mechanism and risk factors

Last reviewed 01/2018

Mechanism:

• repeated tensile and compressional stresses on the arched foot
• fascial anatomy focusing stress into narrow band of fibrocartilage
• cycles of tearing and healing Release of chemical mediators of inflammation, producing pain
• eventually, myxoid degeneration and weakening of the fascia
• a pronated, flat foot and rarely a spontaneous rupture
• painful scar tissue and calcification (spur formation)

Risk factors:

• being over 40 and overweight are the main risk factors. Other risk factors:
  • sedentary lifestyle
  • reduced ankle dorsiflexion
  • hard surfaces
  • flat shoes
  • human leucocyte antigen (HLA) B27 associated spondyloarthropathies - this last association includes psoriatic and reactive arthritis and is commonly accompanied by bilateral plantar fasciitis, which confers a poorer prognosis for resolution
  • evidence of an occupational link is sparse, and plantar fasciitis is not recognised as a work-related or industrial injury

Reference:

1. ARC (February 2004). Hands On - practical advice on management of rheumatic disease, 2.