Flattening in childrenFlat feet in children - a change in the configuration of the skeleton of the foot, associated with the flattening of its arches and leading to a violation of the mechanics of walking. Flattening in children is manifested by fatigue, pain in the legs during movement and static load, edema and deformity of the foot, change in gait, difficulty walking. The diagnosis of flat feet in children is established on the basis of clinical examination, data of planktonography, podometry and radiography of the feet. For the treatment of flat feet in children conservative methods are used( massage, therapeutic gymnastics, physiotherapy, application of plaster dressings and orthoses);operative intervention is carried out in extreme cases.
Flat feet in children
Flat feet in children - the most common orthopedic pathology in pediatrics, manifested by a decrease in the height of the arches of the foot. Flattening can be detected in the child from birth( in 3% of cases);to 2-4 years it is observed in 24-32% of children, by 7 years - in 40%, by 12 years - in 50% of adolescents.
Active formation of the arches of the foot in children occurs gradually, with the appearance and increase in the load on the legs. The critical moment in the development of flat feet is the age period from 8 months to 1.5 years, when the child begins to get up and learn to walk. At an early age, all children have a physiological flat foot, due to age-related anatomical and functional features: the cartilaginous structure of bones, more elastic and elongated ligaments, weak muscles. With the right development with increasing strength and endurance of muscles, this condition in children independently normalizes to 5-6 years. With certain violations in children, flat feet develop, leading to a sharp decrease in the damping capacity of the foot, an increase in the load on other elements of the musculoskeletal system with damage to the knee and hip joints, deformation of the spine, disruption of the internal organs.
Classification of flatfoot in children
The foot has longitudinal and transverse arches supporting muscles and ligaments, providing balance of the body, distribution and mitigation of shock load during walking, running and jumping, and also increasing endurance to the axial load. According to the anatomical sign in orthopedics, longitudinal, transverse and combined flat feet are distinguished. Children often encounter longitudinal flat feet with a flattening of the longitudinal arch and an elongation of the foot that touches the floor with the entire surface of the sole. With transverse flat feet in children, the length of the foot decreases, its front section rests on the heads of all metatarsal bones.
Flattening in children can be congenital and acquired. The congenital form is rare enough and is associated with malformations of the bone structures and the musculoskeletal apparatus of the foot. Acquired platypodia in children depending on their origin can be static, traumatic, rachitic, paralytic. The most common static flatfoot is more common in school-age children when there is a discrepancy between static and dynamic load on the foot and muscle tone.
Causes of flatfoot in children
Flat feet in children can develop for various reasons. Congenital flat feet in children is observed in utero underdevelopment of the bones, muscles, ligaments and tendons of the shins and feet. Acquired flat feet in children also develops against the background of congenital insufficiency of connective tissue and can be combined with an additional chord in the heart, bend of the gallbladder, myopia, etc. In the formation of flat feet in children, the hereditary factor - the presence of this pathology in close relatives - is of great importance.
Flattening in children can be caused by the weakness of the musculoskeletal foot apparatus that does not withstand heavy loads;defeat of the musculoskeletal system in rickets;incorrectly fused fractures of the ankles, metatarsals, heel and talus bones;paralysis or paresis of the muscles of the lower leg and foot( including after poliomyelitis);neurological pathology( encephalopathy).
The appearance of static flat feet in children is promoted by wearing incorrectly picked up shoes( cramped, dissimilar, on a thick sole), overweight and obesity, prolonged continuous walking or standing. Often flat feet develop in children with flat-foot deformities of the feet.
Symptoms of flat feet in children
In most cases of congenital flatfoot, one foot is affected in children, which looks like a rocking chair or a "paperweight" with a convex sole and a flattened, even concave back. There is heel instigation of the foot, a sharp pronation with the removal of the fingers outwards. With the advent of static load, congenital flat feet are aggravated and fixed.
In children 6-7 years of age, flat feet are manifested by rapid fatigue when walking and standing, by trampling the shoe along the inner edge of the sole and heel. Clinical symptoms of acquired flat feet in children are aching pains in the foot area, which increase after a long stay on the legs;puffiness of the feet in the evening, fatigue when walking.
There are three degrees of longitudinal flat feet in children, determined by the degree of deformation of the foot. At I degree, the height of the arch of the foot is 25-35 mm, there is no visible deformation of the foot. At II degree - the height of the arch is from 25 to 17 mm, flattening of the foot is visible to the naked eye;Platypodia in children is manifested by an increase in pain in the foot, ankle and calf muscles, difficulty walking. The shape of the foot changes - its length increases, the middle part widens, the gait becomes heavy and clumsy;children have a rapid overall fatigue. Flattening of the third degree is characterized by a pronounced deformation of the foot, a decrease in the height of the arch less than 17 mm, constant pain in the legs and lower back, headaches, inability to walk in ordinary shoes.
Flattening causes the curvature of the toes of the foot, the appearance of calluses, the formation of disorders in the child's posture( scoliosis) and spine diseases( osteochondrosis, herniation of intervertebral discs), deforming arthrosis, meniscal inflammation, etc.
Diagnosis of flatfoot in children
children up to 5-6 years of age are quite problematic. The diagnosis of severe flat feet in children can be made by a pediatric orthopedic surgeon during a clinical examination that allows to detect changes in the length, width and volume of foot movements, a violation of the state of its arches, and the wear of footwear.
Objective methods of assessing flat feet in older children are planography - obtaining a footprint of a footprint on paper and a subgrade - measuring the "sub-metric index" of the arch of the foot. Clarify the diagnosis of flat feet in children I help the results of radiography of the feet with the load performed in 2 projections.
