IMMEDIATE PAIN RELIEF AND RAPID RECOVERY THROUGH ARCH REALIGNMENT TAPING: A CHRONIC MEDIAL FOOT PAIN CASE IN A RECREATIONAL FOOTBALL PLAYER FROM SWAT, PAKISTAN

Abstract

Background: Chronic medial foot pain in athletes is commonly attributed to overuse syndromes related to excessive pronation, including posterior tibial tendon dysfunction and plantar fasciitis. In resource-limited settings like Swat, Pakistan, where access to advanced diagnostics and custom orthotics is constrained, simple, low-cost interventions are vital. This case report explores the immediate and short-term effects of a specific arch realignment taping technique based on the Mulligan Concept in a recreational footballer. Case Presentation: A 32-year-old male recreational football player from Swat, Pakistan, presented with a 9-month history of insidious-onset, progressive medial left foot pain, localized to the navicular tuberosity and along the course of the posterior tibial tendon. Pain (7/10 on NPRS) was exacerbated by running and jumping, severely limiting his sport participation. Physical examination revealed a significant bilateral flexible pes planus (left > right), a navicular drop of 12mm on the left, and tenderness over the navicular and posterior tibial tendon. Weight-bearing footprint analysis confirmed excessive midfoot collapse. Interventions & Outcomes: A low-dye taping technique with a specific medial glide component (Mulligan-inspired realignment) was applied to support the medial longitudinal arch and correct talonavicular subluxation. Immediate post-taping re-assessment showed a dramatic reduction in pain to 2/10 on the NPRS, an 8mm improvement in navicular drop to 4mm, and pain-free single-leg heel raises. The patient was provided with self-management education, a graded intrinsic foot muscle strengthening program, and instructed on self-taping for athletic activity. After two weeks of tape-supported activity and daily exercises, he reported sustained pain levels at 1-2/10 and successfully returned to full football training. At a 6-week follow-up, he remained pain-free without taping, demonstrating maintained arch posture and strength. Conclusion: This case suggests that a simple arch realignment taping technique can provide immediate biomechanical correction, pain relief, and facilitate rapid functional recovery in a patient with chronic medial foot pain related to hyper pronation. It highlights a viable, cost-effective first-line intervention for similar patients in resource-limited settings like Swat, Pakistan. Further controlled studies are necessary to validate its efficacy.