One of the most common diseases of our time, in which the outer and inner arches of the foot noticeably thicken, is flat feet. There are a huge number of reasons that can cause it: constant work “standing”, incorrectly selected shoes, excess weight, long walking. The muscular system of the foot is disrupted, it swells and is also flattened.
If flat feet (its degree of development) are determined in a timely manner using ordinary home methods in adults and children, then it is not difficult to deal with it later. We will tell you how to determine flat feet at home.
The following symptoms can be used to identify the disease during regular home examinations:
Based on individual signs of deformation, the presence of transverse flatfoot can be determined during home examinations:
These symptoms may not only mean that you have flat feet, but also indicate that you are susceptible to completely different diseases. For example, such as a violation of the vascular or endocrine system. Therefore, it is better to undergo a full examination in the office of a specialist doctor, identifying such symptoms during home checks.
There are several home ways to determine flat feet and its degree.
One of the first simple home ways to determine the disease is the following: smear your feet with any fatty cream or using any homemade dyes. Stand on top of a piece of clean white paper.
You cannot lean on anything, you should stand straight, without bending, only then will it be possible to determine the correct result of home measurements.
The peoples of Spain have such a good expression: “A stream could flow under the feet of a beauty.” Let's apply it to our home footprint inspection. Look carefully, if in your print you can easily notice a recess on the side of the inner edge of the foot, occupying a little more than half the width of the foot, and the inner part forms like a bridge for a stream, then do not worry about deformation.
It was determined that the notch is not so deep or the imprint turned out without indentations, or vice versa - the heel and toes are separate, you should definitely consult a doctor for help, it seems like there really is flat feet. This method is not suitable if you want to determine flat feet in young children at home.
The next method to determine the disease is more difficult; here we work with the same traces. Draw a line from the center of the base of the big toe to the center of the heel. We also draw the second line from the center of the heel, but draw it to the point between the bases of the index and middle fingers.
We have determined that the narrowest point of your foot goes beyond both of these lines or is located on the border of the second, then there is no flat foot. Is the outline of this place imprinted between the two drawn stripes? You have first degree flat feet. We determined that the contour is on both lines or extends beyond them, then the second degree, and possibly the third degree of deformation.
Determination of flat feet using the Friland method. The length and height of the foot are measured, then the height is multiplied by 100 and divided by the length. A result of 29-31 is considered normal. We determined the numbers from 27 to 29, then flat feet are likely.
Numbers less than 25 indicate pronounced flat feet.
Take a good look at your feet under calm, home circumstances. Are your feet narrow and your big toe much longer than the rest? These are called “Egyptian”, the risk of flat feet is approximately 50%.
If the foot is wide, the first two toes are the same length, then it spreads out much easier, and the risk of flat feet is very high. To avoid this, walk barefoot more often, do special exercises using home remedies, and be sure to massage your lower limbs, relaxing your muscles.
If your second toe is much longer than all the others, your foot is of average width, then you are not very susceptible to flat feet.
The method of determining flat feet with a mark during home examinations is inaccurate when it comes to a child’s foot. This is due to the fact that in children under 4 years of age the foot is not yet sufficiently developed and is almost completely filled with adipose tissue.
In young children, it is difficult to determine leg deformities during home examinations, so you should take them to a pediatric orthopedic surgeon annually. Having regular home observations of your child’s gait will make it possible to identify limb disease in a timely manner. Flat feet are determined by the following behavior at home:
If you see exactly these signs of your baby’s behavior at home, it is better to contact a specialist as soon as possible. Many mothers are concerned about the age at which it is possible to accurately determine the disease of a child’s legs.
Flat feet can be determined through regular home examinations; its degree in children can only be determined if they are already 5 or 6 years old.
It is easier to correct flat feet from childhood, so it is important to determine at home whether it exists in advance, and having home observations of your child’s behavior will be very helpful.
At the initial stage, flat feet do not greatly affect our lives, but over time they can cause more serious problems. Therefore, it is better to identify the disease as early as possible. There is a concrete opportunity to stop the constant development of flat feet in adults and children, subject to constant home observations. The less deformed the foot, the better for timely correction and stopping the progression of the disease. Therefore, be attentive to yourself and your loved ones!
Normally, a person’s foot rests on the heel, the area near the little toe and the area under the big toe. These areas are held together by muscles, ligaments and tendons. Structurally, this design forms two arches - longitudinal and transverse. Accordingly, flat feet can be longitudinal, transverse and combined, when both arches are poorly formed. Longitudinal flatfoot is easier to diagnose, so this diagnosis is more common - they still see whether there is space between the foot and the floor along the inner surface of the foot or not. Transverse flatfoot can only be determined by a specialist - an orthopedic doctor.
First, parents should know that the foot develops from 3 to 8 years of age. Accordingly, we can talk about flat feet if the child is over 8 years old (according to some sources - only after 12 years). Up to 3 years of age, all children have physiological flat feet, since the foot has a pronounced fat pad, visually creating a flat surface. At 9-16 months, when the baby begins to learn to walk, fat pads on the soles act as shock absorbers, protecting fragile bones from shocks. Accordingly, the question “how to determine flat feet in a 2-year-old child” does not make sense. Children of this age have flat feet by definition, and this is the norm.
Secondly, it should be understood that only a specialist should make a diagnosis. In order not to rack your brains, do not miss preventive examinations with an orthopedist at 1, 3, 6, 9, 12 months and then every six months to a year, depending on the doctor’s recommendations and the child’s condition.