Flat feet treatment in children
Flattening in children is a progressive disease, and the earlier treatment is started, the more effective the results. The treatment of congenital flat feet begins with the first weeks of the child's life, which allows eliminating all the components of the foot deformity. With congenital flat feet, children undergo special therapeutic exercises, massage the muscles of the foot and lower leg;the foot is held in the correct position by means of bandaging, the imposition of stage plaster casts, and night orthoses( from the age of 6 months).With aggravation of flat feet in children, a subartar arthroesis is performed.
Treatment of static flat feet in children, aimed at strengthening the musculoskeletal apparatus of the foot, includes massage, physiotherapy and exercise therapy. Young children are excluded from soft shoes( felt boots, rubber boots, Czechs);It is recommended to wear shoes with a firm sole and a small heel, which fix the ankles well. When flat feet in older children shows wearing orthopedic shoes with a foot-instep, raising the lowered arch and returning the foot to the correct position.
To eliminate flat feet in children, hydromassage, contrasting foot baths, paraffin, ozocerite and mud applications on the foot area, magnetotherapy contribute to the elimination of flat feet. In the absence of the correction effect, gypsum dressings and longi are used;in severe cases of combined flatfoot surgery is possible on the bones and soft tissues of the foot and lower leg. The optimal age for surgical treatment of flat feet in children is 8-12 years.
Prognosis and prophylaxis of flatfoot in children
Weak and moderately pronounced flatness in children with timely correction is completely curable;The neglected cases are difficult to correct. In the absence of treatment, flat feet in children leads to severe deformation of the foot, joints and spine.
The prevention of flat feet in children is the wearing of properly matched shoes;physical education, game sports( basketball, football) and swimming;walking barefoot on uneven ground, sand, pebbles;normalization of calcium-phosphorus metabolism;control of body weight.
Disease forms, degrees and their signs
The following types of disease stand out:
- plosco-valgus stop - X-shaped curvature of the ankle joint. Usually this is not an independent form of pathology, but the last stage is the longitudinal form of flatfoot.
The compilation of the arches of the foot has such stages:
- Predilezny. Muscles of the lower leg and the top of the foot ache only after prolonged exercise.
- Intermittent flatfoot( 2nd stage).The muscles of the lower leg and the feet tighten and hurt by the end of the day. The lowering of the foot can be seen visually, in the evening. In the morning, the foot looks normal.
- At this stage, the final development of the flat foot is noted. The symptoms are as follows: legs become tired even after a short standing;there is a visual flattening of the foot, there is a need to choose shoes at once 1-2 sizes larger. In addition, the thumb is pushed aside.
- The stage of valgus curvature of the foot: the ascent is flattened simultaneously with the turn of the foot by the sole of the inside.
There are several degrees of transverse and longitudinal flat feet;they are evaluated according to different criteria. Diagnosis is carried out either according to the footprint( in children up to 7-10 years old), or by X-ray( after this age).The degree of transverse flattening is judged by the angle of the deviation of the thumb, and also by the angle between the thumb and forefinger:
- is normally the first indicator - less than 14 °, the second - less than 9 °
- at 1 degree - 15-20 ° and 10-12° between I and II fingers
- 2nd degree is characterized by the figures 21-30 ° and 13-15 °
- the transverse flatfoot of the 3rd degree is characterized by the digits 31-40 ° and 16-20 °
- 4th degree - more than 41 ° and more than 21 °.
The degrees of longitudinal flatfoot are estimated from the radiograph data:
- 1 degree: arch 2.5-3.5 cm high, arch angle 131-140 °
- 2 degree: 1.7-2.4 cm, 141-155 °
- 3degree: less than 1.7 cm, 156 ° or more.
How to determine flat feet at home? This will help to make a simple test, which can be performed in a child over 5 years old( before this age - only medical diagnosis).To do this, you need to smear the baby's feet( especially painting the inside of the foot and thumb) with watercolor paint or oil, and then put it on a landscape sheet that can absorb your dye. The child is entertained for 30-60 seconds, so that he stands on the sheet calmly and in his usual pose. Next, the prints are evaluated( scientifically, the plottogram):
- , the normal notch in the middle of the print leaves half the width of the foot
- at the I degree - slightly more than 1/3
- at the II degree - less than 1/3
- at the third degree there is no excavation at all
- atflattening of the transverse arch between the heel and the metacarpal heads there is no generally shaded gap
- the valgus foot leaves a wide and deformed trail( resembling a bear's paw).
Also look at the thumbprint.
Diagnosis of newborns and infants until the year is not put: if you suspect a flat foot recommendation for a set of passive exercises, the regime of the day, massage, wearing shoes and food.
In children older than 1 year, a survey is conducted, such as a swelling - measurement of the foot with subsequent calculations of the indices of the longitudinal and transverse arches.
Pre-school children also spend:
- podrafiyu - the study of the phases of walking, load distribution on the foot. A test is carried out in special shoes, in which the child is asked to pass on the metal track
- electromyography - examination of the activity of the calf and foot muscles
- determination of calcium and phosphorus levels in the blood
- computer tests in which the programs count biomechanics walking.
If the diagnosis is confirmed by these methods, X-rays of the feet are taken, which gives the most accurate result.
Treatment of flatfoot
The disease is chronic, that is, if left untreated, it will progress, causing all the consequences listed above with time.
How to correct flat feet: the nature of the therapy will depend on the stage of the disease and the age of the child. In early childhood, the foot has even more cartilage than bones, and if you give them the right position, then there is a great chance that their ossification will occur in the right position.
So how do I heal I-III stages of flatfoot? Everything starts with conservative methods.
Preparations for flat feet are prescribed when the disease is accompanied by severe pain or swelling of the legs. In these cases, tablets or syrups with pain medication can be used: Nurofen, Analgin. To eliminate edema, local medications that strengthen the venous vessels( Troxevasin-gel) and dilute blood( heparin ointment) can be used. A teenager can safely apply these drugs, but the parents of a baby should first consult a doctor.
For medicamental flatfoot therapy, drugs that affect the cause of the disease should be used: vitamin D for rickets, muscle relaxants and antibiotics for the treatment of the paralytic foot.
