By Dr. Gray Prant,
Anyone who treats heel pain — technically plantar fasciitis — glosses over one of the single biggest contributors to that pain – excess weight. Often for a podiatrist, it’s the elephant in the room. Let’s address the elephant.
When we are young, the tight band on the bottom of the foot known as the plantar fascia is elastic. The plantar fascia acts like a spring when we walk. With every step our foot collapses a little bit and stretches the plantar fascia. As we propel ourselves into the next step, the plantar fascia rebounds and helps give us that spring forward in our step.
As we get older, the plantar fascia – like our skin – loses some of its elasticity. Unfortunately, we often gain weight as we get older as well. Weight gain as little as 10 or 15 pounds can noticeably increase stress on the plantar fascia. According to this article from Johns Hopkins Arthritis Center, only 10 extra pounds of weight can increase the force on the knee by 30 to 60 pounds with each step, so imagine what that would mean for the foot.
On the bright side, a relatively small amount of weight loss can produce significant results. In a1997 Framingham study of the elderly, it was found that for every 11 pounds of weight lost, the risk of osteoarthritis decreased 50 percent.
We who treat plantar fascia every day see several broad groups of patients. For many of them, weight loss would greatly improve their symptoms.
There are people who have gained a little bit of weight and stand on cement surfaces for many hours. These people are particularly hard to treat because their jobs require them to stand on a rigid surface. For these patients, the best long-term treatment may be addressing what they can change, and sometimes that means losing a little bit of weight.
The second and largest group of people we see with heel pain are those who have gained more than 15 pounds over the years. This group does respond well to various foot treatments, however, I often observe that the most effective treatment can be reaching a normal weight. If medical efforts relieve that person’s pain and allow them to move more and lose weight, our treatment’s effectiveness improves exponentially. In addition, I can almost guarantee those who are 50 or 100 pounds overweight can get relief of their foot problems if they lose that 50 or 100 pounds.
Just think what other health and lifestyle benefits those with foot pain would enjoy from being a normal weight! With the dawning of the New Year, consider this just another reason to pursue healthy lifestyle changes.