Gymnastics for flat feet is an element of physical therapy (physical therapy). And in combination with wearing orthopedic insoles and massage, it is an integral component in the treatment and prevention of flat feet.
Physical therapy (physical therapy) for flat feet helps strengthen the muscular-ligamentous apparatus, which supports the arched structure of the feet and fixes them in the correct position. For this, physical therapy (physical therapy), walking on uneven surfaces (pebbles, gravel), and soft ground (loose soil, sand) are used.
At home, it is convenient to use a special orthopedic mat with a coating in the form of “pebbles”. Exercises on such a mat help compensate for the lack of motor activity and stimulate the muscles and ligaments of the foot. At the same time, massage of the plantar surfaces occurs.
A complex of physical therapy (physical therapy) for patients with flat feet:
The presented complex of physical therapy (physical therapy) consists of 12 exercises, suitable for children and adults. Each exercise must be repeated 20 times. Performing the entire complex takes 10-15 minutes in the morning and evening. Exercises recommended for children with flat feet in the form of homework.
Exercise “ROLLER” - a child rolls a ball, rolling pin or bottle back and forth. The exercise is performed first with one leg, then with the other leg.
Exercise “ROBIGER” - the child sits on the floor with his legs bent. The heels are pressed tightly to the floor and do not come off during the entire period of the exercise. By moving his toes, he tries to pull under his heels a towel (or napkin) laid out on the floor, on which some kind of load (for example, a stone) lies. The exercise is performed first with one leg, then with the other leg.
Exercise “PAINTER” - a child, sitting on the floor with his legs extended (knees straight), runs the big toe of one leg along the instep of the other in the direction from the big toe to the knee. “Stroking” is repeated 3-4 times. The exercise is performed first with one leg, then with the other leg.
Exercise “COLLECTOR” - a child, sitting on the floor with bent knees, collects various small objects laid out on the floor (toys, clothespins, Christmas tree cones, etc.) with the toes of one foot and puts them in piles. With the other leg he repeats the same thing. Then, without using his hands, he transfers these objects from one pile to another. Objects should not be allowed to fall while being carried.
Exercise “ARTIST” - a child, sitting on the floor with his knees bent, holding a pencil between his toes, draws various shapes on a sheet of paper, holding the sheet with the other foot. The exercise is performed first with one leg, then with the other leg.
Exercise “CATERPILLAR” - the child sits on the floor with his knees bent. Curling his toes, he pulls his heel forward (heels pressed against his toes), then his toes straighten again and the movement is repeated (imitating the movement of a caterpillar). Moving the heel forward by flexing and straightening the toes continues until the toes can touch the floor. The exercise is performed with both legs at the same time.
Exercise “BOAT” - a child, sitting on the floor with his knees bent and pressing the soles of his feet together, gradually tries to straighten his knees until the toes and heels of his feet can be pressed together (trying to give the feet a boat shape).
Exercise “SICKLE” - a child, sitting on the floor with his knees bent, places the soles of his feet on the floor (the distance between them is 20 cm). The bent toes first come closer together and then spread in different directions, while the heels remain in one place. The exercise is repeated several times.
Exercise “MILL” - a child, sitting on the floor with straightened legs, describes circles with his feet in different directions.
Exercise “WINDOW” - a child, standing on the floor, spreads and closes his straightened legs without lifting the soles of the floor.
Exercise “DRUMMER” - a child, sitting on the floor with his knees bent, taps on the floor only with his toes, without touching his heels. During the exercise, the knees gradually straighten.
Exercise “WALKING ON HEELS” - the child walks on his heels without touching the floor with his toes and soles.
Before starting the conversation, I would like to introduce myself - my name is Lyubov Zoteevna, by profession I am an instructor-methodologist in Physical Culture and Physical Therapy (physical therapy), I have been working with children for more than 20 years.
All this time of actively working with children, I collected and accumulated information, mainly on strengthening and preserving the health of frequently ill children, including those with flat feet and poor posture.
The central place in the exercise complexes I have compiled is occupied by the elements of Hatha yoga, as the most physiological and natural for humans. Most of them bear names from the living world and, according to their names, repeat the movements and poses of a tree, fish, cat, stork, and lion. This makes it easier for children to learn and remember these exercises.
An important feature of Hatha Yoga gymnastics in comparison with other physical exercises is their static nature. Performed here with calm and smooth movements, filled with meaningfulness and exerting a mild, moderate load on the body. The physical exercises of Hatha yoga are combined with breathing exercises and relaxation.