You can, of course, entertain yourself and your little one and conduct a test at home by wetting the child’s feet and then placing it on a thick sheet of paper. The foot prints obtained on it will help to generate some suspicions - nothing more.
If you are suspicious, contact your orthopedist. He will dispel them or, conversely, give recommendations for treatment.
If a child has flat feet, treatment will have to be done. In childhood, this problem is solved with relatively little effort. Required:
Orthopedists are convinced that there is no need to limit a child’s physical activity. For that matter, if you have flat feet, physical education at school is only beneficial. Often parents themselves give their child a certain loophole: since they have flat feet, the physical education group should be for weakened children. At the same time, the same child runs great and plays with friends in the yard. It should be remembered that the cause of flat feet is weak ligaments and muscles, which means they need to be strengthened through physical activity.
Flat feet? Physical therapy will help you. Massage, therapeutic exercises, walking on an uneven surface, for example, on an orthopedic mat, walking barefoot on sand, pebbles, grass, pine and salt foot baths - all these procedures will strengthen muscles and ligaments.
First of all, these are game exercises. Compete with your baby to see who can keep the pillow on their head longer. Ask him to walk on his toes, on the outside and inside of his feet, roll his foot from toe to heel, roll a stick back and forth with his feet, and pick up small objects from the floor with his toes.
Flat feet is one of the most common diseases of the modern world, which is accompanied by visual changes in the legs and inner arch of the foot.
In order to diagnose the disease in a timely manner, you need to know how to determine flat feet in a child yourself. It is not necessary to visit the clinic, stand in queues, or come into contact with sick patients.
It is quite easy to check your child for the development of flat feet. Diagnosis at home consists of several fairly simple techniques.
In order to prescribe treatment as correctly as possible and eliminate the disease once and for all, you need to know not only the symptoms, but also the reasons that provoked the activation of the process.
Experts say that it is possible to determine for sure the presence of foot pathology in children under 5 years of age only if:
Only from the age of 5 (6) years, when the fat pad on the child’s foot dissolves, can one reliably find out whether the child has any pathologies.
The most common causes of flat feet in children under 13 years of age are:
Before deciding which method to use to diagnose pathology, it is necessary to accurately verify the presence of symptoms indicating pathology.
Before deciding which method to use to diagnose pathology, it is necessary to accurately verify the presence of symptoms indicating pathology. The most common signs of childhood flat feet are presented below:
If there are at least some symptoms, experts recommend diagnosing the body, foot, and anatomical structure of the skeleton.
Regardless of what symptoms of the disease appear, there are several methods for determining longitudinal, transverse, and combined types of deformation of the sole.
Diagnosis of the foot using a print is the simplest and most informative. To do this, you need to take a clean sheet of paper and cover the sole with a thick layer of dye. Then step on a sheet of paper with your foot, without additionally leaning on otherworldly objects, without applying much effort.
Once the fingerprint is received, a diagnosis can be made. An important criterion for a child's foot at 5 (6) years old is the presence of a notch on the inside of the foot. If it is absent or narrowed, we can talk about the presence of flat feet, and, accordingly, the development of concomitant diseases.
Diagnosis of the foot using a print is the simplest and most informative.
To establish the most accurate diagnosis, medical institutions use a plantograph, which is a specialized frame with polyethylene. In order to understand and accurately determine the degree of deformation of the foot, the polyethylene plantograph is painted with ink or ink, and a blank sheet is laid on top. Thus, it is possible to obtain an accurate drawing and understand how much the sole has been changed.
Today, thanks to technological progress in medicine, they began to use an electronic plantograph, which can not only make many prints, but also store them in memory for a year or even more. Along with this, this type of plantar makes it possible to obtain images from the plantar, lateral and posterior sides.
Whether there is flatfoot according to Friland can be determined using basic mathematical calculations. To do this, you need to measure the length and height of your foot. After this, the height value is divided by the length and multiplied by 100. Normal indicators are values in the range of 29-31. If the diagnosis showed an index of less than 25, then we are talking about a pronounced degree of flat feet and the need for urgent contact with an orthopedist.
Whether there is flatfoot according to Friland can be determined using basic mathematical calculations. To do this, you need to measure the length and height of your foot.
If the baby’s thumb is much longer than the rest, then the risk of developing flat feet is reduced to 50%. This foot shape is also called “Egyptian”. For the development of pathology in this case, the presence of several predisposing factors is necessary.
If the baby’s foot is wide in normal condition, and the first and second toes are the same in length, then the risk of developing foot deformities is much greater, and accordingly, treatment of the pathology should begin as early as possible. If only the first symptoms appear in a child, foot deformation at stage 1, then special orthopedic mats, massage, physical therapy, barefoot walking on sand, small stones, and grass can be used as a treatment to prevent the disease. Thus, in a year you can completely cure flat feet and forget about the consequences forever.
If a child has a second toe that is the longest and a foot of average thickness, then we can conclude that the child belongs to a group of people who are not very susceptible to deformation.
If the baby’s thumb is much longer than the rest, then the risk of developing flat feet is reduced to 50%.
Often, within a year, young children learn or can walk well. Therefore, in order to detect the disease in a timely manner, parents only need to be attentive to their children and notice changes.
Of course, children change very quickly, but it is simply impossible not to notice club feet, springy steps, and walking on tiptoes. Another noticeable symptom of the development of pathology in children is the refusal to move independently.
