Longitudinal and transverse platypodia and its treatment
Flattening is a deformation of the arch of the foot, viz. Lowering of the arch. As a result of this deformation, the foot almost completely loses its damping properties, which leads to a number of unpleasant consequences and complications. In this article, we will try to understand as much as possible what is a flatfoot - treatment, symptoms, causes and complications.
In a healthy state, the human foot has two distinct arches - transverse( located under the bases of the fingers) and longitudinal( located along the foot).These arches fulfill the most important function - they enable the person to maintain balance and absorb shock during walking. It is clear that the foot itself, and specifically these arches of the foot are under serious load, because they weigh on the weight of the human body. And if the ligaments and muscles of the feet stop working normally and for some reason weaken, the shape of the foot begins to change - the arches of the feet decrease, it gradually becomes flat, as a result of which the main function of the foot - the spring one - is lost.
Healthy feet - a healthy body
If the foot ceases to absorb the load, then this function will be forced to perform other joints( ankle, knee and hip), and "get" and the spine. But they cope with such a function not too well, because they are not designed for this. In addition, such a peculiar load leads to an accelerated "wear" of the joints.
This is why flat feet are often the cause of pain in the legs and back of the , although at first glance the person simply does not see such a connection. So it is worth remembering that it is as a result of the development of flat feet that pain can appear in the feet, hips, knees and lower back, rapid fatigue when walking. In this case, the pain appears at a time when the body can no longer provide normal movement, and is forced to "redistribute the load."As a result, joints of the legs and hip joint suffer, posture disorders or problems with intervertebral discs may occur. The final result of the effects of flat feet on the body can be the development of scoliosis and arthrosis, often the development of varicose veins.
Another interesting fact is that quite often this disease occurs in people with "sedentary" work, and not only in the category of workers who are forced to spend the whole day on their feet. This is due to the fact that the muscles and ligaments weaken without load( too large loads can also lead to flatfoot development), so it is very important to maintain a certain motor activity.
Many young people are wondering whether they are taking to the army with flat feet. On our site there is already an article that can answer this question.
The causes of flatfoot
The reasons for the development of flatfoot can be quite a lot, we will try to list the most "popular" ones:
- bad or unsuccessfully matched shoes. It means shoes with a high heel or platform, narrow shoes, etc.;
- increase in body weight, which can occur for various reasons( pregnancy, obesity, etc.);
- hereditary predisposition. In this case, we are talking about defects in the development of the muscles, ligaments and bones of the foot;
- various injuries( trauma to the foot, fracture of the calcaneus or ankle, cracks or severe bruising of the cartilage, damage to the muscles and ligaments of the foot);
- diseases( for example, rickets, as a result of which the bones weaken and become soft, so they can easily deform, and the complication of poliomyelitis can arise - the leg and foot muscles paralysis);
- sedentary work and sedentary lifestyle. In this case, the muscles and ligaments of the foot become weaker, since they do not receive the necessary loads;
- excess load - running and jumping sports, standing work.
There are quite a few reasons, as you can see.
The human foot has two main arches, so it is quite logical that there are two types of flatfoot - longitudinal and transverse flat feet. Accordingly, with a decrease in the arch, the foot may increase in width or length. There is also a combined flatfoot, in this case we are talking about the simultaneous flattening of the transverse and longitudinal arches. This situation is also called longitudinal-transverse flatfoot.
Both basic types of flatfoot are quite common, but the most common is the transverse one.
Also, when classifying by species, the acquired and the congenital are often divided. Congenital flat feet are rare, it is the result of malformations of the fetus. Treatment of flat feet in this case begins with the first days of the child's life.
Types of flatfoot
But with the acquired flatfoot the situation is somewhat more complicated - it can appear at any age and can be of several types:
- is ricky;
- is paralytic;
- is traumatic.
Traumatic - occurs as a result of fractures of the bones of the ankle and foot, or with severe damage to ligaments and soft muscle tissue that strengthens the arch of the foot.
Paralytic - occurs as a result of poliomyelitis, or because of paralysis of the tibial muscles and foot muscles.
Rickets - occurs as a result of rickets. This disease disrupts the normal formation of foot bones, they do not have the necessary characteristics in this case and can quickly deform.
But the most common form is static flatfoot. Approximately 80% of all cases are related to this species. Causes in this case may be overweight, uncomfortable shoes, prolonged excessive stress on the feet, weak muscles and ligaments of the foot, etc.
