Comparative Effects of Myofascial Release and Instrument Assisted Soft Tissue Moblization in Pregnant Women With Plantar Fasciitis (MFR-IASM-PF)

June 23, 2026 updated by: Fatima Altaf, University of Lahore

Plantar fasciitis is a common musculoskeletal disorder characterized by heel pain and functional limitations, which may become more pronounced during pregnancy due to weight gain, hormonal changes, and altered biomechanics. Conservative physiotherapy interventions are commonly used to manage symptoms; however, evidence regarding the comparative effectiveness of different manual therapy techniques in pregnant women remains limited.

This randomized clinical trial aims to compare the effects of Myofascial Release (MFR) and Instrument-Assisted Soft Tissue Mobilization (IASTM) on pain intensity and foot function in pregnant women diagnosed with plantar fasciitis. A total of 44 pregnant women aged 20-40 years in their second or third trimester will be recruited and randomly allocated into two treatment groups. Both groups will receive baseline treatment consisting of therapeutic ultrasound, gastrocnemius and soleus stretching exercises, tibialis anterior strengthening, and a home exercise program. In addition, Group A will receive Myofascial Release, while Group B will receive Instrument-Assisted Soft Tissue Mobilization.

The intervention will be delivered over a period of four weeks, with three supervised sessions per week. Pain intensity will be assessed using the Numerical Pain Rating Scale (NPRS), while foot-related pain, disability, and functional limitations will be measured using the Foot Function Index (FFI). Outcomes will be evaluated at baseline and after completion of the intervention.

The findings of this study are expected to provide evidence regarding the most effective manual therapy approach for reducing pain and improving functional outcomes in pregnant women suffering from plantar fasciitis.

Study Overview

Status

Recruiting

Conditions

Intervention / Treatment

Detailed Description

Plantar fasciitis is one of the most prevalent causes of heel pain and is frequently associated with inflammation, microtrauma, and degeneration of the plantar fascia. During pregnancy, physiological and biomechanical changes such as increased body weight, ligamentous laxity, altered gait patterns, and shifts in the center of gravity may increase stress on the plantar fascia, thereby elevating the risk of developing plantar heel pain. These symptoms can negatively affect mobility, functional independence, and overall quality of life.

Various conservative physiotherapy interventions have been used to manage plantar fasciitis, including stretching exercises, strengthening programs, therapeutic ultrasound, and manual therapy techniques. Among manual therapy approaches, Myofascial Release (MFR) and Instrument-Assisted Soft Tissue Mobilization (IASTM) have gained increasing attention because of their potential to reduce fascial restrictions, improve tissue mobility, decrease pain, and enhance functional performance. However, limited evidence exists regarding the comparative effectiveness of these interventions specifically in pregnant women.

This study is designed as a single-blind, parallel-group, randomized clinical trial conducted at physiotherapy, orthopedic, and gynecology clinics of the University of Lahore Hospital. A total of 44 pregnant women diagnosed with plantar fasciitis will be recruited through convenience sampling and randomly assigned to one of two intervention groups.

Both groups will receive standardized baseline treatment comprising therapeutic ultrasound (1.0 MHz, 1.2 W/cm²), gastrocnemius and soleus stretching exercises, tibialis anterior strengthening exercises, and a home-based stretching program. Participants in Group A will receive Myofascial Release techniques targeting the plantar fascia, medial heel region, gastrocnemius-soleus complex, and intrinsic foot musculature. The intervention aims to reduce fascial restrictions, improve tissue extensibility, and restore normal foot biomechanics.

Participants in Group B will receive Instrument-Assisted Soft Tissue Mobilization using specialized stainless-steel instruments. Treatment will focus on the plantar fascia, calcaneal insertion, Achilles tendon, calf musculature, and intrinsic foot muscles through controlled sweeping, cross-friction, and tissue remodeling techniques designed to improve mobility and reduce adhesions.

Both intervention programs will be administered over four weeks, with three treatment sessions per week, resulting in a total of twelve supervised sessions. Each treatment session will last approximately 30 minutes. Pregnancy-specific safety precautions will be maintained throughout the intervention period, including avoidance of prolonged supine positioning, monitoring for adverse symptoms, and adjustment of treatment intensity according to participant comfort.

The primary outcome measure will be pain intensity assessed using the Numerical Pain Rating Scale (NPRS). The secondary outcome measure will be foot-related pain, disability, and functional limitation assessed using the Foot Function Index (FFI). Outcome assessments will be performed at baseline and after completion of the four-week intervention period by a blinded assessor.

The results of this trial will contribute to evidence-based physiotherapy practice by identifying the more effective manual therapy approach for managing plantar fasciitis in pregnant women, thereby assisting clinicians in optimizing treatment strategies for this unique patient population.

Study Type

Interventional

Enrollment (Estimated)

44

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 Contact

Study Contact Backup

Study Locations

  • Pakistan
    • Punjab Province
      • Lahore, Punjab Province, Pakistan, 54000
        • Recruiting
        • University of Lahore Teaching Hospital, Lahore
        • Contact:
        • Contact:

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

  • Adult

Accepts Healthy Volunteers

No

Description

Inclusion Criteria:

  • Pregnant women aged 20-40 years.
  • In the second and third trimester of pregnancy (gestational weeks 12-34).
  • Clinically diagnosed with plantar fasciitis, with symptoms of heel pain at the medial calcaneal insertion of the plantar fascia.
  • The pain is most intense with the first few steps in the morning or after prolonged rest. Positive findings from a Windlass test or palpation-provoked pain indicating plantar fasciitis.

