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What kind of disease is transverse flatfoot?

21 Jul 18

Longitudinal-transverse flatfoot

Longitudinal-transverse flatfoot is formed in the case of flattening of two arches of the foot (longitudinal and transverse). Determined during an external examination of the foot. The doctor clearly notices the widening of the foot and gait disturbances.

With flat feet, the plantar fascia and toe flexors do not function normally. Patients experience longitudinal flattening of the arch. The heads of the metatarsal bones descend. The thumb is displaced. Distribution of load during walking is disrupted.

At the same time, deformation of bones and joints occurs. Individual joints of the foot are not able to function fully. There is a flattening of the foot in the lateral projection.

Causes of longitudinal-transverse flatfoot

Longitudinal-transverse flatfoot can be congenital or acquired. In approximately three percent of cases it occurs for genetic reasons. As a rule, the development of the disease in this case occurs gradually. Doctors immediately after birth identify physiological disorders in the child’s foot.

Acquired flatfoot develops mainly after the age of 35. The most vulnerable are women who often wear high-heeled shoes. It strongly raises the transverse arch of the foot. Contraction of the plantar fascia ultimately causes the metatarsal ligament to become more strained.

Wearing high-heeled shoes for a long time is dangerous; the patient develops a curvature of the big toe on the outside. Longitudinal-transverse flatfoot develops more intensely if a person wears narrow shoes, the patient’s feet sweat, or the patient is obese.

Flat feet develops for the following reasons:

  • Endocrine diseases;
  • Systemic diseases;
  • Foot deformation as a result of vitamin D deficiency;
  • Paralysis of the muscles that support the arch of the foot;
  • Injuries suffered.
  • Clinical picture of the disease

    The mixed form of flatfoot does not show a specific pronounced pattern. The patient is concerned about symptoms characteristic of other pathological conditions of the musculoskeletal system. In children, the first symptoms may not appear; children may not express complaints.

    We list the characteristic symptoms of flat feet:

  • The appearance of aching pain during prolonged physical activity.
  • Leg fatigue and feeling of heaviness. The patient often has a desire to “stretch his legs.” Children experience pain while walking, and the child does not tolerate prolonged walking well. The children cry and refuse to walk or run.
  • Swelling of the legs in the evening. Sometimes it is pronounced. The patient is bothered by heaviness in the lumbar region.
  • The patient notes difficulty wearing everyday shoes. Only orthopedic types of shoes improve the situation with your feet.
  • Shoes wear down more intensely. In children the phenomenon is less noticeable.
  • Calluses appear on the feet.
  • The foot becomes deformed (becomes longer and wider). It is especially noticeable in people over forty years of age.
  • A person’s gait changes: the legs are widely spaced and bent at the large joints. In this case, the hip joint intercepts the greater load on the legs.
  • The clinical picture varies depending on the degree of longitudinal flatfoot.

    Degrees of flat feet

    Transverse-longitudinal flatfoot has three stages.

    1. At the first stage of the disease, clinical changes are minimal. Patients do not seek medical help. And in vain - at this stage, therapeutic and rehabilitation measures are most effective. To prevent complications and further development of the disease, children are seen by a doctor annually, and adults undergo examinations at least once every two to three years.
    2. The second stage of the disease is characterized by the appearance of severe pain in the legs. Changes in gait are minor. A person usually blames the symptoms on poor-quality shoes, uses orthopedic insoles, and custom-made shoes help the patient.
    3. At the third stage, the patient's complaints increase. Posture is disrupted and gait changes noticeably. A person comes to the attention of an orthopedic doctor. Sometimes neurologists, therapists and rheumatologists refer the patient for an appointment.
    4. Treatment of flat feet

      Treatment of the disease occurs with the participation of a traumatologist after a thorough diagnosis. There are conservative and surgical treatment.

      Conservative treatment consists of limiting the load on the sore feet, wearing orthopedic insoles and arch supports. It is important to lose weight (eliminate extra pounds). If there are symptoms of inflammation of the joint capsule, the doctor prescribes analgesics and non-steroidal anti-inflammatory drugs.

      Physiotherapy is often prescribed. Physiotherapeutic treatment reduces the load on the feet and reduces increased muscle tone in the foot.

      Conservative treatment methods are aimed at reducing pain and slowing the progression of the disease. If conservative treatment is ineffective, surgery is prescribed.

      Surgery is recommended for severe headaches. The latest surgical treatment techniques minimize postoperative stress for the patient and significantly reduce the time required for rehabilitation. There is no need to use plaster casts or crutches.

      Home treatment for flat feet

      Treatment of flat feet at home shows results in adults and children. It is possible to use treatment options for the disease at home.

    5. Foot strengthening provides natural foot massage and eliminates the need for surgery. It is useful to walk barefoot - on grass, pebbles, or uneven ground. Swimming is beneficial - it strengthens the muscles of the body.
    6. Moderate physical activity is recommended at home. Remember, it’s the moderates. If you have swelling and pain, physical exercise is not allowed - it is important to take measures to relieve unpleasant symptoms.
    7. Gymnastics is a way to treat flat feet at home. The doctor selects the most suitable sets of exercises.

    About wearing orthopedic insoles

    Orthopedic insoles and arch supports help avoid progression of the disease and surgery. Insoles help reduce stress on the feet, joints of the lower extremities and spine. Arch supports and orthopedic insoles move the foot inward and maintain normal body position. They are easy and comfortable to wear at home.

    Orthopedic insoles provide:

  • Support for all arches of the feet;
  • Insoles provide protection during long periods of walking and standing;
  • Normalize blood circulation;
  • With orthopedic insoles, there is a feeling of lightness in the body;
  • Prevents the development of arthrosis and early spinal disorders;
  • Reduce pain.
  • Orthopedic insoles are useful for children when the musculoskeletal system is intensively developing. Weak muscles are the main pathogenic factor in the development of flat feet. Properly selected insoles will help avoid illness.

