Longitudinal and transverse platypodia: symptoms and treatment, photo. Flat-footedness - what is it?
The foot is one of the main links of the body's support. Its area is about 1% of the entire surface of the body. However, it is the main load that is equal to the mass of the human body. The foot performs several functions: cushioning, supporting, balancing. Under the influence of certain factors, its arch is deformed, a disease such as flat feet develops. As a result, the sole loses its damping features, which is accompanied by unpleasant complications.
Flat-footed - what is it?
The human foot consists of 26 bones. They are interconnected by joints and ligaments, the movement of which is controlled by tendons and muscles. In a healthy person, the foot has 2 arches: transverse and longitudinal. They are located in the base of the fingers and the inner edge of the sole. When walking, a person does not fully rely on the foot. As a rule, three points are involved: the calcaneus, the region of the base of the little finger and the thumb. If the ligaments and muscles of the foot are weakened, its shape begins to change. It gradually becomes flat. When walking, a person has to rely on the soleplate on the surface. As a result, the damping properties deteriorate, flat feet develop. A photo of a leg deformation is presented in this article.
Vaults function as springs or levers, providing comfortable movement with minimal consequences for the body. Damage to this link entails a disruption to the operation of the whole system. The organism, as is known, is a single whole. Any changes in the operation of one system necessarily affect the functioning of the other. Flattening can lead to damage to the femoral and knee joints, deformation of the spine. If the stop does not cope with its functions, they go to the structures above. The spine, knee and hip joints are not adapted to such a load, so they quickly fail.
Classification of the disease
The foot has two arches. Therefore, it is quite justified to isolate the forms of the disease - longitudinal and transverse flatfoot. Symptoms and treatment of each are discussed below. There is also a mixed( combined) variant of the disease.
Classification of the disease by type also provides for the allocation of acquired and congenital flat feet. The first case is extremely rare and is the result of abnormal fetal development. Acquired flat feet can occur at any age. It, in turn, is subdivided into several subspecies:
- is static( arises from a decrease in muscle tone);
- is ricky( as a result of deficiency of vitamin D in the body, the muscular apparatus is weakened);
- paralytic( develops against the background of the transferred poliomyelitis);
- is traumatic( occurs as a result of injuries and fractures of bones).
Symptoms of flatfoot
What signs need to be paid attention to prevent flat feet in time? Symptoms of this disease appear gradually. The very first sign of it is severe pain in the legs at the end of a day's work. By the evening the soles and shins swell, cramps appear. It becomes difficult for women to walk on their heels. Because of the increase in foot from the old shoes, you have to give up and buy a new one, but a larger one. Gradually, the pain syndrome spreads higher, passes to the knee and hip joints. Such signs are characterized not only by flat feet. Symptoms of a similar nature are observed with varicose veins. But treatment for this disease requires a completely different.
To calm yourself, you can conduct a simple test at home. For this, place the soles of your feet with a coloring agent( for example, greenery or iodine).Then leave a print on the sheet of paper so that the load on the foot is uniform. After this, draw a line parallel to the plantar notch from the heel to the fingers. Place the perpendicular in the deepest part to the outer edge of the foot. If the print of the bottleneck of the sole occupies not less than half of the perpendicular to the first line, you have a flat foot. A photo of the example scheme is presented below.
Causes of the pathological process
Flattening is a serious disease characterized by deformities of the foot. In ordinary life, no one pays attention to this defect. Know the features of the disease is in order to take timely measures to correct it. Causes of ailment can be both external and internal. Given the rhythm of modern life and a disparaging attitude towards one's own wardrobe, sometimes flat feet have a mixed aetiology. Even everyone's favorite sneakers can trigger deformation of the foot. Why? The sole of the sneakers is equipped with excellent shock absorption. They take on all the load, fixing the heel. As a result, muscles relax, all conditions are created for the development of such a problem as flat feet. What is a flatfoot, how it arises, is now clear.
Returning to the internal causes of the disease, it is worth noting a number of provoking factors. First of all, this is the presence of concomitant ailments. Rheumatoid arthritis is among them. It affects not only the cartilage, but also the ligaments that are responsible for supporting the foot. Injuries and mechanical injuries to the foot also contribute to the development of a foot defect.
