Flat feet most often develop in childhood and, as they grow older, can negatively affect a person’s entire subsequent life. With the development of flat feet, there is a violation of the supporting function in the lower extremities, which contributes to the deterioration of circulatory processes, the appearance of pain, and sometimes even cramps in the legs.
At the same time, the foot is cold and cyanotic, and its flattening affects the child’s posture, the position of the spinal column and pelvic bones. With flat feet, the gait changes. She becomes awkward and tense. When moving, children stomp loudly and perform chaotic movements with their arms, bending their legs at the knees.
In preschool age, the foot is intensively formed, which is why the prevention of flat feet in preschool children is so important, helping to avoid functional disorders of varying severity. During this period of time, the child’s body is most flexible, and it is quite possible to stop developing flat feet, as well as correct improper formation of the feet by strengthening the ligaments and muscles of the feet.
The condition of the foot affects the ease of walking, smoothness of movement and the amount of energy spent. The structure of the foot allows you to maintain support and shock absorption while walking. The main part of the foot is bone tissue, which is connected by joints, muscles and ligaments.
Footprint (footprint) on a plantogram showing a violation of spring function
A child's feet are significantly different from an adult's. During the first years of a baby’s life, most of the foot is made up of cartilage tissue, the ligamentous apparatus is more elastic and extensible, and the muscles do not have sufficient strength.
In addition, the load on the supporting part of the feet is much greater, compared to an adult, due to an increase in body weight in relation to the size of the foot. If you compare the foot of a child and an adult, then in children it seems more awkward, heavy and flat. However, until the age of three, this is quite natural, because the recesses of the arches of the feet in children of this age are filled with a fatty soft pad, masking the anatomically correct base of the bone.
In the event that one of the arches of the feet declines due to muscle weakening, the load is distributed to other points. At the same time, they experience increased pressure, leading to deformation of the feet and the development of a certain stage of the disease.
Before developing a method for treating and preventing flat feet in children, it is important to know the cause of its occurrence. As a rule, congenital changes in the feet are extremely rare. Such consequences are the result of rickets and early overload of the body.
The main reasons for the development of flat feet in children are:
One of the most important reasons for the development of flat feet in children of preschool age is incorrectly chosen shoes (too tight or, conversely, loose). It is especially dangerous to buy children’s shoes “for growth”, to allow the child to wear warm shoes indoors, etc. In addition, shoes must have a locking heel to support the foot and develop correct posture.
To successfully prevent flat feet, it is recommended to use the entire range of measures, including physical exercise, natural conditions and hygiene procedures.
Natural health-improving preventive measures to prevent flat feet include children walking without shoes (barefoot) on a natural surface (grass, soil, sand, pebbles, etc.), which allows them to develop the tactile and functional ability of their feet.
Hygienic measures include the correct choice of shoes to ensure the anatomical position of the feet. You should choose shoes only from natural materials to ensure good air exchange. There must be an instep support inside that lifts the foot from the inside, and the sole must be as flexible as possible. It is necessary to choose shoes with a small heel (from 5 to 10 mm) to protect the heel area from bruising when walking. The shoe size must match the child's foot size.
The main role in prevention belongs to special exercises that can effectively correct the first signs of flat feet. Gymnastic exercises should be developed by a pediatric orthopedist, but they can be performed both in kindergartens and independently.
Prevention of flat feet can be performed in accordance with the following set of exercises, each of which should be performed at least 10 times and always in a playful way:
Game elements allow you to turn a serious procedure into a fun activity. At the same time, the child remembers the poems that the kindergarten teacher or parents recite and in the future can perform gymnastics independently.
A set of gymnastic exercises recommended for flat feet
Preventing the development of flat feet requires effort and patience on the part of adults. Physical activity must be combined with proper nutrition. In addition, you should follow the recommendations of your doctor and adhere to a sleep and rest schedule.
There are additional ways to combat flat feet in childhood.