Degrees of disease
There are 3 degrees of development of this disease.
Longitudinal flatfoot is less common, but with this disease the change in the shape of the foot is gradual and almost invisible to the patient.
- Longitudinal flat-foot 1 degree is characterized by the appearance of fatigue of the legs. This degree is very poorly expressed, the patient can only experience discomfort when pressing on the foot or while dressing the shoes. In some cases, swelling may appear in the evening.
- Longitudinal flatfoot of the 2nd degree is already manifested by constant pains, which can be quite intense and spread to the region of the shins and ankles. With this degree of disease, the gait is already losing its smoothness, walking becomes heavier.
- Platypodia of the third degree is manifested by persistent severe pains that cover not only the foot, but also the lower leg, and in some cases even low back pains appear. Deformation of the foot with this degree of disease is already pronounced and very noticeable, often there are swelling in the joints of the foot. Walking to a person at this stage of the disease is difficult, in ordinary shoes it becomes very difficult to move around.
Do you happen to have such symptoms?
It is worth paying attention to the appearance of such symptoms:
- shoes trampled on the inside;
Flat feet have every third person in our country
- very quickly get tired feet while standing or walking;
- appears pain in the foot after physical exertion;
- at the end of the day feels pain and fatigue in the legs, there is a feeling of heaviness, puffiness;
- swelling in the ankles;
- walking on heels becomes very hard;
- leg increases in size, resulting in buying shoes for size larger.
Many of these symptoms correspond not only to flat feet, but also varicose veins, so that when they occur, you should immediately consult a doctor.
Symptoms of longitudinal flatfoot
- fatigue in the legs, with pressure on the middle of the foot or sole appears pain, by the evening the back of the foot swells;
- persistent and severe pain in both the feet and in the legs and ankles, it becomes difficult to find comfortable shoes;
- together with pain in the feet begins to appear pain in the lower back, outwardly becomes invisible longitudinal arch;the foot swells, the ankle joint is inactive, in ordinary shoes it becomes very difficult to walk.
Symptoms of transverse flatfoot
- disappear the transverse arch of the foot, as a result of which the deformation of the fingers develops;
- there appear pain and skin pigmentation in the forefoot;
- appears hammer-shaped fingers.
What should be the treatment?
First and foremost, it should be noted that the treatment of transverse and longitudinal flat feet in principle is the same in terms of measures applied. In addition, it must be remembered that if an adult is treated, there will still be no complete recovery, only certain improvements are possible. But the children are fully recovered because the child's leg is just being formed and correction is possible.
Treatment of flatfoot in adults
Since the full recovery of an adult with this disease is impossible, the treatment is designed primarily to stop the progression of the disease, and then create the necessary conditions for adjusting the foot. That is why is very important to diagnose the disease as early as possible .
Since the conservative treatment is the preferred method of treatment of the disease in the early stages of its development, the treatment involves the removal of pain and the improvement of the condition of the muscles and ligaments of the foot, thus stopping the development of the disease.
The video, which you can see below, shows one of the methods of diagnosis and treatment of flatfoot:
For the removal of pain, medications are usually used in combination with physiotherapy procedures.
The basis of the same treatment is therapeutic gymnastics. at flatfoot is determined by the orthopedic physician , and the exercises are selected for a specific patient, taking into account the form and extent of the disease.
A good therapeutic effect with flat feet gives a foot massage, including a hydro massage. Thanks to such procedures, blood circulation is normalized and the muscle tone of the shin and feet is increased.
At the initial stage, a good effect gives the use of special orthopedic insoles, which again are made individually.
But, unfortunately, the above procedures will have a serious effect only in the early stages of the disease. With strong deformations of the foot, which occur in the late stages of the development of the disease, there is only one method of treatment - surgery.
Treatment of flat feet in children
Most often, children develop longitudinal flat feet, and it is successfully treated fully without surgery, since the bones, muscles and ligaments of the child are quite susceptible to conservative methods of treatment.
If you have to deal with a congenital type, then it begins to be treated from the first days of the child's life, for which special langets and bandages are used. But this type of disease is rare.
In most cases, the causes of flatfoot are weak ligaments and muscles, as well as fragile bones. That is why the treatment has a toning effect - mainly therapeutic exercise and massage. Also, contrast baths for feet are often helpful. It is also necessary to wear special orthopedic shoes, and you should take care of the child's gait very carefully.
