Comparison of Myofascial Release Technique and Manual Therapy for the Management of Plantar Fasciitis
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Abstract
Background: Plantar fasciitis (PF) is the most common cause of inferior heel pain, affecting up to 10% of the general population over a lifetime. It accounts for 8% to 15% of foot complaints in both athletic and non-athletic individuals.
Objective: This study aimed to compare the effectiveness of the myofascial release technique and manual therapy in the management of plantar fasciitis.
Methods: Thirty patients diagnosed with plantar fasciitis were enrolled in the study and randomly divided into two groups. Group A received myofascial release (MFR) therapy, while Group B underwent manual therapy. Each treatment was administered three times a week for four weeks, with a minimum one-day gap between sessions. Each session lasted 30 minutes and targeted the affected side. Outcome measures included the Foot Function Index (FFI) and the Numerical Pain Rating Scale (NPRS), recorded at baseline (Week 1), post-intervention (Week 4), and follow-up (Week 12). Statistical analysis was performed using SPSS version 25, with paired and independent t-tests used to evaluate within-group and between-group differences.
Results: Both groups showed significant improvement in pain and function. Group A's mean NPRS score decreased from 8.00 (SD = 1.06) to 1.13 (SD = 1.06), while Group B's score decreased from 9.13 (SD = 0.63) to 4.20 (SD = 0.56), with a p-value of 0.00 for both groups. For the FFI, Group A's mean score decreased from 52.80 (SD = 4.36) to 11.46 (SD = 3.20), while Group B's score decreased from 58.53 (SD = 1.35) to 39.46 (SD = 4.61), also showing a p-value of 0.00.
Conclusion: Both myofascial release and manual therapy effectively managed plantar fasciitis. However, myofascial release demonstrated superior outcomes in pain reduction and functional improvement. These findings suggest that myofascial release should be considered a primary treatment option for plantar fasciitis to enhance patient recovery and quality of life.
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References
Baltich J, Emery CA, Whittaker JL, Nigg BM. Running injuries in novice runners enrolled in different training interventions: a pilot randomized controlled trial. Scandinavian Journal of Medicine & Science in Sports. 2017 Nov;27(11):1372-83.
DiBonaventura M, Richard L, Kumar M, Forsythe A, Flores NM, Moline M. The association between insomnia and insomnia treatment side effects on health status, work productivity, and healthcare resource use. PLoS One. 2015 Oct 1;10(10): e0137117.
. Baltich J, Emery CA, Whittaker JL, Nigg BM. Running Injuries In Novice Runners Enrolled In Different Training Interventions: A Pilot Randomized Controlled Trial. Scand J Med Sci Sports. 2017 Nov;27(11):1372-83.
DiBonaventura M, Richard L, Kumar M, Forsythe A, Flores NM, Moline M. The Association Between Insomnia And Insomnia Treatment Side Effects On Health Status, Work Productivity, And Healthcare Resource Use. PLoS One. 2015 Oct;10(10): e0137117.
Breuer B, Cruciani R, Portenoy RK. Pain Management By Primary Care Physicians, Pain Physicians, Chiropractors, And Acupuncturists: A National Survey. South Med J. 2010 Aug;103(8):738-47.
Covey CJ, Mulder MD. Plantar Fasciitis: How Best To Treat. J Fam Pract. 2013 Sep;62(9):466-71.
Chaiwanichsiri D, Janchai S, Tantisiriwat N. Foot Disorders And Falls In Older Persons. Gerontology. 2009;55(3):296-302.
Arkin RM. Self-Presentation In DM, RR V. AAPOR-The American Association For Public Opinion Research. (2015). Standard Definitions. Final Dispositions Of Case Codes And Outcome Rates For Surveys. Retrieved From http://www.aapor.org/AAPORKentico/AAPOR_Main/media/publications/Standard-Definitions2015_8theditionwithchanges_April2015_logo.pdf Ackoff, RL (1990). Strategy. Systems Practice. 1990;3(6):521-4. Social Sci Inf. 2003;42(2):155-83.
Chou R, Turner JA, Devine EB, Hansen RN, Sullivan SD, Blazina I, Dana T, Bougatsos C, Deyo RA. The Effectiveness and Risks Of Long-Term Opioid Therapy For Chronic Pain: A Systematic Review For A National Institutes Of Health Pathways To Prevention Workshop. Ann Intern Med. 2015 Feb;162(4):276-86.
Shetty SH, Dhond A, Arora M, Deore S. Platelet-Rich Plasma Has Better Long-Term Results Than Corticosteroids Or Placebo For Chronic Plantar Fasciitis: Randomized Control Trial. J Foot Ankle Surg. 2019 Jan;58(1):42-6.