These include:
Preparing for the procedure does not take much time. To prepare a bath, you need to pour water (up to the child’s ankle), dissolve a little sea salt in it, leaving crystals at the bottom of the bath for the child to walk on until completely dissolved. This kind of massage is a good prevention of flat feet.
A consultation with a highly qualified orthopedist will allow you to increase the list of necessary manipulations to obtain maximum effectiveness. In addition, it is good to combine this procedure with contrasting leg washes, which increases blood circulation in the lower extremities and improves the child’s general condition.
Various types of massage help to cope with flat feet. It is best, of course, to trust a professional, but you can perform the massage yourself.
A massage mat can be made using any available materials.
First of all, it is recommended to warm up the body with gymnastic exercises or a contrast shower. The massage should be performed from the upper thigh, moving to the calves and then to the Achilles tendon. Next, massage the outer and inner sides of the feet with a gradual transition to the soles. The duration of the massage is 20–25 minutes. In addition to massage, you can make a special massage track by sewing and gluing various objects onto its surface (buttons of different sizes, pumpkin seeds, beads and other materials). The baby happily “travels” along the fairy-tale path, while massaging his feet.
Currently, flat feet are one of the most common problems in childhood. Not attaching importance to this problem is a deep misconception, because the disease in advanced forms is dangerous due to the possibility of developing problems with the spine, especially at school age. This, in turn, leads to pain in the back, neck and joints. Therefore, preventing flat feet in childhood is of great importance. Prevention should be carried out not only by preschool institutions, but also by parents themselves. Only with an integrated approach can undesirable consequences in the future for an adult be avoided.
Methodological recommendations for instructors and methodologists of physical therapy, teachers of preschool institutions, physical education teachers
N.G. Konovalova, N.V. Kovalenko
Department of Physical Therapy, Physiotherapy and Balneology of Novokuznetsk GIDUV.
1. List of abbreviations
3. Foot as an organ
4. Diagnosis of flat feet
5. Prevention of flat feet
5.1. General issues
5.2. Therapeutic exercises for flat feet
5.2.1. Objectives of therapeutic gymnastics
5.2.2. Therapeutic gymnastics technique
5.2. Approximate list of special exercises
5.3. Self-massage of feet
5.4. An approximate set of gymnastics for the prevention of flat feet
children 4-6 years old, presented in a playful form “at the king of the monkeys”
7. Organization of preventive physical education in a preschool institution
GSS - ankle joint
Preschool educational institution - preschool educational institution
I.P. - initial position
KS - knee joint
MM - maximum power
TBS - hip joint
HR - heart rate
g—gravitational acceleration
Flat feet is a deformation of the foot, which consists in reducing its arches.
Flat feet are not just a cosmetic defect. It is often accompanied by pain in the feet and legs, increased fatigue when walking, difficulty running, jumping, deterioration of coordination of movements, overload of the joints of the lower extremities, and an earlier appearance of pain syndromes of osteochrondrosis.
The causes of flat feet are: congenital pathology (11.5% of all congenital foot defects), rickets, diseases of the nervous system (paralysis, paresis of the lower extremities, general muscular hypotonia and others), foot injuries (fractures of the bones of the foot, ankles, wounds with nerve damage , tendons, muscles) and inadequate static load. As a rule, several reasons act in combination. More often, more or less pronounced factors such as rickets, general muscle hypotension, and inadequate static load are at play. The reason for the latter usually lies not in a violation of the motor regime, but in the wearing of irrational shoes by children with impaired muscle tone and increased elasticity of the bursal-ligamentous apparatus.
2.Foot as an organ
The foot is formed by 26 bones, not counting the sesamoids, connected to each other by joints and ligaments. The latter give the foot a rather complex shape, reminiscent of a spiral or propeller blade and providing mobility in three planes. The activity of 42 foot muscles and lower leg muscles helps maintain the shape and function of the foot.