This fact is explained by the fact that the pain that the child feels when the foot touches the surface causes him inconvenience.
In order to prevent symptoms and the development of the disease, experts recommend that children begin special gymnastics every year and buy only high-quality shoes. Orthopedists recommend that children, from the first steps, purchase shoes made from high-quality natural materials with orthopedic instep support, a hard heel and a small heel.
Do not forget that when purchasing shoes for a child for a year, you should take care of a small reserve in size. Most often it is 5-7 mm. This approach to choosing a purchase will prevent the development and deformation of the foot.
In order to promptly prevent the development of pathology in a child, for example, two years old, experts recommend walking the child barefoot on the grass, cleaned sand, and flat stones.
Children's shoes and flat feet – School of Dr. Komarovsky
Orthopedic traumatologist, Moscow
The human foot has two arches: longitudinal (located along the inner edge of the foot) and transverse (located between the bases of the first and fifth toes). This structure of the foot is necessary for a light, “springy” gait, which does not allow the overlying parts, primarily the spine and large joints of the lower extremities (knees and hips), to experience increased shock load.
Flat feet is a foot deformity that results in a decrease in the height of the arch. Such a deformation is fixed, that is, if it has occurred, then it is no longer possible to correct the arches to normal height.
A decrease in the height of the longitudinal arch is called longitudinal flatfoot, a decrease in the height of the transverse arch is called transverse flatfoot, and a decrease in both arches is called combined or longitudinal-transverse flatfoot. In children of older preschool age, longitudinal and longitudinal-transverse flat feet are more common. Young children (approximately 1 to 5 to 6 years of age) are more likely to have plano-valgus feet—a reversible reduction in the height of the arches of the feet—and ankle valgus (i.e., inward or X-shaped ankles). This deformity is associated with weakness of the muscles and ligaments that support the feet and ankle joints. It often occurs in children with dysplastic syndrome (a disorder of the development of connective tissue that is part of the ligaments, manifested by increased mobility in the joint), overweight (obese children, as a rule, are inactive and have underdeveloped muscles, including in the feet), and also in children who begin to stand up and walk early (from 9 months). Therefore, if your child is already standing on a support at 8-9 months and is ready to take his first independent steps, you need to show the baby to an orthopedist. The doctor will help you choose the right shoes depending on how the child places his feet and whether he has an orthopedic problem or is just emerging. In addition, the specialist will reasonably explain to parents the need for their child to wear shoes.
If the baby weighs more than 12 kg by the age of 1 year or you notice that when taking the first steps the child’s feet fall inward, this is also a reason to contact an orthopedist. In older children, you can also notice a heavy gait (the child has difficulty moving his feet, raising them slightly from the surface), uneven foot wear (the heel wears out faster on the inside). The baby may complain of pain in the calf muscles and feet after physical activity (running, outdoor games) or even a short walk for 15–20 minutes. The baby more often asks to be held, prefers sedentary games or walks in a stroller. The above symptoms should also alert parents and prompt them to show the baby to an orthopedist.
The formation of the arches of the feet occurs mainly before the age of 7, so in preschool age you need to pay special attention to correcting and strengthening low arches. The diagnosis of “flat feet” is made at the age of 4–5 years. If you do not strengthen your low arches, flat feet will progress and it will be impossible to correct it.
While the child is small, flat feet do not cause him much concern, but if the problem is ignored, with age, an increase in body weight will contribute to the progression of flattening of the arches due to an increase in the load on the feet, a further decrease in the spring (shock-absorbing, springing) function of the feet. This, in turn, leads to persistent pain in the legs and feet after little physical activity, cramps in the calf muscles, as well as pain in the lower back, knee and hip joints. Pain is a consequence of the fact that with flat feet the center of gravity of the body shifts, a redistribution of muscle load occurs and, as a result, overstrain of muscles that do not normally bear such a load. On the other hand, a decrease in the spring function of the foot with flat feet increases the impact load on the overlying parts, which is also a cause of pain. The impact load contributes to the rapid destruction of the cartilage tissue of the joints and leads to deformations, limited mobility and the appearance of persistent pain in the knees, hip joints, and lower back.
In order to notice the pathology in time and begin its treatment at an early stage of the development of the disease, it is necessary to regularly show the child to an orthopedist. There are so-called decreed deadlines (that is, mandatory, enshrined in law) when the baby is shown to an orthopedist. One of these key periods is 1 year. As a rule, at the age of 1, a child already begins to walk independently and develops a gait stereotype.
At this age, one can already suspect a pathology in the formation of the arches of the feet, so it is necessary to see an orthopedist. Further examination of the child by an orthopedist is necessary once a year.
At the appointment, the orthopedist will examine the child, evaluate the gait - whether the baby places his feet correctly, whether the front parts of the feet turn inward or outward, and whether the feet roll inward.
Foot problems can be assessed using plantoscopy. The plantoscope is a special low table with a transparent tabletop and a mirror placed at an angle. The child is placed on a glass tabletop and the height of the arches of the feet is assessed by the reflection in the mirror. If such a table is connected to a computer, then using a special program the load on all parts of the feet is calculated and the degree of flattening of the arches is measured. This study is called computer plantography; it allows you to accurately determine the degree of flat feet and is used in the manufacture of individual orthopedic insoles. The most effective use of these methods is from the age of 3, when the fat pad disappears. It is located under the longitudinal arches of the feet, raises the arches and acts as a physiological “instep support” for the baby when he begins to walk. During the study, the fat pad creates the illusion of the absence of the longitudinal and transverse arches of the foot.