The impact of external factors is easily prevented if you take care of your own health and carefully approach the choice of shoes. Exogenous causes of flatfoot include the following:
- excessive physical load;
- insufficient activity due to work;
- hormonal disorders, pregnancy;
- wrong shoes.
With this form of the disease, the length of the foot increases due to the lowering of the longitudinal arch. As a result, the sole completely touches the floor. In the role of the main sign of deformation is the narrowing of the gap between the inner edge of the foot and the surface of the floor itself. In patients with this diagnosis, clubfoot develops over time.
Three degrees of longitudinal flattening are distinguished:
- At the first stage of the disease development, there is no visible deformation. Discomfort in the legs appears after prolonged exertion. When pressing, pain occurs.
- The second degree is characterized by a change in the arch of the foot. Painful discomfort intensifies and spreads to the ankles and legs. Muscles gradually lose their elasticity.
- The third degree of the disease is marked by pronounced deformation of the foot. Painful sensations in the legs do not pass even by evening. There is discomfort in the lower back, decreased ability to work. A person with the diagnosis "longitudinal flatfoot of the third degree" is difficult to walk in ordinary shoes.
With this form of the disease, the length of the foot decreases, the thumb is deflected, and the middle finger is deformed. It takes on a hammerlike appearance. At the base of the first finger appears a small seal in the form of a cone.
There are three degrees of transverse form of flatfoot. Their differences are due to the angle of the deviation of the big toe.
- The first degree is a slightly outlined transverse flatfoot. Symptoms of the disease manifest themselves as it progresses. The deviation of the thumb does not exceed 20 degrees. After exercise, painful discomfort appears. On the foot there are clearly visible papillae in the area of 2-4 fingers.
- At the second degree, the deflection angle is already 35 degrees. With a load, a burning sensation occurs in the area of the sole, the pods increase in size.
- The third degree of ailment is characterized by constant pain. The deflection angle exceeds 35 degrees. Some patients develop bursitis. This disease, accompanied by inflammation of the periarticular bag.
Separately consider mixed flat feet. What is the longitudinal and transverse platypodia, we have already considered, and this pathology is accompanied by the symptomatology, which is typical for both species. The manifestation of features of a mixed form differs in a greater degree of their expression.
What is the difference between flat feet in children?
The leg of a child under five years old is a fragile structure that is in the formation stage. Therefore, the parents are given a great responsibility. They must prevent the disease, recognize it in time and begin treatment.
Children rarely talk about health problems. If they try to hint, the parents do not pay attention to them. Children lead an active lifestyle, are in constant motion, which is usually accompanied by fatigue. But there are certain points that parents should pay attention to:
- flattening of the arches of the feet;
- unevenly worn shoes;
- complaints of a child to leg pain after moving games.
If the child's gait has changed, it has become less moving, it is necessary to consult an orthopedic doctor. An experienced specialist can recognize flat feet at an early stage. Symptoms and treatment of this disease in children practically do not differ from those in adults. Its unique feature is the reversibility of the pathological process. Gradual maturation of the child is accompanied by a natural release from the disease. The foot is formed up to 13 years. During this period it is necessary to focus on physical activity( running, walking).As a result, the muscles will begin to develop harmoniously, and the foot will acquire the right outlines.
Flattening in adults and children can be determined on the basis of clinical symptoms of the disease. To assess the degree of the pathological process requires a serious examination of the patient. It includes several items. This:
- Plantography allows you to determine the severity of the pathological process with the help of prints. For this, a solution of methylene blue is applied to the feet. Then make prints on a blank sheet of paper. The plantography gives approximate data on the state of the arches.
- Friedland's method of submetry makes it possible to estimate the percentage of height of the foot to its length.
- The clinical method is based on the construction of a special triangle. Its base is equal to the distance from the metatarsal head to the heel of the heel. The vertex of the triangle is located in the center. The first leg extends to the highest point of the calcaneus, the second - to the head of the metatarsus. Normally, the height of the arch should not exceed 60 cm.
- The X-ray method is also based on the construction of a triangle, but in this case the vertex angle is measured. This parameter should not exceed 130 degrees.
Based on the results of the examination, an orthopedic doctor can confirm the diagnosis and give advice on treatment.
