The pathomechanics of plantar fasciitis

S.C. Wearing, E.M. Hennig, N.M. Byrne, J.R. Steele, A.P. Hills

    Research output: Contribution to journalArticle

    157 Citations (Scopus)

    Abstract

    Plantar fasciitis is a musculoskeletal disorder primarily affecting the fascial enthesis. Although poorly understood, the development of plantar fasciitis is thought to have a mechanical origin. In particular, pes planus foot types and lower-limb biomechanics that result in a lowered medial longitudinal arch are thought to create excessive tensile strain within the fascia, producing microscopic tears and chronic inflammation. However, contrary to clinical doctrine, histological evidence does not support this concept, with inflammation rarely observed in chronic plantar fasciitis. Similarly, scientific support for the role of arch mechanics in the development of plantar fasciitis is equivocal, despite an abundance of anecdotal evidence indicating a causal link between arch function and heel pain. This may, in part, reflect the difficulty in measuring arch mechanics in vivo. However, it may also indicate that tensile failure is not a predominant feature in the pathomechanics of plantar fasciitis. Alternative mechanisms including 'stress-shielding', vascular and metabolic disturbances, the formation of free radicals, hyperthermia and genetic factors have also been linked to degenerative change in connective tissues. Further research is needed to ascertain the importance of such factors in the development of plantar fasciitis.
    Original languageEnglish
    Pages (from-to)585-611
    Number of pages26
    JournalSports Medicine
    Volume36
    Issue number7
    Publication statusPublished - 2006

    Keywords

    • biomechanics
    • fasciitis
    • golf
    • musculoskeletal disorders

    Cite this

    Wearing, S. C., Hennig, E. M., Byrne, N. M., Steele, J. R., & Hills, A. P. (2006). The pathomechanics of plantar fasciitis. Sports Medicine, 36(7), 585-611.