That is why they are recommended for weakened and often ill children, with flat feet and poor posture, excess body weight, as well as for those who need to normalize the functioning of internal organs, strengthen muscles, improve posture, and develop flexibility. The use of physical culture methods for preventive or therapeutic purposes is called exercise therapy. For preschoolers, therapeutic exercise (therapeutic gymnastics) is a priority method of rehabilitation, especially in cases of poor posture and flat feet. Posture is a pose that does not require muscle tension and is familiar to a relaxed standing person. It is primarily determined by the shape and position of the spine, the degree of muscle development and the angle of the pelvis. Posture in preschool children is still unstable, and any deviations from normal are considered defects or disorders, although they are not considered a disease. The root cause of postural disorders is the functional changes occurring in the musculoskeletal system, leading to the emergence of conditioned reflex connections, which lead to the loss of the skill of correct posture due to the reinforcement of incorrect body position. The child’s posture is also influenced by the functional state of the muscles and environmental conditions, which are reflected primarily in weakened children who often suffered from colds, suffered from tuberculosis or rickets, and have insufficient physical development due to defects in physical education. Correcting violations and defects of posture, regardless of their nature, is a rather lengthy process, but with the help of special exercises the result is achievable. Such physical exercises lead to normalization of the curvature of the spine, improvement of the angle of the pelvis, strengthening of the back and abdominal muscles, and correction of the shape and position of the chest. Naturally, their effectiveness is directly dependent on the starting positions - lying on your stomach and back, standing on your knees. The skill of correct posture is formed in the process of performing muscle exercises, and its consolidation is done during coordination and general development exercises. Games whose rules require maintaining the correct posture are excellent for these purposes. A foot deformity that results in decreased arch height, forefoot supination contracture, and heel pronation is called flatfoot. It leads to a change in the position of the bones of the foot due to pathological stretching of all its ligaments and lowering of the medial edge, weakening up to atrophy of the supinator muscles. Flat feet are accompanied by a decrease in overall performance, fatigue and pain in the calf muscles when walking. Flat feet are expressed by widening and visible flattening of the foot, mainly in the middle part, the heel pronates outward. Plantography using dye solutions helps confirm the diagnosis. For all forms of flat feet, exercise therapy or physical therapy for children is prescribed, which ensures an increase in strength and general muscle endurance, normalization of the motor sphere, and an increase in physical performance. The proposed rehabilitation program primarily solves the problem of strengthening the health of weakened children through physical therapy (physical therapy), as well as increasing strength endurance, strengthening the muscles of the arch of the foot and the muscular corset;
Even the most effective exercises against flat feet require daily repetition if a person wants to get rid of the pathology. Taking care of your feet should be done regularly in combination with treatments prescribed by your doctor.
The best exercises for flat arches
Orthopedists recommend daily therapeutic exercises of various types with changes in body position (standing, sitting on the floor and on a chair). This approach significantly improves the quality of treatment.
Gymnastics against flattening of the arch in a standing position
When therapeutic exercises for the lower extremities are performed in a standing position, the gluteal and thigh muscles are not included in the process, and the entire effect of the procedures is aimed at strengthening the muscular system of the foot and lower leg.
What to do if you have flat feet:
walk on heels, toes and inner parts of the foot;
perform rolls from foot to heel 20-30 times daily;
rotate your feet clockwise and counterclockwise 10-20 times;
straighten and bend your toes alternately, 5-10 approaches on each side;
stand for 10 seconds on the inside of the foot;
draw various shapes with your fingers on the sand or floor;
move small objects with your feet from one place to another.
This set of exercises to prevent flat feet is suggested to be performed both at home and at work during lunch. The only requirement: if you decide to take up gymnastics, you must maintain regularity of classes.
What exercises for flat feet can be done while sitting on a chair?
When sitting on a chair, the gluteal muscles relax, and the load is redistributed to the lower leg and thigh. By performing such exercises daily for flat feet, you can achieve a significant correction of transverse flattening, as well as permanently get rid of pain and swelling of the sole.
