Análise dos fatores biomecânicos que influenciam na sobrecarga da fáscia plantar: uma revisão narrativa

Abstract

Introduction: Our feet play an important role in everyday activities, being the first body segment to come into contact with the ground during walking and sporting activities, such as running. Therefore, injuries to the structure of the feet result in a negative impact on the quality of life of individuals. Among the countless injuries related to the structure of the feet, plantar fasciitis is a common musculoskeletal injury, which affects individuals of all ages and activity levels. Objective: The objective of the present study was to review in the literature the biomechanical factors proximal to the foot joint, which may influence the overload of the plantar fascia. Methods: A search was carried out for available evidence on the proposed topic in the electronic database PubMed, published in the English language and which were accessible as full manuscripts in peer-reviewed journals, from 1993 to October 2023. Reference lists of included articles or others relevant (for example, recent reviews) were searched as additional references. Results: A total of 19 studies were included for the review and subjected to data extraction. Based on these studies, 10 biomechanical risk factors associated with plantar fascia overload were presented, i.e., excessive or prolonged eversion, plantar medial longitudinal arch index, rearfoot alignment, reduced range of motion (ROM) of ankle dorsiflexion , increased ROM of plantar flexion of the ankle, increased ROM of dorsiflexion of the first metatarsophalangeal joint (FMJ) / windlass mechanism, tension of the triceps surae (stiffness/force exerted by the muscle), reduced strength of the intrinsic muscles of the feet, increased strength of ground reaction and type of landing related to running. Conclusion: The reduction in strength of the intrinsic and extrinsic muscles of the foot, the increase in plantar flexion ROM, the increase in the stiffness of the Achilles tendon and the increase in the dorsiflexion ROM of the FMJ (windlass mechanism), are the biomechanical factors that are most related to overload on the plantar fascia and are already well described by several studies.