With flat feet take in the army? This issue worries many young men who have reached adulthood. If the deceased is diagnosed with a deformation of a foot of 1 or 2 degrees, he is subject to service in the ranks of the armed forces. In the longitudinal or transverse flatfoot of the third degree, the youth is freed from the army. He is issued a military ticket with the mark "limited to go."
Principles of treatment
Many people do not pay attention to flat feet, ignore the first symptoms. In fact, this is a fairly serious and rapidly developing pathology, which practically does not lend itself to therapy. Completely cure it can only be in childhood, when the foot is not yet formed to the end. In adults, therapy is aimed at slowing the development of the disease and preventing complications. Treatment of the pathological process is complex. The patient is strengthened by the muscles, eliminates the pain syndrome, stops the progressive longitudinal / transverse flatfoot. Symptoms and treatment of these types of disease are practically the same. Now we will dwell in more detail on modern methods of therapy.
Drugs combined with physiotherapy help to eliminate pain syndrome. Patients are prescribed systemic analgesics( Ibuprofen, Aspirin), as well as ointments for topical application( Dolgit, Voltaren).
The basis of therapy is therapeutic gymnastics. The complex of exercises is selected by the orthopedist taking into account the stage of the disease and the age of the patient. A good therapeutic effect gives a foot massage. Regular procedures help to normalize blood circulation, increase muscle tone. Unfortunately, all listed methods of treatment are effective only at the initial stage of the disease. With strong deformities of the foot, only one option helps - surgery.
Treatment of this disease in children requires a different approach. Most often in small patients diagnosed longitudinal flat feet( that such deformation can not be ignored, should be known to all parents).Pathology is perfectly treatable when it is detected in time. The bones, ligaments and muscles of the child are susceptible to conservative therapy. A positive therapeutic effect is provided by exercise therapy and massage. If a child has a congenital flat foot, it is treated from the very first days of life. To do this, use special bandages and langets.
What is the danger of flat feet?
The human body works as a unit. Between all organs there are not only anatomical, but also functional connections. With flatfoot there is a displacement of the center of gravity. To maintain balance, a person must constantly deviate in the opposite direction. With time, deformation increases, and the back is markedly rounded. Violation of posture and flat feet have similar causes of development. It is the weakness of connective tissue, muscles, and obesity. In a healthy person, the arch of the foot acts as a shock absorber. With flatfoot, it is lost. As a result, the increased load on the spine and knees. This leads to an even more severe curvature of posture, scoliosis.
Deformity of the foot can provoke the development of other specific complications, among which:
- ingrowth of nails;
- bending of fingers;
- heel spurs;
- dystrophic changes in the legs;
- club foot.
Children with this diagnosis are also disturbed by foot shock absorption. As a result, the vibration of the body during movement is transmitted to the lower leg and the spine. Constant irritation of joints leads to inflammation, arthrosis develops. The effect of flat feet on the spine is reflected in its curvature. The child is constantly tormented by pains in the legs and head, his ability to work and progress in school is declining.
Prevention of disease in children and adults
To prevent the development of flat feet, periodic prophylaxis should be performed. First and foremost, doctors recommend paying attention to shoes. Today, in almost every shop, you can buy special orthopedic shoes and insole. The assortment of similar children's products amazes with the variety. Do not forget that shoes and insoles can not correct the deformation of the foot. They only prevent its development.
To strengthen the muscles it is useful to make contrasting baths. It is necessary to dip your legs alternately in basins with cold and hot water. In addition, the strengthening of muscles contributes to the regular intake of vitamins in kind( A, E, C, D) and trace elements( such include copper, selenium, calcium).
Prevention of flat feet in children can begin with increased physical activity. It is useful to engage in martial arts, skiing and horse riding. In summer you can walk barefoot on mown grass, pebbles. Such daily walks have a positive effect on the motor skills of the small muscles of the foot.
Transverse flatfootFlatfoot is a change in the shape of the foot, characterized by a flattening, a decrease in the relief of its plantar surface. This negatively affects not only the foot, but also the entire musculoskeletal system. A heavy degree of flatfoot is the basis for refusing to conscript young men. Few people know that this ailment has varieties. There are flatfoot transverse, longitudinal and transverse-longitudinal.
