The Prevalence of Plantar Fasciitis and its Association with Posture in Salesmen with Prolonged Standing

Abstract

Background: Plantar fasciitis (PF) is a degenerative condition of the plantar fascia that results in heel pain and functional limitations, with occupational standing and postural dysfunction recognized as key contributing factors. Workers engaged in prolonged static standing, such as salesmen, may experience higher PF prevalence due to cumulative biomechanical stress and poor ergonomic environments, yet this occupational group remains under-researched. Objective: To determine the prevalence of plantar fasciitis and assess its association with pelvic posture among salesmen exposed to prolonged standing in retail environments. Methods: A cross-sectional observational study was conducted in shopping malls in Lahore, Pakistan, between January and June 2025. A total of 139 salesmen aged 18–60 years, standing >8 hours/day, were enrolled via convenience sampling. PF was diagnosed using standardized clinical examination and Visual Analog Scale (VAS ≥4) criteria. Pelvic tilt was assessed by goniometry and categorized as anterior, posterior, or neutral. Footwear characteristics, work-related exposure, and functional limitations were also recorded. Logistic regression was used to identify independent predictors of PF. Results: The prevalence of PF was 24%. Anterior pelvic tilt was significantly associated with PF (adjusted OR 2.84, 95% CI 1.30–6.19, p=0.009). Prolonged standing >90% of shift duration (OR 3.71, 95% CI 1.31–10.5, p=0.01), lack of arch support (OR 3.02, 95% CI 1.06–8.61, p=0.04), and elevated BMI further increased PF risk. Functional impairments such as morning heel pain and inability to stand for one hour without pain were strongly correlated with PF presence (p<0.001). Conclusion: Pelvic posture and occupational factors are significant contributors to plantar fasciitis in salesmen, underscoring the need for ergonomic interventions targeting proximal alignment, footwear policy, and workplace redesign.