Journal of Orthopaedic & Sports Physical Therapy
Published Online: May 7, 2021 Pages1-29
https://www.jospt.org/doi/10.2519/jospt.2021.10018
Abstract
Objectives
To determine the independent associations of potential clinical, symptom, physical activity, and psychological factors with chronic plantar heel pain.
Design
Case-control.
Methods
We investigated associations by comparing 220 participants with chronic plantar heel pain (>3 months) and 100 age- and sex-matched controls recruited randomly from the electoral roll. Exposures measured were waist girth, BMI, body composition, clinical measures of foot and leg function, physical activity by accelerometry, depression and pain catastrophising, symptoms of prolonged morning stiffness anywhere in the body, and multisite pain. Data were analysed using multivariable conditional logistic regression.
Results
Waist girth (cm) (OR 1.06; 95% CI 1.03 to 1.09), ankle plantar flexor strength (kg) (OR 0.98; 95% CI 0.97 to 0.99), pain at multiple sites (OR 2.76; 95% CI 1.29 to 5.91 (pain at 1 other site), to OR 10.45; 95% CI 3.66 to 29.81 (pain at 4 or more other sites)) and pain catastrophising status (none, some or catastrophiser) (OR 2.91; 95% CI 1.33 to 6.37 (some), OR 6.79; 95% CI 1.91 to 24.11 (catastrophising)) were independently associated with chronic plantar heel pain. There were univariable but not independent associations with morning stiffness, first metatarsophalangeal joint extension ROM, depression and BMI, and no significant associations with physical activity or body composition by bioimpedance analysis.
Conclusion
Waist girth, ankle plantar flexor strength, multisite pain and pain catastrophising, but not foot-specific factors, were independently associated with chronic plantar heel pain. Three of four of these factors reflect central or systemic associations. J Orthop Sports Phys Ther, Epub 7 May 2021. doi:10.2519/jospt.2021.10018