The most important factor in the treatment of this disease in children is time - the earlier the disease is diagnosed, the greater the chances of complete recovery of children. For the same reason, it is important to prevent flat feet in childhood.
VashaSpina.ruWhen rest, massage and other methods do not help to eliminate the pain, you can resort to drug therapy. Systemic analgesics: aspirin, flugalin, ibuprofen, diclofenac, indomethacin, paracetamol, etc. Topical application: indomethacin ointment, Dolgit cream, voltarene gel, etc. Special treatment procedures : electrophoresis with novocaine, phonophoresis with hydrocortisone, paraffin-ozokerite applications, etc.
Release from the army of conscripts with flat feet( according to RF norms).Based on the "Regulations on Military Medical Examination" No. 123, dated 25.02.2003, military service and enrolling in military schools and schools does not prevent people with the following disabilities:
- I-II longitudinal flat-foot
- Transverse flatfootI degree, in the absence of arthrosis in the joints of the foot( middle section), exostoses( bone-cartilaginous sprouting in the form of a spine) and contractures( restriction of joint mobility).
- Longitudinal or transverse flatfoot II degree c, presence of severe pain, deforming arthrosis of the II stage of the midfoot joints, contracture of the fingers;
- III-degree longitudinal flatfoot, transverse flatfoot III-IV degree
- The formation of the right gait, not to breed socks when walking - this overloads the inner edge of the foot and its ligaments.
- With the predisposition to flat feet to choose the right place of work( work not associated with long loads on the legs).
- Properly selected shoes, on a thick and soft sole, heel not more than 4 cm.
- Wearing insoles for long loads.
- In his spare time, give rest to his legs, at least 30 seconds, 3-4 times a day to stand on the outside of the feet.
- After work, it is recommended to take warm baths for the feet, with their subsequent massage.
- Walking barefoot on an uneven surface, over pebbles, along the sand, walking on the heels, the inner surface of the feet, tiptoe, outdoor games.
- Maximum limit the wearing of shoes with high heels
- Correctly dose physical exercise, avoid excessive loads
Why is posture affected by flat feet?The human body works as a whole. Between bodies there are not only anatomical, but also functional interrelations. With flatfoot, the center of gravity is displaced backward. In order to maintain balance, the spine has to deviate forward. Over time, deformation increases, posture is formed - round back .The normal arch of the foot works like a shock absorber. With flatfoot this function is violated. As a result, the spine and knees have increased loads. This leads to an even more severe violation of posture, scoliosis, herniated discs. Knee joints can develop arthrosis .Flattening and problems on the part of the spine have some common causes: weakness of connective tissue, ligaments and muscles, obesity, increased physical activity.
Which mats can I use with flat feet? How to choose them correctly?Special massage mats have on their surface a variety of pebbles, protuberances, "pimples".They are widely used for the prevention and treatment of flat feet. Effects of massage mats :
- effect on reflexogenic foot points;
- improvement of blood circulation and lymph drainage( due to this there is a decrease in edema on the legs);
- strengthening of muscles and ligaments;
- elimination of seizures, pain;
- elimination of stresses, increase in general tone.
- First of all - consult a doctor .The expert will tell you which model of the rug is best to buy in your case.
- It is best to buy a mat in the orthopedic salon .Before you buy the product, be sure to deploy it, stand with your bare feet and try to walk. If it causes pain or severe discomfort, it is better to choose another model.
- For a child under 3 years old, a mat made of rubber is best. Later you can buy a model on a silicone base. Adults often recommend rugs from the Altai birch.
- Try to choose a rug, which is not one, but several different types of relief .This will provide different types of impact on the sole. For example, in addition to the "stones" on the surface may be villi for soft massage soles.
- Inspect the mat before buying .Make sure that all the protrusions and "pimples" are strong enough. Think about how convenient it is to wash, store the selected model.
- for children and adults diagnosed with flat feet;
- for children, for the prevention of flat feet;
- to people, leading a sedentary lifestyle, those with sedentary work;
- to women, who walk a lot in shoes with stilettos.
