Is Concrete The True Cause of Plantar Fasciitis?

Introduction

Plantar fasciitis is one of those modern-day afflictions that affect  individuals across various ‘walks’ of life. In this blog we will highlight the  tapestry of factors contributing to plantar fasciitis, from lifestyle choices to specific biomechanical patterns. But ultimately we will explore the case for the real cause of plantar fasciitis being hard surfaces like concrete and tarmac.

This is the start of the discussion on the widely overlooked role of walking surfaces, particularly concrete and tarmac, in what might be an unseen cause of a growing pain and injury epidemic. We did not evolve on hard, flat surfaces, but now we virtually spend our whole lives on them.

But first, let’s look at some more commonly acknowledged (and also valid) factors behind plantar fasciitis.

Biomechanical Considerations

Biomechanics, the science of body movement is a major layer of the plantar fasciitis puzzle.

• Overpronation and Supination: Excessive inward or outward rolling of the foot alters forces across the foot, increasing the likelihood of developing plantar fasciitis.
• Abnormal Toe-Out or Toe-In: Irregular toe-out or toe-in during walking affects the forces on the plantar fascia.
• Limbs Length Discrepancy: Significant differences in limb length lead to uneven weight distribution, impacting the plantar fascia.
• Hip Abductor Weakness: Weakness in hip abductor muscles alters biomechanics, affecting gait and contributing to plantar fasciitis.
• Calf Muscles: Imbalances in calf muscles, either due to tightness or weakness, affect foot mechanics.
• Forefoot Varus or Valgus: Forefoot tilt affects foot alignment and contributes to plantar fasciitis.
• Flat Feet (Pes Planus) and High Arches (Pes Cavus): Flat feet alter the arch shape, while high arches may not provide sufficient shock absorption.
• Inadequate Shock Absorption: Gait’s lack of proper shock absorption contributes to an increased impact on the plantar fascia.

Understanding these intricate aspects of biomechanics is vital for effective prevention and management of plantar fasciitis.

Age and Weight

The natural ageing process brings changes to the elasticity of the plantar fascia, making middle-aged individuals more susceptible to plantar fasciitis. Additionally, excess body weight places an increased load on the feet, intensifying stress on the plantar fascia. Addressing these age-related factors and maintaining a healthy weight are integral components of a holistic approach to foot health. Whilst it is vital to acknowledge that neither ageing or weight gain are factors that ‘determine’ plantar fasciitis outcomes. They should be considered as contributing factors.

Occupational and Recreational Factors

Certain occupations that demand prolonged periods of standing or walking on hard surfaces contribute significantly to the prevalence of plantar fasciitis. Furthermore, abrupt increases in physical activity levels or inadequate exercise techniques can strain the plantar fascia, leading to discomfort and pain. This obviously ties in with the main theme of this blog, hard surfaces. Yet the amount of time that one’s job and hobbies expose them to hard surfaces can be a key variable that determines who suffers from plantar fasciitis and who does not.

The Case For Hard Surfaces

Consider the stark difference between jumping down from a 6-10 ft high wall onto concrete, versus a soft natural surface like sand. The jarring impact of the concrete, compared to the gentle cushioning provided by sand, serves as a powerful sign post to the daily stress our feet endure on unforgiving urban surfaces. Our ancestors navigated diverse textured terrains, adapting to the earth’s natural contours, while the modern era subjects us to hard, flat concrete and tarmac.

The catastrophic rise in plantar fasciitis cases has coincided with our shift to walking on hard surfaces. Our bodies evolved for soft, dynamic terrains, but must now endure hard unyielding urban landscapes. Since the Victorians invented floor boards and paving stones we have lived mostly on these very hard surfaces.

Imagine how soft sand and mud are under your bare feet compared with concrete and tarmac. That difference is the reason so many of us suffer from plantar fasciitis.

A good example of how harder surfaces affect us is that of soccer players who play both on astroturf and real turf. Virtually all soccer players find that they are far more prone to injuries and pain when they play on astroturf, compared with normal turf. This is because astroturf is far harder and offers less shock absorption than real turf. It is well documented that soccer players suffer far more injuries when forced to train regularly on astroturf.

People in the hospitality and healthcare industries are also often well aware of the impact hard surfaces have on the body. Healthcare and hospitality workers tend to spend extremely long hours standing on hard surfaces, and many of them notice how hard this is on the joints and soft tissues of the lower body. Office workers tend to suffer pain in their spines (from sitting), and hospitality and healthcare workers tend to get pain in their legs and feet from hard surfaces. All good pain clinicians are aware of this trend.

The complexity of plantar fasciitis encompasses various factors, both general and biomechanical. While lifestyle choices, age, weight, and occupation are widely acknowledged contributors, the often-overlooked influence of hard walking surfaces demands global attention.

Chronic pain is no joke and many experts estimate that it’s impact on society is a match for heart disease. So insights into the underlying causes of our pain vital. By visualizing the stark contrast between the impact on concrete and the gentler touch of natural surfaces like sand, we gain insight into the role of hard surfaces as the unseen cause of a pain and injury epidemic. As we navigate urban landscapes, fostering awareness and prioritizing foot health on all terrains become paramount for a resilient and pain-free future.

Yet we won’t be digging up the world’s highways and byways anytime soon. So the good news is that with the right combination of pain treatments, exercise prescriptions, and foot support, we can easily mitigate the impact of hard surfaces on the feet of plantar fasciitis sufferers. This is what we do on a daily basis at Severn Pain & Injury Clinics. And we can vouch for the fact that it works extremely well. Regardless of whats under our feet.