    Prevention of flat feet

    To avoid the development of the disease, you must:

  • Make sure that the corners of the shoes are not narrow;
  • Do physical education;
  • Monitor your diet and prevent obesity;
  • Undergo preventive medical examinations, especially important for children;
  • Do a warm-up during prolonged standing and static load;
  • Wear quality shoes;
  • Treat musculoskeletal disorders in the early stages;
  • Lead a healthy lifestyle.
  • Paying attention to health helps to avoid diseases of the musculoskeletal system and allows you to maintain it in a healthy state. And you will be able to avoid flat feet and complications that are dangerous to health.

    Symptoms and treatment of transverse flatfoot

    The human foot is made up of many small bones, joints, ligaments and tendons interconnected.

    Wearing shoes incorrectly, being overweight, various injuries and many other reasons can upset the delicate balance of the system that the foot represents. Due to a disorder in a ligament , joint, or bone arrangement, the anatomical arches of the foot begin to flatten.

    Over time, flattening may progress, or may remain at a certain stage permanently. In both cases, this gives reason to diagnose flat feet.

    Several types of this disease are classified

    1. Transverse flatfoot , in which the foot “spreads” in width, and osteochondral overgrowth develops. Instead of placing load on a support in the form of an arch, the foot flattens and exposes additional support in the form of a joint, popularly called a “bunion.” The risk group for this type of disease is women and men aged 35 to 55 years, especially those who are overweight.
    2. Longitudinal flatfoot, on the contrary, manifests itself in the elongation of the foot and is most often observed at a young age - at 16-25 years.
    3. With combined flatfoot, both types of deformities are observed simultaneously, but they all lead to a flattening of the arch of the foot. The combined variant of the disease is observed most often.

    Usually, a predisposition to flat feet is inherited, but there are also types of acquired flat feet for which there was no predisposition.

  • Static - formed due to standing work, physical inactivity, excess weight, increased stress on the foot, endocrine diseases.
  • Paralytic - occurs after suffering paralysis of the limbs and dysfunction of the muscles that hold the arch of the foot.
  • Traumatic - physical changes as a result of injury.
  • Rachitic - acquired, developed due to a lack of vitamin D.
  • According to the degree of development, weak, initial, and progressive flat feet are distinguished.

    Let's take a closer look at transverse flatfoot, one of the most common types of disease.

    A useful addition in the treatment of arthrosis - orthopedic knee pads for arthrosis will help reduce pain and speed up recovery. Read how to choose and wear the device correctly here.

    Why does the foot flatten?

    There are several reasons for transverse flatfoot.

  • Genetic predisposition. As already mentioned, most often flat feet manifest as a congenital disease. It occurs due to congenital weakness of the arch muscles, which is also called “aristocratic foot”. If a person leads a healthy lifestyle, eats right, gets moderate physical activity, and wears good shoes, then this type of flatfoot does not progress and causes virtually no trouble.
  • Disturbances in the muscular and ligamentous apparatus of the foot. In a healthy person, the phalanges of the toes should run parallel to each other. But, as a rule, the slightest and imperceptible disturbance in the development of muscles or ligaments leads to the formation of a fan-shaped arrangement of phalanges. Over time, the phalanges “spread” to the sides, and because of this, transverse flat feet occur.
  • Overweight. The arch of the foot, as well as its muscular and ligamentous apparatus in general, are designed to work only with a certain weight. If it goes beyond normal limits, the load on the foot increases and it flattens.
  • The same situation is observed in people with normal weight, but who have excess load on the foot due to the type of activity. Thus, the work of a lecturer, teacher, factory worker and many other professions are considered “standing”, that is, a person spends most of the day on his feet. Excessive loads disrupt the balance of the foot, and acquired flat feet develop, which is considered an occupational disease.
  • Foot injuries are one of the most common factors in the development of flat feet in men. Fractures of the bones of the foot, dislocations, sprains of muscles and ligaments, disruption of the integrity of the heel bone lead to disruption of the foot apparatus and progressive flat feet.
  • Walking in heels, wearing uncomfortable shoes with unsuitable lasts and other poor foot hygiene are almost one of the most common reasons for the development of acquired flat feet. When walking in heels, for example, the entire body weight is transferred to the forefoot. Instead of being evenly distributed throughout the entire support, it puts pressure and over time deforms the bones, which are unprepared for such loads. It is precisely because of the heels, as well as because of the transmission of a hereditary predisposition to flat feet through the female line, that the ratio of women and men suffering from this disease is eight to two, respectively.
  • Symptoms that indicate the development of pathology

    The development of flat feet is quite easy to recognize. The most common symptoms that accompany transverse flatfoot:

  • Constant pain and a strong feeling of fatigue in the feet, which is especially pronounced towards the end of the day.
  • Burning and cramps in the lower leg area , usually not associated with an uncomfortable position, hypothermia and other external factors.
  • Deformation of the foot and changes in the location of the phalanges of the toes.
  • The appearance of a kind of bump at the base of the thumb (usually called a “bone”).
  • With progressive flat feet - poor posture , pain in the knees and pelvic joints, discomfort in the back.
  • As the disease develops, the entire forefoot becomes deformed .
  • How to diagnose the disease

    Based on the results of the examination, the doctor may prescribe various treatment methods.

    The photo shows a diagram of checking the foot for the presence of longitudinal and transverse flat feet

    Treatment of transverse flatfoot in adults should be comprehensive.