A bit of anatomy
The main parts of the foot: tarsus, plyusna and fingers. All the bones of these sections are interconnected by a multitude of joints( their number in the foot is 24).In addition, the foot is additionally strengthened by numerous muscles, ligaments, connective tissue tendon plates( fasciae, aponeuroses).All these elements ensure the strength and elasticity of our foot, because it accounts for a significant part of the load when moving and maintaining the body in a vertical position.
Nature has taken care to minimize this load as much as possible. The plantar part of the foot is uneven - due to this it springs when moving, and the load does not apply to the whole surface, but to certain places. The unevenness of the sole has the appearance of bends on its surface, called vaults. In the foot, there are 3 vaults - one transverse and two longitudinal( internal and external).The transverse arch is formed by bones of the tarsus( cuboidal and 3 sphenoidal), and also by the heads of 5 metatarsal bones. What is the transverse flatfoot? This decrease in the height of the transverse arch of the foot, leading to changes in its overall configuration.
The main causes of
Depending on the reasons, this type of flatfoot may be congenital and acquired. Congenital flat feet mainly develop due to genetically caused disorders of the skeletal structure of the foot or the inconsistency of fixative ligaments and aponeuroses. It should be noted that the foot is finally formed by the age of 6, and many diseases and injuries of the musculoskeletal system in children are potentially dangerous in terms of flatfoot development.
However, the acquired flattening of the transverse arch is most often observed in adults in the age range from 35 to 50 years. The main reasons leading to this:
- excessive load on the foot - constant long walking, wearing weights;
- sedentary lifestyle;
- osteoporosis - decrease in density and structure of bone tissue;
- inflammatory diseases affecting the musculoskeletal system( rheumatism, rheumatoid arthritis, gout);
- trauma of the foot( fractures of bones, ruptures of fascia, tendons, muscles);
- age-related degenerative changes in the musculoskeletal apparatus;
- paralyzes of the lower limbs with defeat of the brain or spinal cord( strokes, craniocerebral spinal cord injuries);
And the most common reason is incorrectly selected shoes - flat sole or too high heel. In the first case, with a load on the foot, her bones diverge, all the arches of the foot fall. Apparently, this is connected with the fact that in many cases there is a transversely longitudinal flatfoot, when a decrease in the transverse arch of the foot is preceded by a decrease in the longitudinal arches. At too high a heel( more than 4 cm) the pressure on the anterior parts of the metatarsal bones grows, which diverges to the sides. With the excessive height of the heel, the fact is connected with the fact that among the people suffering from transverse flatfoot 75-80% are women.
Clinical signs of
The main symptoms of transverse flatfoot are:
- pain in the legs and in the foot, increasing with walking;
- increased overall fatigue;
- edema of the feet;
- appearance of characteristic abrasions and corns on the base of the fingers;
- difficulties in the performance of certain movements( for example, to stand on your toes).
Decreasing the height of the transverse arch leads to the fact that the length of the foot in the longitudinal( anteroposterior) direction decreases, and in the transverse direction, it increases. This changes the distribution of gravity to the foot. Normally, most of the load goes to 1 metatarsal bone. With transverse flatfoot, almost all of the load falls on the middle sections( 2 and 3 metatarsal bones).
In this case, the height of the metatarsal bone over the remaining bones increases, 2 and 3 fingers are deformed( beak-shaped, hammer-shaped deformation), and the 1st finger is deflected outwards. The deviation can be so pronounced that the first finger can be placed over the second one. In this case, at the base of the first finger, the cartilaginous tissue grows excessively in the form of a characteristic cone. It is from the angle of the deviation of the first finger that one can judge the degree of transverse flatfoot. Normally, it is 150. Depending on the severity of the deviation, there are 3 degrees of disease:
- 1 degree - no more than 200;
- 2nd degree - 20-400;
- 3 degree - over 400.
The change in the shape of the foot leads to an increase in the load on the remaining parts of the musculoskeletal system - the lumbosacral spine, shin, knee and ankle joint. In the future this can cause the development of osteochondrosis of the spine, articular arthrosis.
Treatment of transverse flatfoot can be conservative and operative. It should be borne in mind that it is impossible to completely get rid of transverse flatfoot, and all medical measures are aimed at eliminating symptoms and preventing flatfoot progression. Conservative treatment is effective with flat feet of 1-2 degrees and includes:
- therapeutic exercise;
- folk remedies;
- orthopedic gadgets.
