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Comparison of Transverse Friction Massage and Instrument- Assisted Soft-Tissue Mobilization in Plantar Fasciitis
Sponsor: Foundation University Islamabad
Summary
Plantar fasciitis is a common musculoskeletal condition characterized by plantar heel pain, particularly during the first steps after waking or following prolonged rest. It can substantially affect walking, standing, daily activities, and overall functional ability. Although conservative physiotherapy management is commonly used, the relative effectiveness of different manual therapy techniques remains unclear. The present study aims to compare the effectiveness of Transverse Friction Massage (TFM) and Instrument-Assisted Soft-Tissue Mobilization (IASTM) in patients with plantar fasciitis. The study will be conducted as a single-blinded randomized controlled trial at Foundation University College of Physical Therapy, Islamabad. A total of 34 participants will be recruited using purposive sampling and subsequently randomized into two groups through a sealed opaque envelope method. Participants will be adults aged 19-44 years with clinically diagnosed plantar fasciitis and symptoms. persisting for more than three months. Group A will receive Transverse Friction Massage, while Group B will receive Instrument-Assisted Soft-Tissue Mobilization. Both groups will additionally receive a standardized physiotherapy protocol consisting of stretching exercises, strengthening exercises, ultrasound therapy, home-based exercises, and activity modification. The interventions will be administered twice weekly for four weeks, resulting in a total of eight treatment sessions. The primary clinical outcomes will include pain intensity, foot-related functional impairment, and ankle range of motion. Pain will be assessed using the Numeric Pain Rating Scale (NPRS), foot function using the Foot Function Index (FFI), and ankle range of motion using a goniometer. Assessments will be performed at baseline, after two weeks, and at the end of four weeks. Data will be analyzed using SPSS. Appropriate parametric or non-parametric statistical tests will be applied according to data distribution, with statistical significance set at p\<0.05 and a 95% confidence interval. The study is expected to provide evidence regarding the comparative effectiveness of TFM and IASTM for reducing pain, improving foot function, and enhancing ankle mobility in patients with plantar fasciitis.
Key Details
Gender
All
Age Range
19 Years - 44 Years
Study Type
INTERVENTIONAL
Enrollment
34
Start Date
2026-02-11
Completion Date
2027-01-18
Last Updated
2026-10-02
Healthy Volunteers
No
Conditions
Interventions
Transverse Friction Massage
Transverse Friction Massage (TFM) will be administered to participants in Group A as an adjunct to the standardized physiotherapy protocol.The technique is intended to address abnormal soft-tissue adhesions, improve plantar fascia mobility, reduce scar formation, and alleviate chronic pain. The participant will be positioned in supine lying, and the most painful area of the plantar fascia insertion will be identified. The foot will be dorsiflexed to facilitate stretching of the plantar fascia. Deep friction massage will then be applied using a reinforced index finger in a transverse direction, perpendicular to the tissue fibers. The therapist will perform controlled back-and-forth movements across the affected tissue within the participant's tolerance for approximately 5 minutes. TFM will be provided twice weekly for four weeks, resulting in eight treatment sessions.
Instrument-Assisted Soft-Tissue Mobilization
Instrument-Assisted Soft-Tissue Mobilization (IASTM) will be administered to Group B along with the standardized physiotherapy protocol. The technique is used to facilitate soft-tissue mobility, address adhesions, stimulate local circulation, and promote tissue remodeling. It may help reduce pain, improve tissue flexibility and function. A 3-minute cycling or walking warm-up will be performed before treatment. The participant will be positioned prone with the involved knee flexed to 90° and ankle in neutral. An emollient will be applied to the plantar surface. IASTM will then be performed for approximately 6 minutes using a specialized instrument held at approximately 45° to the skin. Sweeping and fanning strokes will be applied from the calcaneus toward the metatarsal heads, with pressure adjusted according to participant tolerance. Treatment will be provided twice weekly for four weeks, totaling eight sessions.
Locations (1)
Foundation University College of Physical Therapy
Islamabad, Punjab Province, Pakistan