    Conservative methods include:

  • Reducing the load on the foot, up to its immobilization in especially severe cases.
  • Wearing individually selected orthopedic shoes . In difficult cases, this can be special shoes that secure not only the foot, but also the lower leg. At the initial stage of flat feet, orthopedic insoles and gel inserts are used. All of them must be prescribed by a doctor and are selected individually.
  • Measures to reduce weight if it has been determined to be overweight.
  • General strengthening exercises for the treatment of transverse flat feet, included in the course of physical therapy.
  • Medications (analgesics) are prescribed for progressive flat feet and the presence of arthrosis or bursitis.
  • Physiotherapy and massage aimed at relieving pain and relaxing the muscles of the foot.
  • To relieve tension, prevent cramps, and reduce pain , refreshing foot baths, cool compresses, and ointments based on mint and menthol are also used.
  • Non-conservative, folk treatment of transverse flatfoot is aimed mainly at alleviating the pain that occurs during loading of the feet with flat feet.

    These include ice compresses, foot baths based on mint, lemon balm, thyme, calendula, chamomile, linden and lavender.

    If conservative treatment methods do not show results, irreversible changes occur in the foot, and the patient suffers from severe pain, then surgical intervention . As a result of the operation, forefoot deformities are surgically treated. A number of modern techniques make it possible to do this without the subsequent use of plaster - thus, the rehabilitation period is reduced.

    Surgical treatment of transverse flatfoot has a significant drawback - the need to completely stop the load on the foot during the period of preparation and rehabilitation, but at the same time the issue is resolved radically - flatfoot does not progress and no longer causes regular concern, as is the case with conservative treatment.

    To never have problems with flat feet , you should pay attention to the comfort of your shoes, avoid wearing high heels, and maintain your weight at a normal level. People in “standing” professions need to rest more often and change positions while performing duties.

    Like most other diseases, flat feet are easier to prevent than to cure.

    Transverse flatfoot: symptoms, treatment

    There are a large number of bones in the foot; they are connected by joints, ligaments, and tendons. The metatarsal bone is parallel. If the metatarsals diverge excessively, the big toe is deviated, the muscles are redistributed, and the bones have a fan-shaped position.

    If there is excessive divergence of the metatarsal bones, the big toe is deviated and the muscles are redistributed. The tendon changes its direction, the finger stretches outward. The head in the metatarsal bone may bulge outward and become dislodged. When shoes start touching this area, a person's feet rub heavily, and the joints can become very inflamed. Afterwards, bones and cartilage begin to grow.

    Causes of transverse flatfoot

    Often the disease occurs due to a genetic predisposition. Women will inherit it. Rarely, the disease occurs in men, often due to injury. Transverse flatfoot occurs due to standing work, if a person wears uncomfortable shoes for a long time.

    Treatment methods for transverse flatfoot

    Some people think that an instep support will help alleviate the condition; with its help, you can redistribute the load. An arch support can only alleviate the symptoms, but does not get rid of the underlying cause.

    With longitudinal flat feet, you need to constantly strengthen the muscles of the lower leg and foot, for this you need to perform a special set of gymnastics. With transverse flatfoot, this method will not help, because the muscles being controlled are not the culprits of the disease. It is important to do foot exercises every day - turn the foot in different directions, make circular movements, it is recommended to take warm foot baths every day, massage the foot, the bone will stop growing.

    It is recommended to use the following recipe: apply an iodine mesh to the bone area, this way you can stop the inflammatory process and the cartilage tissue will stop growing. Please note, to avoid skin burns, you should only use non-concentrated iodine. It is advised to use compresses with vinegar essence carefully; they can cause serious burns.

    Today, there are a large number of ointments that can be used to stop the inflammatory process in the joints; they improve the condition of the tissues. It is best for an orthopedist to prescribe the ointment.

    If you have flat feet, you should definitely avoid wearing high heels. During the day you need to constantly change your shoes. You cannot wear boots for a long time at work. In the event that the cartilage tissue that has grown on the head of the bone has turned into bone, unbearable pain occurs, in this situation surgical intervention is necessary.

    During surgery, the cartilaginous growth is removed from the metatarsal bone, after which the bone is leveled, the tendon is tightened, and the thumb must be kept straight. You can fix the position of the bone using Mylar tape. The operation is a complex one, after which the person recovers for a long time. This method is effective and can protect against deformation.

    Symptoms of transverse flatfoot

    1. Shoes constantly wear down quickly, and the sole inside wears out a lot.

    2. A person’s legs get tired quickly when he walks; he cannot stay on his feet for a long time.

    3. By evening, your legs hurt a lot and get tired quickly, cramps and heaviness may occur.

    4. Feet and ankle become very swollen.

    5. A woman cannot wear high heels.

    6. You have to wear shoes a size larger because your feet are wide.

    7. The foot expands greatly, the foot cannot fit into the shoes.

    8. The feet are flattened, the forefoot puts pressure on the joint, and the length is greatly reduced.

    In the case of transverse flatfoot, the forefoot is significantly widened, seeming to be spread out. The load on it has been increased. The muscular system is disrupted, problems with the first finger are especially noticeable, it begins to deviate inward. The head in the bone can bulge strongly, the first finger is deviated towards the second, pressing on it, then the second finger is deformed.

    Transverse flatfoot occurs if a person stands on his feet for a long time, is overweight, has decreased muscle tone, decreased elasticity, when a person moves little, and this also often happens after an injury or fracture.

    After a woman walks in high heels for a long time, the weight is redistributed from the heel to the transverse area, the person cannot cope with the load normally, the foot begins to sharply deform, and thus transverse flatfoot occurs. Most often, the disease develops due to the fact that the functioning of the ligamentous apparatus is disrupted.

    Significant deformation of the foot is dangerous. Problems arise when walking, the load falls on the heels, metatarsal bones, large pollens of the foot can deviate in the other direction, because of this, the skin on the sole thickens greatly, then a large number of corns and dry calluses form.