Exercises for feet involve walking on toes and on the heels, on the outside and on the inside of the foot, rolling from the heel to the toe and back, lifting the light objects( pencil, handle) with your toes. It is also recommended, while sitting, to flex and unbend fingers. All these exercises are designed to strengthen the musculoskeletal apparatus of the shins and feet. This is also facilitated by the massaging of the shins and feet, held in the self-massage. All this is quite feasible at home, but on the recommendation of a massage therapist and specialist LFK.
Among the folk remedies used for transverse flat feet are floral and herbal infusions, decoctions( linden, sage, plantain, yarrow), as well as various mixtures of honey, onions, garlic, sea salt, iodine. All this is used in the form of foot basins, compresses, lotions, which strengthen muscle tone, reduce pain, prevent the development of inflammation.
With flatfoot it is necessary to use special orthopedic insoles. Such insoles are made of polymer materials, repeat the contours of the foot and have thickenings in the problem areas - at the base of the fingers. They use it constantly. To wear shoes must be strictly in size, not tight and not narrow. The optimal height of the heel is 3-4 cm. And it is best to use a special orthopedic footwear, equipped with insoles insole and made to order.
With transverse flatfoot of grade 3 with severe pain, surgery is prescribed. In the course of surgery, correction and fixation of transverse water bones, plastic of ligaments, removal of excess cartilaginous tissue are carried out.
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 cramps of the fingers and the muscles of the foot;
- shoes wear out more strongly from the inside;
- the 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, therefore, 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 the foot, but with prolonged walking there is fatigue and pain in the foot, there may be swelling;
- 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 legs, 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 medium 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 deviates 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.
Flattening 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 flatfoot 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 flat foot, 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 a draftee is diagnosed with a flat foot 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 shelf life, usually a non-combat service: a cook, a janitor, a builder.
Flattening in children treatment of
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 observed developmental malformations, the baby may have a congenital flat feet.
Children can also develop acquired flat feet. Its causes:
Transverse flatfoot: symptoms, treatment, photo, preventionFlattening is a predominantly acquired disease of the musculoskeletal system, accompanied by a violation of walking mechanics, a change in the shape of the foot, which normally distinguishes between the transverse and longitudinal arches. Flattening promotes pathological changes occurring in the spine, knee and hip joints and other organs. Among several species, a transverse flatfoot is distinguished, accompanied by a flattening of the transverse arch of the foot, the characteristic feature of which is the formation of the so-called "cone" in the region of the big toe. The disease occurs mainly in women in the age range from 30 to 50 years. The appearance of flat feet directly depends on the excess excess weight, under the influence of which the foot becomes a little shorter and thicker.
Reasons forAn important structural element of the foot is its arch. Thanks to it, the foot distributes the load of the body during the movement. The lead contributes to depreciation, balances, etc. The main cause of transverse flatfoot is the disruption of the functioning of the ligament apparatus of the lower limbs, which is transmitted by inheritance. The predisposing factors of flatfoot are:
- 1) Extra kilograms of weight that increase the load on the ligament apparatus of the legs and especially the foot;
- 2) Paresis or paralysis of the muscles of the lower limbs;
- 3) Prolonged wearing of unsuitable close-fitting shoes with high heels;
- 4) Flat feet are often the result of professional activity( seller, hairdresser, etc.), when it takes a long time to stand in a standing position.
Symptoms of transverse flatfootIn many cases, transverse flatfoot begins with subtle symptoms. At first, there are no visible changes in the foot area. By the end of the working day, a slight discomfort in the leg area worries. After a while, the symptomatology increases, including a change in the shape of the feet. For each degree of transverse flatfoot, the following symptoms are typical:
- 1) At the first degree of flatfoot there is fatigue of the feet, pain in the area of the fingers. The skin on them becomes thicker. The angle of deviation of the thumb is 20 degrees( at a rate not exceeding 10 degrees);
- 2) With the second degree of flatfoot, the angle of deviation of the thumb reaches no more than 40 degrees. Physical exercise increases the feeling of pain and burning, which are noted not only in the fingers, but in the entire foot. Characteristics of the choice of shoes;
- 3) At the third stage of flatfoot symptoms of the disease are pronounced. The angle of deviation of the thumb is more than 40 degrees, which is outwardly manifested by the formation of a "cone".The shape of the foot changes noticeably. It becomes shorter and wider. Pain is noted even in rest. Corns and corns are formed. Against the background of flat feet develop joints of the legs and spine.
