Flat feet: symptoms and treatment, longitudinal, transverse 1, 2, 3 degrees, orthopedic insole with flat feet |Orthopedics
Flattening is the deformation of the foot and its arch. In the overwhelming majority of cases, this acquired disease, which develops due to prolonged "standing" work, when wearing shoes with heels or with a narrow toe, when weight is set, when the bones and muscles of the foot begin to "press" an increasing number of kilograms. Among women, flat feet are found 3 times more often than men. The photos below show how the foot is deformed. Flattening leads to the development of other diseases, so it is important to conduct timely prevention and follow all the recommendations of the doctor if you are diagnosed with this.
Photographs and types of flatfoot
If the flat feet are clearly expressed, this is noticeable even visually when examining the foot.
Doctors speak of such symptoms of flatfoot:
- pain in the foot;
- frequent fits of the fingers and the muscles of the foot;
- shoes wear out more strongly from the inside;
- foot in the area of the fingers becomes wider, so you have to change your shoes;
- "buzz" in the legs after a long walk.
Doctors orthopedists distinguish the following types of foot deformities:
- Rickets flat feet, arises from lack of vitamin D,
- is traumatic, appears as a consequence of fractures of the ankles, foot bones, etc.,
- paralytic - the result of paralysis of limbs and foot muscles;
- longitudinal( the inner arch of the foot changes);
- transverse( deformed toenails).
Normally, the foot touches the floor with the calcaneus, thumb and little finger, so on its inner side there must be a pronounced bend - the arch of the foot. The smaller the distance between the inner side of the foot and the floor, the greater the degree of longitudinal flat foot. Podologies( a physician dealing with foot problems and flat feet) distinguish three degrees:
- there are no obvious visual signs of changes in foot, but with prolonged walking there is fatigue and pain in the foot, swelling is possible;
- disappears the inner arch of the foot, while walking the pain extends to the ankles and lower legs;
- deformation of the foot is clearly pronounced, resulting in changes in the position of the bones in the shin and knee, so there are pains in the shins, knees, lower back, there is a headache. Normal shoes with this degree of longitudinal flat feet is not suitable.
Transverse Plain Feet - Symptoms and Treatment
This type of flatfoot is characterized by a decrease in the length of the foot due to the divergence of the foot bones, as a result of which it is deflected towards the thumb and the average is significantly deformed. Often on the thumb appears "lump" - a painful thickening.
Degrees of flatfoot
Like longitudinal, transverse flat feet have several degrees. They differ in the level of curvature of the thumb and the appearance of corns.
flatness of 1st degree. A longitudinal flat-foot 1 degree is diagnosed if the first finger is deflected by an angle of less than 20 degrees. In this case fatigue occurs with prolonged walking or stress. Under 2-4 fingers appear seals - natoptyshi.
Flatness of 2nd degree
The second degree of transverse flatfoot is called moderate and is characterized by a deviation of the finger by 20-35 degrees. Usually, pain and burning in the foot area become frequent, especially for a long time to walk in shoes. The nattoids occupy a large surface.
Flatness of 3rd degree
The first toe of the foot deviates by 35-50 degrees, which looks like a dislocation. The pain is permanent, on the foot of the foot, more and more. Often the third degree is accompanied by the development of bursitis - inflammation of the periarticular bag.
If the finger deviates more than 50 degrees, diagnose a 4 degree.
To determine flat feet in a domestic environment, you can apply a solution of the colorant to the feet, and then stand on sheets of blank paper the way you normally stand. If the inner bend is poorly expressed or the imprint differs from those listed below, it is worthwhile to see a doctor. This method of diagnosis is called planktography. The doctor will measure the angle between the two lines, one of which is drawn from the middle of the heel to the thumb, and the second from the same point to the second interdigital space. The final diagnosis is made based on X-ray images of the foot, performed in different positions.
In addition to longitudinal and transverse, there is a mixed flatfoot, combining the characteristics of the first two.
Is the army taking a flat foot?
This question excites both conscripts who suffer from this ailment and their parents. Indeed, at 3-4 degrees of flatfoot walking causes painful sensations, and ordinary shoes are not suitable for the patient.
