Sunday, July 12, 2026

Day 2 Of Kinesio Foundations Course

Most of the participants left some of the Kinesio taping done on Day 1 on them throughout the weekend. We went through how that felt so they can better understand how patients feel with tapes on after they leave to go home. Everyone felt that the taping had good results.

We then started Day 2 with the Kinesio Corrective Techniques. The occupational therapists in the class requested for a few scenarios for the upper arm and shoulder after a patient has a stroke and we covered that too, even though that was not in the syllabus.

We left more time at the end to do the Jelly fish and the epidermis, dermis and fascia (or EDF) techniques. The participants took their time as those techniques needed lots of focus and handling skills.

Doing the jellyfish taping
A big thank you to all the participants, my family and colleagues for helping out. Could not have done it without all of you. Stay tuned for the next course most likely in mid 2027.

Saturday, July 11, 2026

Kinesio Foundations Course Day 1

Sports Solutions hosted Day 1 of the Kinesio Foundations Course today. We have occupational therapists, physiotherapists, a medical doctor, a yoga instructor in our class this time.

With Dr Sangita and Sarah
Stay tuned for Day 2 tomorrow where there is a bigger emphasis on the Kinesio Medical Taping section instead of just the Kinesio Taping Methods where muscles, joint and tendons were the main focus. 

Some of the techniques include the Space Correction and webcut applications for bruising and swelling. We will also do the EDF (epidermis, dermis and fascia) and jellyfish taping. 

None of the other brands of tape have any of those techniques mentioned above.

Sunday, July 5, 2026

Tarsal Tunnel Syndrome

Picture from Orthopaedia.com
A patient came in to our clinic declaring she has plantar fascia pain in her right foot. She had seen another physiotherapist a few years ago for plantar fascia pain in her left foot and had gotten better. This time she tried orthotics, lots of stretching and even shockwave (or ESWT) with the same physiotherapist, but there was no improvement.

This is how she described her foot pain. She said there was a burning, aching pain at the bottom of her foot and on the inner heel. She said it almost feels like an electric shock. Her pain gets a lot worse after prolonged standing and sometimes wakes her up at night. She also gets numbness in her toes. 

None of those symptoms sound like plantar fascia pain to me. Patients with plantar fasciitis usually have pain during the first few steps when they get out of bed in the morning. There is rarely numbness, burning or electric shock sensations in the toes.

Upon assessment, there was no pain on the posterior calcaneal tubercle (where the PF inserts) nor along the plantar fascia itself. 

I elicited her pain when I did a modified Straight Leg Raise test by holding her foot in full dorsiflexion and eversion. However, there was no tingling or zinging in the foot when I tap on the medial malleolus (over the tarsal tunnel) - also known as Tinel's test. Online articles often describe a positive Tinel's test.

I explained my findings to her. My patient actually has Tarsal Tunnel Syndrome. This is when the posterior tibial nerve gets 'trapped' and irritated in the tarsal tunnel at the inner part of the foot (pictured below). 

Picture from Teachmeanatomy
The tarsal tunnel is a space just behind and below the medial malleolus and serves as a passageway for the posterior tibial artery, nerve and what we call Tom Dick and Harry muscles (tibialis posterior, flexor digitorum longus and flexor hallucis longus). The 'roof' of this tunnel is covered by the flexor retinaculum. It is a thick and strong fibrous band that holds Tom, Dick and Harry in place.

Tom, Dick and Harry- back of R leg
Entrapment of the posterior tibial nerve in the tarsal tunnel caused my patient's foot pain, not plantar fasciitis.

Online or AI* searches always say that flat feet or severe overpronation can cause tarsal tunnel pain as it can stretch the nerve although my patient does NOT have flat feet.

My patient did have a severe right ankle sprain a few months ago that caused swelling and perhaps thickening in the connective tissue in the tunnel that eventually caused this. It was also not treated properly, causing her to compensate and stand and walk differently possibly 'tractioning' her posterior tibial nerve.

A ganglion cyst in the canal may also cause this since it reduces the space in the tunnel. I have never come across this though in the 27 years of being a physiotherapist.

When a patient complains of bottom of foot pain, plantar fasciitis is usually the diagnosis one thinks of. The symptoms of tarsal tunnel syndrome pain can be similar to lumbar radiculopathy, diabetic and peripheral neuropathy or plantar fasciitis. Hopefully this article will correct that. 

 (*All the articles in this blog are written by me not by AI).

Reference

Boers N, Haverkamp M, Eligh AM et al (2026). Differences in Diagnosing Tarsal Tunnel Syndrome Across The Literature: A Systematic Review And A Call For Standardization. JBJS Rev. 14(2): e25.00222. DOI: 10.2106/JBJS.RVW.25.00222

L flexor retinaculum
Picture from https://drjustindean.com/retinaculaofthefoot/