Before you lace up your trainers and step out of the door for an exercise session, do you ever take a quick glance at your calendar? 

Although research into how the menstrual cycle affects our bodies during exercise remains patchy and under-scrutinised (quelle surprise), a picture is slowly building. Any evidence that illustrates how our anatomy responds to the hormonal peaks and troughs of our cycle can help us adapt our routines to improve performance and avoid pain and injury. 

One such study, reported in the British Journal Of Sports Medicine, found that muscle and tendon injuries in female footballers were twice as likely around the mid-point of their cycle. But have you heard a rumour that our hormones may even affect our feet – specifically the plantar fascia, the band of tissue that connects the heel to the toes, and supports the arch of the foot? 

A study published in the Journal Of Athletic Training, tasked women (when ovulating and when menstruating) to complete balance tasks on a force platform to explore the effect of oestrogen on the plantar fascia. Researchers concluded that women had more laxity in the main ligaments of the foot at ovulation (around day 14 of a typical 28-day cycle) compared with menstruation.

“There have been various pieces of research looking at ligament laxity in relation to the menstrual cycle, concluding that increased laxity at ovulation due to high oestrogen levels may increase the risk of injury. Therefore the same logic could be applied to other ligaments, such as the plantar fascia,” doctor and PT Dr Folusha Oluwajana tells Stylist. 

“However, there is very limited evidence to prove this. There are only a few studies so far, using very small numbers of participants.” 

Osteopath Anisha Joshi, of Osteo Allies, agrees that there isn’t enough credible evidence to confidently conclude that oestrogen affects the plantar fascia. If you experience foot injuries or soreness in that area, it could be that you simply have ligament laxity – an asymptomatic condition believed to be genetic.

“If you have ligament laxity in the plantar fascia then it’s highly lightly that you have it in the entire ankle joint. This is when the ligaments can stretch beyond their limit, consequently leading to joint instability,” says Joshi, explaining that people who take part in regular weight-bearing exercises such as running, hiking or football are predisposed to recurrent ailments including ankle sprains and plantar fasciitis.

And the problems don’t always stop at the bottom. “Weak or lax plantar fascia can lead to abnormal gait patterns and biomechanics when running or doing other weight-bearing exercises,” explains Dr Oluwajana.  

“These can then cause other problems such as flat feet, shin splints or plantar fasciitis. Your musculoskeletal system is connected from top to bottom, so a problem in one part of the chain can lead to problems in neighbouring connected parts. I often see people developing ankle, knee and even hip problems as a result of a problem that originated in the foot.” 

“Plantar fasciitis is considered to be a repetitive overuse injury, due to repeated micro injury to the plantar fascia, commonly seen in runners and other people who perform high-impact activities,” says Dr Oluwajana.

“The classic symptom is pain at the heel which is worse when you take your first steps in the morning. It often eases slightly as the day goes on, but tends to be exacerbated again by prolonged weight-bearing or high-impact activity. More severe plantar fasciitis can cause constant pain, limping and affect your ability to exercise or even perform everyday activities.

“If you are suffering from symptoms of plantar fasciitis you should take a break from high-impact activity, as continuing will make it worse! Rest but continue gentle low-impact exercise and make sure you wear supportive shoes.” 

Joshi adds: “Plantar fasciitis is essentially irritation of the fascia on the base of your foot so it’s important to try and protect the irritation from reoccurring. You can do this by resting from running or weight-bearing exercise for a few days to a week.

“Wear cushioned trainers or slippers around the house and at work if possible. Elevate the legs and place an ice pack on the sole of your foot to reduce any inflammation. You can do non-weight bearing exercise like swimming if you want to stay active,” she suggests.

Both Joshi and Dr Oluwajana recommend that if you are experiencing severe or persistent pain, you should consult a podiatrist or other medial professional. 

“I wouldn’t ever advise a woman to stop moving or exercising,” says Joshi. “But it may be worth considering this and just being more aware of your form or more mindful of your body during [the ovulation point] in your cycle.”

Dr Oluwajana adds: “I wouldn’t go as far as advising you to completely change your routine to rest your feet around ovulation, based on the evidence so far. But I would encourage you to prioritise preventative measures like supportive footwear and regular stretching, especially if you engage in high-impact activity regularly.

“And coming first-hand from someone who is currently out of action due to a foot injury, prevention is better than cure!” 

Images: Getty