So, if the draftee is diagnosed with flat feet of 1 or 2 degrees, he is subject to service in the ranks of the armed forces. If it is longitudinal flatfoot 3 or transverse 3-4 grades( there is pain syndrome, finger contracture, arthrosis of joints and other serious deviations from the norm), then the boy or man is released from the call. However, he is given a military ticket and he is credited to the reserve with the record "limited to go."
With a flat-footed second degree, the recruit is given a B-3 fitness category, usually a non-combat service: a cook, a janitor, a builder.
Flattening in children treatment
Infants have imaginary flat feet due to subcutaneous fat in the foot. When the baby begins to walk, the muscles develop and the foot eventually assumes the correct outlines. Only by the age of three does the formation of the foot end. It is very important that the baby at the time wear the right shoes: with a rounded toe, firm back, on the heel to 1cm, inside is desirable insole insoles, which helps to form the arch of the foot. Categorically, you can not walk barefoot on a firm, level surface.
If during the intrauterine development the developmental defects of the foot were observed, the baby may have a congenital flat foot.
Children can also develop acquired flat feet. Its causes:
Flat-footedness - Causes, symptoms and treatment. MF
Flattening is the most common deformation of feet. Directly the foot performs the function of human support, movement and depreciation due to a complex structure. In a normal physiological structure, the foot has two arches - a transverse( between the bases of the fingers) and a longitudinal( along the inner edge of the foot).Vaults carry the function of shock absorbers and soften shaking when walking. The bone-ligamentous apparatus of the foot works well when the load that falls on the foot is completely balanced. With the weakening of the muscles and ligaments that connect the 26 bones of the foot, subsidence of the arches and flattening occur, which leads to loss of the spring function. With flatfoot this function goes to the spine, knee, ankle and hip joint. These joints are not intended to perform this function and cope badly with it, and therefore quickly fail.
Reasons for flatfoot formation.
There are a lot of conditions that lead to flat feet, here are some of them.
- Congenital flat foot rather rare pathology occurs in 11.5% of the total number of foot diseases. The cause may be various pathologies of intrauterine development of the fetus, due to ionizing radiation, harmful habits of the mother.
- Children with rickets develop a rickety foot, as a result of a decrease in vitamin D production, the strength of bones decreases under mechanical stress, the musculoskeletal apparatus is weakened.
- Paralytic flat feet develop after a history of poliomyelitis, and the degree of flatfoot is directly related to the degree of paralysis.
- Traumatic platypodia develops with fractures of the foot bones or with improperly fused fractures.
- Static flatfoot is one of the most common types of flatfoot. The main reasons for it are reduced muscle tone, excessive fatigue due to prolonged stay on the legs.
Symptoms of flat feet.
Usually a person who spends a lot of time on his feet does not notice the development of flat feet, and the appearance of pains and unpleasant sensations in the legs and feet is associated with fatigue. There are several basic signs on which you can suspect the development of this terrible disease in yourself.
• Your legs begin to swell by the end of the day, marks from your socks appear, you may experience a feeling of heaviness and cramps that may not be long and pass after the massage • You begin to notice that the length of the working day remains the same and the legs are fatigued much faster.• Shoes start to wear out much faster than before, mostly on the inside.• Periodically creates the feeling that the leg has increased in length, and because of this, you have to buy shoes for a size larger.
There are several stages of foot deformation, the passage of which leads to complete clinical flat feet. The prodromal stage, the stage of alternating flat foot, the stage of development of the flat foot, the stage of flat-footed foot and the contractual flatfoot are distinguished.
The first stage of flatfoot is manifested by pain in the foot and gastrocnemius muscle after a long load on the foot, of a statistical nature, a pronounced feeling of fatigue appears.
In the , the intermittent flatness stage is characterized by pain intensification towards the end of the day, pain arises from overexertion of the ligamentous foot apparatus which maintains the optimal position of the foot. Increased fatigue often appears in the middle of the day, and people with flat feet have to change their activities or more often rest. The longitudinal arch of the foot at the end of the working day visually flattened, but after rest, especially in the mornings, the height of the vault is restored.
