Randomized controlled trials evaluating exercise interventions for plantar fasciopathy pain: a systematic review and meta-analysis.

Background

Plantar fasciitis is characterized by mechanical degeneration of the plantar fascia with a possible tear at the calcaneal origin. Clinical findings are heel pain when taking the first step in the morning, local sensitivity and decreased functional capacity. Exercise, such as stretching and strength training are potential effective interventions for plantar fasciitis pain management.

Objectives

This systematic review aimed to assess the effectiveness of exercise on pain intensity (primary outcome) in patients with plantar fasciitis.

Method

We searched six databases (last updated October 10, 2025). Eligible were randomized controlled studies in adults diagnosed with plantar fasciitis, evaluating exercise interventions compared to a control group in which the subjects did not experience any type of exercise. Pain scores from unidimensional pain scales were extracted and the standard mean deviation (SMD) and 95% confidence interval (CI) were calculated. The risk of bias was assessed by Risk of Bias 2. The validation of quality and reporting of exercise training studies were assessed, and the certainty of evidence was rated using grading of recommendations assessment, development, and evaluation.

Results

Three studies met the inclusion criteria (n = 146). The risk of bias was moderate-to-high and the study quality and reporting in exercise showed moderate quality. There was an overall effect favoring the exercise interventions relative to no intervention on plantar fasciitis pain intensity reduction (SMD of -1.10, 95% CI: -2.01 to -0.19, 3 studies, n = 146 participants, I2 = 0.74, low certainty), indicating a benefit of uncertain relevance.

Conclusion

In conclusion, we found uncertain benefit of exercise interventions for plantar fasciitis pain intensity reduction, especially in short-term exercise protocols (≤3 months).