Related Experiment Video
Updated: May 6, 2026
Predictive Measurement for Windlass Change in Length and Selected Treatment Outcomes in Chronic Plantar Fasciitis
Published on: March 1, 2024
Comparison of a physiotherapy program versus dexamethasone injections for plantar fasciopathy in prolonged standing
Michael Ryan1, Jamie Hartwell, Scott Fraser
1*Allan McGavin Sports Medicine Centre, University of British Columbia, Vancouver, British Columbia, Canada; and †Griffith Health Institute, Griffith University, Southport, Australia.
Objective:
To investigate the effectiveness of a physiotherapy-based exercise program versus dexamethasone injection for chronic plantar fasciopathy in workers standing for prolonged periods of time.
Design:
A parallel group nonblinded randomized controlled trial with 12-week follow-up.
Setting:
An outpatient sports medicine clinic in Vancouver, British Columbia, Canada.
Participants:
Fifty-six workers required to stand for greater than 5 h/d with chronic plantar fasciopathy took part. Diagnosis from a physiotherapist must include signs of structural changes to the plantar fascia seen on ultrasound.
Interventions:
The PHYSIO group included 7 physiotherapy-led exercises performed daily over a 12-week period. The INJECTION group received 1 palpation-guided dexamethasone injection followed by a daily routine of calf stretching.
Main Outcome Measures:
The Foot and Ankle Disability Index (FADI) scores 12-weeks postintervention and ultrasound-based measures of ligament appearance.
Results:
At follow-up, both groups reported significant improvements in FADI and visual analog scales for pain at work and with activities of daily living at 6 and 12 weeks compared with baseline scores (P < 0.001). There were no significant between-group differences. There were no significant changes to plantar fascia thickness reported at the 6- and 12-week follow-up point. Both the number of cases with focal anechoic areas and the size of these anechoic areas improved significantly in the PHYSIO (P = 0.003) and INJECTION (P < 0.001) groups at 12-week follow-up.
Conclusions:
Workers standing for prolonged periods experienced the same short-term therapeutic effectiveness with a physiotherapy-led exercise program compared with an injection of corticosteroid with stretching.