The stage of development of flat foot occurs when, due to further fatigue of the leg and foot muscles, the longitudinal arch of the foot is not restored to rest after rest. The patient quickly develops fatigue due to fatigue of the muscles. The pain becomes permanent and aching due to overstretching of the ligamentous apparatus. The height of the longitudinal arch decreases due to the elongation of the foot and the expansion of its longitudinal part. The gait changes, the amount of movement in the foot joint is limited. In this stage of the disease there are three degrees.
Diagnostic measures for flat feet.
In addition to clinical signs, there are several methods that can determine the severity of this pathology. These include planktonography, the analysis of the face line, the dodging and clinical and radiographic methods of diagnosis.
Plantography - a method that allows the determination of the expression of flat feet with the help of prints. The feet are smeared with methylene blue solution, then the footprints are made on a blank sheet of paper, working on the feet evenly with all the weight.
The Friedland method is a definition of the percentage of height of the foot and its length.
The clinical method of measurement consists in the construction of a triangle with a base equal to the distance from the metatarsal head I to the heel of the calcaneus. The top of the triangle is at the top of the inner ankle, one leg extends to the apex of the calcaneal angle, the other to the head I of metatarsal bone. Normally, the height of the vault is 55-60 cm.
The X-ray method is based on the construction of a triangle on the lateral radiograph of the foot that connects the apex of the heel of the calcaneus with the head of the metatarsal bone, and the vertex of the triangle falls on the lower edge of the scaphoid bone, the vertex angle should normally be 120- 130 degrees.
Determination of the degree of flatfoot by X-ray.
Flat-footedness is one of those diseases with which young people are not called to military service( service in the army).II and III degrees of the disease are an absolute contraindication for service in the armed forces. This is due to the large power loads that a man with a flatfoot can not bear. Otherwise, the pain syndrome may increase, and in the future, with the preservation of this load, go to one of many complications.
Flat feet in children.
Newborns are characterized by well-defined arches of feet, but the children's foot is filled with fatty tissue, and when viewed it seems flat. Since 3 years, there has been a significant strengthening and development of the ligamentous apparatus, due to which there is a significant increase in the height of the arch and the foot begins to acquire the appearance of the foot of an adult person. The older the child, the more pronounced the vaulted structure. Thus, the external flat feet of a child can not be taken as a true disease.
The development of flat feet in children is promoted by congenital disorders of the ligamentous apparatus, muscle weakness, obesity, endocrine diseases, improperly selected footwear. Due to its anatomical features, the definition of flat feet in children by the fingerprint method is not always informative and can give a false result.
Very often, children can not complain about leg pain or discomfort, so periodic examination by an orthopedic doctor is an integral part of the annual medical check-up. Treatment of flat feet in children is reduced to rest, temporary prohibition of exercise, massage of the plantar part and walking barefoot on uneven surfaces, it is possible to design orthopedic insoles.
Treatment of flat feet.
Treat flat feet is difficult, and it will not be possible to say with certainty after a period of time that this is a disease in the past. Completely get rid of this pathology can only be in childhood, because the ligamentous apparatus and the bone system is pliable enough. In adult patients, this disease can only be stopped with the help of special rehabilitation measures.
Parents need to remember - "the earlier the symptoms of flatfoot, the more favorable conditions for stopping the progression."
Treatment should be combined and include the removal of the pain syndrome, strengthening of the ligamentous apparatus and the muscles of the foot. To relieve the pain, you need to use anesthetic ointments with a relaxing effect and physiotherapy.
To begin treatment it is necessary with gymnastics, which can be performed daily at home. The therapeutic form of gymnastics is used to achieve correction of the arch of the foot, strengthens the muscles, trains the ligament apparatus, forms the correct type of gait. There is a large number of exercises that are selected individually and depend on age, complaints, position of the foot and its shape. All exercises and their intensity to you will be picked up by an orthopedist.
Treatment in the stage of flat deformation of the foot should be strictly differentiated, along with exercise therapy and massage it is necessary to wear insoles that support the relief of painful areas and correct the deficiencies in the initial stage of the disease and orthopedic footwear at grade II, and at grade III it is often shownsurgical treatment.
