Comparative Effects of Fascial Distortion Model and Foam Rolling on Pain, Calf Flexibility and Ankle Range of Motion Among High Heel Users: A Randomized Clinical Trial

Abstract

Background: Prolonged high-heel use is associated with calf muscle tightness, reduced ankle dorsiflexion, and pain, leading to functional limitations. Effective interventions such as the Fascial Distortion Model (FDM) and foam rolling are increasingly used in musculoskeletal rehabilitation, but their comparative efficacy remains unclear. Objective: To evaluate and compare the effects of FDM and foam rolling on pain, ankle dorsiflexion range of motion (ROM), and functional performance among habitual high-heel users. Methods: A randomized clinical trial was conducted with 30 female participants (age 18–26 years; BMI 21–37 kg/m²). Participants were randomly assigned to either the FDM group (n=15) receiving manual therapy (Trigger Band and Cylinder Distortion techniques) or the foam rolling group (n=15). Both interventions were administered twice weekly for 4 weeks, following a standardized baseline calf stretching protocol. Pain was assessed with the Numerical Pain Rating Scale (NPRS), ankle ROM with a goniometer, and functional dorsiflexion with the Weight-Bearing Lunge Test (WBLT). Results: Among Both interventions produced significant improvements across time points (p<0.001). At week 4, foam rolling showed superior outcomes compared to FDM: NPRS (3.80±0.77 vs. 4.40±0.73), ROM (18.60±1.05 vs. 14.20±1.52), and WBLT (16.36±0.21 vs. 10.22±0.70). Between-group differences were statistically significant (p<0.05). Conclusion: Increased FDM and foam rolling are both effective in reducing calf-related pain and enhancing ankle dorsiflexion among habitual high-heel users. Foam rolling, however, demonstrated greater improvements in pain reduction, ROM, and functional performance, supporting its use as a practical and effective intervention in clinical and athletic settings.

Keywords: Ankle Dorsiflexion, Fascial Distortion Model, Foam Rolling, Gait, Footwear, Rehabilitation, Myofascial Release, Pain Management, Range Of Motion, Weight-Bearing Lunge Test