Cotchett M, Rathleff MS, Dilnot M, Landorf KB, Morrissey D, Barton C. Lived Experience And Attitudes Of People With Plantar Heel Pain: A Qualitative Exploration. J Foot Ankle Res. 2020 Dec;13:1-9.
Fraser JJ, Glaviano NR, Hertel J. Utilization Of Physical Therapy Intervention Among Patients With Plantar Fasciitis In The United States. J Orthop Sports Phys Ther. 2017 Feb;47(2):49-55.
Irving DB, Cook JL, Young MA, Menz HB. Obesity And Pronated Foot Type May Increase The Risk Of Chronic Plantar Heel Pain: A Matched Case-Control Study. BMC Musculoskelet Disord. 2007 Dec;8(1):1-8.
López-López D, Marañon-Medina J, Losa-Iglesias ME, Calvo-Lobo C, Rodríguez-Sanz D, Palomo-López P, Vallejo RB. The Influence Of Heel Height Related On Quality Of Life On The Foot In A Sample Of Women. Rev Assoc Med Bras. 2018;64:324-9.
Kao MC, Minh LC, Huang GY, Mitra R, Smuck M. Trends In Ambulatory Physician Opioid Prescription In The United States, 1997-2009. PM&R. 2014 Jul;6(7):575-82.
Teixeira RN, Lunardi A, da Silva RA, Lopes AD, Carvalho CR. Prevalence Of Musculoskeletal Pain In Marathon Runners Who Compete At The Elite Level. Int J Sports Phys Ther. 2016 Feb;11(1):126.
Meghani SH, Byun E, Gallagher RM. Time To Take Stock: A Meta-Analysis And Systematic Review Of Analgesic Treatment Disparities For Pain In The United States. Pain Med. 2012 Feb;13(2):150-74.
Pollack A, Britt H. Plantar Fasciitis In Australian General Practice. Aust Fam Physician. 2015 Mar;44(3):90-1.
Porucznik CA, Johnson EM, Rolfs RT, Sauer BC. Specialty Of Prescribers Associated With Prescription Opioid Fatalities In Utah, 2002–2010. Pain Med. 2014 Jan;15(1):73-8.
Din NU, Rahman S. Determining The Mean Reduction In Pain Score After Treatment With Heel Pad In Planter Fasciitis. J Saidu Med Coll Swat. 2018 Oct;8(2).
Joshvaghan HG, Omidi-Kashani F. Plantar Fasciitis Risk Factors In Normal Population. Biosci Biotechnol Res Asia. 2018 Jun;15(2):427-30.
Whittaker GA, Landorf KB, Munteanu SE, Menz HB. Predictors Of Response To Foot Orthoses And Corticosteroid Injection For Plantar Heel Pain. J Foot Ankle Res. 2020 Dec;13:1-9.
Scher CD, Belmont Jr LC, Bear MR, Mountcastle SB, Orr JD, Owens MB. The Incidence Of Plantar Fasciitis In The United States Military. J Bone Joint Surg Am. 2009 Dec;91(12):2867-72.
Matthew RH, Alisa WG, Lior C, Steven WL. RCT Of Calcaneal Taping, Sham Taping, And Plantar Fascia Stretching For The Short-Term Management Of Plantar Heel Pain. J Orthop Sports Phys Ther. 2006;32(6):364-72.
Young B, Walker MJ, Strunce J, Boyles R. A Combined Treatment Approach Emphasizing Impairment-Based Manual Physical Therapy For Plantar Heel Pain: A Case Series. J Orthop Sports Phys Ther. 2004 Nov;34(11):725-33.
Abd Aziz NU, Osman N, Rosman NA, Talip NK, Chinnasee C, Nadzalan AM. The Effects Of Elbow Flexion Angles On Handgrip Force Production Among Trained Women. Age (Years). 2019;21:0-93.
Boroushak N, Jafarnezhadgero AA, Rashedi H. Effect Of Quadriceps Muscles Cooling On Plantar Pressure Variables During Running. Jundishapur Sci Med J. 2018 Mar;17(1):11-9.
Kisner C, Colby LA, Borstad J. Therapeutic Exercise: Foundations And Techniques. F.A. Davis; 2017 Oct 18.
Moyne-Bressand S, Dhieux C, Dousset E, Decherchi P. Effectiveness Of Foot Biomechanical Orthoses To Relieve Patients Suffering From Plantar Fasciitis: Is The Reduction Of Pain Related To Change In Neural Strategy?. Biomed Res Int. 2018 Dec;2018:1-7.
