Active Release Technique vs. Dynamic Soft Tissue Mobilization for Plantar Pain

October 29, 2026 updated by: Nosheen Manzoor, University of Management and Technology Lahore

Comparison of Active Release Technique Versus Dynamic Soft Tissue Mobilization on Pain, Range of Motion, Functional Outcomes and Disability in Subjects With Plantar

Plantar fasciitis is one of the most common causes of heel pain encountered in musculoskeletal and orthopedic physiotherapy practice. It is characterized by degenerative changes at the origin of the plantar fascia on the medial calcaneal tubercle, leading to pain, stiffness, and functional limitations during weight-bearing activities. Patients typically report sharp heel pain that is most severe during the first steps in the morning or after prolonged rest, which significantly affects gait and daily functional activities.Current evidence suggests that plantar fasciitis is not purely an inflammatory condition but rather a degenerative fasciopathy resulting from repetitive microtrauma, abnormal foot biomechanics, prolonged standing, obesity, and tightness of the gastrosoleus complex. These mechanical stressors lead to microtears, collagen degeneration, and thickening of the plantar fascia, ultimately resulting in chronic pain and disability.Objective of this study is to compare the effectiveness of Active Release Technique and Dynamic Soft Tissue Mobilization on pain, function, and disability in patients with plantar fasciitis. All the subjects who will eligible for the criteria will randomly allocated in to Group A(ART) and Group B(DSTM).Taping will be our baseline treatment.. This study will be a randomized controlled trial conducted at Pro Care Physiotherapy Clinic, Ittefaq Hospital, and Iffat Anwar Medical Complex over a period of four months. A total of 62 participants will be recruited using probability convenient sampling and randomly allocated into two groups. Group A will receive Active Release Technique along with baseline taping, while Group B will receive Dynamic Soft Tissue Mobilization along with baseline taping. Both groups will receive three sessions per week for four weeks.Outcome measures will include the Numerical Pain Rating Scale (NPRS) and Foot Function Index (FFI) to assess pain and functional disability. Assessments will be taken at baseline, 2nd week, and 4th week. Data will be analyzed using SPSS version 24, and both intra-group and inter-group comparisons will be performed using appropriate statistical tests.

Study Overview

Status

Active, not recruiting

Conditions

Intervention / Treatment

Study Type

Interventional

Enrollment (Actual)

70

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

    • Punjab Province
      • Lahore, Punjab Province, Pakistan, 54000
        • University of Management & Technology

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

25 years to 60 years (Adult)

Accepts Healthy Volunteers

No

Genders Eligible for Study

All

Description

Inclusion Criteria:

Age 25 to 60 years. Presence of unilateral plantar fasciitis. Participants with positive Windlass test. Symptoms more than 6 weeks of duration diagnosed by orthopaedician. Reported pain with the first step out of the bed in the morning or with the first step after prolonged immobilization and presence of heel pain with prolonged standing on the medial calcaneal tubercle plantar aponeurosis confirmed by palpation. both male and female will be included. Pain intensity of ≥3 on the Visual Analog Scale (VAS) or Numeric Pain Rating Scale (NPRS).

Participants willing to provide informed consent and comply with the treatment protocol.

Exclusion Criteria:

Reported previous history of cancer, peripheral vascular diseases, lower extremity fractures Had a trauma or history of surgery to the foot or ankle. Diabetic neuropathy. People who have undergone steroid therapy, platelet rich plasma therapy in the past 3 months.

Severe foot deformities (e.g., severe pes planus or pes cavus) requiring specialized management.

Open wounds, skin infections, or allergies preventing the application of taping.

Presence of inflammatory or systemic diseases such as Rheumatoid Arthritis, Ankylosing Spondylitis, or Gout.

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Treatment
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: Single

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: Active Release Technique (ART)

The patient will sit in a long-sitting position while the therapist assesses muscle and fascial tightness using their hands. The therapist applies specific pressure along the affected tissue from origin to insertion while the muscle is shortened. The patient is then instructed to lengthen the muscle by dorsiflexing the foot. Each session lasts approximately 10 minutes, three times a week for four weeks, along with baseline taping.

The patient will sit in a long-sitting position while the therapist assesses muscle and fascial tightness using their hands. The therapist applies specific pressure along the affected tissue from origin to insertion while the muscle is shortened. The patient is then instructed to lengthen the muscle by dorsiflexing the foot. Each session lasts approximately 10 minutes, three times a week for four weeks, along with baseline taping.

Active Comparator: Dynamic Soft Tissue Mobilization

The therapist will perform 10 minutes of deep, forceful soft tissue mobilization on tight and painful areas of the posterior calf muscles, applying pressure across the muscle fibers medially and laterally. The patient will also perform a passive straight leg raise combined with ankle dorsiflexion using a long belt to improve neural mobility.

The therapist will perform 10 minutes of deep, forceful soft tissue mobilization on tight and painful areas of the posterior calf muscles, applying pressure across the muscle fibers medially and laterally. The patient will also perform a passive straight leg raise combined with ankle dorsiflexion using a long belt to improve neural mobility.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Pain by Numerical Rating Scale (NPRS)
Time Frame: At baseline and after 6 weeks

Numeric Rating Scale (NPRS) is most frequently used instruments to measure pain. The 11-point numeric with 0 representing No pain, 1- 3 representing Mild Pain (nagging, annoying, interfering little with ADLs), 4-6 representing Moderate Pains

(interferes significantly with ADLs), 7-10 representing Sever Pain (disabling, unable to perform ADLs).

At baseline and after 6 weeks
Disability by Foot Function Index (FFI)
Time Frame: At baseline and after 6 weeks

The Foot Function Index (FFI) is a widely used patient-reported outcome measure developed to assess the impact of foot pathology on pain, disability, and activity limitation.The questionnaire consists of 23 items divided into three subscales: Pain (9 items), Disability (9 items), and Activity Limitation (5 items). The questions assess foot pain severity and the extent to which foot problems affect daily functional activities such as walking, standing, climbing stairs, and participation in routine activities.

At baseline and after 6 weeks
Joint Range of Motion by Goniometer
Time Frame: At baseline and after 6 weeks

The patient's knee will be flexed to 30°, with the ankle in the anatomical position. The goniometer axis will be placed near the lateral ankle, with the stationary arm aligned along the fibula and the movable arm along the fifth metatarsal. The examiner will measure both passive and active ankle dorsiflexion using a goniometer. The normal range of ankle dorsiflexion is approximately 15°-20°.

At baseline and after 6 weeks

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

October 29, 2026

Primary Completion (Estimated)

December 31, 2026

Study Completion (Estimated)

December 31, 2026

Study Registration Dates

First Submitted

October 29, 2026

First Submitted That Met QC Criteria

October 29, 2026

First Posted (Actual)

November 4, 2026

Study Record Updates

Last Update Posted (Actual)

November 4, 2026

Last Update Submitted That Met QC Criteria

October 29, 2026

Last Verified

October 1, 2026

More Information

Terms related to this study

Other Study ID Numbers

  • RE-207-2026

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

YES

IPD Plan Description

The results data collected , de-identified individual participant data will be shared.

IPD Sharing Time Frame

6 months after the publication of the manuscript.

IPD Sharing Access Criteria

The data can be requested from the corresponding author.

IPD Sharing Supporting Information Type

  • STUDY_PROTOCOL
  • SAP
  • ICF

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

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