Plantar Fasciitis and Menopause: Understanding the Hidden Connection

04-02-2025
Menopause brings many changes, but musculoskeletal issues like plantar fasciitis are often overlooked. This blog explores why foot pain may rise during menopause and offers tips to manage and prevent it effectively.

Introduction

Plantar Fasciitis and Menopause: Understanding the Hidden Connection

Menopause is a significant life stage that brings with it a multitude of changes, both visible and unseen. While symptoms like hot flashes and mood changes are widely discussed, musculoskeletal issues are less often mentioned, despite being a common concern for many menopausal women. One such issue is plantar fasciitis—a painful foot condition that many women experience during menopause, often without understanding why it happens. In this blog, we will delve into the link between menopause and plantar fasciitis, explore why this condition may become more prevalent during menopause, and discuss effective ways to manage and prevent it.

Author

Julie Scott

Julie Scott is an NMC registered Independent Nurse Prescriber, Level 7 qualified aesthetic injector, and trainer with over 30 years in plastics and skin rejuvenation.

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What is Plantar Fasciitis?

Plantar fasciitis is characterised by pain and inflammation of the plantar fascia, a thick band of tissue that stretches across the bottom of the foot, connecting the heel bone to the toes. It plays a crucial role in maintaining the arch of the foot and absorbing impact as you walk, run, or move. When this tissue becomes inflamed or strained, it results in a sharp, stabbing pain in the heel, particularly noticeable when taking the first steps in the morning or after periods of rest.

Traditionally, plantar fasciitis is associated with athletes or people who spend long hours on their feet. However, it can also become an issue for menopausal women due to the complex interplay of hormonal changes, weight fluctuations, and other age-related factors. Understanding the factors that contribute to this condition during menopause can help in managing it more effectively.

How Hormones Impact Musculoskeletal Health

The hormonal changes that occur during menopause, particularly the decline in oestrogen, have a substantial impact on connective tissue health. Oestrogen is a key hormone that supports collagen production, providing strength and elasticity to tendons, ligaments, and other connective tissues throughout the body. It also has natural anti-inflammatory properties, which help in maintaining joint health and preventing tissue damage.

As oestrogen levels decline during menopause, collagen production is reduced, which makes connective tissues, including the plantar fascia, less elastic and more prone to microtears and inflammation. Without sufficient oestrogen, the plantar fascia becomes more susceptible to damage, increasing the risk of developing plantar fasciitis. This hormonal shift is often overlooked as a factor in musculoskeletal issues during menopause, but it plays a critical role in conditions like plantar fasciitis, frozen shoulder, and general joint pain.

Why Menopausal Women are at Higher Risk of Plantar Fasciitis

Menopause brings a variety of changes that can increase a woman’s risk of developing plantar fasciitis. Here are some of the key factors that contribute to this increased risk:

Changes in Foot Structure and Biomechanics

With age, changes in foot structure, such as fallen arches or flattening of the feet, can occur. These changes alter the way pressure is distributed across the foot, leading to increased stress on the plantar fascia. Hormonal shifts can also contribute to a weakening of the connective tissues, making structural changes more pronounced and problematic.

Reduced Physical Activity and Muscle Weakness

Many menopausal women experience joint discomfort or fatigue, leading to a decrease in physical activity. Reduced activity can lead to muscle weakness, especially in the muscles that support the arch of the foot. Weakened muscles mean that the plantar fascia has to take on more of the load during movement, which increases the risk of strain and inflammation.

Weight Gain and Increased Pressure on the Feet

Weight gain is common during menopause due to changes in metabolism and hormonal imbalances. This extra weight can place significant stress on the plantar fascia, leading to increased strain, inflammation, and pain. The added pressure on the feet from weight gain makes plantar fasciitis more likely to develop, especially for those who already have other risk factors such as a flat foot structure.

