Effects of articulatory manual therapy versus soft tissue massage based on GDS muscle chains method in plantar heel pain: A randomized pilot study.

Abstract

BackgroundPlantar fasciitis (PF) is a leading cause of heel pain, impairing function and quality of life. While manual therapy is widely used, comparative evidence between specific techniques remains limited.ObjectiveThis study aimed to compare the effects of articulatory manual therapy (AMTG) and soft tissue massage based on the GDS muscle chains method (MCTG) on pain, function, and quality of life in individuals with PF.MethodsA two-arm, parallel-group randomized pilot trial with assessor blinding was conducted at a university physiotherapy clinic in Spain. Seventeen adults (18-65 years) with unilateral PF ≥1 month were randomized to AMTG (n = 8) or MCTG (n = 9). Both groups received 8 sessions over 4 weeks, including plantar massage, myofascial trigger point inhibition, and daily home exercises. AMTG included joint mobilizations; MCTG applied soft tissue massage based on GDS principles. The primary outcome was pressure pain threshold (PPT). Secondary outcomes included ankle dorsiflexion, dynamic balance, foot health (FHSQ), pain/disability (FFI), and quality of life (SF-12).ResultsSignificant within-group improvements were observed in PPT (p < 0.001), dorsiflexion (p = 0.005), and FFI (p < 0.001). AMTG showed greater improvement in SF-12 physical role (p = 0.045) and physical component (p = 0.049).ConclusionClinically, these findings suggest that both treatments can be considered valid options for reducing pain and improving function in patients with plantar fasciitis, although articulatory techniques offer an additional advantage in the physical component of quality of life. No adverse events were reported. Both treatments were effective; AMTG showed greater physical health benefits.