How to choose orthopedic insoles for flat feet?Orthopedic insoles can be used for preventive purposes or to combat flatfoot. Medical orthopedic insoles need to be selected together with a doctor. Usually they are made individually, according to one of three methods:
- Computer modeling .A person stands on a special platform, which registers the pressure of various parts of the foot and transfers to the computer. An image is displayed on the monitor.
- Production of plaster casts .
- Thermoforming . Insole is made of special material, which takes the form of a patient's foot.
- Obtaining a print with a special bio-foam.
How is flatfoot encoded in the ICD?In the international classification of flatfoot diseases two codes are assigned:
- M21.4 - acquired flat foot;
- Q66.5 - congenital flat foot.
What gymnastics can I perform with flatfoot?Gymnastics with a flat foot are selected individually, depending on the type and severity of flatfoot. Start classes only after you consult a doctor and find out what exercises are recommended in your case. Some exercises that can be performed with a flatfoot : In prone position : 1. With your legs slightly apart, squeeze and unclench your toes for about 2 minutes. 2. With your legs spread out, rotate the feet clockwise, then in the opposite direction. 3. Pull your foot socks over. You can perform both legs simultaneously or alternately. 4. Detach the heels from the floor, leaning their toes. 5. Bend the legs in the knees, push them apart, simultaneously folding the soles together, so that they touch. Then "clap" your heels: dilute and reduce them, resting with your toes. 6. Place the right foot on the left ankle. Move the right foot along the left shin towards the knee, while trying to clasp her leg. Repeat with the left foot. In sitting position on a chair : 1. Squeeze your right hand into a fist and tightly hold it between your knees. Raise the inner parts of the feet, and the outer one is pressed harder against the floor. Repeat several times. 2. Detach the heels from the floor - at the same time with both feet, then alternately. 3. An exercise similar to the previous one, only this time you need to remove socks from the floor. 4. Place different small items on the floor. Grab their fingers with your feet and shift from one place to another. 5. Bend your fingers while pulling your heels forward, then straighten them. The foot should "crawl" on the floor, like a caterpillar. In standing position : 1. Stand several times on your toes. Then alternately tear off the right and left heel from the floor. 2. Stand on your heels several times. In this case, the toes must be completely detached from the floor. 3. Perform several sit-ups and half-squats on your toes.
Is physical education given to a child given flat feet?This question is solved individually, depending on the type and severity of flatfoot, other factors. If the deformity and foot function are severely deformed, the child can be completely freed from physical training. In other cases, it is classified into one of four groups:
- group LFK: children who have a disease requiring an individual program of study;
- special group: for children, for whom the load in ordinary lessons is too high, restrictions are required;
- preparatory group: no restrictions in physical activity, but the child is exempt from the delivery of standards;
- core group: no restrictions.
How does flatfoot differ from clubfoot?Flat feet are any deformation of the foot at which the longitudinal or transverse arch falls. The reasons for this violation can be different. Clubfoot is a congenital disorder, the causes of which are not yet fully established. In this case, the foot is most often turned down and inward.
What kind of sports can you practice with flatfoot?For flatfoot, the following sports are recommended: :
- Free style swimming .It has a beneficial effect not only on the legs, but also on the spine column, the muscles of the back, helps to combat postural disorders and other pathologies. But with flat feet, you should not get involved in swimming with a crawl, as this increases the load on the muscles of the legs.
- Skiing .In this case, the load on the legs should be small. Intensive skiing is contraindicated.
- Equestrian sport . Horse riding helps strengthen the muscles and tendons of the back, legs.
- Some types of martial arts .Aikido, karate and kung fu do not assume an increased strain on the legs, but help strengthen the tendons and muscles.
Degrees Flatness - 1 - 2 - 3 - Characteristic of the DiseaseRubric: Beauty and Health |11/04/2014 |0 Comments It is known that the human foot is not at all flat. Her bend is not just an art creation of nature, but a real shock absorber, softening the impact of the foot on the asphalt, preventing the wear of the spine and helping to keep the balance when walking. However, if the arch of the foot becomes flat, as before, its functions are no longer able to perform, which threatens the development of such a disease as flat feet. In this article, we consider the types and degrees of flatfoot - 1, 2, 3.
General characteristics of the disease
Immediately we say that the flatfoot is longitudinal or transverse. In this case, each species is divided into three degrees. All of them have their own peculiarities, however, it is possible to express the common features of each species.
