Background: Plantar fasciitis (PF) is a common problem that tends to attack about 10% of the
population during life. This is a degenerative condition of the plantar fascia at its
insertion at the bottom of the heel. Pain appears mainly on the first steps in the morning or
after prolonged lack of weight bearing. The pain intensity can be very high and this can
cause functional limitations and reduce quality of life.
Despite the high prevalence of the PF, treatment is controversial and not supported by
extensive research. Review of the previous studies on various treatments, mentioned steroid
injections, shock waves, night splint, orthotics, heel padding and stretching exercises.
Limitation of ankle dorsi flexion is a common finding and thought to be a contributing factor
to the development of pathology. So far, this issue had been addressed mainly by soft tissue
therapy techniques to improve ankle range of motion in patients with PF. Only one study
(Joshua et al 2009) evaluated the effect of ankle joint mobilizations of PF. However, in this
study mobilizations were part of complex therapy and therefore the effect of treatment cannot
be attributed solely to them.
The purpose of this study is to evaluate the effectiveness of ankle and mid-foot joints
mobilization on pain and function of patients with PF.
The hypothesis is that manual mobilizations of ankle and midfoot joints in addition to
conventional physical therapy will improve pain and function significantly more than
conventional treatment, in patients with PF.
Methods: 50 patients, age 18-75 with a diagnosis of PF that meet the inclusion criteria will
be recruited and randomly divided into two groups. Both groups will receive commonly accepted
physical therapy treatment that includes stretching exercise of the plantar fascia and
triceps surae muscles and ultrasound therapy at the site of symptoms. The study group will
receive in addition manual mobilizations to the ankle and midfoot joints. The procedures will
take place at the physiotherapy clinic Bat-Yamon of General Health Services and will last
four weeks, twice a week.