The feet undergo changes throughout a person’s life, but the formation of the arches of the feet occurs most intensively in the first 7 years. Further, periods of rapid growth of the child during school years and periods of hormonal changes will be critical for maintaining the shape and function of the feet.
The foot in the human body performs three biomechanical functions: spring, balancing and pushing. With flat feet, all functions of the foot are affected.
Spring function - softening shocks when walking, running, jumping. It is possible due to the ability of the foot to elastically flatten under the influence of load and then regain its original shape. Studies have shown that when walking quickly in hard-heeled shoes on a parquet floor, accelerations at the heel reach a value 30 times greater than the acceleration due to gravity (g). In people with healthy feet, the acceleration on the lower leg is 5-6 g, and only 1 g reaches the head. With flat feet, shocks are more sharply transmitted to the joints of the lower extremities, spine, and internal organs, which contributes to the deterioration of conditions for their functioning, microtraumatization, and displacements.
Balancing function - regulation of a person’s posture during movements. It is performed due to the possibility of movement in the joints of the foot in three planes and the abundance of receptors in the bursal-ligamentous apparatus. A healthy foot sculpturally covers the unevenness of the support. A person feels the area through which he passes. With flat feet, the position of the bones and joints changes, the ligamentous apparatus is deformed. As a result, children suffer from coordination and stability.
The push function is the message of acceleration to the human body during movements. This is the most complex function of the foot, as it uses both springing and balancing abilities. The weakening of this function is most clearly manifested when running and jumping.
Another function of the foot has been known since ancient times, which is not directly related to biomechanics. The foot is an area rich in nerve receptors and is the “energy window” of the body. It is known that cooling the feet causes a reflex constriction of the vessels of the mucous membrane of the upper respiratory tract, which is most pronounced in an unhardened person. In traditional Eastern medicine, it is believed that through the foot you can access any part of the body.
3. Diagnosis of flat feet
Children suffering from flat feet may complain of increased leg fatigue, pain in the feet and legs when running, long walking and at the end of the day. Headaches may appear after physical activity as a result of decreased spring function of the feet. In the feet, pain is localized, as a rule, in the arch of the foot, at the inner edge of the heel, in the talocalcaneal-navicular joint, under the ankles. In the lower legs, pain is localized in the calf or tibialis anterior muscles. The height of the inner and outer arches of the foot is reduced, the foot is lengthened and expanded in the middle and forefoot. The navicular bone may be visible through the skin on the medial side of the foot. Characteristic features include a shuffling gait with the toes pointed to the sides, when standing, the tendency to place the foot on the outer edge, and uneven wear of the shoes: the inner part wears down faster.
Figure 1 Figure 2
The diagnosis of flat feet is confirmed by plantography - taking prints of the feet. To carry out plantography, use a plantograph frame with a waterproof fabric stretched over it and smeared with paint on the bottom side. The subject places his foot on the plantograph and stands with an even load on both legs. The foot being examined is circled. Sometimes a dot is placed between the 3rd and 4th fingers at the level of the heads of the metatarsal bones. On the plantogram, this point is connected to the center of the heel. The resulting line is the boundary of the cargo and spring arches. Normally, the cargo vault is painted over, the spring vault is free. There are other ways to process a plantogram. The figures show examples of plantograms of healthy (1) and flat (2) feet. Sometimes radiography is necessary to clarify the diagnosis.
4. Prevention of flat feet
Prevention of flat feet at the earliest stages includes timely and complete treatment of rickets, pathologies of the central nervous system, strengthening the muscles and ligamentous apparatus of the lower extremities with the help of gymnastics and massage. In a later period, starting from the year when the child masters a vertical posture, wearing sensible shoes is no less important when walking.
