Effectiveness of Sandals and PT vs PT Alone on Pain and Function in Plantar Fasciitis

Recent evidence suggests that appropriate footwear can facilitate recovery in individuals with plantar fasciitis. This study evaluated the effectiveness of combining arch-supportive, shock-absorbing flip-flop sandals with physical therapy (PT) compared to PT alone in treating plantar fasciitis.

Sixty-six participants aged 20-60 years with normal body mass index and plantar fasciitis (median symptom duration = 6 months) were randomized into either an intervention group (n = 33; PT plus sandals) or a control group (n = 33; PT alone). Both groups received 8 weeks of PT and home exercises. Outcome measures were assessed at baseline, 4 weeks, and 8 weeks and included pain-related parameters, pressure pain threshold, the Foot Function Index, and the Lower Extremity Functional Scale. The global rating of change was evaluated at weeks 4 and 8.

Both groups demonstrated significant improvements across all outcome measures (P < 0.001). A significant time × group interaction was observed for first-step post-inactivity pain (F = 3.238, P = 0.042), with the intervention group showing greater improvement (mean reduction: 3.71 points, d = 2.01) compared to controls (mean reduction: 2.82 points, d = 1.30). Improvements in all other outcome measures were comparable between the groups.

While PT effectively improves plantar fasciitis symptoms, adding sandals provided significantly greater improvement in first-step post-inactivity pain. Further large-scale trials with extended follow-up are warranted to confirm these findings and assess long-term efficacy.

Source: Lunsarn T, Hunsawong T, Thanasootr KO, Chanavirut R, Chatchawan U, Boonprakop Y. Effectiveness of sandals combined with physical therapy versus physical therapy alone on pain and function in plantar fasciitis: a randomised controlled trial. Malays J Med Sci. 2025;32(4):189-202. doi: 10.21315/mjms-01-2025-018.