Flat feet of the 3rd degree is a violation of the anatomy of the foot, in which it loses the ability to perform its functions.
The lack of treatment for this condition in most cases leads to severe complications in the large joints of the legs, spine, and in general seriously reduces a person’s quality of life.
In fact, there is only one reason for third-degree flatfoot: lack of treatment in the initial stages, when the foot deformity has just begun to appear. As the ligamentous apparatus weakens, the bones of the foot move further and further away from each other, the arches of the foot (longitudinal and/or transverse) “sag,” and its shock-absorbing functions are greatly impaired.
Risk factors that increase the likelihood of severe foot deformities include:
The symptoms that manifest the flattening of the arches of the feet of the 3rd degree can be divided into visually determined ones, felt by the patient himself, and subjective signs determined by instrumental examination.
The changes are obvious at first glance: the foot looks “flattened”, there is practically no rise in its upper part towards the ankle joint, and there may be wide gaps between the toes (the toes are arranged like a fan). Often the changes reach the point at which wearing ordinary shoes becomes impossible - the patient has to turn to specialized workshops for sewing shoes to order.
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Complaints that accompany this degree of foot deformity include the following symptoms:
After examining the patient and studying his medical history, the doctor prescribes a series of studies (x-ray, CT, MRI, podography, etc.), the results of which confirm the diagnosis of “flat feet”. And when measuring the angle of deviation of the foot bones from their normal position, the degree of deformation is determined.
Diagnosis does not end with identifying flat feet and its severity. Considering the number of complications in large joints of the legs and spine caused by foot deformation, it is necessary to outline the range of all health problems as early as possible.
Thus, a patient with flat feet may be prescribed x-rays of the spine and joints, and laboratory blood tests to identify markers indicating inflammatory processes. Also, at the discretion of the doctor, an examination using MRI or CT may be recommended in order to assess the changes that have occurred in other structures of the musculoskeletal system against the background of flat feet and its complications.
If necessary, specialists of a narrow profile can be involved in the examination - an orthopedic surgeon, vertebrologist, rheumatologist, etc. They subsequently monitor the effectiveness of treatment together with the attending physician.
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It is difficult to imagine the human foot as a kind of protective mechanism. But in fact, it performs the most important functions to ensure the durability of other “supporting” structures - joints and the spine. By cushioning when walking, running, jumping, the foot dampens shock waves, preventing them from spreading to overlying areas of the musculoskeletal system.
When the foot is deformed and its arches are flattened, the spring (shock-absorbing) function is disrupted, and the ankle, knee, and hip joints have to compensate for the load. But they are not designed for this - their role is to ensure precise and correct movements. And taking on increased loads, they quickly wear out.
The spine suffers no less: according to statistics, osteochondrosis and herniated intervertebral discs are “in partnership” with flat feet in more than 60% of cases. Moreover, in approximately the same number of situations, these diseases become both consequences of flat feet and its causes.
Treatment of third degree flat feet is a complex process that can last several months or even years. The effectiveness of treatment largely depends on the patient himself and his willingness to strictly follow the doctor’s prescriptions.
Medicines for flat feet are used to a limited extent and, as a rule, are represented by drugs with a general strengthening and protective effect (vitamin-mineral complexes, chondroprotectors, bioactive additives containing hyaluronic acid, etc.).
If complications of flat feet are identified, as well as if the foot deformity is combined with inflammatory or degenerative diseases of the joints, treatment may include a wide range of drugs - from NSAIDs taken in tablet form to intra-articular injections of corticosteroids.
Wearing orthopedic devices is one of the preferred methods of treating flat feet, since in the process of using special insoles and shoes, the foot gradually gets used to the correct position, and the loads are distributed in such a way that normal functions are restored in the ligamentous apparatus of the foot.
Depending on the specifics of the situation, it may be recommended to wear standard insoles, heel pads, intertoe cushions, etc., or it may be necessary to manufacture custom-made shoes or insoles, according to individual measurements.
It should be remembered that it is necessary to undergo regular follow-up examinations, the results of which allow us to evaluate the effectiveness of treatment and adjust it taking into account progress. So, during the treatment, the arches of the feet gradually change shape, and this requires replacing orthopedic insoles or shoes with new ones - with a different instep angle, heel height and other changes in significant characteristics.