Rational (orthopedic correct) shoes for healthy children under three years of age are shoes that fit tightly but do not compress the leg, with a rigid back that fixes the heel in the correct position, a heel 0.3-0.5 cm high, and a sole that allows for rolling. Healthy children under seven years old also need shoes with a small heel (up to 1 cm) and the ability to roll. The back may be soft. It is harmful for preschool children to walk barefoot or in socks on the floor. They can walk barefoot on sand, pebbles, grass, up and down an inclined plane, over peas, and beans.
To prevent flat feet and strengthen the muscles of the feet, it is useful to use Planta exercise insoles, in which the arch area is lined with massage elements. It is recommended to wear these insoles no more than 5-6 hours a day. It is convenient to insert Plant insoles into shoes that a child wears in a child care facility. The time a child is active in a preschool educational institution is approximately equal to the recommended time for wearing insoles. On weekends, the child does not attend preschool education and the feet rest.
If there are foot defects, it is useful to use orthopedic insoles to help correct the defect, or to carry out special shoe correction.
4.2.Therapeutic exercises for flat feet
4.2.1. Purpose and objectives of therapeutic exercises
The goal of therapeutic exercises is to form and strengthen the arches of the feet.
The objectives of therapeutic gymnastics: development of the basic functions of the feet; learning how to place your feet correctly when walking; increased tone, decreased length of the tibialis anterior, extensor digitorum longus, extensor digitorum longus, short muscles of the feet; increase in length, elimination of hypertonicity of the triceps surae muscle; strengthening the ligamentous apparatus and increasing mobility in the joints of the feet; improving blood circulation in the feet; improved coordination of movements.
4.2.2.Methodology of therapeutic exercises
When performing gymnastics, special exercises are combined with general strengthening exercises in a ratio of 3:1, 4:1. At the beginning of the course, the exercises are performed from the starting positions (I.P.) with unloading of the feet: sitting and lying down, then exercises from the I.P. are included in the complex. standing, walking. Gymnastics must be combined with manual or hardware self-massage. When teaching children of preschool and primary school age, it is advisable to use a variety of bright objects and conduct classes in the form of a game.
The effectiveness of therapeutic exercises increases if it is used in combination with water procedures, hardening, balanced nutrition, optimal motor mode, wearing shoes appropriate for the child’s age, and in case of illness - special shoes and orthopedic insoles.
Special exercises for flat feet include exercises that help strengthen the tibialis anterior, extensor digitorum longus, extensor digitorum longus, short foot muscles, increase the length of the triceps surae muscle, and form the arch of the foot. Effective exercises include grasping and shifting small and large objects, rolling objects, walking on a stick, hoop, ribbed board, treadmill, walking on toes, on heels, on the outside of the foot.
4.2.3. Approximate list of special exercises.
I.P. lying on your back.
1. Plantar and dorsiflexion of the feet, holding each position for 4-6 seconds.
2. Circular “bicycle” leg movements with an emphasis on foot movements.
3. Simultaneously clenching your fingers and toes into fists, followed by spreading your fingers.
4. Circular movements of the feet in and out slowly with maximum amplitude.
5. Grabbing a large object (ball, sandbag) with your feet, placing it behind your head and then returning to IP.
6. Alternately and simultaneously stretching your heels for 4-6 seconds.
7. I.P. Lying on your back, legs bent at the knee (KC), hip (Hip) joints, soles on the floor. Raising and bringing the heels together.
8. I.P. as in 5. Alternate and simultaneous lifting of the heels from the floor and holding for 4-6 seconds.
9. I.P. as in 5. Spreading the legs with placing on the toes, bringing down the legs with placing on the heels.
I.P. sitting on the floor. Hands at the back. Legs are straight.
1. Alternately raising straight legs with simultaneous dorsiflexion
2. stop and hold for 4-6 seconds.
3. Straight leg raise, dorsiflexion of the foot. Flexion of the leg in the knee joint simultaneously with plantar flexion of the foot. Extension in the knee joint, plantar flexion of the foot, acceptance of I.P.
