Causes of plantar fasciitis: Facts & Myths
Fact or Myth:
Plantar Fasciitis is caused by prolonged standing on concrete floors.
We can try to answer this question using the same scientific methods that have been used to prove that the planets revolve around the sun and that have allowed us to do almost everything we count on in everyday life from cell phones to airplanes to medical practices that save lives.
We can do this by applying the scientific method. Let’s look at one example. How has it been shown that cigarette smoking causes lung cancer. One easy way to do this is to determine the percentage of all patients who smoke in a given population, let’s say Portland. Please don’t get me wrong. I’ve got nothing against Portland. Its just an example.
Let’s say 30% of people in Portland are cigarette smokers. And to be as accurate as possible let’s say all the people in Portland stay there and never move anywhere else. We now ask all the doctors and hospitals to report their cases of lung cancer. If 30% percent of the patients were smokers and 70 percent were not smokers we might not have proved that smoking causes cancer. However, if 90% of the patients with cancer were smokers then this percentage would suggest that smoking cigarettes causes cancer. The branch of mathematics known as statistics provides scientific equations that allow scientists and researchers to determine that in a given population certain risk factors or behaviors lead to certain outcomes such as lung cancer, heart disease and other less dire diagnoses.
Okay, what can we say about whether or not standing for prolonged periods of time on a concrete floor is a cause of plantar fasciitis. If we think for a moment maybe, just maybe plantar fasciitis can be caused by many causes. If that’s the case then it might be harder to prove that prolonged standing on a concrete (PSC) floor is a cause of plantar fasciitis. There is a branch of statistics that can be used to sort out problems like this, that is to say, when multiple variables might singly or collectively lead to a specific diagnosis or problem. If my memory serves me correctly it is called multivariant analysis. It is a system of equations to look at multiple potential causes or connections with a diagnosis, problem or treatment. If there are any statisticians out there please correct me on this.
Bypassing all the equation stuff for now. If PSC is a cause of plantar fasciitis then at some point we must be able to show in the big picture of things that more patients are getting plantar fasciitis who have PSC than patients who do not have PSC. There is a lot of scientific mumbo jumbo that can take into consideration other factors that we will look into such as weight, the shape of the foot, age, and other activities. Still at the end of the day there must be proof that the PCS produces a higher incidence of plantar fasciitis than not standing on concrete for prolonged periods of time. What does science say about this question? The scientific answer is somewhere between no and maybe. But there is definitely no definitive yes. An article entitled “Cumulative Industrial Trauma as an Etiology of Seven Common Disorders in the Foot and Ankle: What is the Evidence?” attempted to look at the role of workplace standing as a cause of heel pain. If you are interested in the details of their analysis I suggest you roll up your sleeves and dig in to the paper. I will leave you with one salient quote from the article. The authors state, “. . . the evidence that the level of activity involved in the vast majority of industrial occupations increases relative risk for the disorder [heel pain, plantar fasciitis] is sketchy at best.”
Therefore, even though we may think that there should be a link between prolonged standing on a hard surface and the development of heel pain (plantar fasciitis) The authors of the aforementioned paper report “what data exist [to address this question] are not only scant but also contradictory.”
- Plantar Fasciitis is caused by poor shoes.
To Be Completed
- Plantar fasciitis is caused by being over-weight.
To Be Completed
- Plantar fasciitis is caused by having flat feet.
To Be Completed