Important: wearing orthopedic shoes in itself refers to the so-called “passive effect” on the foot, and must necessarily be supplemented with other treatment methods.
In the successful treatment of flat feet that have developed to degree 3, a complex of therapeutic exercises designed to strengthen the ligamentous apparatus of the foot plays an important role. Specific exercises and their combinations are selected by a doctor or exercise therapy instructor individually for each patient, taking into account the specifics of the situation.
Basic exercises include raising your toes, rolling from toe to heel, and alternately tucking your toes in a sitting position. The main requirement for performing the exercise therapy complex is regularity of classes and performing exercises barefoot, standing on a flat and hard surface.
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Unfortunately, advanced foot deformation often requires correction and formation of an anatomically correct arch using surgical methods.
Surgery to eliminate flat feet is recommended when the effectiveness of other methods is low, also in cases of severe deformity in which orthopedic treatment may not be appropriate.
During surgery, the doctor shortens ligaments and tendons that cannot otherwise be returned to their normal position and functionality. This allows you to create conditions for the correct placement of the bones of the foot, forming its arch.
During surgery, deformed joints of the foot can be examined and, if necessary, appropriate measures can be taken (removal of bone or cartilage growths).
Important: the listed treatment methods can be combined in various variations, used in different sequences, and the decision to prefer one method over another remains with the attending physician.
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Flat feet is a disorder of the anatomical structure of the musculoskeletal system, characterized by flattening of the foot of varying degrees of severity. Treatment of this disease is possible only in children. Level 3 flatfoot, which occurs in adults, and any other type of this disease cannot be completely cured; only a certain slowdown in the rate of development of the disease is possible.
With flat feet of the 3rd degree, gross deformation of the foot appears
Modern classifications distinguish forms of flat feet depending on the level of severity (1, 2 and 3), direction (length and transverse) and cause (traumatic, rachitic, etc.). The presence of flat feet of the 2nd and 3rd degrees, as a rule, leads to the development of a number of symptoms in the patient - aching pain in the foot, difficulty walking and choosing shoes, constant tension in the muscles, and fatigue of the legs. The disease at stage 1 most often does not lead to such symptoms, but also requires that treatment be competent and timely.
Depending on the nature of the existing injuries and their direction, experts distinguish the following types of flat feet:
Longitudinal flattening accounts for about 20% of the total number of cases and is often observed in children. This type of pathology is the result of weakness of the calf muscles and tendon apparatus. Photos of such conditions clearly show the patient’s heel moving inward, as well as the arch of the foot dropping. At stages 2 and 3 of the disease, patients experience the appearance of concomitant pathological processes (osteochondrosis, arthrosis, scoliosis); at the last stage, valgus deformity develops.
Transverse deformity of the foot is characterized by flattening of its arch in the transverse direction. In this case, there is an expansion of the forefoot, valgus deviation of 1 toe, tension of the tendons and callus of the skin at the site of the pathology. The initial stages of the development of the disease do not allow the presence of the disease to be detected, however, already at stage 2, patients pay attention to the condition of their own feet.
The combined type of disease is a combination of transverse and longitudinal flatfoot that develops simultaneously. This form of the disease is quite rare, but its treatment is a difficult task even when detected in children.
Depending on the causes of occurrence, there are five main types of flat feet:
Occurs in children with primary developmental disorders of the musculoskeletal system. Treatment of the pathology consists of applying a cast, wearing special shoes and massage courses.
Develops as a result of a neuroinfection with damage to large nerve trunks. The stages of the disease may vary, but most often stage 3 pathology occurs.
It occurs as a result of improper healing of fractures of the metatarsus and ankle bones. The severity of the disease can vary from grade 1 to grade 2 and even grade 3 (depending on the severity of the injury).
It happens that flat feet develop as a result of injury or excess body weight, or rickets suffered in childhood.
It occurs in children after suffering from rickets, which leads to the leaching of calcium from the bones and weakening of the musculoskeletal system. The foot flattens under the weight of the body.