4. I.P. sitting on the floor. Hands at the back. The legs are bent in the knee joint, hip joint, feet are on the floor. Raising and bringing the heels together.
5. I.P. as in 3. Grabbing small objects in front of you, placing them on either side of you, and then returning to their place.
6. I.P. as in 3. Grasping a large object with your feet, straightening your legs in the KS, returning to IP.
7. I.P. as in 3. Corrugating the rug with feet.
8. I.P. as in 3. Rolling a small ball with each foot.
9. I.P. as in 3 Rolling with the feet of a stick.
10.I.P. as in 3. Leg extension with heels, extension with toes.
1. Raise on your toes.
2. Heel rise
3. Half squats on toes.
4. Lifting onto the outer arches of the feet.
5. I.P. standing, toes together, heels apart. Half squats.
6. I.P. standing on a gymnastic stick. Squats.
7. Walking in place without lifting your toes from the floor.
8. Turn the torso to the sides without lifting the feet from the floor
9. Heel spread, I.P. Breeding socks, I.P.
Walking exercises
1. Walking on your toes.
2. Walking on your heels.
3. Walking on the outer edge of the foot
4. Walking on your toes in a half squat.
5. Walking on a gymnastic stick, wall bars with an additional step.
6. Walking with a high hip lift, plantar flexion of the foot.
7. Walking on a ribbed board.
8. Walking on an inclined plane
9. Walking along the trail.
For self-massage, it is convenient to use a massage mat or massage roller. Rubber products have the following advantages over plastic ones: 1) they have a gentler effect on the child’s tissues;
2) the massage elements that make them up can be grabbed with your toes. The duration of hardware self-massage is 2 - 5 minutes, depending on the age and preparedness of the children, and the total duration of the lesson. Self-massage can be performed as a separate procedure, or included in a therapeutic exercise class as an introductory or final part. The force with which the feet press on the massage mat (roller) is determined by the sensitivity of the child. During self-massage, children should not experience pain. The first procedures are carried out while sitting. Subsequently, the introductory and main parts are carried out sitting, the final part - standing. After the massage, it is useful to lie down for a few minutes with your legs raised above a horizontal surface.
I.P. sitting on a chair.
1. Longitudinal rubbing of the feet, moving them forward and backward along the mat simultaneously and alternately.
2. Circular rubbing of the feet, moving them in a circle, moving the load from the heel to the toes along the outer arch simultaneously and alternately.
3. Cross-rubbing the feet, moving them to the sides and towards the center. Performed simultaneously with both legs.
4. Grab the fibers of the mat with your toes and hold for several seconds.
5. Grab the fibers of the mat with your toes and try to supinate your feet without releasing the fibers.
6. Grabbing the lint of the mat with your toes and trying to spread your feet apart (tear the mat) without releasing the lint.
1. Longitudinal rubbing of the feet, alternately moving them forward and backward along the mat.
2. Longitudinal rubbing of the feet with an emphasis on the outer edges.
3. Roll from heel to toe and back while standing on the mat.
4. Raising and bringing your heels together while standing on the mat.
5. Extension and abduction of the forefoot while standing on the mat.
6. Alternately lifting the legs, grasping the fibers of the mat with the fingers of the lifted foot.
4.4. An approximate set of gymnastics for the prevention of flat feet in children 4-6 years old, presented in a playful form “at the king of the monkeys”
Today we will go to visit the king of the monkeys. Monkeys are like children, but they can do everything not only with their hands, but also with their feet. They are sometimes called four-armed for this reason.