Antibiotics for the treatment of flatfoot itself are not used. They are used if there are symptoms of rheumatism or other bacterial diseases that are not related to flattening of the arches of the foot, even in the infant.
At home, but only in combination with other therapies, folk remedies can be used:
- Leaves of wormwood are washed, dried, applied to the soles of the feet and after bandaging are also fixed with socks
- Trays with sea salt( 1 tbsp.per 1 liter of water)
- Contrasting baths: the feet should first be unzipped for 1-2 minutes, then rinse 15 seconds with cool water. In warm water, you can add decoction of the bark of oak
- Warm baths with broth of mint
- Baths with sage.
Recall, this method is ancillary. The main effect of treatment is achieved with the help of exercise therapy, physiotherapy methods, massage, wearing orthopedic shoes or insoles.
This method of treatment is applied at all stages of children's flatfoot. The mother makes a small child massage, the teenager uses self-massage with the help of hands, orthopedic rugs, rollers, balls. You can also make an orthopedic mat with your own hands, if you paste on and paste pieces of rough puzzles, buttons, pebbles, lids from plastic bottles. A good effect is also provided by the Plant simulator - insole, laid out with massage elements, which are worn for a while.
Manual massage enhances blood circulation, restores muscle tone. Performed such techniques as stroking, rubbing, tapping, kneading. The elements of vibration are necessarily included. Using finger pads, we draw a number 7 on the foot, drawing from the thumb to the little finger, leading the line to the heel.
Complex of exercises
LFK is selected by an orthopedist, performed first with an instructor, then repeated at home and in kindergarten. With a child in 1 year passive medical gymnastics is performed - when the movement of the legs of the baby is performed by the mother.
These exercises are used:
- Sitting on a chair and putting feet on the floor, press your fingers several times. The heels thus firmly stand on the floor
- When sitting on a chair, collect cloth, roll a rolling pin, grab small objects
- Perform in the same position. It is necessary to use the thumb of one leg to slide the legs of the other on the shin, then change the legs
- Standing on the toes 5-10 times
- Walk on the inner and then the outer edge of the foot
- When charging, always walk on bars, along the ropes.
Orthopedic insoles and shoes
These devices are prescribed only by an orthopedic doctor from the first stage of the disease. If at I-II stages it is possible to use footwear purchased at specialized stores that will be sold by the orthopedist's prescription, then at stage III shoes and sandals are ordered already at special plants.
- support arches in anatomically correct position
- improve blood circulation
- reduce stress on leg joints and spine
- improve stability when standing
- improve overall well-being.
Reviews about this type of treatment - only positive. You need to wear these insoles in your home and in street shoes, but periodically you need to give them rest, it is desirable that the child at this time was barefoot.
To relax the pathologically stiffened muscles of the foot and improve circulation in them, the following are used:
- applications with paraffin and ozocerite
shock wave therapy is used to soften the ligaments. Operation
Surgery is performed in the orthopedic clinic if, in spite of conservative treatment, flat feet led to the formation of valgus flattening of the foot.
Surgical intervention can consist both in creating an artificial fusion between the calcaneus and navicular bone, and in the gradual, step-by-step plastering of the foot with additional fixation with its spokes.
Rehabilitation after arthrodisal surgery is carried out in multidisciplinary or orthopedic clinics( for example, CM-Clinic, Family Clinic, Medical Center Olympus in Moscow).It consists in temporary plastering of the foot to a third of the shin with the subsequent performance of massage, physiotherapy, therapeutic gymnastics.
The diet after the operation is to eat a balanced diet that includes enough protein, calcium, vitamins( especially group B) and phosphorus.
Prevent flat feet is much easier than curing this chronic process. To do this, you must follow these rules:
- Do not try to put the baby before 7-8 months, and then with support. The optimal option - when the child himself becomes on the legs
- Carry out the prophylaxis of rickets
- Buy an orthopedic mat or make a mat with your own hands. On it, the child will become during the game, charging, cleaning teeth
- At home, it is necessary to perform therapeutic exercises: walking on the side edges of the foot, picking up the fabric and objects from the floor
- The first and subsequent shoes are chosen so: there should be a hard and long back, a small heel. Keds can not be worn categorically. Slippers and flip-flops - for a short while, only with
- heat. Walking barefoot on different surfaces
- . Folk remedies used for the prevention of the disease are successfully used for its treatment.
- Attend kindergarten: the kindergarten will be performed by daily gymnastics that aims to prevent flat feet
- The diet contains enough meat and fish, as well as fruits and vegetables, fresh juices.
The advice is simple: do not look on the Internet how to fix the flatfoot found by you, but look for a specialist who:
- will pay attention to all aspects of the life of the child and family that will help cope with the disease( that is, it will tell you about the diet and about vitamins,and pick up a set of exercises)
- will be busy not only with the treatment of the investigation - flat feet - but also with a search for its cause
- will tell you about the possible consequences of the disease and how they manifest so you know when to sound the alarm.
Flattening in children: causes, symptoms, degrees, treatment, prevention
Flat feet in children is a foot deformity, in which the longitudinalor the transverse arch of the foot is lowered and flattened. There are transverse and longitudinal flat feet in a child. Determine what form the child can, by the way the arch of the foot is flattened. Often there are both forms of this pathology.
The transverse flatfoot differs in flattening the transverse arch of the foot. The arch consists of 5 metatarsal bones, on the heads of which the anterior region of the foot rests. As a result of deformation, metatarsal bones diverge in the form of a fan, the big toe deviates, a valgus flatfoot arises. The middle finger suffers from a hammer-like deformation, the length of the foot generally decreases.
As a result of permanent trauma, a bone is formed on the finger, which is removed by surgical intervention. With transverse flat feet operations are only temporary relief.