With congenital planovalgus deformation of foot of easy degree, children are treated with foot and shin massage, physiotherapy exercises. When a child begins to walk, it is necessary to make orthopedic shoes for him. With insufficiently effective treatment and late treatment, surgical treatment is indicated.
The correct choice of shoes is of great importance in the treatment of flatfoot. Beautiful shoes with high heels, of course, decorate the legs of any fashionista, but do not wear them all the time. Otherwise, after a short time you will only need to wear orthopedic shoes. When choosing shoes, pay special attention to the flexibility and comfort of the sole, the height of the heel( not more than 3-4 cm), it is better to avoid shoes on the platform and excessively wide or narrow.
Complications of flatfoot.
• Strabism in walking, spinal curvature, unnatural posture • Pain in the knees, hips, back and feet • Dystrophic changes in the muscles of the legs and back • Disease of the feet themselves( deformation, curvature of the fingers, calluses, spurs, neuritis) • Diseases of the spine(herniated intervertebral discs, osteochondrosis), hip and knee joint diseases • Growth of nails.
Flat feet prevention.
To prevent the development of flat feet, it is necessary to carry out preventive measures every week. The priority that needs to be done is to choose the right footwear, exclude the wearing of shoes with high heels, the optimal height is 3 - 4 cm. Periodically conduct an examination with an orthopedic doctor, at least once a year. People who have any problems with their legs should be examined more often. It is also necessary to do gymnastics and do physical exercises for the feet. Foot baths and massage will help relax the muscles and relieve tension after a hard day. It is necessary to get rid of excess weight, as it contributes to an additional burden on the spine and legs.
Doctor therapist Zhumagaziev E.N.
With longitudinal flatfoot , a flat longitudinal arch becomes flat, and the foot contacts the floor practically with its entire surface. The length of the foot increases slightly. Longitudinal flat feet occurs, as a rule, in young women with excess weight, as well as in people whose work requires constant static stress( sellers, accountants, secretaries).The greater the weight of a person, the greater the load is on the feet.
The first degree usually does not bother a person, except for fatigue in the legs and pain in the feet during exercise. The second degree makes itself felt by the increasing pains in the legs, the difficulties with the selection of shoes. The third degree of longitudinal flat feet causes constant pain in the soles of the feet, shin and even the lower back, and the selection of shoes at this stage is not just difficult, and sometimes even impossible at all.
Longitudinal flat feet
Causes and varieties
Congenital platypodia is a consequence of a deviation from normal maturation of the ligaments and bones of the foot. It is difficult to diagnose this kind of pathology, because the pediatric foot before the age of 6 due to the incompleteness of development is even normally flat. Still, thanks to research, it is determined that this variety is 3% of all manifestations of the defect.
traumatic platypodia occurs as a result of various injuries. Most often, bones of the metatarsal, ankle, and calcaneus are affected, which do not fuse properly after fractures.
Paralytic platypodia can be defined as neurogenic. Deformation in this case arises from the fact that the muscles of the lower leg and foot are completely absent, paralyzed or weak. This defect is especially common due to the effects of childhood poliomyelitis.
The rickety flatfoot gets its development on the basis of rickets, in which the bones of the foot become soft, supple, and therefore easily deformed even under small loads.
The static flatfoot is the most common form. It is due to the fact that the muscular and ligament apparatus of the lower limbs is poorly developed.
An organism may have a predisposition to flat feet due to hereditary factors. The development of the defect is significantly influenced by the body weight. With a larger mass, the flat feet develop faster. For static flatfoot, a weak musculoskeletal system is only a background, the main factor is caused by provoking factors. The causes of static deformation of the feet are overloads, which are associated with prolonged stay on the legs, weakening with age of the muscles of the knee-foot apparatus, weak physical preparation and so on.
Degrees of longitudinal flatfoot
Let's get acquainted with the physiological characteristics of different degrees of this pathology:
- 1 degree of longitudinal flat feet. Slightly flat feet, corresponds to the angle of the arch of the foot in 131-140 °, height - 35-25 mm.
- 2 degree of longitudinal flat feet. Diagnosis "Longitudinal flat feet of the second degree" indicates that the level of the arch of the foot is 141 - 155 °, the height of the arch is reduced to 24-17 mm. On the talon-navicular joint, signs of curvature may appear.
