Obesity and pronated foot type may increase the risk of chronic plantar heel pain: a matched case-control study
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Damien B Irving, Jill L Cook, Mark A Young and Hylton B Menz
BMC Musculoskeletal Disorders 2007, 8:41
BackgroundBMC journals are open access, which means that anyone can download the full text for free.
Chronic plantar heel pain (CPHP) is one of the most common musculoskeletal disorders of the foot, yet its aetiology is poorly understood. The purpose of this study was to examine the association between CPHP and a number of commonly hypothesised causative factors.
Methods
Eighty participants with CPHP (33 males, 47 females, mean age 52.3 years, S.D. 11.7) were matched by age (+/- 2 years) and sex to 80 control participants (33 males, 47 females, mean age 51.9 years, S.D. 11.8). The two groups were then compared on body mass index (BMI), foot posture as measured by the Foot Posture Index (FPI), ankle dorsiflexion range of motion (ROM) as measured by the Dorsiflexion Lunge Test, occupational lower limb stress using the Occupational Rating Scale and calf endurance using the Standing Heel Rise Test.
Results
Univariate analysis demonstrated that the CPHP group had significantly greater BMI (29.8 +/- 5.4 kg/m2 vs. 27.5 +/- 4.9 kg/m2; P = 0.005), a more pronated foot posture (FPI score 2.4 +/- 3.3 vs. 1.1 +/- 2.3; P = 0.004) and greater ankle dorsiflexion ROM (45.1 +/- 7.1degrees vs. 40.5 +/- 6.6degrees; P < 0.001) than the control group. No difference was identified between the groups for calf endurance or time spent sitting, standing, walking on uneven ground, squatting, climbing or lifting. Multivariate logistic regression revealed that those with CPHP were more likely to be obese (BMI >= 30kg/m2) (OR 2.9, 95% CI 1.4 - 6.1, P = 0.004) and to have a pronated foot posture (FPI >= 4) (OR 3.7, 95% CI 1.6 - 8.7, P = 0.002).
Conclusions
Obesity and pronated foot posture are associated with CPHP and may be risk factors for the development of the condition. Decreased ankle dorsiflexion, calf endurance and occupational lower limb stress do not appear to play a role in CPHP.
Cheers,
Hylton
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