Longitudinal flat feet is an flattening of the longitudinal part of the foot, the length of which increases in size, with the whole sole touching the floor. The development of longitudinal flat feet is affected by excessive weight, which gives a strong load on the legs. Most often, this disease is identified after 15 years.
The deformation of the foot is congenital or acquired. Deformation acquired is divided into types: rachitic, static, traumatic or paralytic.
Congenital flat feet are difficult to determine because all children under 5 years of age have signs of flat feet. There is congenital platypodia due to hereditary subtilism and in case of shortage of connective tissue. Examination of this pathology is made after 7 years. It is impossible to diagnose congenital flat feet in a child up to one year, since there was no stop.
The traumatic appearance of flat feet occurs due to injuries and fractures of the ankles, tarsus or calcaneus. The cause can be considered a defect and a violation of soft tissues, which fix the arches of the foot.
A major cause of paralytic platypodia in a child may be a transferred polio. As a result, the paralysis of the muscles of the foot and the tibial muscles occurs, the posture is curved.
Rickets can occur if there is a rickets disease that interferes with the normal development of the foot bones. Badly formed bones can not withstand the load of the whole body, so a violation of the shape of the feet and posture is detected.
Statistical flat feet is considered to be the most widespread today. The main signs of the development of this pathology is the general weakness of the leg muscles, especially in the shin area, the ligamentous apparatus weakens. Excessive body weight, lack of necessary exercises, such as morning exercises and walking, can become a source of irregularity in the shape of the foot. Also the reason is incorrectly matched shoes.
Symptoms can be considered quick fatigue during an intense walk on a walk. Feeling tired in the legs, there are cramps and swelling of the feet, as well as the ankles. Due to elongation and flattening of the foot, it is difficult for a child to pick up comfortable shoes. The occurrence of pain in the lower back and in the hips, the manifestation of the headache also indicate that flat feet develop.
If the child forms a flatfoot, there is a violation of posture, the gait changes, often the toe grows on the toe.
Such symptoms are inherent not only in flat feet. Similar signs may indicate varicose veins in older adolescents. In any case, you need to undergo a checkup to find out the exact diagnosis.
Deformation of the foot varies in severity. At the earliest stage, the ligamentous apparatus develops poorly. The deformation of the foot is not observed, however, the ligaments are stretched, the child experiences painful sensations.
With a weakly flattened first-degree flatness, the manifests a feeling of fatigue in the legs that results from physical exertion. There is also a wrong walk, swelling of the legs. When pressing on the foot, painful sensations are felt.
If the combined flatfoot of the second degree develops, then there are signs such as flattening of the foot, acute pain .Painful sensations sometimes reach the joints on the knees. It is difficult for a sick child to walk at such a flat foot level.
With a pronounced flattening of the third degree , the painful sensations become difficult to tolerate, the swelling of the legs is evident, the head and lower back ache. The performance is low, you can not exercise sports and physical loads. In order to alleviate the pain, high-quality orthopedic footwear is needed. At the third degree of flatfoot there is deformation of the foot and fingers.
Flat feet in children in the year and older age seems to be the norm, in fact, the development of the disease can lead to very serious consequences. The earlier a violation was detected, the treatment will be more effective and more favorable.
Fully cured longitudinal, valgus or transverse flatfoot can be in childhood, until the child has not fully formed a stop. In adolescents, treatment is aimed at slowing the rate of development of pathology.
Treatment includes strengthening the muscles and ligaments of the foot, eliminating pain. With an easy degree of flat feet, you can do massage. Used orthopedic shoes, a special rug, which you can buy or make with your own hands. Treatment of flat feet in children is carried out at home.
Gymnastics and exercises
Specialists recommend effective therapy that will help to correct the violation - therapeutic gymnastics. Special exercises need to be done every day to achieve maximum effect. Gymnastics for each case is selected separately, takes into account the age of the child, the form of flat feet. The application of IFA with flatfoot allows you to treat a foot disorder and posture will be easier and faster.
Orthopedic shoes or arch supports are also included in the treatment of a child. Such shoes can correct the deformation of the foot. Optimal option will be the individual manufacture of orthopedic insoles for each type of flatfoot. Orthopedic shoes and gymnastics can also correct deformation of posture.
Buy orthopedic accessories for the treatment of flatfoot in any orthopedic center.
Massage mat with your hands
A modern massage mat will help you to flat feet. The mat can be made by hand at home or bought in specialized stores. Massage mat is made of rubber material, polyethylene using solid fillers. Massage mat and orthopedic shoes are simple with flat feet, this is a good prevention and for posture.
The mat provides relaxing foot massage, which improves blood circulation, normalizes blood microcirculation in the spine.
To make a rug by hand, you will need improvised tools, such as ropes, pencils, buttons and much more. Also, the rug is made from various cereals: buckwheat, rice, peas, beans. Watch the video on how to make a massage mat at home, and make the same with the baby.
There are general rules that prevent the disease in children at an early age. Prevention of flat feet in preschool children is the intensive training of ankle muscles. Allow your child to walk more barefoot on land, grass, river sand. If there is no such possibility, make an orthopedic mat yourself.
Walking barefoot on an uneven surface helps prevent foot deformities and posture disorders in children and adults.
Regularly you need to do the exercises, for a few minutes a day. Gymnastics is carried out on the mat to prevent flat feet and correct posture. During exercise, while walking or just standing still, watch the position of the child's posture and feet. The feet must be parallel to each other.
To prevent symptoms and further development of flat feet, it is worth paying attention to the shoes that you buy the child. For the prevention of flat feet it is better to immediately purchase orthopedic shoes. Specially designed shoe form holds the foot tightly, prevents deformation of the foot.
Flattening in children - causes, symptoms, treatment, prevention.