A simpler way to determine the degree of flatfoot is ink plantography. Contrary to the misconceptions of many parents, the child’s feet are not smeared with ink, the legs remain clean. Ink is applied to a layer of plantograph material. The material on top is protected with cellophane film, which prevents the baby’s feet from staining. This is where the child is placed to obtain foot prints. The feet are imprinted on plain paper, the “footprints” are drawn (one line connects the middle of the heel with the third interdigital space, the second is drawn tangentially to the inner edge of the imprint of the heel and the base of the first toe). Then the distance between these lines in the area of the longitudinal arch notch and the relationship between them and the foot print are measured, and the degree of flatfoot is assessed according to special standards that depend on age. This method is also used starting from the age of 3, when the fatty pad of the foot disappears.
The causes of flat feet are varied. The most severe is congenital flatfoot. It is associated with severe anomalies in the development of the bones of the foot and ankle, which leads to disruption of the relationship of anatomical structures. The most severe forms of this type of flatfoot are detected during the newborn period, while milder forms occur up to 4–5 years. A child with congenital flat feet begins to walk late, his gait is very different from normal, he may limp, twist his feet; During outdoor games he gets tired quickly and practically cannot run.
All other types of flat feet are classified as acquired and are divided into:
static (develops with prolonged static load, especially in overweight children and poorly developed muscles). Such flat feet are often a consequence of untreated plano-valgus feet and result from a longer exposure to predisposing factors on the feet than with plano-valgus feet;
paralytic (occurs as a result of a neurological disease with damage to the nerves of the legs or feet, can occur as a result of trauma accompanied by damage to the nerves of the foot, as well as after suffering polio - a viral infection of the spinal cord leading to paralysis. Considering the widespread vaccination against polio, this disease is extremely rare, mainly in children who, for some reason, were not vaccinated or did not follow the vaccine administration schedule);
rachitic (is a consequence of rickets, a disease caused by a lack of vitamin D in the child’s body). With rickets, the ligamentous apparatus suffers: it becomes more loose, as well as the bones, which receive little calcium, as a result of which their strength decreases, but their elasticity increases (the bones become “soft”);
post-traumatic (occurs after fractures of the bones of the foot or ankle joint with a violation of the anatomical relationships).
In children, post-rachitic, static flatfoot and plano-valgus position of the feet are most common.
Severe forms of congenital flatfoot are treated only surgically. The type of operation depends on the anomaly that the child has. Surgery is performed on bones (bones are cut and rotated) and tendons (tendons are lengthened and grafted onto other bones). Mild forms of congenital flatfoot are treated by applying plaster casts, individually made orthopedic shoes, a set of physical procedures, and therapeutic exercises.
Physiotherapy. The main method of treating acquired flat feet in children is conservative (that is, without surgery). This is a complex multicomponent treatment designed to last several years. The main role in such treatment is played by physical therapy; exercises are performed daily and are aimed at strengthening the muscles of the legs and muscles of the feet. Children can fully engage in gymnastics from the age of 2.5–3 years, when the child is able to repeat the simplest exercises after adults.
The child needs to walk barefoot on his toes, heels, the outer and inner edges of the feet, lift small objects from the floor with his toes (pencils, large buttons, elements of a children's mosaic), and walk on a gymnastic stick. At an earlier age, passive gymnastics is performed - exercises are performed with the help of an adult. Such movements are usually shown by a massage therapist during a preventive or therapeutic massage, and then parents do it themselves. The baby's feet are bent towards the sole and dorsum of the foot, the outer edge of the foot tilts inward.
Physical therapy also includes exercises on a massage mat. It has various irregularities on its surface (for example, pebbles, shells, etc.) and, by irritating the plantar surface of the foot, helps strengthen the muscles. Other massage devices are also used for the same purpose: balls and rollers with soft spikes on the surface. They are rolled with their feet, which helps strengthen the muscles of the foot and lower leg. The mother should show the child how to perform these exercises.
Massage. Another component of treatment for flat feet is massage. Depending on the degree of flatfoot, it is done in courses of 10–15 sessions 2–4 times a year and has its own characteristics. Firstly, not only the feet are massaged, but the entire lower limbs (since not only the muscles of the feet, but also the legs, thighs, and buttocks are involved in the process of walking). Secondly, during the procedure, the massage therapist strengthens the internal muscle group and relaxes the external one. The inner group of muscles of the lower legs is involved in the formation of the longitudinal arch of the foot, lifting it up, so this group needs to be toned (or strengthened). The outer group of shin muscles contributes to the “rolling” of the feet inward (i.e., its action is opposite to the inner group), so this group should be stretched (or relaxed).
Orthopedic shoes. Particular attention is paid to the selection of shoes and instep supports (special insoles that raise flattened arches of the foot). Orthopedic shoes for the treatment of flat feet should have a solid hard back, support the ankle joint well, and have a small heel (1–1.5 cm). An instep support is required inside. Shoes with therapeutic arch supports are sold in specialized orthopedic stores or are made individually, to order (as prescribed by an orthopedic doctor).
