Biomechanical dysfunction of the foot is most common cause of plantar fascia disorder and obesity and increasing age are well-known risk factors. Due to being inexpensive and quick, ultrasound imaging techniques are considered the modality of choice to assess plantar fascia. The aim of this study was to investigate the effect of age and body mass index (BMI) on sonographic findings of plantar fascia in normal population. Ultrasonography was used to measure the plantar fascia thickness of 148 healthy adults (54 males, 36.5% and 94 females, 63.5%) during a period of one year. The age, BMI, and walking distance of each participant were recorded and statistically analyzed. The mean plantar fascia thicknesses at 0.5, 1.0, and 2.0 cm distal to the insertion of the plantar fascia were 1.76 ± 0.32 mm, 2.50 ± 0.50 mm and 2.11 ± 0.41 mm respectively. The mean plantar fascia thickness for individuals ≥45 years and BMI ≥25 were significantly higher (p < .001) compared to individuals <45 years and BMI <25. In a normal population, the thickness of the plantar fascia determined by ultrasound measurement was less than 3 mm. We recommend using the position 1.0 cm distal to the calcaneal insertion of the plantar fascia as the reference point for diagnosing plantar fasciitis. The thickness of plantar fascia was significantly increased with age and BMI whereas gender, walking activity, exercise and running did not seem to affect the plantar fascia thickness.
Level of Clinical Evidence
To read this article in full you will need to make a payment
Purchase one-time access:Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
One-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:Subscribe to The Journal of Foot and Ankle Surgery
Already a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
- Long term ultrasonographic follow-up of plantar fasciitis patients treated with steroid injection.Joint Bone Spine. 2005; 72: 61-65
- Imaging of plantar fascia disorders: findings on plain radiography, ultrasound and magnetic resonance imaging.Insights Imaging. 2017; 8: 69-78
- Effect of gender, age and anthropometric variables on plantar fascia thickness at different locations in asymptomatic subjects.Eur J Radiol. 2007; 62: 449-453
- Higher body mass index is associated with plantar fasciopathy/plantar fasciitis: systematic review.Br J Sports Med. 2015; 0: 1-12
- The association between body mass index and musculoskeletal foot disorders.Int Assoc Study Obes. 2012; 7: 630-642
- Extracorporeal shock wave for chronic proximal plantar fasciitis.J Foot Ankle Surg. 2009; 48: 148-155
- Explict finite element modelling of heel pad mechanics in running: inclusion of body dynamics and application of physoiological impact loads.Comput Methods Biomech Biomed Eng. 2015; 18: 1582-1595
- Effects of plantar fascia stiffness on the biomechanical responses of the ankle-foot complex.Clin Biomech (Bristol, Avon). 2004; 19: 839-846
- Plantar fasciitis, sonographic evaluation.Radiology. 1996; 201: 257-259
- Ultrasonographic appearance of the plantar fasciitis.Clin Imaging. 2003; 27: 353-357
- Plantar fasciitis treatment outcome study, plantar fascia measured by ultrasound and correlated with patient self-reported improvement.Foot (Edinb). 2011; 21: 79-83
- Ultrasonographic evaluation in plantar fasciitis.J Foot Ankle Surg. 2007; 46: 442-446
- Assessment the reliability of ultrasonography in the imaging of the plantar fascia: a comparative study.BMC Med Imaging. 2019; 19: 62
- High resolution ultrasonographic diagnosis of plantar fasciitis: a correlation of ultrasound and magnetic resonance imaging.Int J Rheum Dis. 2008; 11: 279-286
- The effect of aging on the biomechanical properties of plantar soft tissues.Clin Biomech. 2010; 25: 601-605
- Gender related effect of aging on the sonographic appearance of plantar fascia.J Musculoskelet Pain. 2014; 22: 33-37
- Effects of body mass index on mechanical properties of the plantar fascia and heel pad in asymptomatic participants.Foot Ankle Int. 2017; 38: 779-784
- Thickness of plantar fascia in asymptomatic subjects.J Med Ultrasound. 2019; 27: 121-123
- Detection of normal plantar fascia thickness in adults via the ultrasonographic method.J Arm Podiatr Med Assoc. 2015; 105: 8-13
- Ultrasound diagnosis of plantar fasciitis.Foot Ankle. 1993; 14: 465-470
- The influence of athletic activity on the plantar fascia in healthy young adults.J Clin Ultrasound. 2006; 34: 17-21
Published online: May 23, 2022
Financial Disclosure: This study was supported by a grant from the Siriraj Research Fund, Faculty of Medicine Siriraj Hospital, Mahidol University.
Conflict of Interest: None reported.
© 2022 by the American College of Foot and Ankle Surgeons. All rights reserved.