Heel pain during menopause (transition)

The relationship between menopause (menopause) and tendinitis (plantar fasciitis).

What is plantar fasciitis? Plantar fasciitis is a common foot condition that involves inflammation of the plantar fascia (tendon plate), a thick band of tissue that runs along the bottom of your foot and connects your heel bone to your toes. This tissue helps support the arch of the foot and absorbs shock while walking.

The most common symptom is sharp, stabbing pain in the heel, although it can also extend along the bottom of the foot. This pain is usually worst with the first steps in the morning or after long periods of sitting or standing.

Menopause can have various effects on plantar fascia, mainly due to the hormonal changes that occur during this period. The factors below can affect the tendon plate during menopause:

• Decreased oestrogen levels:
  • Impact on collagen:
    Oestrogen plays an important role in maintaining collagen production, which is crucial for the elasticity and strength of connective tissues, including fascia. During menopause, oestrogen levels drop, leading to reduced collagen production. This reduction can cause the fascia to become less elastic and more prone to stiffness or injury.
  • Plantar fasciitis:
    With less elastic and more fragile fascia, women going through menopause may be at higher risk of conditions such as plantar fasciitis, in which the thick band of tissue (plantar fascia) that runs along the bottom of the foot becomes inflamed, leading to heel pain.
• Changes in foot structure:
  • Loss of cushioning:
    Menopause can also lead to changes in the distribution of body fat, often resulting in the loss of the natural fat pads in the feet. This loss of cushioning can increase pressure on the fascia, exacerbating conditions such as plantar fasciitis or causing general foot discomfort.
  • Altered foot shape:
    The ligaments in the feet can become weaker due to reduced collagen, potentially leading to a change in the shape of the foot, such as flattening of the arch of the foot (flat feet). This can put additional stress on the foot fascia.
• Increased joint pain and stiffness:
  • Inflammation:
    Menopause is often associated with increased joint pain and stiffness due to inflammation, which can also affect the joints in the feet. This inflammation can spread to the fascia, leading to pain and discomfort.

Overall, menopause can make the foot fascia more vulnerable to injury and discomfort due to the combined effects of hormonal changes, loss of tissue elasticity and changes in foot structure.

Maintaining good foot health, wearing supportive footwear with corrective and relieving podiatric insoles, foot training and monitoring the right balance of load and strain on your feet can help manage these changes effectively.

Source:
- Sarah Venard, MRCPod Specialist, Musculoskeletal Podiatrist, LinkedIn.
- Leblanc, D. R., Schneider, M., Angele, P., Vollmer, G., & Docheva, D. (2017). The effect of estrogen on tendon and ligament metabolism and function. The Journal of steroid biochemistry and molecular biology, 172, 106–116. https://doi.org/10.1016/j.jsbmb.2017.06.008