Physical exercises on a chair:
bend your knees and place your legs parallel. In this position, try alternately raising your heels up 10 times on the right and left sides, and then the same number of times together;
perform sliding movements with your foot on the floor, first in one direction and then in the other. Repeat the manipulation not on the floor, but along the outer surface of the lower leg;
Place a rolling pin around the circumference of the chair and try to step on it with both feet at the same time. Number of repetitions – 5-10 times;
while sitting on a chair, move small objects with your feet;
place a pencil on the floor. Take it with your toes and draw a geometric shape on a blank piece of paper. Repeat the manipulation for the other leg. Children really like this exercise, but it is quite difficult to perform;
Try also raking sand with the heels of your feet. In this case, the socks should be brought together. The sand is, of course, imaginary;
Place a piece of cloth in front of the chair. Move it in different directions, first to the left and then to the right;
lift the ball with your feet and roll it first forward and then back.
Correct exercises for flat feet should be performed on an uneven floor. In such a situation, in addition to strengthening the muscles, stimulation of the reflexogenic points of the sole will be provided, which activates the vestibulo-motor reflex.
Therapeutic gymnastics for flat feet on the floor
When a person sits on the floor, the muscles of the lower limbs and gluteal region are unloaded. At the same time, physical activity allows you to actively strengthen the ligamentous-muscular aponeurosis of the foot.
How to exercise on the floor with a flat transverse arch:
bend your knees. Lower them down with light pressure, but at the same time connect your feet together;
tap the inside of the sole on a horizontal surface. Of course, blows should not cause severe pain and progression of swelling;
Bring your feet together so that your heel bones are pressed tightly against each other. In this position, try to place the toe of one foot under the sole of the other. Switch legs and repeat the procedure. It is advisable to do 10-15 repetitions for each side in one session.
Exercises with a gymnastic or wooden stick help to maintain the height of the arch in the required position when performed regularly. The stick must be smooth so as not to get hurt, with a length of 0.5-1.5 meters.
Gymnastics complex with a stick for flat valgus foot deformity:
Place the product on the floor and walk along it like a tightrope. After 10 minutes of exercise, change legs. After this, try to walk on the stick with both feet at once;
movement across the product. Place the stick in the middle of your foot. Step over it from one edge to the other for 10 minutes;
walk your toes forward and then back. Such gymnastics will allow you to treat not only transverse, but also longitudinal flat feet.
Before using this gymnastic equipment, experts recommend taking a warm bath and also warming up your feet.
Combined complexes of gymnastic loads for flat feet
Combined exercises for the prevention of flat feet are prescribed by doctors when it is necessary not only to strengthen the ligaments of the foot, but also to correct the abnormal arrangement of the bones that form the arch.
List of complex exercises:
stand straight on the floor and rise up onto your toes. Then smoothly move to the outer part of the sole. Stand on it for a few seconds, and then also smoothly return to the starting position. Perform a similar set of procedures while standing on the inside of the foot;
To consolidate the effect of the above exercise, you should move around the room, first on the inside of the foot, and then on the outside;
You can strengthen the arch in adults by walking around the room on tiptoe;
children will love walking “like a bear with clumsy feet.” To do this, we first move along the floor on the outer parts of the foot. The toes of the feet should be turned inward. Then we continue to move on our toes, and after a while on our heels. Attention! You should not perform the exercise if it causes pain;
movement on an inclined surface helps to complicate the gymnastics complex from a flat arch. For these purposes, you can purchase special gymnastic boards in the store.
The above set of exercises for flat feet is best used after taking a bath with sea salt, which will improve blood circulation in the legs.
For children, therapeutic exercises should resemble a game. They walk with great pleasure like a bear on the floor or jump like a squirrel, but do not want to do regular exercises or sit on a chair for a long time.
In conclusion: exercises against flat feet only help if performed correctly and regularly. It is better not to carry out any manipulations unless you are sure that you will spend time on your feet every day. Otherwise, such gymnastics will cause more problems than benefits.
Exercises for flat feet. Video:
Exercise therapy for scoliosis is prescribed for curvatures of the spine. Scoliosis is a change in the position of the spine in which it curves either to the left or to the right. This can be either a congenital disease or an acquired one. Externally manifested by protruding shoulder blades and ribs. More severe degrees of scoliosis can lead to serious diseases of the internal organs due to their constant compression.
When a diagnosis of spinal curvature is made, the patient is prescribed a course of physical therapy exercises. The exercise therapy complex for scoliosis is most often used in the initial stages, when exercises can effectively correct curvatures, remove asymmetry of the shoulders and pelvis, and straighten the bolsters. In combination with wearing a corset and physiotherapy, this complex is effective in the treatment of scoliosis.