Toddlers, starting from the age of seven months, are gradually accustomed to the upright, which causes them to significantly increase the load on the lower limbs. When wearing the right, quality shoes and proper development, normal physiological development of the feet and feet occurs. With a constant load on them, various diseases, excessive physical exercises, there may be various disorders in the development of the legs, one of which is flat feet.
Flatfoot - the most common disease of the musculoskeletal system in children, characterized by deformation of the foot with a flattening of its arch( usually longitudinal), as a result of which the sole becomes flat, touching the floor with its entire surface.
In all mice up to 2 years of age, the longitudinal arch of the foot is flat. And this is considered the norm, because in their soft and elastic bone tissue is not enough minerals to give it strength. Also, the muscular system is not fully developed. In 7-9 months, when the kids begin to get up on their feet and take the first steps, the function of the shock absorber is performed by the "fat pad" located on the sole. In 2-3 years in bones the amount of mineral substances reaches the norm, the ligaments and muscles become firm, the articular surfaces become normal. The formation of bone tissue stops until about 5-6 years of age. Only after this period it is possible to diagnose or eliminate flat feet in the child.
However, in some children( about 3%) flatfoot can already be detected immediately after birth. It is considered congenital and is a developmental defect of the musculoskeletal system. Most often congenital platypodia is combined with the disease - flat-valgus deformation of the foot.
Symptoms of flatfoot in children
Children 6-7 years old who suffer from flat feet will complain of rapid fatigue while standing and walking, swelling and aching pain in the area of the feet, worse by evening.
External symptoms of flat feet in children:
- an increase in foot width;
- quickly removes the outsole and the inside of the heel on the shoe;
- changes gait( impaired posture, appears clubfoot).
How to determine flat feet in children at home
You can determine the flat feet of a child with a simple test. It is necessary to smear his feet with oil or cream, put a clean sheet of paper on the floor and ask him to stand on it, evenly distributing the body. If the child has no problems with his legs, the footprint on the sheet of paper will look like in Figure 1; if, however, as in Figure 2, he is likely to have flat feet. It is necessary to visit a doctor-orthopedist, who will conduct a planography and be able to most accurately diagnose.
Factors provoking the development of flat feet in children:
- Heredity .There is a possibility of flat feet in children, if their close relatives suffer from this disease.
- Incorrect, substandard footwear .The development of flat feet is heavily influenced by the shoes that the child wears. It should not have a completely flat sole, be soft and without a instep.
- Excessive strain on the legs of ( eg, due to obesity).
- Small motor activity of the child .In the age of high technology, most children prefer to stay at home with their favorite phone or tablet, rather than go out and play on the street. As a result, posture is added to the flat feet and a violation of posture.
- Rickets .The disease develops in children due to a lack of bones in vitamin D and calcium. As a result, the bones become brittle, and since large body loads fall on the feet, the child can experience flat feet.
- Injury of the feet ( fracture of the calcaneus, ankle, tarsus bones).
- Paralysis of the muscles of the foot and lower leg .Paralysis arises from a disease that has been transmitted, which causes platypodia.
Treatment of flat feet in children
Congenital flat feet in children of mild form is treated by applying plaster bandages, which will be fixed in the correct position of the foot. The dressings are applied for 7-10 days, then they are removed and new ones are applied again. Treatment lasts 8-10 weeks. After the baby is assigned courses of physiotherapy, massage and wearing individually manufactured orthopedic shoes. Heavy forms of congenital flat feet are treated only surgically.
Acquired platypodia in children is treated conservatively. Treatment is multicomponent and is designed for a fairly long period. It includes:
Therapeutic physical training .Exercises are aimed at strengthening the musculature of the feet and muscles of the legs. Spend them daily. Also in exercise therapy includes classes on a special massage mat, the surface of which consists of various irregularities. When in contact with the sole, these irregularities help to strengthen the muscles.
Orthopedic footwear .Treatment of flat feet in children will not be effective without wearing the right shoes - suitable in size, with a high rigid back, good fasteners for fixation on the foot made of natural materials, with a small heel( 5-7 mm).Particular attention should be paid not only to the selection of shoes, but also to the insole with the instep. Medical shoes can be purchased in specialized stores or, according to the appointment of an orthopedist, it is made individually.
Massage .Depending on the degree of flat feet, the massage is conducted in courses of 10-15 sessions up to 4 times a year.
Physiotherapy .Pronounced flat feet need to be treated with physiotherapy. The most commonly used electrophoresis is the calcium of the ankles, which helps strengthen the ligaments, and electromyostimulation of the lower leg muscles, which causes the weakened muscles to contract. Assign physiotherapy courses 2 times a year for 10 sessions.
Plane prophylaxis in children
To reduce the risk of flat feet in the child, it is necessary, starting from the earliest age when the baby starts to get on its feet, to carry out the prevention, which is as follows:
- As soon as the baby begins to make the first attempts to stand at the support, it is necessary that he does it in the shoes to prevent the wrong installation of the feet. In this case, shoes should be made of natural materials, have a small heel, a hard back, a pronounced instep, an elastic and corrugated sole, be of size and well fix the ankle and foot.
- A toddler should not wear out someone else's shoes, because it always stalks in different ways and is not always right. Therefore, if a child wears out shoes inherited, he will get all the problems with the feet that are available to the previous owner.
- A good prevention is hardening. Often ill with colds of the baby, not only the immune system suffers, but muscles are weakened, which leads to a decrease in motor activity, and this can provoke the development of flat feet. Effective contrast baths for feet. For them, it is necessary to take two tanks into which the child's legs can be placed in the water up to the knee. In one tank water is poured 40 ◦С, in another - 33 ◦С.The legs of the child alternately for a few seconds should be lowered then into warm, then into cold water. The duration of the procedure is 5-10 minutes. It is performed only when the baby is healthy.
- Reduces the risk of flat feet with warm baths for feet with sea salt or bathing in sea water. Sea salt tones blood vessels and muscles, and water exercises a massage effect.