Orthopedic shoes are necessary for any degree of flatfoot or for flat-valgus feet. Wearing it begins at the age of 3 (from the moment when the fat pad on the child’s feet disappears) and continues until 5–6 years, then, if the problem remains, they switch to regular shoes, into which insoles-instep supports are inserted.
Shoes with a “standard” arch support are suitable for children with the first degree of flat feet or with a mild degree of plano-valgus feet. If a child has second or third degree flat feet or severe flat-valgus deformation of the feet, then it is recommended to manufacture individual insoles-instep supports for orthopedic shoes.
Arch supports. Therapeutic arch supports are made individually according to the child’s foot and are regularly adjusted in accordance with changes in the feet that occur as the baby grows. As a rule, this happens once every 4–6 months. They also begin to wear arch supports from the age of 3 (from the moment when the fat pad disappears) and use them until flat feet are completely cured or throughout life if the problem remains.
The insole-support is selected according to the size of the child’s foot, depending on the type of flat feet. Such an insole can be intended to treat only longitudinal flat feet (raises only the longitudinal arch) or longitudinal-transverse (raises the longitudinal and transverse arches of the feet).
Physiotherapy. In cases where flat feet are severe, courses of physiotherapy are used. This is most often electromyostimulation (stimulating muscle contraction with electrical signals) of the lower leg muscles and calcium electrophoresis on the area of the knee and ankle joints. Electromyostimulation causes weakened muscles to contract, training them; calcium electrophoresis strengthens ligaments, making them less extensible. Physiotherapy is prescribed in courses of 10 sessions and is carried out 2 times a year.
Operation. Unfortunately, there are situations when, despite all efforts, flat feet progress. In this case, surgical treatment is resorted to. The essence of the operation is to strengthen the arches of the foot with the help of artificial ligaments, as well as to apply special notches to the bones, with the help of which the axis of the bone can be changed. In children, they try to perform the operation in preschool age so that the child goes to school on time already healthy.
A child suffering from flat feet is shown to an orthopedist twice a year.
To avoid flat feet, it is necessary to carry out prevention, starting from a very early age - from the moment when the child begins to stand on his feet.
The baby should put on his first shoes from the moment he begins to stand at the support to prevent incorrect placement of the feet. The child should be accustomed to shoes gradually, putting them on first for 5–10 minutes a day, then every time he gets up. If you showed your child to an orthopedist and the doctor did not find any problems with the feet, it is enough to choose shoes that fit, with a flat insole, a high hard back, lace-up and with a heel 1-1.5 cm high. Shoes for the child should be selected according to size or size. one size larger.
A child should not wear someone else's shoes. Each person wears shoes in his own way, and not always correctly. Therefore, a child who wears shoes for his older brother or sister, if they have problems with their feet, acquires all the problems that the previous owner suffered from.
Methods for preventing flat feet include hardening. It is known that a child who often suffers from colds not only suffers from immunity, but also weakens his muscles due to physical inactivity (decreased physical activity). Therefore, special attention should be paid to hardening.
Hardening includes contrast foot baths , which are done for 5–10 minutes. To carry them out, two containers are taken so that the child’s legs are immersed in water up to the knees. Water at a temperature of 32–33oC is poured into one container, and 40oC into the other. The baby's feet are alternately immersed in cold and hot water for a few seconds. Hardening procedures also include walking on loose soil, sand, pebbles, mown grass, etc. Such procedures should be started only when the child is completely healthy.
Swimming in sea water or warm baths with sea salt also prevents the appearance of flat feet . Water has a massage effect, and sea salt tones muscles and blood vessels.
acquire flat feet by school age . Even more sick people are leaving school.
Where does flat feet come from?
It is not true that children under three years of age do not have flat feet. It can be congenital, or it can arise due to dysfunction of the central nervous, endocrine systems, due to infections and a host of other reasons. The most harmful thing is not pain and deformation, but their consequences - disruption of the entire musculoskeletal system, including the spine. Curvature of the spine in a child can be avoided or at least its development can be stopped if treatment is started in time. The foot is formed before the age of 5. The earlier flat feet are detected, the easier it is to treat. After five years of life, this is already more difficult to do. But by starting treatment, you can improve the condition of the foot, stop the development of flat feet and prevent spinal deformities. It is worth showing the orthopedist a child who quickly gets tired of walking and asks to be held.
Pay attention to the child’s heel: is it standing vertically, is it burning in one direction or another. From a very early age, throughout the entire period of intensive growth of the body - at 3 and 6 months, at 1, 3 and 5 years - it is necessary to regularly visit an orthopedist.
During the period of intensive growth of the body - at 3 and 6 months, 1, 3 and 5 years - differentiation of the shape and structure of bones occurs. Frail bone apparatus, connected by still too tensile ligaments, as well as weak muscles are the cause of significant fluctuations in the height of the longitudinal arches of the foot when loaded. This contributes to the occurrence of static deformations of the feet, which can lead to disorders of statics and kinematics. In children of this age, during the period of learning to walk, conditions arise for the development of planovalgus deformity, since in order to increase the area of support and keep the body in balance, the child spreads his legs wide, leaning on the inner parts of the foot. The widespread belief that flat feet in children under 6 years of age is physiological and does not require correction is not entirely correct. It is up to 5-6 years, when the ossification points are not closed, that it is easier to correct or prevent the development of foot deformities and form a correct gait.
As already mentioned, in young children, flat feet can also be congenital, caused by insufficiency of connective tissue. But congenital flat feet are still a significant rarity.