Therapeutic exercise prescribed to the patient has the following goals:
There are four degrees of scoliosis:
According to the forms of curvature, scoliosis is divided into types:
To ensure maximum effect, the following conditions must be met:
Any physical therapy session includes a warm-up, then the main exercises, and the final part. The main condition for these exercises is symmetry; they can be performed even at home. Exercise therapy for grade 1 and grade 2 scoliosis are practically the same.
Attention: we repeat any exercise 5-10 times!
Watch videos of the most popular exercises:
Exercise therapy for grade 2 scoliosis, in addition to the basic set of exercises, also includes highly targeted exercises with the help of which deformities are corrected. It is also possible to use general strengthening exercises to strengthen the back muscles and properly develop the muscle corset.
Exercise therapy exercises for lumbar scoliosis are aimed at balance and various inclinations. In combination with basic exercises and massage, such exercises give quick and reliable results.
The problem of spinal curvature in children is very acute. At birth, a certain percentage of children may have a congenital curvature, which can only be diagnosed by a specialist. If a child has avoided congenital scoliosis, he can easily acquire it in elementary school.
A first-grader has a constant thirst for movement; it is difficult for him to sit still. But lessons at a desk and homework at a table form first and second degree scoliosis of the spine! The child fidgets, takes uncomfortable positions, and bends the pelvis and shoulders.
When a doctor makes a diagnosis, he prescribes a set of procedures: physiotherapy, wearing a corset, therapeutic massage, taking healing baths and, of course, exercise therapy for spinal scoliosis.
It is necessary to strictly observe your child's attendance at classes. If the child is small or especially restless, you can walk with him or learn the exercises and do them at home on your own.
Exercises in the presence of such a curvature are usually aimed at correcting the deformity of the spine in the thoracic and lumbar regions.
General strengthening of the latissimus dorsi and paravertebral muscles.
There are a number of exercises that are strictly contraindicated for patients with scoliosis. This:
You should also refrain from exercise therapy if it causes pain, dizziness and spasms.
Even if you don’t have scoliosis, but you strain your back with a sedentary lifestyle, you need to know how to prevent the appearance of curvatures.
Unfortunately, almost half of modern people suffer from flat feet by the age of fifty. Moreover, women are more susceptible to this disease than men. The causes of flat feet can be different: diseases of the blood vessels and joints of the legs, various injuries, obesity, congenital weakness of ligaments and muscles. Also, flat feet can develop as a result of constantly wearing shoes with too high heels, or due to wearing shoes that are too tight. The beginning of flat feet is indicated by pain in the legs that appears at the end of the day, swelling. You can also suspect flat feet when shoes that previously fit suddenly become tight. Unfortunately, flat feet are quite common in children.
Treating flat feet is incredibly difficult. The main thing that can help here is [physical therapy]. The danger of flat feet is that when the functions of the foot are impaired, pathological changes also occur in the functions of the spine, hip and lower leg. In this regard, when treating flat feet with exercise therapy methods, not only exercises that are aimed at the foot are used, but also those that develop the muscles of the back, abdomen, calf and gluteal muscles, as well as the front of the thigh.
As a result of exercise, treatment is achieved through the impact of physical activity on the entire body as a whole. Also, it is necessary to use massage and special gymnastics, which strengthens the system of muscles and ligaments of the entire foot. When starting to use [physical therapy for flat feet], you need to use two starting positions: lying and sitting. In this case, minimal load will be placed on the foot. When treating this disease, physical therapy is based on supination of the feet with their simultaneous flexion. In the case when the exercises are performed from a standing position, the toes of the feet must be kept together, and the heels must be spread apart. Therapeutic exercise includes a variety of exercises that are performed with special devices, as well as walking and raising on toes.
Physical therapy is prescribed to all patients, regardless of the form of flat feet. Its main objectives are to strengthen the entire body, increase its performance and resistance to disease, as well as increase the strength and endurance of the leg muscles. In addition, with the help of physical therapy, you can reduce foot deformation, form correct posture, get rid of incorrect heel position, and supination contracture of the foot. Therapeutic physical education is simply necessary to normalize the motor sphere, strengthen the ligaments of the lower leg and foot, strengthen the muscles, and also to develop the correct position of the feet while walking.