Diagnosis of the diseaseThe orthopedist is engaged in the diagnosis and treatment of transverse flatfoot. At the initial visit, an examination is carried out, complaints of the patient are taken into account. Additional methods of research, specifying the degree of flatfoot, include:
- 1) Plantography - a method that allows you to obtain a footprint on paper. A similar method of determining flat feet can be carried out at home. For this, it is necessary to lubricate the sole with any coloring material and stand on the sheet of paper, assuming the usual position of the body. From the obtained fingerprint it is indirectly possible to judge the presence and stage of flatfoot;
- 2) X-ray examination is one of the reliable methods, allowing to assess the nature of the changes, the degree of the disease, to follow the dynamics of the pathological process. The X-ray is done in two projections in the patient's standing position;
- 3) The method of electromyography determines the condition of the calf and foot muscles due to the registration of the impulses sent from the surface by a special device;
- 4) Modern diagnostic methods include computer-hardware complexes that allow to determine with the greatest accuracy the shape, width, length, foot index, etc.
Treatment of transverse flatfootConservative treatment methods include:
- 1) Use in wearing special shoes and orthopedic insoles;
- 2) Perform special physical exercises that strengthen the ligamentous apparatus of the foot;
- 3) Therapeutic massage will improve blood circulation, eliminate swelling in the area of the feet;
- 4) Physiotherapy procedures, for example, phonophoresis with hydrocortisone, electrophoresis with novocaine - will temporarily reduce the senses of pain.
- 5) The medications related to the NSAID group( diclofenac, indomethacin, voltaren, etc.) help to relieve pain. They are used in the form of tablets, ointments, creams.
Transverse and longitudinal flat feet in children and adults: symptoms and treatment
- 4.4 Treatment of
Flat feet are called deforming changes characterized by a decrease in the height of the arches,and pronation( turning inside) of the posterior. In other words, this is a progressive decline in the vaults, until their complete disappearance. This deformation is accompanied by a change in the normal location of bones and a violation of their nutrition. The formation of a similar pathology affects both children( 10%) and adults( 16.4).
The encryption code for ICD-10: M.21.4.
Classification of pathology
There are different types of flatfoot depending on the origin:
- congenital - occurs infrequently( 3%);
- rachitic - develops on a background of a rickets because of loading on weak bones of the bottom extremities;
- paralytic is the result of transferred poliomyelitis;
- traumatic - may occur after a breach of the integrity of the foot bones( tarsus, ankles, heel);
- static - is observed most often and is formed due to weakness of the ligaments and musculature of the foot.
Static is divided into 2 main types of flatfoot, depending on which arch takes part in the deformation:
- transverse flatfoot;
By combined flat feet is understood as combined flattening of both arches.
Causes of the disease
Exogenous and endogenous causes of flat feet stand out. The external risk factors include:
- excess weight;
- a multi-hour static operation in a standing position;
- weakening of muscle strength as a result of physiological aging processes;
- sedentary profession and lack of training;
- selection and wearing of uncomfortable shoes.
The main internal cause is the genetic predisposition of a person, expressed in the weakness of the musculoskeletal apparatus of the foot.
Compaction of the transverse arch of the foot
It is the most common orthopedic pathology among adults. It accounts for 80% of all cases of foot deformities. More often observed in women of young and working age( from 30 to 50 years).
Etiology and pathogenesis
When walking for a long time, the degree of load in the area of the foot is changed. This leads to stretching the ligaments and reducing the tone of the short muscles of the foot. There is a discrepancy between the bones of the metatarsal bone and the type of "fan", the 1st finger is deflected outward, and the third is hammered( the end of the phalanx is lowered, which creates a sensation of the "claw" of the finger).
This overload causes prolonged traumatization of the foot tissues and leads to a disruption of its nutrition.
The thickness of the subcutaneous fat is reduced, and painful hyperkeratical formations( corns) are formed.
The clinical picture depends on the degree of flat feet and the development of secondary deforming changes in the foot. There are 3 degrees of this pathological condition. At each stage leading signs of the disease are exacerbated.