It is a purely mechanical form of the disease, which is formed due to high body weight, the use of uncomfortable shoes and prolonged immobility. Thus, a similar form of the disease in stages 1 and 2 often occurs in surgeons who are forced to stand at the operating table for a long time. The static mechanism of development is practically not found in children due to their high mobility.
There are three forms of flat feet depending on the severity of the existing changes:
The first degree of the disease practically does not make itself felt: visual changes are noticeable only upon careful examination. However, already at the first – almost imperceptible – degree, patients begin to experience some discomfort when walking and rapid fatigue of the feet.
The height of the arch of the foot is 25-35 mm (the longitudinal form of the disease is considered). With transverse deformity, the first stage of changes is characterized by a slight shortening of the length of the foot and the occurrence of periodic pain in the front part of the foot when walking. Treatment of the disease at stage 1 brings the best results.
Flat feet of the 3rd degree causes a lot of inconvenience to a person - posture changes, legs hurt when walking, etc.
At stage 2 of the disease, deformities become visible to the naked eye. The patient's gait undergoes significant changes, some clubfoot and heaviness occur when walking. Patients experience pain almost always when there is a need to walk a relatively long distance. The height of the arch is about 17-25 mm, changes in the joints and significant deviations of 1 finger become visible. Treatment of this stage of the disease in adults is usually aimed only at improving the quality of life and slowing down the development of pathology. A complete cure for stage 2 of the disease is almost impossible.
The height of the arch of the foot in the presence of the third stage of the disease does not exceed 17 mm. In this case, there are pronounced changes in the articular apparatus, deviations of the toes, significant flattening of the forefoot with the development of calluses and corns. Patients experience significant difficulty walking and cannot cover even relatively short distances on foot without rest. During the examination, it is possible to identify the presence of pathology of other joints, osteochondrosis, intervertebral hernias, and changes in the position of internal organs. Treatment is also aimed at slowing down the pathological process and improving quality of life.
Flat feet is a pathology in which the foot becomes flattened. If nothing is done, the shape of the foot continues to change, and the transverse and longitudinal arch of the foot descends. In advanced stages of flatfoot, all points of the sole touch the surface. Flat feet occur in people of all ages. Flat feet happen:
Various factors lead to the development of flat feet.
Compared to the initial stage of flatfoot, the second degree is characterized by the presence of a noticeable deformation of the foot, which affects the patient’s gait and the condition of the higher parts of the musculoskeletal system.
1, 2, 3 and 4 degrees flat feet
One of the main clinical signs of second-degree flatfoot is the presence of pain in the legs. Most often, pain appears on the arch of the foot, ankle, sole and heel bone.
Painful sensations also occur with the first degree of flat feet, but they are not constant and most often occur in the evening (they go away after rest). This disease of the second degree is characterized by constant pain: the legs hurt both at rest and during physical activity.
Unlike the first degree of flatfoot, the second degree of the disease is characterized by the appearance of pain not only on the sole, but also in higher parts. The muscles of the lower leg and knees often ache, and the muscles of the back and front of the thigh may ache.
Other symptoms of the disease include heaviness in the legs and swelling of the feet. Towards the end of the day, as well as after physical activity, the pain becomes severe. Flat feet can lead to calf cramps. With this disease, clubfoot appears and difficulty walking occurs.
Examination of the foot may reveal foot deformity. The flat arch of the foot is noticeable, and its width is increased. With transverse flatfoot this is noticeably stronger than with other types. Due to transverse and longitudinal flat feet, it may be necessary to buy shoes one size larger, as the foot changes in size. The presence of the disease can be guessed by the condition of the shoes: a lot of wear appears on the inside.
In order to confirm the diagnosis, anthropometric studies of the foot parameters are carried out: the arch angle, height are compared, and the Friedland index is checked. An x-ray is also taken for this purpose.
Flat feet are not a cosmetic defect that simply affect a person's walking and may cause pain. This is a dangerous disease that affects the musculoskeletal system and can lead to serious complications. With a normal arch, the load is distributed evenly, so the knees, spine and hip joints are protected. Since the foot in this disease does not perform a spring function, the load on the overlying joints increases, which leads to the development of other diseases. Patients run the risk of acquiring an intervertebral hernia, osteochondrosis, etc. Due to flat feet of the second degree, arthrosis of the second degree may develop.