    If transverse flatfoot lasts for a long time, the big toe deviates significantly and severe unbearable pain occurs. Then an inflammatory process develops, the area becomes red and very swollen. Afterwards, cartilage tissue can grow. Osteoarthritis may develop in the joints, followed by severe pain. The toes are deformed. It is dangerous when subluxation forms in the joints. The middle finger becomes hammer-shaped. Due to pain, a person cannot move, is constantly irritable, this leads to mental problems.

    Consequences of transverse flatfoot

    1. Diseases of the spine, poor posture - osteochondrosis, curvature, radiculitis, hernia.

    2. Due to excessive load, arthrosis and osteoarthritis occur.

    3. Pelvic disease.

    4. Due to foot deformation, neurological problems arise.

    5. Plantar aponeurosis, heel spur, which causes severe burning pain.

    6. Problems with the cardiovascular system.

    So, transverse flatfoot is a serious problem that definitely needs to be addressed urgently. The patient must undergo a course of therapy on time.

    Transverse flatfoot

    Transverse flatfoot is a widespread pathology in which there is a transverse spreading of the foot and deviation of the first toe outward. The main cause of transverse flatfoot is insufficiency of the ligamentous apparatus of the foot. Along with external deformation, it manifests itself as pain in the feet, pain and burning in the muscles of the feet and legs after physical activity. The diagnosis is made on the basis of radiography. Symptomatic conservative therapy is carried out; in case of severe deformity, corrective operations are performed.

    Transverse flatfoot is a pathological condition in which the forefoot is flattened and the first toe deviates outward. The pathology is widespread, women suffer about 20 times more often than men. It is usually detected in middle-aged and elderly women, less common in men (usually elderly), and in some cases found in children and adolescents. In traumatology and orthopedics, a combination of transverse and longitudinal flatfoot is often observed - combined flatfoot.

    Usually accompanied by more or less severe pain, heaviness in the feet and fatigue when walking. Over time, stiffness of the metatarsophalangeal joints and progressive deformities in the area of ​​the first and second fingers occur. The reason for visiting a doctor, along with pain, is often a pronounced cosmetic defect and problems in choosing comfortable shoes. Treatment of transverse flatfoot is carried out by traumatologists and orthopedists.

    Causes and mechanism of development of transverse flatfoot

    Transverse flatfoot is a polyetiological disease that occurs under the influence of various factors, which include uncomfortable narrow shoes, high heels, prolonged standing, excess weight, previous foot injuries, etc. However, the main reason for the formation of transverse flatfoot is congenital weakness of the ligamentous apparatus stop. Currently, this pathology is considered as an irreversible deformation that cannot be corrected by conservative methods, since there are no medications or orthopedic devices that can affect the restoration of the tone and strength of the connective tissue formations of the foot.

    Normally, the metatarsals are held in their anatomically correct position by the interosseous fascia and plantar aponeurosis. When the listed connective tissue structures are weak, in 30% of cases all metatarsal bones fan out. In 27% of cases, there is a deviation of the first metatarsal bone to the medial side, while the remaining metatarsal bones maintain a normal position. In 5-6% of cases, the diameter of the foot increases due to the deviation of the V and IV metatarsal bones. In other cases, combinations of the above options are observed.

    Deviation of the metatarsal bones is not the only pathological change that occurs with transverse flatfoot. The first metatarsal bone often rotates around its axis and rises. A redistribution of the load occurs: the first metatarsophalangeal joint becomes poorly supported, and the outer parts of the foot constantly suffer from overload. Due to changes in the normal relationships between the elements of the foot and the traction of the muscles, the first toe “goes” outward. The first metatarsophalangeal joint is deformed.

    A “bone” forms on the inner surface of the foot, which can be either an exostosis (an osteochondral growth) or a combination of exostosis with a protruding, curved first metatarsophalangeal joint. Due to excessive shoe pressure on the first metatarsal bone, bursitis occurs in the joint area, accompanied by local swelling and redness of the skin. Arthrosis of the first metatarsophalangeal joint develops, which causes increased pain. The range of motion in the joint decreases.

    The curved 1st finger “enters” the 2nd finger. Over time, a hammertoe deformity of the second, or less often of the II-III, fingers often develops, and corns form on the plantar surface. The metatarsophalangeal joints “go” into a state of subluxation. All of the above causes intense pain, creates severe inconvenience when wearing regular and sometimes orthopedic shoes, and leads to forced limitation of mobility and ability to work.

    Patients with transverse flatfoot complain of aching, pulling, stabbing or burning pain in the feet, mainly in the area of ​​the I-II metatarsophalangeal joints. The pain intensifies after prolonged standing and may be accompanied by a feeling of heaviness in the feet and a burning sensation in the muscles. In the evening, swelling of the feet and ankles may occur. Patients note significant difficulties when walking in high heels, as well as problems when choosing shoes - the foot becomes too wide and does not fit into standard shoes.

    The hallux valgus deformity of the first finger (Hallux valgus) is visually determined. The forefoot is widened. In advanced cases, a hammer-shaped curvature of the II-III fingers is detected. The skin in the area of ​​the first metatarsophalangeal joint is thickened and hyperemic. Corns and calluses are visible on the inner and plantar surfaces of the forefoot. The range of motion in the metatarsophalangeal joints is limited. Pain may occur on palpation.