Much more often, flat feet become the result of a whole bunch of wrong actions.
First of all - low-quality shoes . You can mock the tasteless and scary Soviet children's shoes as much as you like, but medical requirements were strictly fulfilled in them. For the correct formation of a growing child's foot, shoes must have a hard heel that secures the heel, a small heel half a centimeter high (no more and no less) and an insole with a small elastic thickening (instep support) on the inside of the foot.
Now look at the modern shoes for kids that merchants offer us. Flip-flops, shoes with nails, slippers with absolutely flat soles. Socks range from deliberately blunt to extremely tapered. The other extreme is modern sneakers: they are so springy when walking and running that they completely free the foot from this function, and it, like any muscular structure, begins to “be lazy.” Both the shoes described above may instill good taste in your child (and most likely, they will simply amuse your own vanity), but they will quite realistically reward him with flat feet.
To finish the topic of shoes, I note that some doctors advise not to let children wear someone else’s shoes, since a last worn out by someone else’s foot essentially becomes the imprint of someone else’s foot and incorrectly distributes the load on the feet. However, as far as I know, there is no scientific evidence for this yet.
For proper foot formation, children need more than just good shoes. Nutrition also matters . Connective tissue is somewhat similar in composition to bone tissue. And in the same way he suffers from rickets, that is, improper phosphorus-calcium metabolism in the body. With a lack of calcium, as is known, the bones become soft and deformed under the influence of weight and muscles, and the connective tissue of the foot ceases to be elastic and elastic and in the same way submits to the pressure of the body weight.
So even if your baby does not show signs of rickets, do not forget about flat feet - another consequence of calcium deficiency. This means that you should include a sufficient amount of phosphorus- and calcium-rich foods in your child’s daily diet. Don’t forget about getting enough sunbathing or taking preventative vitamin D in the winter.
Like any other muscle function, the formation of an elastic arch of the foot requires development and training. “Barefoot life” is best suited for this . Let the child at least from time to time walk on pebbles, sand, earth, tufts of grass - anything that forces his legs to constantly strain, transfer the weight of the body from one surface to another, from heel to toe. At home, this exercise can be successfully done with the help of small cubes, balls, small non-sharp toys, peas, beans, beans, in short, any uneven floor. At the same time, he can wear thick socks, but not shoes (even with thin soles).
of the prevention of flat feet in advance. But what to do if the doctor diagnoses the initial stage of flat feet? And is it possible to make such a diagnosis yourself, keeping in mind the eternal “unobtrusiveness” of medical care in our country? You should be concerned if:
— the child complains of sore feet after physical activity;
- by the evening the feet get tired and even swell, and in advanced cases the pain reaches the knees;
- the child’s leg grew too quickly, especially in width (in fact, it simply flattened);
— on the child’s old shoes, the heels are worn out on the inside.
a simple test for flat feet not on the loose surface of beach sand, but at home using a piece of not too thick (and not satin) paper and any fatty cream or vegetable oil. Apply cream (oil) to your child's soles and have him step on paper placed on a hard surface (not carpet). You should not put your entire body weight on one leg - you need to stand on both legs at the same time, otherwise the result may be erroneous.
Now look carefully at the fatty imprint of each foot. Normally, there should be no imprint on the inner edge of the foot. If there is an imprint, there is a developed longitudinal flatfoot. If there is no imprint, but the zone of its absence is narrower than half of the sole, this is the initial stage of longitudinal flatfoot.
If there are alarming results, you cannot do without a visit to the doctor. We still don’t have enough specialists in foot problems – podiatrists. So you will have to contact an orthopedist. In a good clinic, an orthopedist will make the final diagnosis based on X-rays or computer scan data of the foot.
In childhood, complete cure for flat feet is still quite possible . Daily exercises for “lazy” foot muscles are done with the help of massage, contrast baths and special gymnastics. In the evenings, soak your child's feet in a hot bath with a tonic infusion of chamomile, pine extract or sea salt. Stroke the steamed feet, and then knead them with force with your thumbs or fist. Stretch the outer edge of the foot especially vigorously - it should be the strongest. After kneading, pour cold water over your feet or wipe with a piece of ice.
The child will have to spend at least 10 minutes a day on special gymnastics Where can a busy student get these ten minutes? Buy a massage mat and place it in the bathroom. While the child is washing and brushing his teeth (twice a day), let him stand on the mat with bare feet, rise on his toes, roll from toe to heel, and stand on the outer edge of the soles.
All children under 2 years of age have a flat longitudinal arch of the foot. Experts consider this condition to be physiological, because the bone tissue in babies is soft and elastic. It contains few minerals, which give bones strength, and the muscular system is not well developed. When children begin to stand on their feet (at 7-9 months) and walk independently (at 10-12 months), the “fat pad”, which is located on the sole, under the skin, takes on the function of a shock absorber. At 2-3 years, the bones acquire a sufficient amount of minerals, the articular surfaces acquire normal shape, the ligaments become stronger, and muscle strength allows you to stay on your feet longer. The process of formation of the bones of the foot continues until approximately 5-6 years of age. Only during this period can we talk about the presence or absence of flat feet in a child.