Podolsky R, Kalichman L. Taping For Plantar Fasciitis. J Back Musculoskelet Rehabil. 2015 Jan;28(1):1-6.
Dimitrios S. Tendinopathy: The Role Of Stretching. Australas Med J. 2017;10(1):63.
McClinton SM, Heiderscheit BC, McPoil TG, Flynn TW. Effectiveness Of Physical Therapy Treatment In Addition To Usual Podiatry Management Of Plantar Heel Pain: A Randomized Clinical Trial. BMC Musculoskelet Disord. 2019 Dec;20(1):1-4.
MacDonald R. The Positional Release Phenomenon And The Effects Of Counterstrain Manipulation: Reflections And Implications. Int Musculoskelet Med. 2013 Sep;35(3):95-8.
Akbari M, Pahnabi G, Karimi H. Immediate Effect Of Kinesio Taping On Knee Joint Position Sense After Anterior Cruciate Ligament Reconstruction. J Clin Physiother Res. 2017;2(4):162-8.
Bath M, Owens J. Physiology, Viscerosomatic Reflexes.
Hemlata NK, Praveen S, Kumar S, Badoni N. Comparison Of The Effectiveness Of Myofacial Release Technique And Stretching Exercise On Plantar Fascitis. Physiother Occup Ther. 2019 Apr;12(2).
Akram MR, Yousaf MN, Waseem M, Chaudhary FS. Comparison Of Mean Pain Score Of Oral Non-Steroidal Anti-Inflammatory Agents And Locally Injectable Steroid For The Treatment Of Plantar Fasciitis. J Pak Med Assoc. 2022 Feb;72(2):231-6.
Covey CJ, Mulder MD. Plantar fasciitis: How best to treat. J Fam Pract. 2013 Sep 1;62(9):466-71.
Chaiwanichsiri D, Janchai S, Tantisiriwat N. Foot disorders and falls in older persons. Gerontology. 2009; 55(3):296-302.
Arkin RM, Self-presentation in DM, RR V. AAPOR-The American Association for Public Opinion Research. (2015). Standard definitions. Final dispositions of case codes and outcome rates for surveys. Retrieved from http://www. aapor. org/AAPORKentico/AAPOR_Main/media/publications/Standard-Definitions2015_8theditionwithchanges_April2015_logo. pdf Ackoff, RL (1990). Strategy. Systems Practice, 3 (6), 521-524. Social Science Information.;42(2):155-83.
Chou R, Turner JA, Devine EB, Hansen RN, Sullivan SD, Blazina I, Dana T, Bougatsos C, Deyo RA. The effectiveness and risks of long-term opioid therapy for chronic pain: a systematic review for a National Institutes of Health Pathways to Prevention Workshop. Ann Intern Med. 2015 Feb 17;162(4):276-86.
Shetty SH, Dhond A, Arora M, Deore S. Platelet-rich plasma has better long-term results than corticosteroids or placebo for chronic plantar fasciitis: randomized control trial. The Journal of Foot and Ankle Surgery. 2019 Jan 1;58(1):42-6.
Cotchett M, Rathleff MS, Dilnot M, Landorf KB, Morrissey D, Barton C. Lived experience and attitudes of people with plantar heel pain: a qualitative exploration. Journal of foot and ankle research. 2020 Dec;13:1-9.
Fraser JJ, Glaviano NR, Hertel J. Utilization of physical therapy intervention among patients with plantar fasciitis in the United States. J Orthop Sports Phys Ther. 2017 Feb; 47(2):49-55.
Irving DB, Cook JL, Young MA, Menz HB. Obesity and pronated foot type may increase the risk of chronic plantar heel pain: a matched case-control study. BMC Musculoskelet Disord. 2007 Dec; 8(1):1-8.
López-López D, Marañon-Medina J, Losa-Iglesias ME, Calvo-Lobo C, Rodríguez-Sanz D, Palomo-López P, Vallejo RB. The influence of heel height related on quality of life on the foot in a sample of women. Revista da Associação Médica Brasileira. 2018;64:324-9.
Kao MC, Minh LC, Huang GY, Mitra R, Smuck M. Trends in ambulatory physician opioid prescription in the United States, 1997-2009. PM&R. 2014 Jul 1;6(7):575-82.
Teixeira RN, Lunardi A, da Silva RA, Lopes AD, Carvalho CR. Prevalence of musculoskeletal pain in marathon runners who compete at the elite level. Int J Sports Phys Ther. 2016 Feb; 11(1):126.
