# Core Muscle Weakness May Be a Risk Factor for the Development of Plantar Fasciitis

## TL;DR

This study suggests that core muscle weakness, possibly from surgeries like cesarean section or spinal fusion, may increase the risk of developing plantar fasciitis.

## Contribution

The study provides new evidence linking core muscle weakness to the development of plantar fasciitis through a large-scale retrospective analysis.

## Key findings

- Women who had cesarean sections had a 24.1% higher risk of developing plantar fasciitis within a year compared to vaginal births.
- Patients who underwent posterior lumbar fusion surgery had an 11.7% higher risk of developing plantar fasciitis than controls.

## Abstract

Introduction

Plantar fasciitis (PF) is a common diagnosis in the United States and worldwide. Core musculature helps to stabilize the spine in order to prevent buckling and provide optimal production of motion. Core deficits may contribute to lower extremity injury through kinematic changes in lower extremity movement. There may be an association between a theoretical core muscle deficit and the subsequent development of symptomatic PF.

Methods

A retrospective case-control study was designed using the Truven Health MarketScan® database. The incidence of new, concurrent PF diagnoses was determined within one year of the date of specific surgeries (cesarean section and posterior lumbar fusion) and for matched controls. The control group was selected using age, sex, employment, region, insurance, Charlson scores, and/or Elixhauser conditions as variables. The adjusted odds of a new PF diagnosis were determined using logistic regression.

Results

Women who underwent cesarean section had 24.1% greater odds of PF within 12 months of delivery compared to vaginal births (odds ratio (OR) 1.241, 95% confidence interval (CI): 1.152-1.336). Patients who underwent posterior lumbar fusion surgery had 11.7% greater odds of developing PF (OR 1.117, 95% CI: 1.084-1.150) than the control group who did not have an existing core or spinal condition diagnosis.

Conclusion

The risk of developing PF is increased after procedures that might create transient core weakness. Given the results of this model, attention to core strengthening and rehabilitation may be of value in the treatment and prevention of PF.