Treatment of Plantar Fasciitis and Calcaneal Spur with UC-BL shoe insert.

Myung Sang Moon; Seung Koo Rhee; Yong Pal Ahn

doi:10.4055/jkoa.1975.10.1.265

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Moon, Rhee, and Ahn: Treatment of Plantar Fasciitis and Calcaneal Spur with UC-BL shoe insert.

Original Article

J Korean Orthop Assoc 1975;10(3):265-271.

Published online: 23 March 1975

DOI: https://doi.org/10.4055/jkoa.1975.10.1.265

Treatment of Plantar Fasciitis and Calcaneal Spur with UC-BL shoe insert.

Myung Sang Moon, M. D., Seung Koo Rhee, M. D., Yong Pal Ahn, M. D.

Department of Orthopaedics, Catholic Medical College, Seoul, Korea

Department of Internal Medicine, Catholic Medical College, Seoul, Korea

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

The ideal arch support should satisfy the following conditionså that is, it should reduce the tension of plantar fascia during weight bearing and make the high longitudinal arch.

According to Campbell and Inman(1974), the defect of a conventional arch support is increment of tension of plantar fascia with bow-string effects, and therefore it cannot relieve the tension and plantar pain in flat foot though it can effectively make the high arch.

Authors pointed out the restriction of dorsiflexion of toes during push off phase as a another basic important defect of a conventional arch support in this report.

New arch support which satisfy these defects came to the front by Campbell and Inman(1974) recently. Yet, there are still technical difficulties to make it.

Lastly, authors introduced clinical experiences of the UC-BL shoe insert which effectively relieved the obstinate painful flat foot, fascitis and calcaneal spur.

REFERENCES

1.Basmajian J.V.., Stecko G.1963. The role of muscles in arch support of the foot: an electromyographic study, f. Bone Joint Surg. 45A:1184.

2.Bruce. J.., Walmsley R.1938. Some observations on the arches of the foot and flat foot. The lancet sept. 17:656–659.

3.Campbell J. W.., Inman V. T.1974. Treatment of plantar fasciitis and calcaneal spurs with the UC-BL shoe insert, eli. orth. No. 103. 57-62.

4.Elftman ., Herbert . 1960. The Transverse tarsal Joint and its control, clin, orthop. 16:41–46.

5.Engel G. M.., Staheli L. T.1974. The natural history of torsion and other factors gait in casting. A study of the angle of gait influencing tibial torsion, knee angle, hip rotation, and developinent of the arch in normal children, cli. orth. 99:1217.

6.Giannestras N.J.1973. Foot disorders. Medical and surgical management 2np ed 17-23.

7.Henderson W. H.., Campbell J.W.1967. UC-BJ shoe insert; Casting and fabrication. Biomechanics Laboratory, University of California, San Francisco and Berkeley. Technical report 53. Reprinted in Bull. Prosthet. Res. 10-11: 215.

8.Hick J. H.1954. The mechanics of the foot. The plantar aponeurosis and the arch. J. Anat. 88;25.

9.Mann R.., Inman V. T.1964. Phasic activity of intrinsic nuscles of the foot. J. Bone and Joint Sur g. 46 A; 469.

10.Manter J. T.., Hicks J. H.1941. Movements of the subtalar and transverse tarsal Joints. Anat, Res. 80:397.

11.Snook G. A.., Chrisman O. D.1972. The management of subcalcaneal pain. Cli orth. and Related research. No. 82:163–168.

12.Viladot A.1973. Metatarsalgia due to Biomechanical alterations of the forefoot. Orth. Cli. of North Arne. 4;1, Jan. 165-178.

13.Wright D. G.., Desal S. M.1964. Action of the subtalar and ankle Joint complex During the stance phase of walking. J. Bone and Joint Surg. 46-A:361–382.

14.Wright D. C.., Rennels D. C.1964. A study of the elastic properties of plantar fascia. J. Bone and Joint Surg. 46-A:No.(3):Apr.482–492.

Fig. 1.

Bowstring effect resulting from upward force on plantar fascia exerted by an arch support. (Campbell and Inman. 1974).

Fig. 2.

Axis of the subtalar joint. (Manter and Hicks. 1941.).

Fig. 3.

Position of foot for taking plaster cast for shoe insert.

Fig. 4.

Plaster-negative mould.

Fig. 5.

Plaster-positive mould

Fig. 6.

Cilastic UC-BL shoe insert.

Fig. 7.

Outlook of a patient's shoes with the UC- BL shoe insert in his shoes

Fig. 8.

Arch development. Engel and Staheli, (1974)

Fig. 9.

Arch makers responsible to each phase of a walking cycle (Mann and Inman. 1964.)

Fig. 10.

The windlass mechanism. (Hicks 1954.)

Table 1.

Causes of the plantar pain

causes	No. of foot
1. plantar fasciitis
due to flat foot	5
2. plantar fasciitis
due o heavy weight	1
3. calcaneal spur	2
4. pes cavus
due to post-poliomyelitis	1
Total	9

Table 2.

Etiologies of the plantar pain

1. pain on whole plantar aspect of the foot

1) foot strain

2) flexible or spastic flat foot

3) shortening of the achillee tendon

4) pes cavus

2. pain on plantar aspect of the heel

1) plantar fasciitis

a. chronic strain due to flat foot

b. asso, with metabolic disturbance (egågout,

rheumatism)

2) calcañal spur

3) calcaneal apophysitis (Sever’ s dis.)

3. pain on plantar aspect of the mid-foot

1) Köhler's dis.

2) accessory navicular (os tibiale externum)

4. pain on plantar aspect of the fore foot (Viladot, 1973)¹¹³

1) overload of the ant. support

a. equinus foot

b. cavus foot

2) irregular distribution of the metatarsal head

a. first ray insufficiency synd rome.

1. cong. shortening of the first metatarsal

2. metatarsus primus varus

3. backward placement of the sesamoid

4. hallux valgus, dislocation of sesamoid

5. iatrogenic origin

b. first ray overload synd.

1. hallux rigidus

2. sesamoiditis

c. central ray insufficiency synd.

1. neurological origin-Fridreich's dis.

2. cong. origin-cong. shortening of the ce
ntral metatarsal lobster claw foot

3. iatrogenic origin

Table 3.

Indications and kinds of arch support

Indications

Orthothotic appliances

1. flat foot
2. claw foot
3. plantari ascitis
4. caleaueal spur.
5- foot strain

1) Med. Long. Arch. Support
   A. internal modifications
      a. med. long counter
      b. cookie
      c. scaphoid.
      d. pad for calcaneal spur.
          (Nicholas, 1972)
      e. plastic heel cup. (Snook,
          1972)¹¹⁰
      f. whitman's steel arch sup
          port
^∗g. UC-BL shoe insert
   B. external modifications
      a. thomas heel
      b. robert's heel
      c. metatarsal bar
      d. wedges (Thomas heel or
          med. sole wedge)
      e. med. shank filler
      f. med. flaring
      g. valgus strap.
      h. corrective shoe
2) lat. long. arch, support
   A. internal modifications
      a. lat long countsr
      b. sole wedge insert
   B. external modifications
      a. reverse Thomas heel
      b. lat. sole wedge

      c. varus strap

Table. 4.

A study of the elastic property of plantar fascia (Wright and Rennels 1964)

Load (Lbs)	Tension on Plantar fascia (Lbs)	Elongation (per sent)
0	0
50	23.5	0. 24
100	47	1.20
150	70.5	1.44
200	94	1.68

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