Meghani SH, Byun E, Gallagher RM. Time to take stock: a meta-analysis and systematic review of analgesic treatment disparities for pain in the United States. Pain Med. 2012 Feb 1; 13(2):150-74.
Pollack A, Britt H. Plantar fasciitis in Australian general practice. Aust Fam Physician. 2015 Mar; 44(3):90-1.
Porucznik CA, Johnson EM, Rolfs RT, Sauer BC. Specialty of prescribers associated with prescription opioid fatalities in Utah, 2002–2010. Pain Med. 2014 Jan 1; 15(1):73-8.
Din NU, Rahman S. Determining the mean reduction in pain score after treatment with heel pad in planter fasciitis. Journal of Saidu Medical College, Swat. 2018 Oct 8;8(2).
Joshvaghan HG, Omidi-Kashani F. Plantar Fasciitis Risk Factors in Normal Population. Biosciences Biotechnology Research Asia. 2018 Jun 25;15(2):427-30.
Whittaker GA, Landorf KB, Munteanu SE, Menz HB. Predictors of response to foot orthoses and corticosteroid injection for plantar heel pain. Journal of Foot and Ankle Research. 2020 Dec;13:1-9.
Scher CD, Belmont Jr LC, Bear MR, Mountcastle SB, Orr JD, Owens MB. The incidence of plantar fasciitis in the United States military. J Bone Joint Surg Am. 2009 Dec 1; 91(12):2867-72.
Matthew RH, Alisa WG, Lior C, Steven WL. RCT of Calcaneal Taping, Sham Taping, and Plantar Fascia Stretching for the short-term Management of Plantar Heel Pain. J Orthop Sports Phys Ther. 2006; 32(6):364-72.
Young B, Walker MJ, Strunce J, Boyles R. A combined treatment approach emphasizing impairment-based manual physical therapy for plantar heel pain: a case series. J Orthop Sports Phys Ther. 2004 Nov; 34(11):725-33.
Abd Aziz NU, Osman N, Rosman NA, Talip NK, Chinnasee C, Nadzalan AM. The effects of elbow flexion angles on handgrip force production among trained women. Age (years). 2019;21:0-93.
Boroushak N, Jafarnezhadgero AA, Rashedi H. Effect of Quadriceps Muscles Cooling on Plantar Pressure Variables During Running. Jundishapur Scientific Medical Journal. 2018 Mar 21;17(1):11-9.
Kisner C, Colby LA, Borstad J. Therapeutic exercise: foundations and techniques. F.A. Davis; 2017 Oct 18.
Moyne-Bressand S, Dhieux C, Dousset E, Decherchi P. Effectiveness of foot biomechanical orthoses to relieve patients suffering from plantar fasciitis: is the reduction of pain related to change in neural strategy?. BioMed research international. 2018 Dec 12;2018:1-7.
Baltich J, Emery CA, Whittaker JL, Nigg BM. Running injuries in novice runners enrolled in different training interventions: a pilot randomized controlled trial. Scandinavian Journal of Medicine & Science in Sports. 2017 Nov;27(11):1372-83.
Podolsky R, Kalichman L. Taping for plantar fasciitis. Journal of back and musculoskeletal rehabilitation. 2015 Jan 1; 28(1):1-6.
Dimitrios S. Tendinopathy: The role of stretching. Australasian Medical Journal (Online). 2017;10(1):63.
McClinton SM, Heiderscheit BC, McPoil TG, Flynn TW. Effectiveness of physical therapy treatment in addition to usual podiatry management of plantar heel pain: a randomized clinical trial. BMC Musculoskeletal Disorders. 2019 Dec;20(1):1-4.
MacDonald R. The positional release phenomenon and the effects of Counterstrain manipulation: Reflections and implications. International Musculoskeletal Medicine. 2013 Sep 1;35(3):95-8.
Akbari M, Pahnabi G, Karimi H. Immediate Effect of Kinesio Taping on Knee Joint Position Sense after Anterior Cruciate Ligament Reconstruction. Journal of Clinical Physiotherapy Research. 2017;2(4):162-8.
Bath M, Owens J. Physiology, viscerosomatic reflexes.
Hemlata NK, Praveen S, Kumar S, Badoni N. Comparison of The Effectiveness of Myofacial Release Technique and Stretching Exercise on Plantar Fascitis. Physiotherapy and Occupational Therapy. 2019 Apr;12(2).
Akram MR, Yousaf MN, Waseem M, Chaudhary FS. Comparison of mean pain score of oral non-steroidal anti-inflammatory agents and locally injectable steroid for the treatment of plantar fasciitis. JPMA. The Journal of the Pakistan Medical Association. 2022 Feb 1;72(2):231-5.