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Moscow Pedagogical State
Abstract on physical culture
“Therapeutic exercise for flat feet”
Introduction (Description of exercise therapy). 3
1.1. Definition of flat feet. 4
1.2. Types of flat feet. 6
1.3. Causes of flat feet. 7
1.4. Treatment of flat feet. 10
1.5.Modern views on the prevention of flat feet.……………….12
A set of exercises for flat feet (therapeutic gymnastics)…………. 16
Introduction ( Description of exercise therapy)
Therapeutic exercise (physical therapy) is a set of methods of treatment, prevention and medical rehabilitation based on the use of physical exercises, specially selected and methodically developed. When prescribing them, the doctor takes into account the characteristics of the disease, the nature, degree and stage of the disease process in systems and organs.
of physical exercise based on strictly dosed loads applied to the sick and weakened. There is a distinction between general training - to strengthen and improve the health of the body as a whole, and special training - aimed at eliminating the impaired functions of certain systems and organs.
Gymnastic exercises in physical therapy are classified:
a) according to the anatomical principle - for specific muscle groups (muscles of the arms, legs, respiratory muscles, etc.);
b) by independence - active (performed entirely by the patient himself) and passive (performed by a patient with impaired motor function with the help of a healthy limb, or with the help of a methodologist).
To accomplish the task, certain groups of exercises are selected (for example, to strengthen the abdominal muscles - exercises in a standing, sitting and lying position), as a result of which the body adapts to gradually increasing loads and corrects (evens out) disorders caused by the disease.
prescribes physical therapy , and the physical therapy specialist determines the method of exercise. The procedures are carried out by an instructor, and in particularly difficult cases by a physical therapy doctor. The use of physical therapy, increasing the effectiveness of complex therapy for patients, accelerates recovery time and prevents further progression of the disease.
You should not start physical therapy classes on your own, as this can lead to a worsening of the condition; the training methods prescribed by the doctor must be strictly followed
Exercise therapy for flat feet
1.1. Definition of flat feet
The foot performs a supporting and spring function, resting on the support area of the heel bone and the heads of the metatarsal bones. The bones of the foot, connecting with the help of joints and powerful ligaments, form arcs convex upward - the transverse and longitudinal arches of the foot. When the muscles and tendons weaken, the arches of the feet drop and flat feet develop. With flat feet, prolonged physical activity on the lower extremities (walking, running, jumping, outdoor sports games, etc.) leads to pain in the feet. There are normal, flattened and flat feet.
Examination of the foot is carried out while walking barefoot on the floor in different directions and kneeling on a chair (facing its back) with the feet hanging freely. Pay attention to the inner edges of the feet and the degree of flattening of the longitudinal arch (normal, elevated, flat). With flat feet, there is an elongation of the feet, their widening in the middle part, and an increase in the width of the isthmus. On the inner side of the isthmus, a compensatory muscle ridge is formed, easily determined by palpation, flattening of the longitudinal arch, some convexity of the line of the outer edge of the foot, pronation of the heel - its departure outward from the midline. In addition, during examination, attention should be paid to the condition of the transverse view, deformation of the fingers (hammer fingers). The study of the foot is carried out using plantography (footprint) and codometry - measuring the foot with a stopometer, for example a simplified Frindland stopometer.
To diagnose the condition of the parts of the foot, it is necessary to remove typos of its plantar part - a plantogram. To do this, take an aqueous solution of some dye (for example, a 1% alcohol solution of brilliant green) and lubricate the surface of the sole of the subject. Then he is asked to stand firmly with both feet on a blank sheet of paper measuring at least 30×40 cm. The weight of the body should be evenly distributed on both feet, with footprints clearly imprinted on the paper. After this, the plantogram is assessed using the V.A. method. Yaralov-Yaraland (Fig. 1) . To do this, two lines are applied to the print: AB , connecting the middle of the heel with the middle of the base of the big toe, and AC , connecting the middle of the heel with the second interdigital space. If the internal bend of the contour of the foot print extends beyond the AC or is located at its level, the foot is normal; if it is between the lines AB and AC , the foot is flattened (flat feet of the 1st degree); if it does not reach the AB - flat feet of the 2nd and 3rd degree.
Rice. 1. Assessment of the plantogram using the method of V.A. Yaralova-Yaralenda:
a – normal foot shape;
b – flat feet of the 1st degree;
c – flat feet of the 2nd or 3rd degree.
AB – line connecting the middle of the heel with the middle of the base of the big toe;
AC – line connecting the middle of the heel with the second interdigital space
The resulting plantogram can also be assessed using the method of I.M. Chizhina (Fig. 2) . To do this, you need to draw a tangent line to the most protruding points of the inner edge of the foot and a line through the base of the second toe and the middle of the heel bone. We draw a perpendicular through the middle of the second line until it intersects with the tangent and with the outer edge of the foot print. Then we calculate the index: the ratio of the length of segment A to the length of segment B.