- 3 degree of longitudinal flat feet. At the third degree of longitudinal flatfoot there is an increase in the angle of the arch - over 155 ° and a decrease in height - less than 17 mm;also becomes noticeable deforming arthrosis of other foot joints.
Degrees of longitudinal flatfoot
Diagnostics of flatfoot and determination of its degree is carried out using various techniques. The simplest and most accessible of them consists in determining the sub-metric index by the method of Friedland. In this case, the doctor uses a special compass to measure the height of the foot from the floor to the top of its arch. Next, it determines the length of the foot between the end of the thumb and the edge of the heel. Then the height of the foot is multiplied by 100 and divided by its length. The ratio of these quantities is called a sub-metric index. The norm is 29-31.If the index is 27-29, then we speak of flatfoot, if it is 25, then we are talking about a large degree of defect.
A more accurate method of identifying flatfoot and establishing its degree is planography. When using it, the patient's soles are covered with special colorants, then he needs to stand on a paper sheet. Imprint on a blank sheet is analyzed. It determines whether there is pathology and how it is expressed.
In the case of a mild degree of strain, there is no need to perform special therapeutic measures. Correction of the violation and prevention of its amplification are carried out. Prevention of flat feet is easy. The patient should not stand for a long time and walk a lot. If you need to walk long enough, you need to make sure that the toes of the feet are parallel to each other.
With a long standing, it is also necessary to make sure that the feet do not move apart. To strengthen muscles, exercises in natural conditions are very useful: it is good to walk on sand, loose soil, a small scattered on the floor of objects, on a log, on a morning dew in the summer. In order to prevent flatfoot and treat it at an initial stage, you need to choose a comfortable and suitable size shoes. Another condition: the sock is not tight, and the heel does not exceed 5 cm in height.
When flatfoot is expressed to a small extent, it is corrected with the help of special insoles in shoes. If the deformation is quite large, the patient is equipped with orthopedic footwear, created to order. Frequent use has found a technique for making plaster casts from a plaster of a carrier of a disease, by which orthopedic insoles are made.
With strongly pronounced flat feet, accompanied by a constant pain syndrome, surgical treatment is necessary. Before the operation, the patient, on the recommendation of the doctor, wears special rigid bandages on the foot, they to some extent contribute to its correct position. Flattening is most often removed by transplanting the tendons of the muscles, which descend on the foot from the shin. The degree of manifestation of deformation determines the volume of the operation.
In some cases, the reason for flatfoot is the changes in the bone apparatus of the foot, for example, when it occurs against the background of rickets. Medical intervention gives the bones the right shape, often by excising their fragments. Immediately produce and transplant tendons. On the bones, the operation is more reliable than on the tendons, because in the latter case there is a redistribution of the muscle tone, in the future they again can not cope with the increased loads on the foot, and the flatfoot returns.
When all types of surgery are performed, the patient's lower extremities are closed with plaster bandages from the fingertips to the upper third of the shin. After 1 - 1,5 months.remove bandages, and massage and physiotherapy procedures.
Basically flat feet have a weak degree of severity and are eliminated conservatively. The outcome of operations is usually favorable.
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Flattening - Causes, Symptoms, Stage
Flattening is a foot deformation common in the population. A person's foot provides a supporting function, movement and also amortization due to a complex structure. With loosening of ligaments and muscles, connecting 26 bones of the foot, there is a sagging of the trunks and flattening, thereby leading to a loss of the spring function. This function with flat feet passes to the spine, ankle, knee and hip joint. Such joints are not intended to perform such a function, and cope with it badly enough, thereby failing quickly enough.