Exclusion Criteria:

  • Known foot fractures or significant foot deformities.
  • Systemic inflammatory diseases (e.g., rheumatoid arthritis) that may affect tissue healing and response to therapy.
  • Active obstetric complications that contraindicate physiotherapy.
  • Recent corticosteroid injections to the heel (<6 months prior).
  • Inability or unwillingness to comply with follow-up visits or the intervention protocol.

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: Myofascial Release (MFR) Group
Participants in this group will receive Myofascial Release (MFR) in addition to conventional physiotherapy. Conventional treatment includes therapeutic ultrasound (1.0 MHz, 1.2 W/cm²), gastrocnemius and soleus stretching exercises, tibialis anterior strengthening exercises, and a home exercise program. The MFR intervention targets the plantar fascia, medial heel region, gastrocnemius-soleus complex, and intrinsic foot muscles using sustained manual pressure and fascial mobilization techniques. Treatment will be delivered three times per week for four weeks, with each session lasting 30 minutes.
Procedure: Myofascial Release (MFR)
Myofascial Release (MFR) is a manual therapy technique aimed at reducing fascial restrictions, improving tissue mobility, and alleviating pain. Participants will receive MFR targeting the plantar fascia, medial calcaneal region, gastrocnemius-soleus complex, and intrinsic foot muscles. Techniques include longitudinal fascial release, thumb or knuckle gliding, sustained pressure, cross-fiber friction, deep longitudinal sweeping, and myofascial spreading. Treatment will be administered for 30 minutes per session, three times per week for four weeks (12 sessions total), in addition to conventional physiotherapy consisting of therapeutic ultrasound, stretching exercises, strengthening exercises, and a home exercise program.
Experimental: Instrument-Assisted Soft Tissue Mobilization (IASTM) Group
Participants in this group will receive Instrument-Assisted Soft Tissue Mobilization (IASTM) in addition to conventional physiotherapy. Conventional treatment includes therapeutic ultrasound (1.0 MHz, 1.2 W/cm²), gastrocnemius and soleus stretching exercises, tibialis anterior strengthening exercises, and a home exercise program. IASTM will be performed using specialized stainless-steel instruments applied to the plantar fascia, calcaneal insertion, Achilles tendon, calf muscles, and intrinsic foot muscles to reduce soft tissue restrictions and improve mobility. Treatment will be delivered three times per week for four weeks, with each session lasting 30 minutes.
Procedure: Instrument-Assisted Soft Tissue Mobilization (IASTM)
Instrument-Assisted Soft Tissue Mobilization (IASTM) is a manual therapy technique that utilizes specialized stainless-steel instruments to identify and treat soft tissue restrictions. Participants will receive IASTM over the plantar fascia, calcaneal insertion, Achilles tendon, gastrocnemius, soleus, and intrinsic foot muscles. Techniques include longitudinal sweeping strokes, cross-fiber strumming, edge-loading techniques, adhesion-targeting strokes, and fascial spreading. Treatment will be administered for 30 minutes per session, three times per week for four weeks (12 sessions total), in addition to conventional physiotherapy consisting of therapeutic ultrasound, stretching exercises, strengthening exercises, and a home exercise program.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Pain Intensity Assessed by Numerical Pain Rating Scale (NPRS)
Time Frame: Baseline and Week 4 (Post-Intervention)
Pain intensity will be measured using the 11-point Numerical Pain Rating Scale (NPRS), where 0 indicates "no pain" and 10 indicates "worst imaginable pain." Participants will be asked to rate the intensity of their worst heel pain, particularly during the first steps taken in the morning. The NPRS is a valid and reliable tool for assessing pain severity in individuals with plantar fasciitis. Changes in NPRS scores will be used to evaluate the effectiveness of Myofascial Release and Instrument-Assisted Soft Tissue Mobilization in reducing plantar heel pain among pregnant women.
Baseline and Week 4 (Post-Intervention)

Collaborators and Investigators

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

Sponsor

University of Lahore

Investigators

  • Principal Investigator: Fatima Altaf, MSPTWH, The University of Lahore, Lahore

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 (Estimated)

June 30, 2026

Primary Completion (Estimated)

July 30, 2026

Study Completion (Estimated)

July 31, 2026

Study Registration Dates

First Submitted

June 23, 2026

First Submitted That Met QC Criteria

June 23, 2026

First Posted (Actual)

June 30, 2026

Study Record Updates

Last Update Posted (Actual)

June 30, 2026

Last Update Submitted That Met QC Criteria

June 23, 2026

Last Verified

June 1, 2026

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • 70106611

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

Clinical Trials on Plantar Fasciitis

Clinical Trials on Myofascial Release (MFR)

Search Similar Trials

Sponsors and Collaborators

Medical Conditions

Drug Interventions

CROs by country

CROs in Sri Lanka

Conditions

Rare Diseases

Drug Interventions

Dietary Supplements

Sponsor/Collaborators

Locations

3
Subscribe