Association of Plantar Fasciitis With Functional Limitations and Work Productivity Among Teachers

Abstract

Background: Plantar fasciitis (PF) is a prevalent cause of heel pain that compromises gait and occupational functioning. Teachers experience prolonged standing on hard surfaces, yet quantitative links between PF severity and work productivity in this workforce remain under characterized. Objective: To estimate the apparent prevalence of PF in a convenience sample of teachers and assess the association of PF severity with work productivity and activity limitation. Methods: A cross-sectional study (March–August 2025) enrolled teachers aged 30–45 years from institutions in Sialkot, Daska, Gujranwala, and Hafizabad. Eligibility required 7–8 working hours/day and routine use of hard, non-cushioned footwear. PF was examined using the Windlass test; pain and function were measured by the Plantar Fasciitis Pain/Disability Scale (PFPS; 0–100, higher worse), and productivity by the Work Productivity and Activity Impairment (WPAI) questionnaire over the past 7 days. Spearman’s ρ estimated associations. Results: Of 318 participants (29.6% male; mean age 34.9 years), 122 were Windlass positive, yielding an apparent prevalence of 38.4% (95% CI 33.2–43.8). PFPS correlated with WPAI absenteeism (ρ=0.455; p<0.001), presenteeism (ρ=0.569; p<0.001), overall work impairment (ρ=0.455; p<0.001), and total activity limitation (ρ=0.601; p<0.001). Windlass positivity showed smaller associations: absenteeism (ρ=0.182; p<0.001), presenteeism (ρ=0.380; p<0.001), overall work impairment (ρ=−0.179; p<0.001), and activity limitation (ρ=0.386; p<0.001). Conclusion: In this teacher cohort, greater PF severity—especially by PFPS—was associated with higher presenteeism and activity limitation. Findings support symptom–function screening and ergonomic interventions; generalizability is limited by the exposure-conditioned, convenience design.