    Diagnosis of transverse flatfoot

    The diagnosis of transverse flatfoot is made on the basis of external examination and X-ray results of the foot. To obtain a complete picture of the disease, radiography of the I, II and III metatarsophalangeal joints is usually prescribed. In the process of describing the images, the radiologist assesses the severity of valgus deformity of the first toe, taking into account the angle between the first toe and the second metatarsal bone and the angle between the first and second metatarsal bones. There are three degrees of deformation:

  • 1st degree - the angle between the 1st finger and the 2nd metatarsal bone does not exceed 25 degrees, the angle between the 1st and 2nd metatarsal bones does not exceed 12 degrees.
  • 2nd degree - the angle between the 1st finger and the 2nd metatarsal bone does not exceed 35 degrees, the angle between the 1st and 2nd metatarsal bones does not exceed 18 degrees.
  • 3rd degree - the angle between the 1st finger and the 2nd metatarsal bone exceeds 35 degrees, the angle between the 1st and 2nd metatarsal bones exceeds 18 degrees.
  • In addition, when studying radiographs, attention is paid to the presence of arthrosis, which is evidenced by deformation of the articular platform, narrowing of the joint space, osteosclerosis of the subchondral zone and marginal growths. If necessary, for a detailed study of the dense structures of the foot, the patient is sent to a bone CT scan, and to assess the condition of the soft tissues - to an MRI. If there is a concomitant pathology of the nervous or venous system, consultations with a phlebologist and neurologist are prescribed.

    Treatment of transverse flatfoot

    Treatment tactics are determined depending on the severity of the pathology, the intensity of the pain syndrome and the patient’s cosmetic needs. It is worth noting that modern medicine does not know non-surgical methods for eliminating deformity of the first metatarsophalangeal joint, and all proposals to “remove the bone without surgery” are just advertising gimmicks. Conservative therapy for transverse flatfoot is aimed at reducing pain and slowing the progression of the disease.

    In the early stages, patients are recommended to wear interdigital pads and custom orthotics. In case of severe deformities, orthopedic shoes are made to individual measurements in accordance with the recommendations of an orthopedic doctor. In addition, massage, foot baths, a special set of exercises to strengthen the muscles and ligaments of the foot, as well as physiotherapeutic procedures are prescribed: magnetic therapy, UHF, electrophoresis with trimecaine or novocaine, phonophoresis with hydrocortisone, inductothermy, paraffin and ozokerite. For pain and signs of inflammation, local and general NSAIDs are recommended.

    Surgeries are performed for severe foot deformities and intense pain. The reason for surgical intervention in young women is often a cosmetic defect with moderate valgus deformity of the first finger. Depending on the characteristics of the pathology, surgical interventions on soft tissues, on bones, as well as combined interventions on soft tissues and bones are used. Treatment is carried out after the necessary examination, as planned, in an orthopedic or trauma department.

    During operations on soft tissues, tendons are cut off or moved to restore uniform traction of the muscles that abduct and adduct the first finger. Palliative interventions that eliminate external deformity, but do not affect the defective position of the first metatarsal bone, include excision of the subcutaneous bursa and exostosis in the area of ​​the first metatarsophalangeal joint. Such operations can reduce cosmetic defects and make it easier to use standard shoes, but over time their effect often disappears due to further progression of the deformity.

    In order to eliminate the inward deviation of the first metatarsal bone, Scarf osteotomy or chevron osteotomy is currently usually used - operations during which the orthopedist removes a fragment of the bone and restores its anatomically correct position. After surgery, special orthoses are used for 6 weeks. Subsequently, the patient is advised not to overload the foot, wear comfortable wide shoes, do self-massage and perform special exercises to strengthen the foot muscles.

    Flatfoot 2nd degree with arthrosis: causes, treatment, symptoms

    Flat feet is one of the most common and difficult to treat diseases, as a result of which the foot becomes flat and loses its shock-absorbing function.

    Flat feet is one of the most common and difficult to treat diseases, as a result of which the foot becomes flattened and loses its shock-absorbing function.

    Flatfoot is a deformation of the sole, in which prolapse of the transverse and longitudinal arches is diagnosed.

    The initial stage of flat feet can be diagnosed by the appearance of rapid fatigue after a short walk or standing. In the evening you may already feel tired, pain, cramps, and swelling.

    According to statistics, 50% of patients suffer from transverse flatfoot, and in 27% of cases a longitudinal change is diagnosed in combination with other types of diseases. Pathology can be diagnosed by disorders in the ligaments, which result in discomfort and pain.

    Symptoms of 1st degree flat feet are mild fatigue at the end of the day, pain when pressing on the foot, swelling of the legs. The main methods of treating the disease at this stage are orthopedic insoles, foot massage, therapeutic exercises and wearing comfortable shoes. It is easier to cure stage 1 disease in childhood, when the musculoskeletal system is developing.

    It is worth noting that 1st degree flatfoot with arthrosis (longitudinal, transverse or combined) is not a reason for exemption from military service.

    During the medical examination, the conscript will be assigned fitness category “A”, which indicates suitability for service in any troops of the Russian Armed Forces, despite the fact that the disease can progress under significant loads.

    2nd degree flatfoot is manifested by a change in the shape of the foot (the arches straighten, the leg becomes wider). The second stage of the disease is often a combined type of flat feet, walking causes pain, by the end of the day swelling of the legs appears, and the gait changes.

    One of the signs of the disease is discomfort in the spine.

    Stage 3 pathology is characterized by a pronounced change in the shape of the feet, swelling of the knees, severe pain in the lumbar region, head, legs, and all joints. Because of this, there is a decrease in working capacity, and movement becomes difficult.

    Often it is at this stage that patients go to the clinic. Depending on the degree of development of the disease and its manifestations, doctors prescribe the wearing of orthopedic shoes, the use of special insoles, as well as massage and therapeutic exercises. If the foot is severely deformed, electrophoresis, magnetic therapy, and ozokerite may be prescribed.

    Types of flat feet

    Longitudinal. With longitudinal flatfoot, the patient's soles change and the size of the foot increases.

    Only with 1st degree of longitudinal flatfoot the legs may not change in size, but already at 2nd and 3rd degrees deformations are observed.

    The second stage is characterized by a decrease in the arch of the foot and intense pain in the joints, especially in the knees. Stage 3 longitudinal flatfoot is characterized by an almost complete change in the feet, pain in the head and lower back appears.

    With longitudinal flatfoot stage 3, a person experiences severe headaches.