1. Let's go around the hall. Normal walking.
2. How tall the grass is. We walked on our toes and raised our hands up. So I'll see you guys. Walking on toes, arms up.
4. So we passed this section. Normal walking.
1. Swamp, walking is dangerous. We walk strictly along the trail. Walking along the trail.
2. We cross the stream. Walking with a side step on a gymnastic stick.
3. Ducklings are walking near the stream. Walking on your heels, hands on your shoulder joints.
4. Some suspicious noise in the forest. Let's go quietly. Walking in a half-squat on your toes.
5. This is the bear coming. Walk on the outside of the foot, hands on the belt.
6. Here we come. Monkey houses are already visible. Normal walking, lining up along the hoops.
7. The little monkeys also want to see us: they rise on their toes. Raising on your toes, arms up. Inhale. I.P. exhalation.
1. The monkeys turn to the right, look at us, turn to the left, they want to see us all. I.P. main stand. Turns to the right with the right arm abducted to the right - inhale, IP - exhale. Turns to the left with the left arm abducted to the left - inhale, IP - exhale. Performed without lifting your feet.
2. The monkeys show us what kind of balls they have. I.P. standing on a hoop, holding a ball in his hands. Half squat, lift the ball - inhale. I.P. - exhale.
3. Balls are probably monkeys’ favorite toys. I.P. Same. They picked up the ball, put their right foot back on the toe - inhale, I.P. - exhale.
4. The monkeys decided to show us all their toys: they sat down in front of their houses and with their legs they took out small toys from the houses. I.P. Sitting.
5. Hands in support behind. The legs are bent at the knee joint, hip joint. Grabbing small objects in front of you with your feet and moving them to the right and left.
6. Now the monkeys decided to play with big balls. I.P. as in 14. Grabbing a large ball with your feet, straightening your legs in the KS - exhale, I.P. - inhale.
7. Monkeys are very flexible. They straightened their legs and bent over, reaching for their feet with their hands. Tilt to straight legs - exhale -4-6 seconds. Feet in dorsiflexion position. I.P. inhale.
8. The monkeys collect their toys in the house. Grabbing small objects with your feet on the right and left and moving them in the center in front of you.
9. The monkeys went for a walk. Here they are walking along an inclined log towards a tall tree. Walking on an inclined gymnastic bench.
10. Climb the tree branches higher and higher. Wall climbing.
11. They move from one tree to another. Walking with side steps on the wall bars.
12. Descend to the ground. Wall climbing.
13. They walk along a rocky ridge. Walking on a ribbed board.
14. And they end up right on the shore with an abundance of small pebbles. Monkeys massage their feet. Foot massage using roller massagers.
15. The monkeys returned home. They went to their houses. They curl up in balls and rock themselves to sleep. Rolls in a group.
16. The monkeys straightened up, relaxed, listening to their feet resting.
The effectiveness of preventive procedures will be even higher if hardening is included in the complex. Hardening the feet allows not only to improve regional blood supply, but also to improve the health of the body as a whole.
The most common is foot soaking, since it has a pronounced effect on the prevention of colds. To do this, water from a watering can, ladle, tap or shower is poured onto the legs and feet for 15-20 seconds. The water temperature is taken at 30 degrees Celsius, gradually reduced by 1 degree per day and brought to 14-16 degrees.
Contrast dousing of the feet is even more useful. This procedure trains the reaction of blood vessels to temperature changes. The combinations of warm and cold water are varied. Healthy children - the first group - receive douches according to the scheme 38-18-38-18. Children of the second group receive a more gentle regime both in terms of the number of shifts and the temperature difference of the water: 38-28-38. For weakened children, contrast douches are carried out, changing the temperature very gradually, starting from 25-36 - warm water and gradually bringing it to 40-41, cold - from 24-26, gradually reducing to 18. Dousing the feet is usually carried out after a day's sleep. The feet are wiped dry, or not wiped, and allowed to dry. The latter option prolongs the effect of the refrigerant.
Sometimes barefoot walking on a water path, grass, or earth is used to harden the feet. When walking indoors, the floor temperature is not advisable below 18 degrees. Weak children are recommended to start walking in socks, and after a week - barefoot. Procedures begin with 3-5 minutes, gradually increasing by 1 minute per day. Before putting on shoes, wash your feet with cool water, the initial water temperature is 36-35, followed by a decrease of 1 degree per day to 20 degrees.
