# Physiotherapy Management of Plantar Fasciitis: A National Cross-Sectional Survey in Saudi Arabia

## TL;DR

This study surveyed physiotherapists in Saudi Arabia to understand how they manage plantar fasciitis and compared their practices to international guidelines.

## Contribution

The study provides the first national insight into physiotherapy practices for plantar fasciitis in Saudi Arabia.

## Key findings

- Most physiotherapists use clinical signs like pain during stretching and morning heel pain for diagnosis.
- Exercise therapy, stretching, and strengthening are the most common interventions.
- Advanced treatments like shockwave therapy are underused, suggesting a need for training and guidelines.

## Abstract

Background/Objectives: Plantar fasciitis is the most common cause of heel pain, affecting 4–7% of the general population. Physiotherapy is a key component of conservative management. However, there is limited evidence on how physiotherapists in Saudi Arabia manage this condition. This study aimed to investigate current physiotherapy practices for plantar fasciitis in Saudi Arabia and assess their alignment with international clinical guidelines. Methods: A cross-sectional survey was conducted among licensed physiotherapists practicing in Saudi Arabia who had treated patients with plantar fasciitis. An online questionnaire, adapted from a validated UK-based survey, gathered data on participant demographics, service characteristics, diagnostic criteria, treatment goals, outcome measures, and intervention strategies. Descriptive statistics were used for analysis. Results: A total of 399 physiotherapists participated. Diagnosis was mainly based on clinical signs such as pain during plantar fascia stretch (72.9%), early morning pain (70.4%), and medial heel tenderness (69.4%). Common goals of intervention included pain reduction (93.4%), functional improvement (69.9%), and patient education (57.3%). Pain scales (74.9%) and functional tests (49.1%) were the most frequently used outcome measures. Interventions such as exercise therapy (92.0%), stretching (89.4%), and strengthening (84.7%) were widely used. More advanced modalities like shockwave therapy and dry needling were less frequently reported. Conclusions: Physiotherapy practices largely align with international guidelines. However, variation in outcome assessments and underuse of advanced modalities indicate the need for national clinical guidelines and targeted training programs. These steps may promote more consistent, evidence-based care and improve patient outcomes in Saudi Arabia.