1. Plantar Fasciitis

​The plantar fascia is a thick band of tissue that runs across the bottom of your foot and connects your heel bone to your toes.  It maintains the foot arch (foot arch) to distribute weight and relieve shock. Plantar fasciitis commonly causes stabbing pain that usually occurs with your first steps in the morning. If it becomes chronic, you can feel heel or foot pain every step you walk.

What causes plantar fasciitis?

A foot with a normal foot arch distributes weight and absorbs the shock by walking. However, if the foot has a low arch, the weight distribution, and shock-absorbing function decrease. If tension and stress on this bowstring become too great, small tears can occur in the fascia. Repeated stretching and tearing can irritate or inflame the fascia due to sudden exercise, standing for a long time, sudden weight gain, and fatigue.

   
Normal Arch ​The foot has a low arch, and the function is decreased.

 

What are the symptoms of plantar fasciitis?

  1. The pain is usually the worst with the first few steps after awakening.02. A stinging pain appears on the heel side when you wake up after sitting for a long time.03. When standing for a long time, it feels stiff, and pain intensifies.04. The pain will get worse with dorsiflexion.

Orthotics help treatment of plantar fasciitis.

​Foot orthotics treatment is most important when the foot arch is collapsed. In the case of the plantar fascia, which occurs when a person has a normal foot arch, it can be treated without foot orthotics. In general, over 90% of patients will experience symptoms within 6 to 8 weeks through EMS pain treatment.

9-2. Bunion– Deformity and Pain of Big toe

 

What causes a bunion?

A foot with a normal foot arch distributes weight and absorbs the shock generated by walking. However, if the foot arch is low due to various causes, the weight distribution and shock-absorbing function are deteriorated, resulting in the deformation of the big toe.

​What are the symptoms of a bunion?

01. The big toe pushes against the index toe.

02. The first metatarsophalangeal (MTP) joint turns outward (or medially) and the big toe points in the opposite direction and becomes red due to friction with shoes. Callus gets stuck, inflammation and pain occur.

03. Because the big toe cannot use strength, the gait is deformed, the feet and legs are easily tired, and the waist easily hurts.

 

What angle b/w 1st metatarsal and the proximal phalanx can determine the bunion?

     
Mild: Angel <20 degrees, intermetatarsal angle usually less than 11 degrees. Moderate: Angle 20~40-degree, the intermediate angle between 11 and 18 degrees. Severe: Angle > 40 degree, intermetatarsal angle> 16~18 degree

 

  1. Even though you do not wear high heels or narrow shoes, a bunion can occur. Why?
     
​Normal arch ​Low arch ​Flat feet

 

​For people with low foot arches or flat feet, the propulsion of the big toe is weak, so even if you do not wear high heels, you can walk with a toe out gait or twist your big toe while walking. If left untreated, it becomes more severe and can cause spinal and pelvic pain due to foot imbalance.

  1. Treatment depends on the type of bunion.
There is a bunion, but what if the arch is normal? Progressive bunion

Since it is not a problem with the original foot, it is likely a problem with the shoe itself.  So merely avoiding high heels by wearing wide-footed shoes can prevent the progression of the bunion.
What if you have a bunion and a low arch? Fixed bunion

Since the foot shape is already distorted or the foot itself is a problem with the foot imbalance, changing the shoes will not stop the progress. The symptoms of hallux valgus should be resolved through foot orthosis.

To prevent bunion deformation early, treatment with a foot orthosis is most important. For deformations of 40 degrees or less, the progression of bunion transformation can be prevented only with foot orthosis and exercise therapy without surgery. In addition, exercise therapy to strengthen the muscles of the foot and calf and to avoid the habit of exacerbating the deformity can easily prevent the progression of the bunion.

Having a diagnosis of a bunion is more critical than consulting with a medical professional rather than having to perform surgery quickly. * Since the Bunion strain has a genetic tendency, it is recommended to perform an early flatfoot correction before the foot arch is completely formed if the parent has a bunion and the child has flatfoot.

  1. 9-3. Habitual Sprain– Ankle instability after sprain! ​What are the symptoms of a habitual sprain?
    1. Pain and swelling in the ankle ligament and gait disorders are common.02. In the case of a sprain, when the swelling occurs immediately with the sound of ‘pumping’ at the ankle if you cannot walk after spraining, it means severe damage.03. In case of a severe sprain, after one or two days of damage, bruises are formed around the entire ankle without being confined to the outside of the ankle.
         
    Lateral ligament ankle sprain
    About 85% occur in the lateral ligaments of the ankle.
    Outer ligament ankle sprain About 85% occurs in the lateral ligaments of the ankle.    		 Digital tibiofibular ligament ankle sprain

    In about 5%, the ligament damage that connects the tibia and fibula takes a long time to recover.

    		 Medial ligament ankle sprain

    Ankle medial ligament damage is not common.
    Medial pain may be chronic in people with flat feet or low foot arch.

     

    ​The goal of sprain treatment is to prevent chronic pain and instability. Even a light sprain can become habitual and requires sufficient treatment. Also, severe sprains can lead to chronic pain, ankle instability, and arthritis. Active and continuous treatment is required.

    Tingling and pain of medial sole!

9-4. Tarsal Tunnel Syndrome

Tarsal tunnel syndrome refers to the numbness and tingling of the soles caused by the pressure of the plantar nerves passing through the tarsal tunnel. Most of the tendons, nerves, and blood vessels that move and nourish the feet pass between the inner ankle and the heel, which is called the tarsal tunnel. When the nerve passing from the ankle tunnel to the sole is pressed, symptoms of ankle tunnel syndrome occur.