Rice. 2. Plantogram assessment according to I.M. Chizhin:
index from 0 to 1 – normal foot;
index from 1 to 2 – flattened foot;
index more than 2 – flat foot
1.2. Types of flat feet
Occurs when there is functional overload or fatigue of the anterior and posterior tibial muscles.
The longitudinal arch of the foot loses its shock-absorbing properties, and under the action of the long and short peroneal muscles, the foot gradually turns inward.
The flexor digitorum brevis, plantar aponeurosis, and ligaments of the foot are unable to support the longitudinal arch. The navicular bone settles and, as a result, the longitudinal arch of the foot becomes flattened. People with a large mass are most often at risk of developing this type of flatfoot. The greater the weight, the greater the load on the feet, the more pronounced the longitudinal flatfoot.
More often women suffer from this pathology. Longitudinal flatfoot occurs most often at the age of 16-25 years.
The development of this type of flatfoot depends on the weakness of the plantar aponeurosis in combination with the same reasons as with longitudinal flatfoot.
Symptoms of transverse flatfoot are very characteristic. This is a wide forefoot, protruding inward, enlarged due to osteochondral growths of the head of the first metatarsal bone. It is often called “bone” or “gout”. Outward deviation of the big toe or, otherwise, Hallux valgus, painful calluses on the side of the sole, hammertoe deformity of the second and sometimes third toes, calluses on the toes.
The greater the deformity, the more patients complain of pain, difficulties in selecting and using shoes, and fatigue.
Transverse flatfoot is usually combined with an outward curvature of the first toe.
Transverse flatfoot occurs most often at the age of 35-50 years.
Often both forms of flat feet are combined. People don’t die from flat feet, of course, but its development leads to a number of problems, including pain in the back, knee and hip joints, poor posture and other consequences that reduce the quality of life. Therefore, special attention should be paid to timely diagnosis and prevention of flat feet.
1.3. Causes of flat feet
There are many reasons for flat feet: a hereditary predisposition (rather to a certain lifestyle), paresis or paralysis of the plantar muscles of the foot or lower leg, injuries to the bones of the foot and ankles. The most common cause is general weakness of the musculoskeletal system as a result of rickets, frequent or long-term illnesses.
Especially dangerous against the background of weakness of the musculo-ligamentous system is overload of the feet: prolonged standing, long continuous walking, overweight child.
Wearing ill-fitting shoes has an extremely unfavorable effect on the condition of the feet.
Flat feet develop especially often in children with the so-called flat-valgus foot alignment, which develops at an early age. Every parent can determine the correct position of the feet; just look carefully at the standing barefoot child from the back. Normally, the heel is located according to the longitudinal axis of the lower leg; in the case of flat-valgus feet, the heel is noticeably deviated outward.
This defect, according to the latest data, indicates a congenital anomaly of the nervous system (encephalopathy) and entails developmental disorders of the entire skeleton. In almost all children, flat feet are accompanied by certain defects of the musculoskeletal system, especially often by various disorders of posture.
Based on anatomical characteristics, flat feet are divided into longitudinal, transverse and mixed. In children, longitudinal or mixed forms are most common.
In childhood, flat feet are most often combined with outward deviation of the heels; such feet are called flat-valgus. Treatment and prevention of this defect are almost the same as for ordinary flat feet (Olontseva G.N., 1985).
Valgus deformity of the legs.
We can talk about valgus (X-shaped) curvature of the legs when the distance between the inner ankles with tightly compressed and straightened knees exceeds 4-5 cm. Typically, such deformation of the legs is combined with flat-valgus feet.
Contrary to popular belief, this is not a congenital defect, not an investigative quality, but an acquired defect. Curvature of the legs most often appears some time after the child stands on his feet and begins to walk. This happens especially often if the baby got to his feet ahead of time, if he stood a lot (for example, in the playpen), if he did not crawl. This is explained by weakness, underdevelopment of his musculo-ligamentous apparatus and excessive load on the lower extremities.
One of the most likely causes of bowed legs is rickets suffered in infancy, especially its asymptomatic and untreated form. Rarer causes include congenital dislocation or dysplasia of the hip joint, some foot defects, and diseases and injuries of the knee joints.
