21/02/2025
What mechanical factors are associated with Plantar Heel Pain (PHP)?
I’d love to have a clear answer here but it appears the evidence is quite mixed! It seems that association is likely with reduced ankle dorsiflexion and decreased toe flexor strength and PHP has been connected with high BMI in non-athletic groups.
Sullivan et al. (2020) note that the association between heel pain and foot alignment is unclear plus there is limited evidence to suggest heel pain is associated with running mileage or weight-bearing at work.
Each of these factors may influence the load on the plantar fascia so there is value in assessing each on an individual basis.
Both athletic and sedentary people can encounter PHP which may be why research findings can vary as different populations may have different causative factors and treatment needs. The key thing is to recognise this and tailor treatment to the person rather than the condition.
Reference:
Sullivan J, Pappas E, Burns J. Role of mechanical factors in the clinical presentation of plantar heel pain: Implications for management. Foot (Edinb). 2020 Mar;42:101636. doi: 10.1016/j.foot.2019.08.007. Epub 2019 Sep 3. PMID: 31731071.
