The inflammation of the plantar fascia, most commonly known as plantar fasciitis, can lead to a number of upsetting symptoms. Patients complain of having difficulties taking the first steps in the morning, of heel pain after prolonged standing/sitting, and of additional changes, such as a reduced range of motion.
With regard to gender, it has been said that plantar fasciitis is equally present in both men and women. However, according to the latest research, it seems that there are clear differences where the appearance of plantar fasciitis is concerned. It seems that this condition is more common in young male athletes[1] and middle-aged women. Today, we are going to discuss the specifics of plantar fasciitis in the male population, shedding some light on the subject.
Contents
What are the risk factors associated with plantar fasciitis in the male population?
Obesity & high BMI
If the condition is diagnosed in middle-aged individuals, who also lead a sedentary lifestyle, the number one risk factor is obesity. In fact, it has been demonstrated that 70% of the patients diagnosed with plantar fasciitis suffer from obesity[2]. The association between high BMI and plantar fasciitis has clearly been made for the non-athletic population.
Occupational hazard
It is possible that the condition occurs in men, due to occupational hazards. For example, a study was performed on factory workers, in order to identify the risk factors associated with the appearance of plantar fasciitis. The study[4] concerned assembly-line workers, identifying the time spent standing on a hard surface, the time spent walking and the number of times going in/out of a forklift, among the most important risk factors. The years of factor work added to the problem. The risk of developing this condition was reduced, by rotating the shoes worn by the staff during the work week.
Pre-existing medical conditions
Pre-existing medical conditions can favor the appearance of plantar appearance, especially if they involve the health of the bones/musculoskeletal system. For example, it has been ascertained that patients between 20 and 40 years of age, diagnosed with spondyloarthropathies, such as ankylosing spondylitis, present a higher risk of developing plantar fasciitis. This may have something to do with the entire posture of the body being affected, thus modifying the support on the soles and arches of the feet (more stress and/or tension on the plantar fascia).
Sedentary lifestyle
A sedentary lifestyle is, without any doubt, one of the most obvious risk factors associated with plantar fasciitis[3]. When one is involved in little or no physical activity, the muscles tend to shorten and the tendons become stiff. Sedentary patients who develop plantar fasciitis present tight calves, their Achilles tendon being weak and prone to tears. They also present a reduced ankle dorsiflexion (tested with the knee extended), which is considered to be a significant risk factor for the appearance of this condition.
Abnormal foot mechanics
Abnormal foot mechanics can be seen in male individuals of all ages and occupations. One of the most common ones is overpronation, which places a lot of stress on the plantar fascia and leads to its subsequent inflammation. However, this is not the only risk factor belonging to this category. Individuals with flat feet, high arches or those who have a tendency for over supination, can develop plantar fasciitis as well.
Weight-bearing activities
Whether they are work-related or not, it is true that weight-bearing activities can favor the appearance of plantar fasciitis in men. This is mostly related to prolonged standing, with too much pressure being placed on the plantar fascia[6]. At the same time, because of such activities, there is inadequate shock absorption at the level of the soles, which can favor plantar fasciitis as well.
Sports participation
At the beginning of the article, it was mentioned that young male athletes present a high risk for developing plantar fasciitis. This is commonly seen in runners but it has also been confirmed in professional soccer players, gymnasts, and dancers. In fact, plantar fasciitis is considered to be one of the most common ankle and foot overuse injuries, in professional athletes.
Running is considered indeed a major risk for plantar fasciitis, whether it is done professionally or as a hobby. Plantar fasciitis is more common in those who are accustomed to running barefoot or use thin-soled athletic shoes (worn-out athletic shoes fall in this category as well). Studies have confirmed that running on pavement, using spiked shoes or presenting abnormal foot mechanics can lead to an earlier onset of plantar fasciitis in runners. It was also confirmed that a high arch is a potential risk factor for runners, in association to developing plantar fasciitis.
Case study
A 2013-published article, in Podiatry Today, presented a number of case studies regarding the treatment of plantar fasciitis[5]. One of the case studies was of a male, over 50 years of age, who had suffered from heel pain in one of the feet, for more than a year. The symptomatology was characteristic, with the pain being worse with the first steps taking in the morning and after prolonged sitting. The patient worked in the military (active duty) and also enjoyed running, for a considerable distance, several times per week.
As the condition was not new, the patient had benefitted from previous therapies, such as stretches, ice massages, wearing night splints and custom orthotic devices, not to mention physical therapy. Upon undergoing physical examination, it was discovered that he presented overpronation. Initially, he underwent extracorporeal shockwave therapy; with the symptoms becoming worse, he decided to go for the surgical intervention. He suffered from complications from the surgery, deep vein thrombosis but, with the right treatment, he successfully recovered and returned to full activity within three months.
Final word
Plantar fasciitis is an inflammatory condition, which affects men in particular categories, such as professional runners, middle-aged individuals who lead a sedentary lifestyle or those who present occupational hazard. What matters is that one does not delay going to the doctor, as this can make the difference between a condition that is easy to treat and one that is accompanied by a number of complications.
References:
[1] Plantar fasciitis, Epidemiology, 2016. http://emedicine.medscape.com/article/86143-overview#a6
[2] Plantar fasciitis, 2012, Journal of Research in Medical Sciences, Mohammad Ali Tahririan et al. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3687890/
[3] Plantar fasciitis: A Concise Review, 2014, The Permanente Journal, Schwarz & Su. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3951039/
[4] Heel pain – Plantar Fasciitis: Revision 2014, Journal of Orthopaedic & Sports Physical Therapy, Martin et al. http://www.jospt.org/doi/full/10.2519/jospt.2014.0303?code=jospt-site
[5] Case Studies in Treating Chronic Plantar Fasciitis, 2013, Podiatry Today, Fullem. http://www.podiatrytoday.com/case-studies-treating-chronic-plantar-fasciitis
[6] Systematic review: plantar fasciitis and prolonged weight bearing, 2015, Oxford Journals – Occupational Medicine, Waclawski et al. http://occmed.oxfordjournals.org/content/65/2/97.full