    Transverse flatfoot is determined by a decrease in the sole and thickening of the foot. Treatment of the transverse type consists of wearing shoes with orthopedic insoles and special inserts that partially compensate for the shock-absorbing properties.

    In the first degree, deviation of the thumb, thickening of the epithelium, and the appearance of corns are diagnosed.

    The second degree is characterized by the progression of the disease, that is, an increase in the size of the corns, an even greater deviation of the thumb, and twisting of the second and third fingers.

    Combined flatfoot is characterized by transverse and longitudinal changes of varying severity. The main symptoms of the pathology are pain in the legs.

    Reasons for the manifestation of combined forms

    With the simultaneous development of several diseases, such as arthrosis and flat feet, the patient’s condition noticeably worsens.

    Transverse flat feet can develop due to excess weight.

    The most common causes of the development of such forms of the disease are:

  • congenital form of leg dysplasia, which is a defect in the structure of the joints;
  • injuries;
  • fracture;
  • sprains in the feet, heel bones, ankles;
  • obesity;
  • metabolic disorder;
  • wearing the wrong shoes.
  • Often, flat feet complicated by arthrosis are diagnosed in women. This is due to the fact that women wear high-heeled shoes (5 cm or higher).

    Often, flat feet complicated by arthrosis are diagnosed in women due to the fact that they wear high-heeled shoes (from 5 cm).

    Frequent compression of the foot with a changed center of gravity and impaired blood flow leads to deformation of the cartilage. In this case, the disease is diagnosed at stage 2. Acute manifestations of the disease with obvious disturbances of the endocrine system occur after 45 years, with the onset of menopause.

    In the presence of congenital pathologies of the joints and lack of treatment, arthrosis can manifest itself already in adolescence.

    Therefore, to reduce the risk of developing a combined form of the disease, experts recommend systematically doing massages and wearing only good quality orthopedic shoes.

    Symptoms of combined pathologies

    The first stage of the combined form of flat feet and arthrosis is characterized by mild pain in the legs, swelling, and fatigue of the lower extremities.

    To get rid of flat feet, you need to provide your feet with proper rest.

    At the second stage of development of the combined form of the disease, symptoms appear more acutely: constant pain is observed, bones are deformed, fatigue and swelling are felt in the lower extremities.

    Constant pain is felt, regardless of position - both during movement and at rest. They spread higher up the leg all the way to the lumbar region.

    Swelling and fatigue of the legs, caused by deforming arthrosis, decrease only after pain relief with drugs (ointments, creams) and long rest (at least 8 hours).

    Due to changes in the shape of the foot, it is more difficult for the patient to maintain balance, and problems arise with choosing suitable shoes. Ignoring the symptoms of the disease leads to curvature of the spine, poor posture, and the development of more complex back diseases over time.

    Treatment of combined forms of diseases is carried out only under the supervision of qualified specialists.

    Unfortunately, most adults do not pay attention to flat feet and do not treat them until they are scheduled for surgery.

    Depending on the degree of development of the disease, an orthopedist or rheumatologist may prescribe:

  • wraps;
  • painkillers;
  • physiotherapy;
  • manual therapy;
  • chondrotherapy;
  • surgical intervention.
  • In order to eliminate acute pain (inflammation) caused by arthrosis, doctors can prescribe a course of drug therapy with drugs such as Diclofenac, Ketoprofen, Aspirin, Ibuprofen. The action of these drugs is aimed at eliminating the inflammatory process and associated pain.

    If there are spasms or cramps in the feet, doctors may prescribe muscle relaxants that relax muscle tissue.

    In grade 2 pathology, changes in cartilage tissue are observed.

    In order to eliminate acute pain caused by arthrosis, it is recommended to take Diclofenac, Ketoprofen, Aspirin or Ibuprofen.

    Therefore, in order to slow down the process of wear and tear of cartilage tissue, doctors prescribe chondrotherapy drugs that promote accelerated cell regeneration. Flat feet with arthrosis are characterized by the minimal presence of a substance that provides shock absorption to the joints. Due to the lack of this substance, bone tissue is damaged and the feet are overloaded.

    To correct the heel, metatarsal bones, and toes, specialists can prescribe manual therapy and special massages.

    Sometimes, with particularly complex forms of the disease, surgical intervention is required, during which the position of the bones is corrected and their surfaces are cleaned of osteophytes.

    Regardless of the degree of progression of the disease, it is recommended to wear orthopedic shoes with insoles and special inserts.

    Regardless of the degree of progression of the disease, it is recommended to wear orthopedic shoes.

    To prevent the development of flat feet complicated by arthrosis, experts recommend following the following rules:

  • Do not wear shoes with heels higher than 5 cm. Constantly wearing tight shoes with high heels provokes the development of the disease.
  • Fight obesity. Excess weight can lead not only to foot pathologies, but also to other problems in the body.
  • Don't overexert your legs. With excessive stress, blood flow is disrupted, and, accordingly, the functioning of organs.
  • Lead an active lifestyle and play sports.
  • Walk barefoot on natural surfaces.
  • Perform therapeutic exercises daily.
  • Wear proper shoes with orthopedic insoles and preventive inserts.
  • Longitudinal, transverse or combined flatfoot is easier to treat at the initial stage. Timely identification of pathology is the key to successful treatment.

    Arthrosis of the ankle joint, what to do and how to treat?

    Live healthy! Flat feet

    Exercises for the treatment and prevention of flat feet.

    Flatfoot is a pathological flattening of the foot, which leads to disruption of its shock-absorbing function and to painful changes in the spine and skeleton as a whole.

    With flat feet, the structure of the normal arch of the foot, both longitudinal (along the inner edge of the foot) and transverse - along the line of the base of the toes, is quite pronounced or almost completely changes.

    As a complication, pain occurs in the spine, arthritis and arthrosis of the knee and hip joints.