Impact of Bone Health

During menopause, declining oestrogen levels also affect bone density, making women more susceptible to conditions like osteopenia and osteoporosis. While plantar fasciitis itself is a soft tissue issue, weakened bones in the feet can change movement patterns and put extra strain on the plantar fascia, indirectly contributing to the condition.

Recognising and Managing Plantar Fasciitis During Menopause

Recognising plantar fasciitis involves understanding its symptoms—typically a sharp pain in the heel, especially noticeable in the mornings or after periods of inactivity. However, the key to managing plantar fasciitis during menopause lies in addressing the root causes, including hormonal imbalance, weight changes, and lifestyle factors. Here are some effective strategies:

Supportive Footwear and Orthotics

Wearing proper, supportive footwear is one of the easiest and most effective ways to alleviate the symptoms of plantar fasciitis. Look for shoes with cushioning and arch support to help distribute weight evenly and reduce pressure on the plantar fascia. Custom orthotic inserts can provide additional support, especially for those with flat feet or other structural changes.

Stretching and Strengthening Exercises

Regular stretching can help maintain flexibility in the plantar fascia, Achilles tendon, and calf muscles. Stretching exercises, such as calf stretches or using a towel to stretch the arch of the foot, can alleviate tension in the plantar fascia. Additionally, strengthening exercises for the foot and lower leg can help improve stability and support the arch, reducing the load on the plantar fascia.

Weight Management and Diet

Maintaining a healthy weight is crucial in managing plantar fasciitis, as it helps to reduce the stress placed on the feet. A balanced diet rich in anti-inflammatory foods, such as leafy greens, berries, and omega-3 fatty acids, can support overall musculoskeletal health and may help to reduce inflammation in the plantar fascia. Avoiding processed foods and excess sugar is also beneficial, as these can contribute to inflammation.

Hormone Replacement Therapy (HRT)

Hormone Replacement Therapy (HRT) may help mitigate some of the musculoskeletal effects of declining oestrogen. By restoring oestrogen levels, HRT can support collagen production and connective tissue health, potentially reducing the risk of plantar fasciitis. However, HRT is not suitable for everyone, and women should discuss the risks and benefits with their healthcare provider to determine if it is the right choice for them.

Physiotherapy and Professional Interventions

Physiotherapy can be highly effective in treating plantar fasciitis. A physiotherapist can guide menopausal women through exercises that improve flexibility and strengthen the muscles supporting the arch of the foot. In some cases, additional treatments such as shockwave therapy or corticosteroid injections may be recommended to reduce inflammation and promote healing, but these should be approached with caution, particularly for those with weakened bones.

Preventative Measures for Plantar Fasciitis

Preventing plantar fasciitis during menopause involves being proactive about foot health. Here are some preventative measures to consider:

Stay Physically Active: Engaging in regular, low-impact activities like swimming, walking, or yoga can help maintain muscle strength and joint flexibility without putting too much strain on the feet.
Incorporate Stretching into Daily Routine: Regular stretching of the feet and calf muscles can help maintain the elasticity of the plantar fascia, reducing the risk of strain.
Choose Footwear Wisely: Avoid high heels or unsupportive footwear. Invest in shoes with good arch support and cushioning to protect the feet from unnecessary strain.
Maintain a Healthy Weight: Keeping your weight within a healthy range will help reduce the pressure on your feet and decrease the risk of plantar fasciitis.

Conclusion

Plantar fasciitis can be a painful and limiting condition, and its prevalence may increase during menopause due to hormonal shifts, weight gain, and changes in foot structure. However, by understanding the link between menopause and plantar fasciitis, it is possible to manage and even prevent this condition effectively. From wearing supportive footwear and staying active to considering hormone replacement therapy and focusing on weight management, there are many strategies available to support foot health during menopause.

At this stage in life, taking care of musculoskeletal health is key to maintaining mobility, comfort, and quality of life. If you’re struggling with foot pain or suspect you might have plantar fasciitis, consider speaking with a healthcare provider who understands the unique challenges of menopause. With the right approach, it’s entirely possible to find relief and continue living an active, fulfilling life.