- The first degree of flatfoot is a weak defect, which can be called cosmetic, as it does not cause pain and does not provoke other diseases.
- The 2nd degree of flatfoot is a moderate pronounced defect, in which the flattening of the foot is noticeable to the naked eye. The person in this case experiences moderate pains and complains of fatigue of the legs. In addition, he can appear clubfoot and heavy tread.
- 3rd degree of flatfoot is a pronounced defect in which complete deformation of the foot is observed. In this case, the patient experiences severe pain in the ankle, his legs get tired quickly, but the most dangerous is that this condition leads to disruption of the musculoskeletal system, which means the development of scoliosis, arthrosis, osteochondrosis or even the appearance of a herniated intervertebral disc. These are only common features of two types of flatfoot. Let's consider each of them separately.
In case of development of this type of disease, a longitudinal arch is disappearing in a person, which means that practically the entire foot becomes flat. But the length of the foot slightly increases. There is such an ailment, as a rule, in young women, especially those who are overweight or those whose work is associated with constant static stress( secretaries, sellers).
- The 1 st degree of the disease usually does not let you know about yourself unpleasant symptoms. Occasionally there is only fatigue of the feet, and even with prolonged loads. The height of the arch of the foot varies from 25 to 35 mm.
- The 2 nd degree of flat feet is manifested by increased pain and even difficulty in selecting shoes. The height of the vault is in this case within the range of 17-24 mm, and also the curvature of the scaphoid joint can be seen.
- 3rd degree causes constant pain in the lower leg and even in the lumbar region of the patient. As for the selection of shoes, in this state it is very difficult, and sometimes impossible. The height of the vault is less than 17 mm.
In the case of this type of disease, the lateral arch is flattened, and the length of the foot is somewhat reduced. The joint of the big toe is deformed and deviates from the rest. Characteristic of this ailment for people over 40 years of age, and usually in patients there are natoptypsis or the bone of the toe begins to grow.
- The 1st degree of flatfoot is manifested by weak foot pains. The angle between the bones does not exceed 12 degrees.
- 2-nd degree is marked by pronounced painful sensations under the heads of metatarsal bones. The above angle does not exceed 15 degrees.
- The third degree of defect makes you aware of yourself with severe aching pains and the formation of large corns. The angle between metatarsal bones in this case becomes more than 20 degrees.
As you can see, the degrees of flat feet - 1, 2, 3, vary considerably among themselves, and therefore the earlier a person notices the symptoms of an illness and thinks about treatment, the more he has the chance to never experience the unpleasant symptoms of flatfoot. Take care of your health!
What is this disease
Flat-footedness implies an obvious physical change in the arch of the foot in longitudinal or transverse form. But most often in patients of all groups there is a transverse flatfoot, which can be accompanied by other diseases of the joints. Longitudinal version of flatfoot is much less common, but also often burdened by passing diseases. Flattening occurs in several species, each of which is due to various causes of this disease.
Rickets appear flat in people with rather weak feet that can not withstand the weight of their own weight. That is, when walking, the total weight of the body is distributed on the feet, and they do not stand it.
Static flat feet is the most common type of this disease and occurs in 80% of cases. This kind of flatfoot is associated with the weakness of the muscles of the foot and shin, as well as the whole apparatus of bones connected to each other in this part of the leg. The reasons for this kind of flatfoot can be working in a sitting position, increasing the mass of the whole body, and, respectively, the load on the foot. In addition, such a disease can result in a decrease in muscle strength at a certain age or a complete lack of physical exertion on the foot in connection with a certain way of life. Also, the frequent cause of static flatfoot is heredity or some external causes. For example, an overload of the foot caused by the peculiarities of the profession, wearing uncomfortable shoes or keeping an incorrect lifestyle. Often such a disease occurs in people who work in shops for a long time and are forced to stand for 7-8 hours a day.
Traumatic flat feet can appear due to fractures, for example, tarsometal bones, heel bone or ankle fracture. The congenital form of flatfoot manifests itself at the age of five to six years old, it is difficult to determine the disease before, because in children the foot and so, as a rule, is flat.
Paralytic form of flatfoot or as it is called, paralytic flat foot, is a direct consequence of the paralysis of the muscles of the sole, which begin on the shin. Most often, the disease becomes a consequence of poliomyelitis.