The likelihood of developing flat feet in children is low. It is difficult to identify the disease, since children are just starting to walk, so an abnormal gait will not be a sign of the disease. Most often, second-degree flatfoot is diagnosed already in adolescence. To prevent flat feet, children are prescribed to wear orthopedic shoes or orthopedic insoles (only when prescribed by a specialist). Doctors do not recommend letting children wear used shoes, since at an early age the foot is just beginning to strengthen; the previous owner of the shoe may have foot problems, so worn shoes can lead to the development of foot deformities in another child.
Longitudinal flatfoot is present in 20% of patients with this disease. Most often, the development of this type of flatfoot is influenced by poor condition of muscles and ligaments, wearing incorrect (inappropriate) shoes. With longitudinal flatfoot, both the length and width of the foot increase. The arch becomes lower, the patient suffers from constant pain, which spreads not only to the feet, but also to other parts of the legs.
The second stage of longitudinal flatfoot is characterized by the fact that the foot tends to recover after rest. The flattening of the foot is especially noticeable in the evening. If it stops restoring its shape, then irreversible deformation of the foot occurs.
With this disease, the main weight is transferred to the front of the heel bone. The foot turns inward. Without treatment at this stage, valgus deformation of the finger occurs.
The disease occurs in 75% of cases. Visually, the second degree of transverse flatfoot is characterized by a change in the position of the first toe and expansion of the foot in the forefoot. The foot becomes shorter. The 1st finger deviates; the 2nd and 3rd fingers may become deformed. The thumb bends under the other fingers, the patient experiences constant pain in the area of the bone of this finger, and cramps may also occur. Due to the increased load on the foot due to its deformation, corns and calluses form. The angle of bending of the first finger under the others can be 20-35 degrees. During physical activity, a burning and aching pain is felt in the area of the first toe and the entire foot. The second degree of transverse flatfoot leads to the growth of the head of the first metatarsal bone.
Combined flatfoot of the 2nd degree includes signs of transverse and longitudinal flatfoot. Both arches of the foot change. The height of the arch decreases in its middle part. Since this part contains important nerves and blood vessels, this is fraught with the development of diseases. The metatarsal heads move downwards and the first toe may become displaced. The proper functioning of the ligamentous apparatus of the fingers is disrupted, bone deformation occurs, this is noticeable in the functions that the interphalangeal joints no longer perform. It becomes difficult to turn the foot.
The second degree of transverse-longitudinal flatfoot most often occurs in people after 35 years of age, mainly in overweight women. Wearing narrow shoes accelerates the development of flat feet.
People with this disease may often wonder how to cure second-degree flatfoot. Treatment methods for flat feet are determined by an orthopedic doctor. Each case requires an individual approach. If measures were not taken at the initial stages of the disease, then conservative methods are used to prevent further development of the pathology. In the initial stages, exercise therapy, physiotherapy and massage therapy - activities that strengthen muscles - can help. In the second stage of the disease, it is necessary to wear special insoles and orthopedic shoes that control the position of the foot. If longitudinal flatfoot has been diagnosed, then the use of inserts between the toes is prescribed, in particular, in case of longitudinal flatfoot with displacement of the big toe.
The use of orthopedic insoles and inserts is prescribed only for a certain time, so that the foot cannot completely get used to them - this is fraught with weakening of the muscles and deterioration of the condition of the foot.
Treatment involves a systematic approach.
If all of the above treatment methods are ineffective, and the patient complains of unbearable pain, then the orthopedic doctor may decide on surgical intervention. Such a decision must be made as a last resort. More than 500 types of operations have been developed. They are carried out both on soft structures and on bones. Some operations involve interference with the functioning of the bone and tissue systems. If the operation is successfully performed, the likelihood of foot deformity is low. However, the patient must constantly work and prevent this disease.