    Depending on which arch of the foot is involved in the deformation, there are:

  • longitudinal flatfoot - flattening of the longitudinal arch of the foot, which is formed along its inner part. With longitudinal flat feet, shoes wear inward.
  • transverse flatfoot - the formation of a plane in the area of ​​the first phalanges of the fingers, which is why the shoes become narrow in the toe.
  • combined or mixed, while the foot increases in width and length, the shoe is deformed in two directions.
  • Flat feet can also be congenital, as a variant of a developmental defect; it is usually severe and occurs rarely, and acquired during life.

    Photo: longitudinal flatfoot and its degrees

    Photo: transverse flatfoot and its degrees

    Flat feet occur in people with sedentary work and with insufficient loads on the legs and feet, as well as in people who are engaged in heavy physical labor and are forced to spend long periods of time on their feet. This is due to both deficiency and excess load on the foot. At the same time, the muscles and ligaments are either not trained enough, or simply get tired and stretched.

    Also, flat feet are formed due to rickets suffered in childhood and osteoporosis in adulthood, due to injuries to the foot and ankle, ligaments and joints, due to lesions of the nervous system in the area of ​​the conducting nerves with the formation of hyper- and hypotonicity in certain muscle groups.

    Flat feet are predisposed by hereditary factors and connective tissue defects, excess weight, lack of training and physical inactivity, wearing the wrong shoes, heels, pregnancy, and occupational hazards.

    Manifestations of flat feet

    Symptoms of flat feet are ignored for a long time, attributing them to fatigue or manifestations of other diseases.

  • fatigue of the legs when standing and walking,
  • pain in the foot, especially after physical activity and heavy lifting,
  • fatigue and pain in the legs at the end of the day,
  • heaviness in the legs, “lead feet”,
  • cramps and swelling in the ankles and legs,
  • inability to wear heels,
  • change in leg size,
  • problems with choosing comfortable shoes,
  • trampling the heel inward,
  • discomfort when walking.
  • In advanced cases, the sacrum and lower back area hurt when walking, headaches may occur, and walking long distances is painful and painful.

    With longitudinal flatfoot, the manifestations are as follows:

    • severe leg fatigue
    • pain when pressing on the middle of the foot or sole,
    • swelling of the dorsum of the foot,
    • problem with choosing shoes, constant tripping in heels,
    • pain in the feet and lower back,
    • deformation of the shoe inward, spreading of the heel.
    • With transverse flatfoot the following is detected:

    • violation of the formation of the transverse arch, stretching of the toe of the shoe,
    • deformation of the toes, especially the big toe,
    • calluses on the sole in the area of ​​the pads,
    • hammer fingers.
    • With severe flat feet, the doctor only needs to look at the patient’s foot and shoes.

      Additionally, plantography is carried out to measure the angle of flat feet and the severity of the disorders, as well as podometry. If necessary, radiography of the foot and ankle is performed in several projections.

      Treatment methods for flat feet

      There are differences in the treatment of longitudinal and transverse flatfoot - with transverse flatfoot, conservative therapy can be effective only in the initial stage.

    • weight correction,
    • choosing the right shoes,
    • reducing stress on the legs,
    • wearing special orthopedic bolsters and pads.
    • With the progression of transverse flatfoot and its transition to 2-3 degrees with severe deformation of the fingers, it is necessary to use surgical correction: resection of the protruding areas of the bone on the first finger, plastic surgery of the joints and tendon transplantation. But these operations only eliminate the consequences, but do not treat the causes of flat feet - problems of muscles and ligaments.

      After the operation, it is necessary to wear special shoes with special arch supports or insoles for life.

      When treating longitudinal flatfoot, it is used

    • gait correction,
    • walking for the maximum amount of time barefoot on pebbles or sand, massage mats,
    • Regular unloading of the foot muscles and periodic rolling onto the outer edge of the foot are applicable.
    • For longitudinal flat feet, massages, physical therapy, and physiotherapy are effective. In the stage of pronounced disorders, a change in working conditions is necessary with a decrease in the static load on the legs and feet, and a decrease in body weight.

      For severely flat feet, special orthopedic insoles and individually tailored shoes are used. Surgical treatment is indicated only in very severe and advanced cases.

      Prognosis and prevention

      With timely diagnosis, flat feet can be corrected in a few months, but wearing special shoes can become a lifelong problem. With progression and severe forms, the prognosis is unfavorable - disability may develop.

      Diagnosis by symptoms

      Find out your probable illnesses and which doctor you should go to.

      Transverse flatfoot in adults: causes, symptoms and treatment

      Transverse flatfoot is a pathology characterized by flattening of the foot, when sometimes the foot is completely in contact with the floor surface. It affects people who are not only forced to spend their day constantly moving, but also those who, due to their occupation, practically never leave the table. In the first, the load on the legs is too great, and the ligaments cannot cope with their functions. In the second, on the contrary, weakness of ligaments that are deprived of load leads to pathology. Most often, this anatomical disorder is diagnosed in women. Let's talk in more detail about the symptoms of transverse flatfoot and treatment methods.

      Types of flat feet and its impact on human health

      Since the foot has longitudinal and transverse arches, there are 3 types of flat feet:

    • Transverse - a decrease in the transverse arch, expressed in a slight shortening of this part of the foot and in an increase in its anterior section. Transverse flatfoot usually develops by age 35.
    • Longitudinal - a decrease in the longitudinal arch, leading to an increase in the length of the foot. Longitudinal is typical for young people, in the age group of 16-25 years.
    • Longitudinal-transverse or combined - simultaneous manifestation of both types.
    • Despite the fact that lowering the arch is considered a local disorder, the consequences that flat feet can lead to are very serious.