Symptoms of longitudinal flatfoot
The main indicator of this disease is the emerging pain in the feet. A person begins to complain constantly about painful sensations when walking. Also, with a disease such as longitudinal flatfoot of the first degree, the symptom may be an increase in the length of the foot and deformation of the middle finger. And since platypodia in most cases is detected in people aged 16 to 25 years, then any pain should cause caution. If a person notices the symptoms of flat feet, then he should consult a specialist and undergo a survey. Such a problem, like longitudinal flat feet of the first degree, occurs in eighty percent of people.
Diagnosis and disease detection
Determination of flatfoot
In order for a specialist to diagnose a flatfoot of one degree or another, a person must undergo a survey. This procedure involves a detailed conversation with the doctor, a visual examination of the patient and the appointment of radiography, which is carried out in two angles, that is, in a recumbent or relaxed state, and with a load, that is, standing up. But before the roentgenography, the orthopedist conducts a study with the help of a podoscope, which is used during a physical examination. Analyzing the images obtained with this device, the doctor can almost certainly diagnose a flatfoot, for example, a transverse flatfoot of the first degree. In addition, the specialist during the examination determines the following characteristics:
what is the highest degree of flatfoot?1?
This is the third degree.
Degrees and types of flatfoot
Flattening is a fairly common foot disease, it is observed in men and women of different ages and even in children. There are several degrees of development of this pathology:
* 1 degree( mild platypodia).At this stage, flat feet is more like a cosmetic defect and is manifested by fatigue with prolonged walking, pain in the feet. Unpleasant sensations after rest, as a rule, pass.
* 2 degree( combined flat feet).The foot is visible to the unaided eye, the arch of the foot is flattened, the foot expands, the gait( clubfoot, heavy trot) changes. The pains grow and cover not only the ankle and feet, but also reach the knee.
* 3 degree( pronounced flat feet), which is accompanied not only by deformation of the foot, but by various disorders in the musculoskeletal system( osteochondrosis, arthrosis, herniated disc, scoliosis).The pain is very troubling to the patient. With this form of flatfoot is particularly difficult to walk, and doing sports is completely impossible. The patient can only move around in orthopedic shoes. Heel spurs, "puffed" curved and elongated fingers( "hammer-like"), ingrown nail - these are just some of the manifestations of flatfoot in the neglected stage.
It should be noted that flat feet disease, prone to constant progression, so treatment should be started immediately after diagnosing this ailment.
There are several types of flatfoot:
* longitudinal flat feet. It occurs mainly in young women suffering from overweight or in people working at work, requiring a lot of static stress - sellers, weavers, etc. Longitudinal flat feet is characterized by a flattening of the longitudinal arch of the foot, while the width and length of the foot increases.
* transverse flatfoot, women are also more likely to develop it, but older( 30-50 years).It is characterized by an increase( widening) of the forefoot, and the foot itself is shortened, because a divergence of metatarsal bones in the form of a fan is observed. The fingers are deformed, acquiring a hammer-shaped form( mainly the middle finger), the thumb is deflected to the outside. There is a characteristic "bone"
* sprouting of the head of the I-th metatarsal bone, frequent on the head. One of the prerequisites of transverse flatfoot is wearing inconvenient, narrow shoes with high heels.
* combined flat feet( both longitudinal and transverse flattening of the arch of the foot is observed).
There is another classification of flatfoot, based on the causes of the origin of the disease:
1. Static flatfoot is the most common type. They suffer about 80% of all patients with this ailment. This form of flat feet refers to acquired diseases. He is led to both hereditary predisposition( "aristocratic foot"), and professional harm( long static load on limbs or inactivity).Another prerequisite is endocrine diseases and overweight.
2. Congenital platypodia is a rather rare form, preventive examinations help to reveal this kind of flatfoot. An accurate diagnosis can be made no earlier than 5-6 years of age( since all young children have a flattened foot due to physiological reasons).
3. Ricky flatfoot - caused by deformities of the foot due to an acute shortage of vitamin D, is extremely rare.
4. Paralytic flat feet arise after the paralysis, for example, in case of poliomyelitis. It develops as a result of paralysis of the muscles supporting the arch of the foot and tibial muscles.
5. Traumatic platypodia is a consequence of trauma( fracture of the tarsal bones, ankles, heel bone).
Modern medicine medicine all the problems in the 3 stages divides. ..1st light, 2nd medium, and 3rd heavy. ..