You should not treat your child on your own. Massage, physiotherapy, corrective devices (orthopedic insoles), therapeutic exercises are prescribed by a doctor, who takes into account the age, severity of the pathology, and also takes into account the main reason for the development of flat feet. As for orthopedic insoles, they must be made strictly individually, taking into account the anatomical, physiological and static-dynamic functions of the child’s foot. Children's shoes should have a small heel, a hard heel and an individual spring instep support - a kind of “stones” and “bumps” under the feet. Only a spring-type instep support will ensure the correct formation of the arch of the foot.
Probably all parents understand that preventive examinations by specialists are not a whim of doctors, but a necessary measure. The main thing is not to miss visiting the doctor. An examination by an orthopedist is carried out:
- in the first month of life, this is necessary to exclude congenital deformities and skeletal diseases, including congenital flat feet;
- at 3 and 6 months of age, when rickets can be detected;
- at 1 year. This is an important stage in a child’s life when he sits, crawls, and walks independently. At this time, the doctor checks the correct natural curves of the spine and the range of motion in the joints;
- at 3 years old. The orthopedist checks posture, gait, measures the length of the limbs, and examines the condition of the feet.
Ideally, from this age on, you should visit an orthopedist with your child every year so as not to miss the development of flat feet. Parents need to be prepared for the fact that the orthopedist (if he doubts the final diagnosis) will refer the little patient for additional examination to a consultative and diagnostic center.
If the child goes to kindergarten, this problem goes away by itself - preschool children in child care institutions are examined quite regularly. And if a child grows up at home until the 1st grade, parents should remember about a mandatory medical examination. Children who are found to have flat feet are monitored by an orthopedist and undergo an appropriate course of treatment until they are 14-15 years old. During this time, they undergo courses of physiotherapy, therapeutic massage, are sent to sanatorium-resort treatment, and, if necessary, special orthopedic shoes are made for them.
If the diagnosis is confirmed
Most often, longitudinal flat feet occur in children. It can be congenital or acquired. The congenital form of the disease is rare and is a consequence of intrauterine malformations. It is already detected in the maternity hospital. In most cases, one foot is affected, but sometimes both are affected. This pathology is very noticeable in children: a convex sole and the forefoot “turned” outward. Treatment is carried out from the first days of the child’s life: the deformation is gradually corrected using plaster casts. If this does not help, they resort to surgery.
Occurs after fractures of the bones of the foot and ankle. Partial or complete damage to the ligaments during such an injury, as well as the child’s prolonged stay in a plaster cast, contribute to the flattening of the arches of the feet.
Occurs due to disorders of the central or peripheral nervous systems (more often - consequences of polio).
This is the most common form of pathology. It occurs due to overload with a significant increase in body weight, usually with obesity and endocrine disorders.
Occurs when there is excessive elasticity of the ligaments and weakening of the muscles of the arches of the foot. The cause may be a lack of vitamins and microelements - with rickets or general exhaustion, as well as with congenital pathology of connective tissue.
So, the foot turned out to be deformed. What happens in the body?
The ligaments send “signals” to the nervous system about trouble in this “area”. In response, the muscles receive an “instruction” to engage in a “fight” with the deforming forces - that is, to tense up as they should. But they are not able to withstand such a load for a long time, so they quickly become exhausted, relax and stretch. And the deforming force continues to act now on the ligaments. Soon, stretching occurs in them (especially if there is a congenital pathology of the connective tissue) since they cannot work for a long time without muscle support. Now all the load falls on the bones. When they cannot stand it, deformation from compression begins. By this time, the ligaments finally “fail” and the deformation enters the final, irreversible phase. The gait loses its plasticity and smoothness. Children often complain of fatigue when walking, pain in the ankle joints or lower legs, and often in the lower back. Some cannot clearly identify where exactly they experience discomfort or pain, so they do not complain, but simply prefer calm, less active games. A deformity of the ankle joint appears (it is also called valgus or X-shaped), as shown in the figure).
If one or more of these signs are present, consultation with an orthopedic doctor .
signs of flatfoot development in a 2-3 year old child.
1. After a short walk (30 minutes or more), the child quickly gets tired, asks to be held, or prefers to move in a stroller.
2. After 1 - 2 months, new shoes lost their original shape (for example, the inner edge of the sole or the heel along the inner edge was worn down, the boot was deformed inward). In these cases, it is necessary to urgently consult an orthopedic doctor.
In a child 3 years old (but not earlier), an initial diagnosis of the pathology can be made using the most common method - plantography (footprint). This is easy to do at home. A blank sheet of paper is placed on the floor, and the baby stands on it with both feet. It is better that the soles are wet, then their clear imprint will remain on the paper. At the same time, the torso must be kept straight, legs together. The outline of the feet in this position is outlined with a pencil. Then a straight line is drawn perpendicular to the contour line, crossing the entire narrow part of the foot. Compare your results with the picture below.
X-rays are not taken for children at this age. Firstly, the bones of the foot have not yet fully “matured”, the cartilage tissue is not visible on an x-ray, and it is difficult to assess the true height of the longitudinal arch. And secondly, this diagnostic method is quite harmful for a child, so it is performed only for serious indications and more often after 9 years.
Unfortunately, one cannot count on complete relief from flat feet, especially with advanced pathology. But you need to be treated carefully, regularly and conscientiously. The earlier the signs of the disease are identified, the smaller the foot deformity, the more favorable the conditions for stopping the progression of flat feet and its correction.
