Manual therapy for plantar heel pain

Foot (Edinb). 2018 Mar:34:11-16. doi: 10.1016/j.foot.2017.08.001. Epub 2017 Aug 5.


Background: Manual therapy employed in the treatment of plantar heel pain includes joint or soft tissue mobilizations. Efficacy of these methods is still under debate.

Aims: To determine whether manual therapy, consisting of deep massage, myofascial release or joint mobilization is effective in treating plantar heel pain.

Methods: A critical review of all available studies with an emphasis on randomized controlled trials (RCTs) was performed. PubMed, PEDro, and Google Scholar databases were searched for keywords relating to plantar heel pain, joint, and soft tissue mobilizations. There were no search limitations or language restrictions. The reference lists of all retrieved articles were searched. The PEDro score was used to assess the quality of the reviewed papers.

Results: A total of six relevant RCTs were found: two examined the effectiveness of joint mobilization on plantar heel pain and four the effectiveness of soft tissue techniques. Five studies showed a positive short-term effect after manual therapy treatment, mostly soft tissue mobilizations, with or without stretching exercises for patients with plantar heel pain, compared to other treatments. One study observed that adding joint mobilization to the treatment of plantar heel pain was not effective. The quality of all studies was moderate to high.

Conclusions: According to reviewed moderate and high-quality RCTs, soft tissue mobilization is an effective modality for treating plantar heel pain. Outcomes of joint mobilizations are controversial. Further studies are needed to evaluate the short and long-term effect of different soft tissue mobilization techniques.

Keywords: Joint mobilizations; Manual therapy; Plantar heel pain; Soft tissue mobilizations; Treatment.

Publication types

  • Review

MeSH terms

  • Fasciitis, Plantar / diagnosis
  • Fasciitis, Plantar / therapy*
  • Female
  • Heel / physiopathology*
  • Humans
  • Male
  • Musculoskeletal Manipulations / methods*
  • Musculoskeletal Pain / therapy
  • Pain Measurement*
  • Prognosis
  • Randomized Controlled Trials as Topic
  • Treatment Outcome