Excess weight of a child has an adverse effect on the condition of the legs. However, children with stocky builds are less prone to this defect than thin children. Girls suffer more often, which is due to their wider pelvis.
With hallux valgus, the main changes occur in the knee joint. Uneven development of the femoral condyles (faster growth of the internal condyles than the external ones) leads to the fact that the joint space becomes wider on the inside and narrower on the outside. The ligaments that strengthen the joint are stretched, especially on the inside, and the knee loses its stability. The shin deviates outward; in severe cases, there may be curvature of the shin bones with a convexity inward. If you look at such a child from the side, you will notice hyperextension of the legs at the knee joints.
General weakness of the muscular-ligamentous apparatus manifests itself in all joints, the feet gradually become deformed and acquire a stable flat-valgus position (the heels are deviated outward), and flat feet develop (Krasikova I.S., 2002).
1.4. Treatment of flat feet
With the help of conservative treatment, it is impossible to eliminate existing foot deformities due to flat feet. Complete cure for flat feet is possible only in childhood. In adults, the development of the disease can only be slowed down. Correction of flat feet has the following goals: strengthen the muscles and ligaments of the foot and prevent the foot from “falling apart” further; protect the entire body, and especially the spine, from overload; prevent the development of complications - arthrosis of small joints of the foot, deformation of the fingers and diseases of the spine.
Treatment of flat feet includes several main areas. Medicines and physical therapy are used to relieve pain.
To restore the natural shape of the foot, corrective insoles (instep supports) are used. Properly selected instep supports not only help you get rid of pain, but also regulate muscle tone with their shape.
There are different types of arch supports:
inserts under the forefoot are used to flatten the longitudinal arch;
heels - allow you to reduce the load on the heels and pain in them;
interdigital inserts allow you to move the big and second toe apart, thereby preventing the progressive deviation of the big toe outward;
The best option is an insole with an instep support under the heel and a pronator under the anterior section.
Such an insole, as it were, “twists” the foot - in this case, the muscles are subjected to less tensile forces and, thus, are in conditions for work.
The highest quality arch supports are made to order after examining, taking the measurements of the foot and establishing the level of flattening of the arch. The materials from which instep supports are made have undergone their evolution: from cork, the most ancient and quite effective, to synthetic ones (from Europlastic, supralene, silicone), as well as from soft foam material.
For pointed-toe shoes, special model half-insoles have been developed, without a front part. By the way, they are suitable for any shoes, since they additionally relieve the forefoot. It is necessary, however, to make a reservation that these devices only mitigate the harm caused by high heels. They are unable to eliminate it. Therefore, the recommendation not to abuse such shoes remains valid.
For open sandals, there are special pads that are made of silicone or leather. For transverse flat feet, pads in the shape of a drop are suitable, for mixed ones - in the form of the letter T. They cost less than a regular arch support, but it is difficult to find exactly the place for them that is needed. Therefore, the pads are not suitable for frequent use.
For sports, arch supports covered with a special fabric are suitable, which absorbs moisture well and is easy to wash. But they can only be used in shoes with a flat inner surface, without a built-in arch support.
When the blood supply to the legs is impaired (for example, with diabetes), the feet become especially vulnerable, and flat feet develop by leaps and bounds. Seamless instep supports have been created especially for diabetics, covered on top with soft material - plastazote. Diabetic arch supports are designed to provide maximum safety for the feet. Their price is higher than traditional models.
In cases of advanced flatfoot, special orthopedic shoes are made in the form of boots with lacing, a solid sole and lateral support for the foot. These shoes are made to order, using a plaster cast.
If there is a sharp deformation of the big toe, constant pain and the inability to choose shoes, one has to resort to surgical treatment. However, it is not always possible to artificially create a normal foot shape and restore its functions, and the recovery period after such operations is quite long.
For the treatment of flat feet and its prevention, there are also massage and physical therapy.
1.5. Modern views on the prevention and correction of flat feet
Flat feet are a progressive disease; therefore, the earlier treatment is started, the better results it brings. Conversely, advanced cases are much more difficult to treat.
Treatment for flat feet should be comprehensive and aimed at strengthening the entire body. Therapeutic exercises, massage, physiotherapeutic procedures, orthopedic insoles or shoes - there are enough measures to correct the feet. It is important that the correction process be regular and continue until complete recovery.
Primary attention should be paid to shoes, they should be “rational”, that is, stable, and fit tightly around the foot without interfering with movement. A small heel, thin sole and material that allows the feet to “breathe” are also necessary qualities of good children's shoes.
