Barefoot Walking VS Standardised Conservative Care for Plantar Fasciopathy

Clinical and Economic Effectiveness of Barefoot Walking Compared to Standardised Conservative Care for the Treatment of Plantar Fasciopathy: a Pragmatic Randomised Controlled Trial

The goal of this clinical trial is to learn if a barefoot walking programme can treat plantar fasciopathy (heel pain) in adults aged 18-70. The main questions it aims to answer are:

• Does a barefoot walking programme reduce heel pain compared to a standardised stretching and strengthening programme?
• Does a barefoot walking programme improve foot function and quality of life in adults with plantar fasciopathy?

Researchers will compare a barefoot walking programme to a standardised stretching and strengthening programme to see if barefoot walking is an effective conservative management approach for plantar fasciopathy.

Participants will:

• Be randomly assigned to either a barefoot walking programme or a stretching and strengthening programme
• Complete a 12-week home-based exercise programme
• Complete short weekly questionnaires throughout the 12 weeks
• Complete 3 follow-up surveys over 6 months after the intervention ends
• Receive education on load management and plantar fasciopathy

Inclusion Criteria:

• Aged 18-70 years;
• Clinical diagnosis of Plantar Fasciopahty, defined by: a) Pain localised to the medial calcaneal tubercle of sharp or stabbing quality; b) Pain worst with the first few steps in the morning or after a period of rest (first-step pain); c) Pain reproduced with palpation of the medial calcaneal tubercle OR positive Windlass Test;
• Symptom duration greater than 4 weeks;
• Able to walk independently without a mobility aid
• Able to provide informed consent and comply with study protocol

Exclusion Criteria:

• Prior surgery on the affected foot
• Diabetes with peripheral neuropathy or other neurological condition affecting lower limb sensation or motor control
• Active inflammatory arthropathy, uncontrolled vascular disease, or inability to walk unaided
• Current or recent (less than 6 months) bony stress fracture or other acute foot or ankle injury on the affected side
• Pregnancy during the intervention period
• BMI greater than 40 kg/m²
• Corticosteroid injection to the affected foot within the previous 3 months
• Night splints initiated less than 4 weeks prior to enrolment
• Any condition that would make participation unsafe, including open foot wounds