What causes tarsal tunnel syndrome?

  1. It can feel dull pain (hot or low pain) on the soles of the feet.02. It can feel the pain descending to the sole or extending toward the legs.03. Symptoms worsen by activity and recover when you rest.04. There is a pain when touched according to nerve traveling.05. When symptoms worsen, the feet become numb, or the weakness causes them to deform like a toe.

 

What are the causes of nerve compression on the tarsal tunnel?

     
Damage from ankle sprain, fracture, and bruising People with low foot arches Sudden excessive exercise
Suddenly gain weight or stand for a long time
High arch with habitually sprains

 

Tarsal tunnel syndrome is recovered by the treatment of foot orthotics that straighten the foot arch.
Also, acupuncture treatment relieves nerve entrapment.
Fast and easy symptom relief through muscle and fascia correction by Re-memory therapy for foot and calf muscle recovery.
Symptoms usually go away after 3 to 6 weeks of treatment.

9-5.Sinus Tarsi Syndrome

Sinus tarsi is a tunnel between the talus and the calcaneus bones.
Sinus tarsi occur with a little movement so that the foot can adjust to the uneven ground, and a strong ligament secures the bone between the bones so that it does not move too much.
​
Sinus tarsi syndrome is pain or injury to this area. Traumatic injury to the ankle/foot (such as an ankle sprain) or overuse (such as repetitive standing or walking) are the main causes of this syndrome. It may also occur if the person has a pes planus or an over-pronated foot, which can cause compression in the sinus tarsi.

What causes sinus tarsi syndrome?

   
​Normal arch Flat feet or low arch

 

Flat feet or low arches cause excessive ankle movement when standing. Ankle instability increases, ligament muscles tend to overstretch or tear, causing inflammation. Ligaments tore, and it doesn’t recover properly the foot muscle syndrome develops and becomes chronic, leading to degenerative arthritis

 

What are the symptoms of sinus tarsi syndrome?

  1. Even if you walk a little or do some activities, you feel your ankles are sore02. Your ankle does not have enough, so you feel like going to sprain your ankle.03. It does not recover after an ankle sprain and proceeds chronically.

​Sinus tarsi syndrome occurs when flatfoot or low foot arches.
If it is not treated properly and becomes chronic, degenerative arthritis occurs in the subtalar joint, so early treatment is the most important.

​Since the functional binding patterns of the feet that cause Morton’s neuromas are diverse, a foot orthotics should be used after an accurate examination of the shape of the foot. Even though only using precise foot orthotics can provide excellent treatment results.

9-6.Achilles Tendinitis

The Achilles tendon is a tough band of fibrous tissue that connects the calf muscles to the heel bone (calcaneus). The Achilles tendon is the largest and strongest tendon in the body. When the calf muscles flex, the Achilles tendon pulls on the heel. This movement allows us to stand on our toes when walking, running, or jumping.  The inflammation of the Achilles tendon is called Achilles tendinitis.

The Achilles tendon is a very strong tendon that connects the calf’s muscles and heels and has the same tensile force as a rebar of the same cross-section. It does the most work in our body, and when we stand still when we walk or run, it provides the driving force. It is a very important structure. This Achilles tendon is called Achilles tendinitis, tendinitis.

​What causes Achilles tendinitis?

       
The calf muscles are too tight and stiff ​The foot is deformed Leg length discrepancy ​Pain in the heel area
Because of shoes
If the calf muscles are too hard and stiff, the ability to contract and relax decreases, resulting in increased tension in the Achilles tendon, which is easily torn and damaged. With flat feet or low foot arches, the calf muscles’ tension is prone to Achilles tendonitis. It requires using foot orthotics to treat the deformation of the foot and the muscles. Due to the leg length discrepancy, if a heavy load is applied to one Achilles tendon, it is easily damaged. If this condition persists, the improvement and exacerbation are repeated and can develop into chronic Achilles tendinitis. The upper part of the heel often causes pain due to friction caused by the heel of the shoe, and if the shoe has recently changed, the shoe is likely the cause of the pain.

 

​What are the symptoms of Achilles tendonitis?

  1. Heel Achilles tendon pain after intense exercise or movement.02. Exercise limitations due to swelling of the ankle.03. Pain may occur in the soles of the feet when waking up in the morning and stepping on the feet.04.  Cramps on the calf

 

Tingling, pain, and burning sensation on the toes!

9-7.Morton’s Neuroma

​Morton’s neuroma is a symptom of pain, tingling, and burning in the toes caused by repeated compression and friction of nerves between the toe bones. It is easy to appear when there is a functional defect in the foot or inflammation of the tissue around the plantar nerve.
It can be treated quickly and reliably with foot support, saliva, and re-memory therapy.

​What causes Morton’s Neuroma?

​Wearing high-heeled or narrowed shoes Foot deformities
High arches or flat feet		 ​The big toe is stiff, so it doesn’t move well. ​The gap between the heads metatarsal bone is wide due to the low transverse arch of the foot

What is the symptom of Morton’s neuroma?

  1. The toes, especially between the 3rd and 4th toes, are sore and tingling.02. Symptoms get worse when wearing shoes, and pain alleviates or disappears when taking off shoes.03. Fever or pain in the front part of the foot04. Symptoms are aggravated when wearing pointed shoes or high heels