- The correct formation of the arch of the foot is almost impossible without barefoot walks. In the warm season, the child should often walk barefoot on pebbles, grass, sand and other uneven surfaces. But before, you have to make sure that there is no broken glass, nails or other objects on the way of the baby, about which he can get hurt. Such surfaces can be recreated and at home, for example, on the floor to sprinkle beans, which will perfectly replace pebbles.
- Excellent prevention is to lift your toes from the floor of small items - pencils, large buttons.
Flattening is a disease that, in the absence of therapy, can cause serious consequences - diseases of the musculoskeletal system, severe deformities of the foot bones. Therefore, neglect treatment and prevention is not worth it!
Diagnosis: flat feet in children. Signs, causes and methods of treatment of infant and children's flat feet.| |Woman.ruLike Only the child makes his first independent steps, parents immediately ask themselves how to avoid the occurrence of flat feet in the baby, what shoes are best for preventing this disease, whether it is necessary to train the baby's legs in a special way. ..In fact, flat feet in children is a rather speculative disease: in fact it is present to some extent in all children, but this should not disturb their parents in any way. Why is that?
- Perhaps, it will surprise you, but without exception, all newborn babies come to this world with absolutely flat soles of the feet.
Every baby is a flatfoot specimen
Essentially every baby is a flatfoot specimen! And only with time, very gradually and not quickly( during 5-6, and sometimes 10-12 years), the baby's feet form a special bend.
This bend serves as the most powerful shock absorber on our skeleton. Namely: when walking, running, jumping and other movements on the bones of our skeleton( and that is very important - on the spinal column!), There is a tremendous pressure that is "extinguished" just thanks to the special structure of the foot - a small bend, which is commonly called "arch".As far as the arch of the foot is developed or underdeveloped, the fingerprint speaks most eloquently.1 - normally formed arch of the foot;2 - too high arch of foot;3 - flat feet. All three situations are well "read" on the trail - dip the baby's leg in gouache, and then put it on Whatman: you will immediately see how developed or not the arch of the child's foot.
This arch is formed gradually as the child grows, but the most intensive period occurs at a time when the baby starts walking alone.The arch of the foot is formed completely and finally in a young man and a girl at the age of about 12 years. And until the moment of its final formation, any position of the foot is recognized by physicians as absolutely fixable and physiological. That is why the very term "flat feet in children" is somewhat absurd as a diagnosis.
Flatfoot prevention in children
Doctors do not consider physiological flat feet in children for some serious flaw. Ordinarily, however, orthopedists keep an eye on how their feet are shaped by the arch of the foot in the course of time. And often they advise parents to take various preventive measures for the timely and correct formation of the arch of the foot, as well as to strengthen the joints and muscles of the child.
Correct bending of the foot is formed under the influence of a certain group of muscles, which are used best when the baby walks barefoot on an uneven surface - for example, a sand or pebble beach, a grass lawn, wooden stairs, etc.
Since modern flat-topped surfaces( asphalt on the streets, parquet, laminate or linoleum indoors) are the most often "on the road" for modern children, there are not many options for preventive maneuvers. The most accessible ones are:
- 1 In order to prevent flat feet, the baby should be placed on an uneven surface at every opportunity - sand on the beach, grass on the lawn, slides and climbing frames on the playground, etc.
- 2 Uneven surfaces can be arranged at home - for example, sprinkle nuts on the carpet( chestnuts or hazelnuts are ideal), for which the toddler should walk with bare feet. Also, nuts can be filled with a tissue bag or pillowcase - by supporting the baby, let it stomp or jump on this bag. Finally, you can purchase a special orthopedic mat in the children's store.
- 3 Buy the first footwear for a child who is just beginning to walk alone, with a small preventive instep( a special insert in the shoes that delicately helps to form the correct arch of the foot).
- 4 Take some time to special exercises for the feet. For example, a child can walk alternately on socks and on the heels, on the inside of the foot and on the outside. Another exercise - standing still, rolling from the socks to the heels( with a roll on the heels, raise the socks upwards).The most common and effective exercise is with a sports stick. It is necessary to put a stick on the floor, put the baby on it( barefoot or in socks, the main thing - without shoes), and carry out side steps along it. In doing so, you need to ensure that the stick is always strictly across the foot.
Flat feet and shoes: what's the connection?
When doctors announce by the parent that their children have a flat foot( that, again, for children up to 5-6 years is not a sign of illness or a certain deviation in development), 95% of them instantly "sin" on incorrect or substandard footwear.In fact, flat feet and shoes do not have any connection with each other. In addition, perhaps one: sometimes, in rare cases, with some forms of flatfoot, you can somewhat improve the situation for the better by wearing special orthopedic shoes. But if the leg is healthy - making it "flat-footed" with the help of any kind of shoes is almost impossible.
A sedentary lifestyle plays a real negative role in the formation of the wrong foot. To the arch of the foot has acquired the desired bending and strength, it is necessary that the foot muscles actively "work".To do this, you need to make sure that the baby moves a lot during the day, especially on uneven surfaces. Do not pass by - the children's hills in the courtyard, the Swedish wall, sand and pebble beach, etc.
Recall: the diagnosis of "flatfoot" orthopedists put 95% of all children under the age of 2, forgetting, however, often add that this platypodia is absolutely normal( physiological) phenomenon - because the baby's foot is just beginning to form. .. If your baby is activemove, this infantile flatfoot will pass by itself( you will not even notice it!).
And only after 6 years, if the baby's foot still has a flat footprint, it makes sense to think about serious prevention and even easy correction of flatfoot. But again - even such a "belated" formation of the arch still remains within the physiological norm. And only at 12 years old the doctor can put the official diagnosis of the disease "flat feet" and prescribe adequate treatment.
