The Role of Instrumental Soft Tissue Mobilization and Foam Rolling in Managing Plantar Fasciitis: A Randomized Controlled Trial
Phase: NA
Conditions: Plantar Fasciitis, Chronic
Sponsor: Manav Rachna International Institute of Research and Studies

STUDY PROTOCOL 
Oﬃcial Title: 
The Role of Instrumental SoŌ Tissue MobilizaƟon and Foam Rolling in Managing Plantar FasciiƟs: A 
Randomized Controlled Trial 
NCT Number: 
Not yet assigned 
Document Type: 
Study protocol summary with StaƟsƟcal Analysis Plan 
Document Date: 
April 2025 
 
 

Background 
Plantar fasciiƟs is one of the most common causes of heel pain and funcƟonal limitaƟon. The plantar 
fascia is a thick band of connecƟve Ɵssue extending from the calcaneus to the toes and plays an 
important role in maintaining the medial longitudinal arch of the foot. RepeƟƟve stress and 
microtrauma can lead to degeneraƟon and inﬂammaƟon of the plantar fascia, resulƟng in pain during 
the ﬁrst steps aŌer rest and reduced funcƟonal capacity. 
Various physiotherapy intervenƟons have been proposed for the management of plantar fasciiƟs, 
including stretching exercises, strengthening exercises, orthoses, and manual therapy techniques. 
Instrument-Assisted SoŌ Tissue MobilizaƟon (IASTM) has gained popularity in recent years due to its 
ability to improve soŌ-Ɵssue mobility and promote Ɵssue healing through controlled micro-trauma 
and sƟmulaƟon of ﬁbroblast acƟvity. Foam roller therapy is another widely used intervenƟon that 
applies self-myofascial release to soŌ Ɵssues. It is believed to improve ﬂexibility, increase blood ﬂow, 
and reduce muscle Ɵghtness. 
Although both intervenƟons have shown beneﬁcial eﬀects individually, there is limited evidence 
comparing the eﬀecƟveness of IASTM and foam roller therapy in individuals with plantar fasciiƟs. 
Therefore, this study will be conducted to compare the eﬀects of these two treatment approaches on 
pain, range of moƟon, strength, quality of life, and funcƟonal disability. 
ObjecƟve 
 
To compare the eﬀecƟveness of Instrument-Assisted SoŌ Tissue MobilizaƟon and Foam Roller 
therapy in reducing pain and improving ankle range of moƟon in individuals with plantar fasciiƟs. 
 
To evaluate the eﬀect of IASTM on pain, range of moƟon, muscle strength, and quality of life. 
 
To evaluate the eﬀect of foam roller therapy on pain, range of moƟon, muscle strength, and quality 
of life. 
 
To compare improvements in foot funcƟon and disability between the two intervenƟons. 
Methods 
Study Design 
This study will be a Randomized Controlled Trial conducted as an experimental comparaƟve clinical 
study involving two intervenƟon groups. ParƟcipants diagnosed with plantar fasciiƟs will be recruited 
and allocated into two groups receiving diﬀerent physiotherapy intervenƟons. Outcome measures will 
be assessed at baseline and aŌer compleƟon of the treatment protocol. 
Study Seƫng 
The study will be conducted across physiotherapy outpaƟent seƫngs across Delhi NCR, India. 
ParƟcipants 
A total of 56 parƟcipants diagnosed with plantar fasciiƟs will be recruited and allocated into two 
groups. Group A: 28 parƟcipants and Group B: 28 parƟcipants. 
Eligibility Criteria 
ParƟcipants will be eligible for inclusion if they are between 18 and 45 years of age, experiencing pain 
on palpaƟon at the medial tuberosity of the calcaneus, and reported pain during the ﬁrst steps in the 
morning that decreased aŌer walking. Individuals with symptoms persisƟng for more than one month 
will be included in the study. Both male and female parƟcipants meeƟng these criteria would be 

considered for parƟcipaƟon. ParƟcipants will be excluded if they have a history of foot surgery, 
inﬂammatory rheumaƟc disease, previous steroid injecƟon in the aﬀected region, or radiculopathy 
aﬀecƟng the lower limb. 
IntervenƟons 
ParƟcipants in Group A (Instrument-Assisted SoŌ Tissue MobilizaƟon (IASTM)) would receive IASTM 
applied to the plantar fascia, gastrocnemius, and soleus muscles using specialized stainless-steel 
instruments. The therapist will use scanning and stroking techniques to idenƟfy and release soŌ-Ɵssue 
restricƟons. Treatment will be administered for approximately 5–10 minutes per session, followed by 
cryotherapy for 10–15 minutes. IASTM sessions will be provided on alternate days for three weeks. 
ParƟcipants in Group B (Foam Roller Therapy) ParƟcipants in this group will perform self-myofascial 
release using a foam roller applied to the calf muscles and plantar fascia. The foam roller will be moved 
back and forth along the muscle groups while maintaining controlled pressure. Each session shall 
consist 45 seconds of rolling followed by 15 seconds of rest for ﬁve repeƟƟons. 
Both groups would also follow a standardized exercise program consisƟng of stretching and 
strengthening exercises targeƟng the calf muscles and plantar fascia. The stretching component 
included gastrocnemius stretching, soleus stretching, and plantar fascia stretching, with each stretch 
held for 30 seconds and performed for three repeƟƟons. The strengthening program shall comprise 
toe curl exercises, ankle invertor strengthening, ankle evertor strengthening, and heel raise exercises 
to improve foot and ankle muscle funcƟon. The intensity and progression of the exercises will be 
adjusted according to the individual parƟcipant’s performance and tolerance to ensure safe and 
eﬀecƟve rehabilitaƟon. 
Outcome Measures 
The outcomes of the study include pain intensity, ankle range of moƟon muscle strength, quality of 
life, and foot funcƟon. Pain intensity will be assessed using the Numeric Pain RaƟng Scale (NPRS), an 
11-point scale ranging from 0 (no pain) to 10 (worst imaginable pain). Ankle range of moƟon will be 
measured in degrees using a universal goniometer. Quality of life will be assessed using the Short Form-
36 (SF-36) quesƟonnaire, which evaluates physical and mental health domains. Foot funcƟon and 
disability related to plantar fasciiƟs were measured using the Foot FuncƟon Index (FFI) quesƟonnaire. 
Study DuraƟon 
The intervenƟon protocol shall last for three weeks, with outcome measures recorded before and aŌer 
the treatment period. 
StaƟsƟcal Analysis 
StaƟsƟcal analysis will be conducted to compare pre- and post-intervenƟon values within each group 
and between the two groups. Paired t-tests will be used to assess within-group changes. Unpaired t-
tests will be used to compare outcomes between the two groups. StaƟsƟcal signiﬁcance will be 
considered at p < 0.005. 
Ethical ConsideraƟons 
Ethical approval has been obtained from the insƟtuƟonal ethics commiƩee before commencement of 
the study. ParƟcipants will be informed about the study procedures and shall provide wriƩen informed 
consent prior to parƟcipaƟon.