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A person’s foot can be used to judge the condition of all internal organs; there are zones on it that are reflexively connected with all organs. It is necessary to monitor the condition of your feet, not only maintain them in frequency, but also strengthen them, choose the right shoes, as this is directly related to posture and health in general. One of the disorders in the formation of the foot is flat feet, which can be longitudinal or transverse. With normal development, there are anatomical curvatures and bends in the foot, with the help of which the pressure on the leg is mitigated, i.e. these formations perform a spring function. From the very phrase flatfoot it is clear that the foot is flat, that is, the anatomical bends and curvatures become flat or disappear altogether.
Based on the cause of development and the degree of flattening of the curves of the foot, flat feet are distinguished between congenital and acquired. Depending on the degree of flattening, different degrees of development of the problem are distinguished:
1. Flat feet 1,2,3,4 degrees. The degree of flat feet is determined by a simple test. The dye is applied to the foot and the wet foot is stepped on a sheet of paper. On a sheet of paper you can see the remaining unpainted recess from the footprint, which corresponds to the spring arch of the foot. This or that degree of flatfoot depends on the size of the unpainted notch. The smaller it is, the stronger the flatfoot. If the foot print is continuous, the foot is completely flat. For diagnosis, X-rays, CT, MRI are used, muscle strength of the feet is measured, and a visual examination is performed. Flat feet of 1.2 degrees are easy to treat; it can be treated at home with the help of strengthening physical exercises. It is more difficult to treat grade 3 flat feet, since the foot is very much changed. It happens that grade 3 flat feet have to be treated with surgery.
Depending on which part of the foot is flattened, flat feet are of the following types:
Longitudinal flatfoot - the longitudinal arch of the foot is flattened, and the foot comes into contact with the surface over its entire area. This type of flatfoot is the most common. Transverse flatfoot is less common, mainly among the fair sex, who prefer to wear stiletto heels and sandals for a long time. With transverse flatfoot, the entire load goes on the metatarsus and toes. It is worth noting that in children under 10 years of age, transverse flatfoot is considered a normal variant. Also, transverse flatfoot develops as a result of hereditary diseases and connective tissue weakness
Each of us may have noticed symptoms of flat feet, but it is not at all necessary that you have this disease. The main symptoms of flat feet are the following:
Each parent wants the best for their child, so they are very sensitive to the health of their children. If your child is diagnosed with flat feet, do not panic; you need to adequately assess the situation. Children's bodies grow, all organs develop, and the foot forms its own bends and curvatures. Weak muscles, pliable bones - all these are conditions for the development of flat feet; it is not recommended to treat it yourself; this should be done by a specialist.
Many experts consider transverse flatfoot in children under a certain age (some up to 5-6 years, others up to 10-11 years) as a normal variant.
The whole point of treating flat feet in children before the development of the foot is complete is its prevention. An orthopedist recommends wearing special shoes for children for a year, ideally until the foot is fully formed. Do not put shoes on your child until he can walk. Encourage children to walk barefoot on sand, small pebbles, and grass - this strengthens the foot muscles. If this is not possible, create artificial bumps in the apartment for your child using large beads, nuts, and sand. Do not overload children with sports or long walking. A very effective method of preventing flat feet is to massage the legs, in particular the feet, almost from the moment of birth; as the child grows up, your touch will become more intense and prolonged. After the child begins to confidently stand on his feet and walk, an exercise such as grasping small objects with the fingers. This exercise develops fine motor skills well and strengthens the muscles and ligaments of the child’s legs.
Despite great progress, no drugs have yet been developed to cure this disease. An orthopedic doctor individually selects strengthening exercises for the treatment of longitudinal or transverse flat feet, recommends wearing special shoes equipped with arch supports, or placing hard bolsters under the middle part of the foot to properly distribute the load on the foot. For grade 1-2 transverse flatfoot, soft fabric pads are used between the big and second toes to reduce friction against each other. Physical therapy is the main and, perhaps, the only effective method of treatment. Complex therapy uses massage, physiotherapeutic procedures, and a warm compress. It is necessary to treat flat feet comprehensively; the initial stages can be easily corrected, but with severe deformation of the foot it is difficult to treat flat feet.
An approximate set of exercises for the treatment and prevention of disease:
Do a flatfoot test. If you find any changes, consult your doctor. It is necessary to treat all diseases in a timely manner, watch your feet, wear comfortable shoes. Remember that flat feet should be treated by a specialist.