Flat feet in children over 12 years of age
So, as a rule, flat feet in children disappears by about 6-10 years old. Legs become less flexible, pronounced arches of feet appear. According to statistics, only in 1-2 of 10 children by the age of 12 years is still flat feet. Someone at this age is already appropriating this or that degree.
The distinguishes three basic degrees of flatfoot in children over 12 years of age:
- 1 First degree( flexible flat feet).In fact, we can say that all small children with flat soles just have this degree of flat feet. This is a completely non-painful condition, is observed to the same extent on both legs, does not lead to disability and does not need any serious treatment. And children, and children over 12 years with the first degree of flatfoot, as a rule, only preventive measures are recommended.
- 2 The second degree( in other words - a flexible flatfoot with a short Achilles tendon).This form is very rare in young children. Usually it is characterized by low pain during walking and running. It is observed, as a rule, on both legs and in the absence of proper treatment and prevention can lead to a more neglected and severe stage of flatfoot.
- 3 The third degree( rigid flat feet) is the least common type of disease. Rigid platypodia is most often seen in people with congenital defects of the bones of the legs( especially in the region of the tarsus).Approximately one in four people with stiff flat feet experiences severe pain when walking. Rigid flat feet can "hit" as soon as one leg, and both at once. As a rule, the third degree of flatfoot is accompanied by a whole "bouquet" of accompanying problems with the musculoskeletal system. For example: scoliosis of different severity, hernia of intervertebral discs, growth of calcaneal spurs, etc.
Methods of treating flatfoot
If the child has a simple, flexible, flat feet of the first degree, which does not cause him painful sensations when walking, no special treatment is prescribed. However, he is prescribed an active prophylactic plan: special massage, exercises for feet, insoles in shoes, etc. In this case, there is a large share of the probability that the arch of the foot will form properly and there will be no flatness in the future speech.
At the second and third degrees of flatfoot, when the arch of the foot remained unformed and already rigidly fixed in this position, alas, the treatment is reduced only to relieve the person of the pain symptoms accompanying the disease. To form a "healthy" arch in the foot in the second and third stages of flatfoot in some artificial way, medical science has not yet learned, but to stop the progressive deformation and save the person from the pain while walking is fully capable. For this, various methods of physiotherapy, thermal treatment, as well as surgical intervention are used.
The first and second degrees of flatfoot are very common - almost half of the adult population of the planet( residents of large cities - to a greater extent) suffer from them. In some, the insufficiently developed arch of the foot remains from childhood, while the other bend of the foot gradually deforms already at the age after 40-45 years with a sedentary lifestyle, excess weight and other circumstances. However, physicians believe that the harm from such flat feet is insignificant and does not prevent a person from living a long, not burdened with serious diseases, life. How is the pediatric foot formed?
Normally, in all children up to 2 years, the arch of the foot is absent, that is, the physiologic flatfoot is noted. This is due to the fact that the bone tissue in babies is not sufficiently formed, contains insufficient mineral substances. Weakly developed ligaments and muscles.
On the plantar surface of the foot in place of the arch, the child at that age has a fat pad. It is the function of the shock absorber( instead of the arch of the foot), when the child begins to walk.
After the child reaches 2-3 years of age, the bones, muscles and ligaments become more durable, and from this age until about 6 years the process of forming the correct form of the foot continues. Therefore, only by the age of six can you determine whether there is a flatfoot in the child.
But during the period when the baby's foot is formed, it is necessary to consult an orthopedist who can control the process annually. Approximately in 3% of children with flat feet it is a congenital malformation, which is immediately apparent at birth. And in other cases, flat feet acquired, it is formed in the development of the child.
The arch of the foot is formed from bones and ligaments. It allows you to distribute the body weight on the support evenly and provides shock absorption during running and walking. With a normally formed foot there are only 3 points of contact between the foot and the floor: the heel, the "cushion" at the base of the thumb and the outer edge of the foot( part of the foot from the little finger to the heel).
With flatfoot, the arch is deformed, and the entire plantar surface of the foot is flattened, adjacent to the ground or floor. The center of gravity of the body shifts, which contributes to the violation of posture.
Everyone knows that on the plantar surface of the foot there are biologically active points( "representations" of various organs and systems).Constant irritation of these points with flat feet can cause various pathological conditions from the muscles, joints, internal organs.
Causes of flatfoot
The only reason for the development of flatfoot can not be named. There is a sufficiently large number of factors contributing to the development of this pathology.
Factors contributing to flatfoot :
- hereditary factor: a predisposition of the child to this pathology, if the family has flat feet in close relatives;
- increased stress on the legs( increased body weight, barbell work in adolescents, etc.);
- congenital weakness of the musculoskeletal system of the foot;
- paralysis of the musculoskeletal apparatus of the foot( due to cerebral palsy or poliomyelitis);
- trauma to the foot.
Scientists have established that in children living in the city, flat feet develops 3 times more often than in rural children who have the opportunity and habit of walking barefoot.
Therefore, for the correct formation of the foot is recommended at least occasionally to allow the child to walk barefoot on grass, sand, small gravel( pebbles).At home it is possible to train a developing foot by walking a toddler in socks over strewn peas.
Foot massage with flatfoot
For proper formation of the foot, the load on it is important: with a small motor activity of the child, the probability of flatfoot development is higher. This is especially important now, when children from a small age "get attached" to a computer, a TV set and spend very little time on the street. As a result, not only a flat foot is formed, but also a violation of posture.
No less important for the prevention of flat feet is the child's shoes: it should have a small heel( 0.5 cm), soft instep and hard back. The child should not wear the shoes of other children, since in mixed footwear the load on the foot is not correctly distributed."Wrong" is not only a very flat( completely without heels) shoes, but too narrow or too wide shoes.
For the prevention of flatfoot, it is important that the baby's nutrition is adequate, with sufficient calcium, phosphorus, vitamin D. Diets.
Even if the baby has correctly formed a foot, the child is not guaranteed the lack of flat feet later on. In some cases, the disease is not detected at preschool age and continues to progress;reveal it in adolescence and even later.