- I degree. The normal gait is maintained. The patient complains of soreness in the lower extremities and fatigue at the end of the day.
- II degree. There are persistent intense pain in the legs and feet. The gait becomes less elastic. Shoes wear much faster and mostly on the one hand.
- III degree. Intensive pain is possible not only in the lower extremities, but also in the lumbar region. The longitudinal arch disappears almost completely. The choice of suitable footwear is very difficult. The gait is very heavy, inelastic. Stop stops giving in to an active correction. The deformation is clearly pronounced.
Among the symptoms of transverse flatfoot in adults, the following symptoms appear to be of primary concern:
- Soreness on the plantar surface. In the subsequent in these places are formed napotypes. Pain can spread to the lumbar spine, which makes differential diagnosis of osteochondrosis and sciatica necessary. If the disease develops slowly, the pain syndrome may be absent or be negligible. Rapidly increasing process is characterized by intense pains of "shooting" character. Often there are convulsive muscle contractions. The cause of the pain is the tension of the soft tissues of the soles, which pull behind the branches of the plantar nerve.
- Change of gait by "stilted" type. The foot expands, and adults start to struggle to pick up their shoes.
- The formation of valgus deviation of the thumb.
If there is a suspicion of transverse flatfoot development, you should contact an orthopedic doctor who will carry out the necessary studies to diagnose( radiography, biomechanical studies, planograms) and explain how to correct a flatfoot. Many people do not think about what dangerous flat feet, and it can cause serious violations:
- reduce blood circulation in the foot right up to the formation of trophic ulcers;
- disturbances of innervation;
- strong and irreversible deformation, which changes gait, makes it difficult to choose shoes and spoils the appearance of a person;
- development of ingrown nails, the removal of which requires surgical intervention.
Any advice on how to treat flat feet should be given by a qualified technician. There are conservative( at home) and surgical means.
Non-operative methods of correction include therapeutic physical culture, bandaging of the distal foot, stimulation of vermicular muscles, electrophoresis of phosphorus and calcium ions, massage of lower limbs. They should be conducted regardless of the degree of flat feet.
at flatfoot is of paramount importance not only as a medical measure, but also as a preventive measure. Therapeutic physical training should be aimed at the solution of the following tasks:
- correction of incorrect stop installation, that is formation of physiologically conditioned arch using special projectiles and positions;
- cupping or reducing soreness;
- creating a correct idea of the position of the legs during standing and walking;
- strengthening of the muscular apparatus, which should support the arch in the correct position;
- activation of the motor state and improvement of metabolism and circulation in the lower extremities.
Performing exercise with flat feet should be for at least 2-3 years. All exercises are aimed at restoring muscle tone. Gymnastics with flat feet is done at home and includes the following techniques:
- getting up on the fingertips;
- active supination of the foot( turn outward) in the sitting position;
- walking on the raised thumbs with their approach and turning the heel outwards;
- walking on the outer surface of the foot with turning it inside.
Sometimes, therapy in the period of pain requires complete discharge of the legs, which implies bed rest for some time.
Of particular importance is the correct selection of shoes and the constant use of instep arresters with the laying of the transverse arch. Such products are very effective even for the prevention of flatfoot after successful conservative or surgical treatment. Shoes with high heels for permanent wearing are not recommended.
To reduce the soreness and softening of the corns that have formed due to pressure during transverse flatfoot, one can resort to folk medicine and do daily baths with soap and soda solution at home.
For this it is necessary to dissolve 2 tablespoons of baking soda in two liters of warm soapy water. After thirty minutes of steaming, pumice or a special foot scraper can be used to remove hyperkeratics.
Electrostimulation has become widespread in the therapy of this disease. It is conducted by courses of 10-15 procedures and has a beneficial effect on the tibial muscles, plantar and flexor of the thumb.
With pronounced foot changes conservative treatment of transverse flatfoot is ineffective, and, of course, no folk remedies can help here. Is it possible to cure flat feet at advanced stages, if the patient suffers from a disease for more than a decade? It is possible, but in such cases it is necessary to resort to surgical intervention to correct the condition.
Compaction of the longitudinal arch
occurs in more than 20% of patients with static deformities of the foot. A similar variant of flat feet in children is observed more often than other species, but it also affects teenagers who have not been prevented. Can be diagnosed as at the age of 5 years, and in the older.