Self-massage will have a very beneficial effect - fortunately, there are many devices for it (special mats, bolsters, balls). Exercises with them are performed arbitrarily (walking on a massage mat, rolling a massage roller with your feet, etc.). As a result, blood circulation improves and muscle tone normalizes. It is better to do gymnastics in the morning, when the muscles are not yet tired. It is better to show the technique and pace of exercises to your child by example. The room should not be stuffy or drafty, and the child should exercise in comfortable clothes that do not restrict his movements.
Gymnastics for flat feet
Starting position: sitting on a chair, feet on the floor. Tuck your toes, repeat 3-5 times; Without lifting your heels from the floor, alternately lift your feet towards you (3-5 times); without lifting your fingertips from the floor, lift your heels (3-5 times); alternately lift only the big toes (3-5 times); lift all your toes one by one, with your feet slightly turned inward, and do not lift your heels off the floor (3-5 times).
Starting position: sitting on a chair, feet on the floor. Run the big toe of your right foot along the front surface of the shin of your left leg from bottom to top (3-5 times). Repeat the same with the big toe of your left foot (3-5 times). You can complicate the exercise and try to pull the knee socks onto the shin of your left leg with the big toe of your right foot. Then change legs.
Starting position: sitting on a chair, one foot on the ball, the other on the floor. With your foot on the ball, swing it left - right, forward - back, 3-5 times. Change legs and repeat the exercise. Next, grab the ball with your feet and hold it suspended for several seconds, lower it to the floor, and then lift it again (3-5 times).
Starting position: sitting on a chair. You can put a piece of fabric, small objects (checkers, elements of a children's construction set, river pebbles, etc.), or a rolling pin under or near your feet. Task: gather fabric with your fingertips, grab and move small objects, roll a rolling pin. You can also roll the rolling pin with all your feet.
Starting position: standing. Stand on your toes (Rise on your toes?) (3-5 times). Turn your feet inward (3-5 times). Walk in place. Walk forward, standing on the outer edges of your feet. Walk along the line.
Starting position: standing. Squat without lifting your heels from the floor (3-5 times). If possible, walk on the rungs or walk on uneven, bumpy surfaces. You can also balance on the ball. (Attention! Adults must insure the child!)
Starting position: standing on a block placed on the floor. Squat on a bar (3-5 times). Stand on the block either on your right or left foot. The feet should be placed across and then along the bar. Also, you can walk several times with side steps across the block and walk along it.
A special role in the treatment and prevention of progression of flat feet is given to the prescription of orthopedic insoles, which are prescribed already at the first degree of pathology. They help relieve painful areas of the foot and correct identified deformities at the initial signs of flat feet. The height of the arches of the feet in the insoles depends on the degree of flattening.
What are the complications of flat feet? Unfortunately, very different. First of all, this is a flattening of the transverse arch of the foot with subluxation of the 1st toe outward in adolescence. If the foot has been in an incorrect position for a long time, and especially if there is a valgus deformity of the ankle joint, this can lead to deformation in the joints of the foot and even to a change in the ratio of the articular surfaces of the knee and hip joints. This is accompanied by pain in the legs, especially in the evening, and a decrease in shock absorption functions leads to pain in the spine. In the future, this can lead to scoliosis, that is, an arched deformation of the spine to the right or left.
The “culprit” for acquired flat feet may be incorrectly selected shoes. As soon as the child starts to stand up, it’s time to buy him his first boots. This usually occurs between 7-8 months. The criteria for “correct” children's shoes are clearly defined. The first shoes should:
- Secure the foot and ankle joint tightly using lacing or Velcro, but in no case squeeze the leg or be too loose.
— Have a minimum number of internal seams so that the baby does not rub the skin around the ankle joints.
— Natural materials should be used in their manufacture (including insoles).
— The back should be high, rigid, reaching the border of the lower or middle third of the shin. This is necessary in order to avoid lateral curvature in the ankle joint.
— It is better if the surface of the shoes is perforated so that the feet can “breathe.”
— The sole should be stable and non-slip, with a small (1 - 1.5 cm) heel. In addition, it must be tough. This prevents hyperextension of the foot joints and hyperextension of the ligaments. And for your baby at home, boots with leather soles are quite suitable.
— Shoes for children under 2 years old should not have an instep support, because the function of a shock absorber is performed by that same “fat pad,” otherwise it will interfere with the normal formation of the arches of the feet. True, everything is very individual. Perhaps some children will have to choose shoes without arch support even at an older age. It is better to discuss this issue with your doctor.
— When trying on, you need to take into account that the shoes have a margin that does not interfere with the child’s walking - about 1.5 cm.
— After a walk, you should pay attention to the baby’s feet: if the texture of tights or the inner seams of a shoe are imprinted on the skin, the shoes need to be changed. This will give little feet a chance to rest from their usual position, and if the child’s feet are sweaty, the damp shoes can be properly dried without compromising the next walk.
Confirming the presence of flat feet helps not only with a correct examination of the child’s feet, but also with planetographic observation of foot prints. The most accurate method for determining the size of the arches is radiography while standing under load.
Starting treatment for flat feet at an early age helps not only to protect the arches, but even to make them larger, saving the person from the defect.
It is already too late to try to correct feet in adolescence, and the goal of treatment at this age should be to stabilize flat feet, improve the functional state of the child’s legs and spine, and prevent deformities of the toes.
Children with flat feet should always wear orthopedic insoles - arch supports or insoles that create arches. Then, when not only the height of the arches is reduced, but also there is an incorrect alignment of the feet, it is recommended to wear orthopedic shoes.