        Flat feet cause accelerated wear and tear on the musculoskeletal system, contributing to:
      • development of poor posture;
      • the occurrence of spinal pathologies (osteochondrosis, intervertebral hernia, radiculitis);
      • degeneration and inflammation of joints - arthrosis and osteoarthritis;
      • development of hip joint pathology – coxarthrosis;
      • impaired coordination of movements;
      • the appearance of lameness as a result of decreased functionality of the venous vessels of the calf muscles;
      • development of varicose veins due to blood stagnation;
      • the formation of the plantar aponeurosis, or otherwise, heel spur;
      • the occurrence of abnormalities in the functioning of the cardiovascular system.
      • Causes

        The causes of transverse flatfoot include disturbances in the functionality of the ligamentous apparatus.

        Provoking factors may be:

    • congenital muscle weakness;
    • genetic predisposition;
    • rickets;
    • leg muscle paralysis;
    • features of the profession;
    • shoes with tight toes and high heels;
    • obesity.
    • Transverse flatfoot can occur during pregnancy due to a rapid increase in body weight, as well as as a consequence of age-related changes or foot injuries.

      Stages of disease development

      There are congenital and acquired types of pathology.

      According to the degree of development of acquired transverse flatfoot, 3 stages are distinguished:

    • The first is diagnosed when the thumb deviates inward by 20 degrees or more. This stage is characterized by leg fatigue after prolonged walking or standing. Redness of the skin and thickening of 2-4 fingers occurs. Quite strong pain is possible in the thumb.
    • The second stage is noted when the thumb deviates inward by about 20-40 degrees. In this case, the person complains of a burning sensation and severe pain in the foot. Calluses appear on the skin of the feet.
    • In the third stage, the deviation of the thumb is 35-40 degrees. The pain becomes unbearable; any load on the leg causes it. There is flattening of the front of the foot and deformation of the big toe. The size of the corns increases. There may be a change in the appearance of the foot.
    • The progression of pathology occurs gradually. In the initial stage, there may be a slight discomfort, expressed in the “humming” of the legs. After some time, pain begins, radiating to the spine.

      Symptoms and external signs of transverse flatfoot

      A person can guess for himself that he has developed flat feet based on the following signs:

    • rapid fatigue of the lower extremities;
    • significant wear and tear of shoes, especially on the inside of the foot;
    • pain and cramps in the legs in the evening;
    • inability to wear high-heeled shoes with narrow toes;
    • the need to buy larger shoes due to the increased width of the foot;
    • widening of the foot so much that the foot no longer fits into the shoes that the person previously wore.
    • The anatomical structure of the foot is such that normally the main load falls on the 1st and 5th metatarsal bones. In the presence of pathology, the support of the leg is distributed over the heads of all metatarsal bones. This leads to disruption of the ligaments and muscle tissue, resulting in inward deviation of the thumb. In this case, the thumb puts pressure on the second, leading to its deformation.

      Increasing stress on the front of the foot causes the skin to become rough and calluses to develop.

      With significant flat feet, an inflammatory process often develops, affecting the area located just below the big toe.

      Possible overgrowth of cartilage and formation of a protruding “bone”.

      The mobility of the joints of the first finger is significantly reduced due to osteoarthritis, accompanied by pain. Significant changes affect other fingers as well. The middle fingers, the load on which greatly increases, acquire a hammer-like shape. In addition, subluxations form between the main phalanges and the heads of the metatarsal bones.

      The gradual increase in pain in the foot area is associated with the hammer-shaped toes. This symptom is also sometimes an obstacle to the use of orthopedic shoes, since they are not able to eliminate pain. Forced inactivity and constant discomfort can destroy a person’s psycho-emotional balance.

      Inflammation of the sciatic nerve - sciatica - can be felt as pain in the lower back, buttock or sacral bone, migrating to the hip, knee and further down the entire leg. How to get rid of excruciating pain? Read about this in the article.

      New generation medications are successfully used to relieve pain and various types of inflammation: http://pomogispine.com/zdorove/lekarstva/npvs.html

      Despite the identification of a number of signs inherent in flat feet, it should be taken into account that similar symptoms often develop with other diseases. Therefore, several tests and x-rays are necessary.

      Radiography allows you to identify pathology with maximum accuracy. Lateral and AP photographs of the feet are taken while the patient is standing. Studying the images makes it possible to determine the angle of deformation and diagnose the degree of the disease.

      The podometric method is based on calculations. Parameters such as foot height and length are measured. The height is multiplied by 100 and the result is divided by the length. The resulting index shows the probability of change. The norm is 29-31. A decrease in the index to 27-29 is a sign of flat feet. An index below 25 is a pronounced degree of pathology.

      Treatment and prevention

      Treatment of the congenital form of transverse flatfoot is possible only until the child reaches the age of 12-13 years. Later, a fully formed arch is practically impossible to adjust.

      The orthopedist’s task is to reduce symptoms and achieve a stable condition that excludes further progression.

      For this purpose, complex treatment is used, including:

    • Exercise therapy exercises to strengthen the muscular-ligamentous system;
    • wearing orthopedic shoes and special insoles for transverse flat feet;
    • massage;
    • foot baths.
    • Flat feet is a disease in the treatment of which traditional methods of reducing leg fatigue with the help of herbal decoctions are widely used. Baths and massage treatments can effectively eliminate the effects of stress. If the pathology is severe, it is necessary to use shoes specially tailored to individual measurements.

      To avoid the disease, it is recommended to actively engage in sports from childhood, wear shoes that do not compress the foot, and monitor your diet. With a congenital type of flatfoot, it is necessary to constantly perform a set of therapeutic exercises so as not to provoke the development of the disease.

      Transverse flatfoot causes pain when walking and has a negative effect on almost the entire body. To get rid of the pathology, it is necessary to constantly perform exercise therapy, strengthening the muscular-ligamentous apparatus, and be sure to use orthopedic insoles for shoes.

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