The Impact of Petrissage on Functional Measures of High-Heeled Shoe Wearers


  • Sana Kayenat Association for Children with Emotional and Learning Problem
  • Amir Malik Jinnah Postgraduate Medical Centre
  • Basma Gul Jinnah Postgraduate Medical Centre


Ankle joint, Disability, Massage, Pain, Range of motion


Many women enjoy wearing high heels despite knowing they can harm their feet. Many uncomfortable conditions can originate from wearing this shoe, leading to biomechanical changes in ankle joints. Hence, the study is aimed to identify the effects of massage therapy in improving muscular flexibility among women wearing high heels.

Forty female participants with chronic heel pain were included in the single-blinded, randomized controlled trial. Participants were divided into Group-A (Stretching and deep heat) and Group-B (petrissage and deep heat). The treatment was performed for 4 weeks, 3 sessions/week in both groups. Foot function index and ankle dorsiflexion were recorded at baseline and after 4-weeks of intervention.

Forty female participants with a mean age of 28.23±6.24 were recruited. Both groups showed significant improvement in all three variables, i.e. pain, disability, and ankle dorsiflexion. However, Group-B showed more significant results with mean differences of 1.80±2.22 and 4.1±6.7 (p<0.05) for pain and disability, respectively. A similar result was observed for ankle dorsiflexion in which a mean difference of 0.95±1.08 in the left and 1.25±1.12 in the right ankle was observed.

Both treatment programs are highly effective in reducing pain, reducing disability, and improving ankle joint ROM. However, petrissage massage and deep heating were superior to superficial heat with static stretching for females with chronic heel pain.



Author Biographies

Sana Kayenat, Association for Children with Emotional and Learning Problem

Senior Physical Therapist

Amir Malik, Jinnah Postgraduate Medical Centre

Senior Physical Therapist

Basma Gul, Jinnah Postgraduate Medical Centre

Senior Physical Therapist


Song W-M, Seo H-J, Shin W-S. Effects of Electric Stimulation with Static Stretching on Hamstrings Flexibility. The Journal of Korean Physical Therapy. 2015;27(3):164-8.

Foster A, Blanchette MG, Chou YC, Powers CM. The influence of heel height on frontal plane ankle biomechanics: Implications for lateral ankle sprains. Foot Ankle Int 2012;33:64-9.

Jonhagen S, Nemeth G, Eriksson E. Hamstring injuries in sprinters the role of concentric and eccentric hamstring muscle strength and flexibility. The American journal of sports medicine. 1994;22(2):262-6.

Khan S, Shamsi S, Alyaemni AA. A comparision of superficial heat,deep heat and cold for improving plantar flexors Extensibilty. Middle-East Journal of Scientific Research.2013;13(4):477-482.

Bell DR, Padua DA, Clark MA. Muscle strenght and flexibility charachterisitics of people displaying excessive medial knee displacement. Archives of physical medicine and rehabilitation.2008;89(7):1323-1328.

Young R, Nix S, Wholohan A, Bradhurst R, Reed L. Intefrvention for increasing ankle joint dorsiflexion: a systemic review and meta-analysis. Journal of foot and ankle research.2013;6(1):46-55.

Steven E, Peres, David O, Draper, Kenneth L. Pulsed short wave diathermy and prolong long duration stretching increases dorsiflexion range of motion more than identical stretching without diathermy. T. Ath. Train. 2002; 37(1):43-50.

Knight CA, Rutledge CR, Cox ME, Acosta M, Hall SJ. Effects of superficial heat, deep heat, and active exercise warm up on the extensibility of plantar flexors, Physical therapy.2001;81(6):1206-1214.

Kaufman KR, Brodine SK, Shaffer RA, Johnson CW. The effect of foot structure and range of motion on musculoskeletal overuse injuries. The American Journal of sports medicine.1999; 27(5).585-593.

Kisner C,Kolby, LA. Chest physical therapy. In therapeutic exercise. Foundations and techniques, Jayepee Brother’s.1996;665-666.

Frey C, Thomas F, Smith J, Sanders M. American orthopedic foot and ankle society womens shoe survey, Foot Ankle.1993;14(2): 78-81.

Wearing High Heel Effect on body. Personal health zone, February 2009.

Kim Y, Lim JM, Yoon B. Changes in ankle range of motion and muscle strength in habitual wearers of high heeled shoes. Foot and ankle International,2013; 10-14.

Tidus PM. Manual massage and recovery of muscle function following exercise: A literature review. Journal of orthopedic and sports physical therapy.1997;25(2):107-112.

Singh S, Sinha AGK. Comparision of six minutes effleurage and kneading massage on alpha motor neuronal excitability in normal healthy individuals. Human biology Review.2014:3 (4),275-281.

Kablan N, Alaca N, Tatar Y. Comparison of the immediate effect of petrissage massage and manual lymph drainage following exercise on biomechanical and viscoelastic properties of the rectus femoris muscle in women. Journal of sport rehabilitation. 2021 Feb 22;30(5):725-30.

Singh S, Mehta A. Effects of concomitant use of PNF stretching with thermotherapy and massage on plantar flexors flexibility in young females. International Journal of Health and Rehabilitation Science, ISSN: 2278-9014, Vol:4, Issue:2.

Chris M Bleakley, Joseph. Do the thermal agents affect range of movement and mechanical properties in soft tissues? A Systemic review. Jan-2013;94(1):149-63.