Assessing the Influence of Improper Q Angle, Foot Alignment and Eversion on the Risk of Plantar Fasciitis Among Women Working in Retail Settings

Abstract

Background: Plantar fasciitis is a leading cause of heel pain in occupations requiring prolonged standing, with female retail workers particularly vulnerable due to repetitive loading and limited ergonomic support. Biomechanical factors such as increased quadriceps angle (Q-angle), excessive rearfoot eversion, and pronated foot posture are hypothesized to exacerbate plantar fascia stress, yet their combined influence in this occupational group remains underexplored. Objective: To evaluate the associations of Q-angle, foot alignment, and rearfoot eversion with plantar fasciitis among women employed in retail settings. Methods: A cross-sectional study was conducted among 175 female retail workers aged 20–45 years in Faisalabad. Q-angle and rearfoot eversion were measured using a goniometer, while foot alignment was assessed with the Foot Posture Index-6. Pain intensity and plantar fasciitis were determined through the Numeric Pain Rating Scale and clinical examination. Data were analyzed in SPSS v27 using chi-square tests, Pearson correlations, and multivariable logistic regression, adjusting for age and body mass index (BMI). Results: Elevated Q-angle, excessive eversion, and pronated foot posture were each significantly associated with plantar fasciitis (all p < 0.001). Multivariable analysis confirmed these as independent predictors, with adjusted odds ratios ranging from 2.19 to 2.85, whereas BMI showed no significant effect. Conclusion: Improper Q-angle, abnormal foot alignment, and excessive rearfoot eversion significantly increase the risk of plantar fasciitis in female retail workers. These findings highlight the importance of early biomechanical screening and support the integration of preventive orthoses, intrinsic foot muscle training, and workplace ergonomic adaptations to mitigate risk in high-exposure occupational groups.