Etiology and pathogenesis of
The main causes of flat feet in children and adolescents is a decrease in muscle tone and severe fatigue as a result of prolonged standing on the legs. The weakening of the muscular apparatus leads to the lowering of the inner edge of the foot, the ligaments are stretched, the heel unfolds inward.
Also with longitudinal flat feet, the shape of the ankle joint changes. Thus, during the disease, children can be divided into 3 main periods:
- The foot is reduced, slightly flattened, but functional abnormalities are not detected. This is most often observed in preschool age and is a predisposing factor for deformities of the foot.
- Functional deficiency is formed, which leads to rapid fatigue and the appearance of pain in the calf muscles. Vaults are expressed, but there is a tendency to flatten them.
- The muscular-ligamentous apparatus of the foot is decompensated and its subsequent deformation develops. During this period there is a marked flattening of the arch.
What is the danger of flatfoot for a child's body? The fact is that it provokes heavy loads on the spine, which in a few years can cause scoliosis. An increase in the load on the ankle joints due to loss of foot damping properties over time can lead to arthrosis.
Clinical picture of
The first sign of longitudinal flat feet in a child is leg fatigue and leg tenderness. After a while, the pain increases with walking and prolonged standing. The child complains of the soreness of the foot, the medial malleolus, the sole and the back of the lower leg and thigh.
In this case, flat feet 1 degree and 2 is characterized by a greater pain syndrome than at 3. Most likely, this is due to the adaptation of the soft tissues of the child to the new conditions of the load that have arisen over several years of the disease.
Sharp pain syndrome in the feet and calf muscles is most typical of flat feet of the 2nd degree.
It is important for parents to know how to determine the flat feet of a child. An indication of the formation of the disease can be the detection of the shoeing of shoes from the inside of the sole and heel. To make a diagnosis, you need to consult an orthopedist who will tell you how to get rid of flat feet in this particular case.
The diagnosis is based on the complaints of the child, the detection of the characteristic symptoms of flat feet, and also from the results of these instrumental studies:
- radiography in two projections( direct and lateral) with load;
- - measurements of arch height, length of tops, definition of special indexes;
- subgraphs - determination of indicators of foot biomechanics;
- electromyography - a conclusion about the state of the muscular system and the determination of the degree of reduction of the bioelectric activity of each muscle.
The main role is played by flatfoot prevention and early therapy. From flat feet in children will help the following exercises:
- jumps and bouncing on the fingers;
- walking on "socks" and the outer edge of the foot;
- pulling socks with their emphasis in a static object;
- gripping small objects with your toes from the floor surface.
From flat feet help not only exercise, but also walking the child barefoot, on the sandy surface, or any uneven soil, massages, warm baths.
Gymnastics for flat feet in a child should be regular, performed during the day for 5-6 minutes several times. Exercises from longitudinal flat feet will help faster if combined with the use of orthopedic insoles or shoes. Such remedies are effective at the initial stages of the disease and with flat feet of the 2nd degree in children and adolescents.
Treatment of severe flat feet includes plaster bandages in the supination position.
The field of pain relief and gypsum removal must be worn orthopedic footwear, exercise therapy. Against the background of this therapy it is useful to do toning massage of the inner and anterior muscle group, and on the foot - the plantar group, whose function is to maintain the arch. The course of sessions should be at least 15-20 procedures.
How to cure flat feet, if gymnastics and orthopedic shoes do not give the child the proper effect for several years? Unsuccessful conservative treatment of longitudinal flat feet is an indication for the operation, which is performed by surgeons not earlier than ten years of age.
Most often, surgical treatment is recommended for flat feet of grade 3, which does not lend itself to conservative therapy at home.
Parents should know that the child's longitudinal arch is formed only in the fourth year, therefore it is not always rational to apply to orthopedists before the age of 4.This only makes sense when forming a congenital flat foot. In 2-3 years the child has a physiological flat foot. In such cases, measures to prevent flat feet in pre-school children( stimulating foot massages, gymnastics with flat feet) are of great help.
In addition, up to 5-6 years is not recommended wearing shoes with a hard sole, lacing and heel. Also it is necessary to avoid instep support. If parents suspect that their child has a deformity of the foot, then it is necessary to visit a specialist every year until the final formation of the arch.