Causes of flatfoot
I would like to note that there are quite a lot of factors that lead to the development of flat feet, they include:
- traumatic platypodia, which develops due to fractures of the foot bones or with improperly fused fractures;
- with rickets in children, the development of the rachitic foot occurs, due to the decrease in the production of vitamin D, the strength of bones decreases under mechanical stress, thereby weakening the musculoskeletal system;
- statistical flatfoot is one of the most common types of flatfoot. Its main causes are reduced muscle tone, severe fatigue, which is associated with a prolonged stay on the legs;
- is a rather rare type of flatfoot that is congenital, and occurs in about 11.5% of the total. The causes may be those or other pathologies of intrauterine development of the fetus, as a result of ionizing radiation of the mother's bad habits;
- the development of paralytic platypodia occurs after the transferred poliomyelitis, and the degree of flatfoot directly depends on some degree of paralysis.
Symptoms of flatfoot
Those people who are on their feet every day may not notice the development of flat feet at all, and throw off this for normal fatigue. However, there are a number of some signs on which it is possible to determine the presence of flat feet. So, it is customary to refer to them:
- shoes start to wear out much faster than before, especially on the inside.
- By the end of the working day, the legs are swelling, there are signs of wearing socks, there may be seizures and heaviness that can go away after the massage.
- In some cases, it may appear that the leg is enlarged in length, so the sick person is forced to buy shoes at a larger size.
- At the usual working day, a person can note fatigue much faster than before
Stages of flatfoot
I would like to note that there are a number of stages, the passage of which, in the final analysis, can lead to a complete flat foot. So, the stages of flatfoot are:
1 stage of flatfoot. With it there is pain in the foot, as well as the calf muscle after a long load on the foot, there is no statistical character and a strong feeling of fatigue appears.
Stage of intermediate flatfoot. It is caused by increased pain by the end of the day, pain is associated with overexertion of the ligamentous apparatus of the foot. As practice shows, often fatigue can manifest themselves by the middle of the day.
Stage of flat foot development. Its development occurs as a result of further overfatigue of the foot and lower leg muscles, the longitudinal arch of the foot can not be restored even after rest. The patient can feel a strong fatigue, due to muscle overstrain. The pain becomes aching and permanent due to overstretching of the ligamentous apparatus. Also, the height of the longitudinal arch can be reduced because of the elongation of the foot, and also the extension of its longitudinal part.
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What are the stages of flatfoot? Please describe them. Thank you.
1st stage. Prodromal form - manifested by rapid fatigue and a feeling of painful fatigue in the legs by the end of the day. These sensations in the muscles of the foot and shin depend on the discrepancy between the strength of the muscles and the load. Externally, there is no abnormality from the normal shape of the foot in this stage of the disease, and accordingly, no changes are detected either on the footprints or on the radiographs.
2nd stage. Intermittent flat feet - is characterized by the periodic failure of the muscles, even the extension of the ligamentous apparatus with the habitual bias of the foot to the valgus( the foot falls to the outside).At the beginning of the work day, when the muscles are not tired, they still manage to maintain the correct installation of the foot. But in the future, when muscle fatigue occurs and their support stops, the foot begins to shift under the influence of gravity into the valgus position. When examining the naked legs from behind it is possible to note that the axis of the shank and the axis of the heel form an open angle outside( the heel is deflected outward - it is permeated).
3rd stage. Pes plano-valgus vulgaris. This stage of flat feet covers a number of degrees of deformation and painful symptoms. The main feature of this form of flatfoot is the constant installation of the entire foot in a more or less pronounced valgus( deviates outward) position due to persistent insolvency of the muscles. The degree of flattening of arches is subject to wide fluctuations. Extremely different and the intensity of pain. On the footprints, a more or less pronounced flattening of the arches is found.
4th stage. Pes Plano-valgus abductus. It is a heavy and persistent form of flatfoot, usually of long standing, with a large divergence of the middle and anterior parts of the foot. The process of penetrating the heel and flattening of the arches developed slowly without acute sensations, since the ligamentous apparatus and nerve endings had time to adapt to the new state without being subjected to acute traumatization. Therefore, the patient can not complain of acute pains, and all complaints are reduced to a feeling of painful fatigue, which hinders walking and prolonged standing. Patients with this form of flat feet have difficulty in selecting shoes.
Frontal flattening is divided into:
1 degree - slightly flat foot.
2 degree - medium.
3 degree - strong flatfoot, well stop as fins, they will take it to the navy))))
If I'm not mistaken then 1,2,3, and 4,
and the second are still divided into 2 categories