Biomechanical Factors Associated with Plantar Fasciitis in Non-obese Patients

Jong Hwa Lee; Sang Beom Kim; Kyeong Woo Lee; Dong Wook Han

doi:10.5763/kjsm.2011.29.1.9

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Lee, Kim, Lee, and Han: Biomechanical Factors Associated with Plantar Fasciitis in Non-obese Patients

Clinical Article

Korean J Sports Med 2011;29(1):9-14.

Published online: 20 January 2011

DOI: https://doi.org/10.5763/kjsm.2011.29.1.9

Biomechanical Factors Associated with Plantar Fasciitis in Non-obese Patients

Jong Hwa Lee, MD, Sang Beom Kim, MD, Kyeong Woo Lee, MD, Dong Wook Han, MD

Department of Physical Medicine and Rehabilitation, Dong-A University College of Medicine, Busan, Korea

Received 8 September 2010 Revised 1 November 2010 Accepted 17 January 2011

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

The purpose of this study was to identify the biomechanical factors that correlate with plantar fasciitis in non-obese patients whose body mass index were below 25 kg/m². The subjects were non-obese patients who were diagnosed as plantar fasciitis by clinical appearance, physical examination, and ultrasonographic findings (n=48), and non-obese control persons without clinical diagnosis of plantar fasciitis (n=30). The two groups were compared on fat pad thickness, ankle dorsiflexion range of motion (ROM), resting calcaneal stance position (RCSP), incidence of calcaneal spur, and calcaneal pitch. The results showed that, there were statistically significant differences between two groups in ankle dorsiflexion ROM, RCSP, and calcaneal pitch (p＜0.05). Multiple logistic regression analysis showed ankle dorsiflexion ROM and RCSP strongly correlated with presence of plantar fasciitis as independent predictors (p ＜0.05). In conclusion, reduced ankle dorsiflexion ROM and negative RCSP (valgus tendency in rear foot) may be the biomechanical factors associated with plantar fasciitis in non-obese patients.

Keywords: Plantar fasciitis, Biomechanical factors, Non-obese patients

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Fig. 1.

The ultrasonographic image of fat pad thickness of a foot at the unloaded position.

Fig. 2.

Participants were drawn a line connecting 3 points on the midline of rearfoot. And then the investigator recorded the resting calcaneal stance position with gravity goniometer.

Fig. 3.

The calcaneal pitch angle, represented by a line drawn from the plantar surface of the calcaneus to the in-ferior border of the calcaneus-cuboid and line drawn from the plantar surface of the calcaneus to the inferior surface of the 5th metatarsal head.

Table 1.

Demographic characteristics of subjects

	Plantar fasciitis group (n=48)	Control group (n=30)
Gender
Male	12	11
Female	36	19
Age (y)	41.6±13.2	38.7±13.6
Body mass index (kg/m²)	x 23.8±3.7	24.1±3.5
Affected foot Right	27	−
Left	21	−

Values are presented as number or mean±standard deviation.

Table 2.

Comparison of biomechanical factors between plantar fasciitis group and control group

	Plantar fasciitis group (n=48)	Control group (n=30)
Fat pad thickness	7.8±2.4	8.1±2.8
(mm)
Ankle dorsiflexion	12.5±4.7∗	18.4±2.3
ROM (^o)
RCSP (^o)	−3.4±1.1∗	−0.8±1.8
Calcaneal spur	9/48 (18.8)	4/30 (13.3)
Calcaneal pitch (^o	^o) 18.0±4.2∗	22.7±4.9

ROM: range of motion, RCSP: resting calcaneal stance position. Values are presented as mean±standard deviation or num-ber (%).∗p＜0.05.

Table 3.

Estimated contributing factors of plantar fasciitis

Variables	p-value	OR	95% CI
Variables	p-value	OR	Lower	Upper
Ankle dorsiflexion ROM	0.041∗	1.920	1.027	3.593
RCSP	0.046∗	5.608	1.029	30.567
Calcaneal pitch	0.056	2.137	0.981	4.657

OR: odd ratio, CI: confidence interval, ROM: range of motion, RCSP: resting calcaneal stance position.∗p＜0.05.

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