It is better for preschool children to wear boots or shoes that support the ankle joints well.
Children with flat feet, and especially with flat-valgus feet, should not wear soft shoes, for example, felt boots, rubber boots, soft slippers, slippers, sandals.
But often rational shoes alone are not enough to correct flat feet. Then orthopedic insoles or orthopedic shoes are used.
These treatments are quite effective, as they make walking easier, take on part of the load, and prevent further development of the disease.
However, you cannot order, much less buy, ready-made orthopedic insoles without a doctor’s prescription. These types of insoles may cause more harm to your child's feet than good.
Orthopedic insoles are placed in the same “rational” shoes that support the foot well. Insoles in soft slippers or worn-out shoes are useless. Since the insole takes up a certain volume in the shoe, purchase boots one size larger than required for the length of the foot.
It should be taken into account that insoles have a certain expiration date. Custom-made cork insoles must be replaced at least once every six months. Insoles made of softer elastic materials should be changed even more often - every three to four months.
Orthopedic shoes are ordered in special workshops on the direction of an orthopedic doctor; you should have at least two pairs: one for the street, the other for home.
Special shoes and insoles do not correct the deformity, but only prevent its further development. These unique “crutches” should be used when the child is on his feet for a long time. It is not recommended to use them constantly, as the foot muscles weaken even more.
If there is no effect from correction with orthopedic shoes, staged plaster casts are used in order to normalize the ratio of the bones of the foot joints. Splints are used during sleep. In severe forms of flat feet with severe constant pain, surgical treatment is indicated.
Orthopedic correction of the feet must be carried out in combination and against the background of other treatment methods: physiotherapy, massage and therapeutic exercises.
Physiotherapeutic procedures for the treatment of flat feet are prescribed quite widely and are carried out mainly in clinics.
The exception is thermal procedures that can be performed at home. Paraffin, ozokerite and mud applications can be applied to the entire lower leg and foot, but it is advisable to emphasize the thermal effect on the anterior outer surface of the lower leg and the dorsum of the foot.
For paraffin applications, the optimal temperature is 48-500; The duration of the procedure is 30-40 minutes, daily or every other day. For ozokerite applications, a temperature of 30-400 for 15-20 minutes is sufficient, two days in a row with a break on the third day.
The course of treatment is 15-20 procedures, which can be repeated after two to three months.
Thermal procedures give maximum effect if you perform therapeutic exercises immediately after them.
At home, you can use contrast skin baths. To do this, you need two basins with water: one with warm water (40-450), the other with cool water (16-200). The child immerses his feet alternately in warm and cool water for a few seconds. The procedure lasts 5-10 minutes and is performed daily or every other day for two to three weeks. Baths not only strengthen muscles and train the joints of the feet, but also have a wonderful hardening effect.
Massage is a necessary part of the comprehensive treatment of flat feet. It allows you to normalize the tone of the muscles of the foot and lower leg: strengthen weakened, stretched muscles and relax tense ones, and this is very important for restoring their coordinated work. In addition, by improving blood circulation and innervation, massage helps improve nutrition of the muscles, ligaments and bones of the foot. Brings relief in cases of foot pain and restores normal conditions. For the development and growth of the lower extremities.
In pediatric practice, special massage is often performed against the background of a restorative massage of the whole body (except for the hands). If this is impossible for some reason (little time or lack of sufficient preparation), then you can limit yourself to a back and leg massage. You must be careful when contacting specialists (especially paid ones) - foot massage alone is not very effective. The muscles of the lower extremities are controlled by nerves that begin in the lumbar spinal cord. Therefore, any foot massage should begin with a massage of the back or at least the lumbar region.
Depending on the age and, therefore, the height and weight of the child, as well as the volume of the massage, the session takes from ten minutes to half an hour.
A massage course for flat feet usually lasts about 20 sessions, every other day or daily. Repeating the course 3-4 times a year is considered effective. However, if your child complains of pain and tired legs after a long walk or vigorous play, do not hesitate to massage “as needed.”
You can massage your baby on a table (if it fits there), on a hard couch or on the floor. In any case, the person lying down should have good support. For flat feet, a general toning, that is, quite energetic massage is performed. It is better not to use oils and creams, as they increase the slipping of the hands and, therefore, reduce the intensity of the effect.
A set of exercises for flat feet (therapeutic gymnastics).