Healthcare professionals are known for blaming a large number of health conditions on obesity for example, heart disease, high blood pressure, cancer, arthritis etc. Many plantar fasciitis sufferers that visit their GP (general practice doctor) are often told they need to lose weight and are promptly rushed out of the door without much further advice. This can lead to many patients not feeling understood and that their weight is wrongfully blamed by their doctor as the cause of their heel pain. So, is it fair to blame being overweight as the cause of plantar fasciitis? Or is it an easy scapegoat for the GP to use? Read on to find out.
It is a logical assumption that the higher a person’s total body weight (body mass index), the higher the peak pressure placed on the foot as this is the body’s main weight bearing support structure. This excessive peak pressure placed on the heel is believed to be a primary intrinsic risk factor for the development of plantar fasciitis.
Research supports the logical assumption above by demonstrating that obese adults experience higher plantar pressures in comparison to non-obese adults (Hills et al 2001). One study observed that individuals with a body mass index (BMl) > 30 kg/m had an odds ratio of 5.6 for plantar fasciitis compared to those with a BMI < 25 kg/m2 (Riddle et al 2005). Another study consisting of 1411 patients found that being overweight or obese significantly increased the chances of having tendinitis in general. The authors of the study concluded that if a person is overweight or obese, there is an increased likelihood of plantar fasciitis (Frey & Zamora 2007). There is an additional explanation for the link between high BMI and plantar fasciitis, Faria et al (2009) found that as body mass index increases, muscle-tendon unit stiffness also increases. This suggests that people with a higher BMI will have an increased risk of a tight Achilles tendon which as we know, increases the risk of developing plantar fasciitis (see one of my previous articles for more details on this here).
If you are overweight and suffer from plantar fasciitis it is of paramount importance that you include weight loss as part of your treatment plan. Some readers may not like or want to read this, however it's the truth. Ignoring this simple component may prevent you from gaining the most out of your treatment as carrying excess weight is linked to plantar fasciitis. This does not mean that losing weight is the key to curing plantar fasciitis as there are many people with a health body weight that suffer with plantar fasciitis, but by losing weight you are addressing one of the most likely causes. Weight loss can be achieved in a number of ways. Amongst the most effective are diet and exercise. Understandably, this is easier said than done however there are many weight loss programmes readily available that can help you achieve this.
With regards to exercise as a weight loss method, I recommend low-impact activities such as cycling, using a cross trainer or rowing machine or swimming as these will not cause impact related pain to the heel. Running, particularly on a hard surface not recommended and may worsen your plantar fasciitis as it is a high impact activity.