Excessive Weight Bearing Compromises Foot Structure and Function Across the Lifespan - The Mechanobiology of Obesity and Related Diseases - page 157

research to determine whether foot discomfort due to long-term excessive body
mass affects participation in physical activity, and suggests the potential for
promoting non-weight bearing activities for overweight and obese children who
suffer foot discomfort. However, the probable short- and long-term functional
limitations resulting from increased pressures generated beneath the feet of obese
children when walking remains unknown, as does the plantar pressure threshold
that might lead to possible foot damage. Nevertheless, what this study does
highlight is that obesity poses negative health consequences for pre-pubertal
children and adolescents, including foot pain that may hinder participation in
physical activity, thereby perpetuating the cycle of obesity and further foot
pathologies.
4.3 Adults (18-60 years)
Although there are an increasing number of investigations exploring the effects of
bearing excessive body mass on the developing feet of children, relatively limited
research has examined the effects of overweight and obesity on the feet of adults.
Adult-onset obesity has been associated with a greater prevalence of musculo-
skeletal disorders, particularly disorders that involve the lower limb [ 89 ]. In fact,
obesity in adulthood consistently emerges as a key and potentially modifiable risk
factor in the onset and progression of common foot problems [ 90 , 91 ]. Frey and
Zamora [ 92 ] compared the incidence of orthopaedic foot and ankle complaints
reported by 887 women and 535 men in an orthopaedic foot and ankle practice.
Those patients who were overweight or obese (BMI C 25 kg/m 2 ;n= 738) had a
significantly increased likelihood of reporting tendinitis compared to the normal
weight patients (BMI = 18.5-24.9 kg/m 2 ;n= 684). If the participants were
overweight or obese, there was also an increased chance, although not significant,
of experiencing plantar fasciitis and osteoarthritis. As they are usually secondary
to overuse and increased stress on the soft tissues and joints, this increased
prevalence of tendinitis, plantar fasciitis, and osteoarthritis in the overweight and
obese participants might be directly related to the increased load imposed on these
structures [ 92 ]. Similar to children and adolescents, it is imperative that we
understand the effects of bearing excessive body mass on the feet of adults because
the pain associated with these foot problems often impacts upon the ability of
adults to participate in physical activity. A reduction in the ability to be physically
active can lead to a downward spiral of increasing body mass and a worsening of
an individual's overall health. This is especially evident in advanced diabetic
problems associated with obesity (e.g. neuropathy and peripheral vascular disease)
and worsening foot deformities that require surgical intervention. Surgery, how-
ever, becomes more difficult and risky with increased BMI and the associated
comorbidities [ 91 ].