Symptoms of flatfoot
By the time of the onset of foot pathology:
- congenital flat feet due to genetic disorders or connective tissue dysplasia;
- acquired flat feet as a consequence of diseases or pathology of the musculoskeletal system of the foot.
Because of the onset:
- is paralytic( in children with cerebral palsy);
- is ricky( due to a violation of vitamin and mineral metabolism);
- is static( as a result of muscle weakness of the foot, regardless of its cause).
In the direction of spacing:
- transverse( an increase in the lateral size of the foot, the most frequent variant in the early age of the child);
- longitudinal( the longitudinal size of the foot increases);
- is longitudinally transverse( with an increase in both longitudinal and transverse dimensions of the foot, in children it is extremely rare).
Parents may suspect the development of flat feet in a child by such signs:
- when walking a child "clumsy": the feet wrap inside, while the feet should be located in the child while walking in parallel;
- the child comes when walking on the inner edges of the feet;
- child complaints of fatigue when walking, back and leg pain, refusal to walk for a long time;the severity of complaints increases with the child's age;
- uneven stomping of the heels of shoes( more on the inside) in children after 5 years.
If a child has any of these symptoms, consult an orthopedic practitioner.
A more obvious test is flatfoot: the sole surface of the child's feet is smeared with paint or oil and put on a sheet of paper( the legs should be straight and closed).Then raise the child and look at the printed pattern. If it has the shape of a string bean - the arch of the foot is correct, if the entire foot is widely printed, you should consult an orthopedist. This test is applicable only to children older than 5-6 years, when the foot is already formed.
Orthopedist usually also uses the method of planography - the study of a footprint on a piece of paper after the soldering of soles with a special solution.
When a child reaches the age of 5, a compulsory examination of the orthopedist is necessary, even if there are no complaints.
What are the consequences of flatfoot?
Effects of Plane-Footage
Many parents mistakenly think that flat feet do not pose a serious threat to a child's health, and do not even consider him a disease. Such parents do not take seriously the complaints of the baby for fatigue and pain in the legs or back, consider them just whims, do not consider it necessary to show the child to the orthopedist.
Such an attitude is unacceptable, since it can lead to untimely treatment and the development of a number of complications and the consequences of flatfoot.
Stop performs the function of "spring" when walking or running. With flatfoot, there is practically no depreciation due to the foot. Therefore, when walking or running, "recoil," or shaking, falls on the shin, hip joint and spine, which contributes to the development of arthrosis( dystrophic joint damage due to destruction of the intraarticular cartilage).
Often, the appearance of scoliosis( curvature of the spine) is associated with asymmetry of the sacrum that occurs with this pathology. Frequently, with flat feet, the nails grow, the toes are curved.
"Harmless" flat feet can lead not only to deformation of the foot bones, limp and clubfoot of the child, increased fatigue while walking, but also cause spinal hernia, persistent sciatica, arthritis( inflammation of the joints) and osteochondrosis in the future.
Activation of biologically active energy points on the sole can cause, according to some experts, many diseases of various organs.
It is impossible to delay with the reference to the doctor and treatment, because timely treatment provides an opportunity to prevent further progression of the disease and the development of complications. In itself, the flat feet will not pass.
Treatment of flat feet
Treatment prescribed by the orthopedist helps to strengthen the foot muscles, improve its blood supply, soft impact on the ligaments and joints to correct the existing deformation of the foot and ankle.
To achieve success is easier in childhood, when the full ossification of the skeleton has not yet come. Treatment should be carried out even with a minimum degree of flatfoot. The later treatment begins, the more difficult it is to correct the existing disorders.
Treatment of flat feet in children is carried out by different methods:
- exercise therapy: a set of special exercises, individually tailored to each child, depending on the degree of change;
- physiotherapy methods: in the polyclinic - iontophoresis, electrophoresis;houses - baths with sea salt, herbal decoctions;
- therapeutic massage;
- manual therapy;
- wearing special shoes: selected strictly in size, made of natural material, with a small heel and a hard back;Individual insoles are also selected;shoes and insoles not only help to correct the formation of the foot, but also reduce discomfort during walking;
- if necessary, treatment in a sanatorium is recommended.
During treatment, the orthopedist will determine the frequency of visits to the doctor to monitor treatment and correct it( if necessary).
It is possible to diagnose a flatfoot in a child not earlier than 5-6 years, but prevention should be done from the very birth of the child.
- In order to timely notice the problems with the foot, it is necessary to visit the orthopedic physician on a regular basis. It should be visited at 1, 3, 6 and 12 months, so as not to miss the appearance of signs of rickets, contributing to the development of flat feet. After a year, the baby should be shown to the orthopedist at least once a year.
- Since birth, the baby needs to do a foot massage daily.
- Use the walking of a child on uneven surfaces barefoot( on grass, sand, pebbles or a special massage mat).
- Every day, do a special set of exercises( see below).
- Provide the child with properly selected footwear( in size, made of natural material, with a hard back, flexible sole and a small heel).The main criterion for choosing shoes should be not its beauty, but compliance with the above requirements. For the child, the shoes should be as comfortable and comfortable as possible: to keep the fingers free and the heel securely fixed.
- Do not wear worn, heavily worn shoes.
- For the purpose of tempering and improving the circulation of the blood, pour the feet with cool water.
- Correctly to dose physical exercises, walking, mobile games, for the harm to the child will cause both insufficient and excessive loads.
special gymnastics complex for strengthening the ligaments and muscles of the foot and preventing flatfoot includes such exercises:
- in the sitting position on the stool:
- extension and flexion of the toes;
- alternately lifting from the floor of socks and heels;
- circular movement of each foot;
- stretching of socks from themselves and to themselves;
- maximum dilution to the heels of the heels, without tearing the socks off the floor;