/10.1249/01.MSS.0000142297.10881.11
- The pathomechanics of plantar fasciitis.Sports Med. 2006; 36: 585-611https://doi.org/10.2165/00007256-200636070-00004
- The extensibility of the plantar fascia influences the windlass mechanism during human running.Proc. R. Soc. B Biol. Sci. 2021; 288https://doi.org/10.1098/rspb.2020.2095
- Running status and history: a self-report study.Phys. Ther. Sport. 2019; 39: 8-15https://doi.org/10.1016/j.ptsp.2019.06.003
- Measurements used to characterize the foot and the medial longitudinal arch: reliability and validity.Phys. Ther. 2000; 80: 864-871https://doi.org/10.1093/ptj/80.9.864
- Arch structure and injury patterns in runners.Clin. Biomech. 2001; 16: 341-347https://doi.org/10.1016/S0268-0033(01)00005-5
- Pain scale for plantar fasciitis.Foot Ankle Online J. 2009; 2https://doi.org/10.3827/faoj.2009.0205.0003
Article Info
Publication History
Published online: June 27, 2022
Accepted:
June 24,
2022
Received:
October 7,
2021
Identification
Copyright
© 2022 Elsevier Ltd. All rights reserved.
