Risk Factors for Plantar Fasciitis in Physically Active Individuals: A Systematic Review and Meta-analysis.

Plantar fasciitis is common among active people, but doctors and therapists have struggled to agree on what causes it, which makes prevention and treatment harder. A team led by Hamstra-Wright searched through medical databases up to mid-2020 and gathered 16 studies that compared active people who developed plantar fasciitis with those who didn't. They pooled data from 11 of those studies to look at what physical features or movement patterns might increase someone's risk.

Three factors stood out: people with greater flexibility in pointing their foot downward (plantar flexion), those with a higher body mass index, and those who weighed more showed increased risk of developing the condition. The differences were statistically significant but modest in size. The authors suggest that prevention and treatment might start by addressing these three areas, though they emphasize that the overall evidence quality was limited by inconsistencies in how studies defined and diagnosed the condition.

This study looked at what physical characteristics seem to make active people more likely to develop plantar fasciitis. Researchers found that people with more flexibility in their ankle (specifically when pointing the foot downward), those carrying extra weight, and those with a higher body mass index appeared somewhat more prone to developing this condition.

That said, the research was limited because different studies measured and diagnosed plantar fasciitis in different ways, so we should be cautious about drawing firm conclusions. Having one or more of these characteristics does not mean you will definitely develop plantar fasciitis, and many people with these features never experience it.

The findings suggest these are areas that might matter in both preventing and managing the condition, but the science is not yet conclusive enough to say exactly how much each factor plays a role.

This is a summary of research, not medical advice. Talk to your own healthcare provider about anything affecting your care.

This systematic review identified three factors associated with plantar fasciitis risk in physically active populations: increased plantarflexion range of motion (7 degrees greater in affected individuals), elevated body mass index (2.13 kg/m² higher), and increased body mass (4.52 kg heavier). The meta-analysis pooled 11 studies with small effect sizes, and the review was limited to 16 studies overall with inconsistent diagnostic criteria and blinding practices across the included research.

The authors propose that these factors may load the plantar surface structures differently, though the abstract does not elaborate on mechanism. The heterogeneity in study definitions and methodology means these findings should be interpreted as suggestive rather than definitive, and the small effect sizes warrant caution against overweighting any single factor in clinical reasoning.

Further research using standardized diagnostic protocols and prospective designs would strengthen confidence in these associations.