Walking barefoot is useful not only as a prevention of flat feet and an element of hardening to the cold. Walking barefoot on hot sand, cold pebbles, and pine needles is tonic, and walking on warm sand, road dust, and grass is calming. Walking barefoot on prickly surfaces: stubble, cones and other prickly materials, preferably of natural origin, triggers an “avoidance reflex” associated with an increase in tone and a decrease in the length of the arch-forming muscles, an increase in the arch of the foot and the removal of soft tissues in the arch area from the pricking surfaces.
In Sparta, known for its set of rules for raising healthy people, children under 10 walked only barefoot. Socrates was also a supporter of this approach. Knowing the benefits of walking barefoot, it is necessary to remember that long-term walking barefoot on hard, flat surfaces (on the floor) helps to flatten the feet.
6.Organization of preventive physical
culture in a preschool
The main objectives of the kindergarten for physical education are:
1. Protection and promotion of children's health.
2. Formation of vital motor skills of the child in accordance with his individual characteristics, development of physical qualities.
3. Creating conditions for the fulfillment of children’s needs for physical activity.
4. Fostering the need for a healthy lifestyle.
5. Ensuring physical and mental well-being.
Successful solution of the assigned tasks is possible only if all means of physical education are used comprehensively.
Considering the high percentage of orthopedic pathology, in particular foot deformities in children, there is a need to increase the volume of targeted physical activity using traditional and non-traditional forms of physical education throughout the child’s stay in kindergarten. Rational distribution of physical activity, regulated in form and intensity, allows you to fully satisfy the biological need for movement, corresponding to the functional capabilities of a growing organism, while simultaneously strengthening the muscles and ligamentous apparatus of the lower extremities.
However, all this requires certain changes in the work of preschool staff.
Scheme of rational motor mode.
Flat feet, without exaggerating at all, can be called a universal disease, given its widespread prevalence.
To verify this, it is enough to remember your relatives and friends - at every step you hear complaints about pain in the feet, leg muscles, knee and often hip joints and spine, which are a consequence of flat feet.
This is a kind of price that humanity pays for life in civilization. The increasing debility of our muscular system, a sedentary or, even worse, standing lifestyle, and lack of sufficient physical activity lead to disastrous results.
Long before psychology became an independent science, the French shoemaker Jean-Baptiste de André and his Italian colleague Salvatore Ferlamo drew conclusions about his character based on the way a person’s soles were erased: erased across the entire width - quiet; only the inner side is erased - greedy; the outer side is erased - wasteful; the backs of the heels are worn out - stubborn, unyielding. There was even a proposal to found a new science - scarpology - to determine the character of a person by his shoes. But its practical value would be small: after all, most people do not want to walk in worn-out shoes.
However, some conclusions can be drawn by examining worn shoes. In the normal position of the heel in a shoe, the heel wears out evenly at the back, slightly sore on the outside. With flat feet, the wear of the heel occurs mainly along the inner edge. If the heels are worn away heavily on the inside and, in addition, the back of the shoe “breaks outward,” this indicates flat-valgus feet. Clubfoot manifests itself in severe wear of the heel along the outer edge and “wrapping” of the shoe inward. Each person has their own individual foot shape and wears their shoes accordingly. Therefore, under no circumstances should you wear someone else’s shoes, even if they are strong and beautiful, especially for children.
Properly selected, comfortable shoes are extremely important for the full development of a child’s feet. Tight shoes, like very loose ones, are harmful and can even cause some foot diseases.
Short and narrow shoes limit movement in the joints, almost completely eliminate the movement of the fingers, lead to their curvature, ingrown nails, and also interfere with sweating and blood circulation. Therefore, feet in tight shoes quickly freeze, and cold feet are a common cause of colds and inflammatory processes in the kidneys and bladder.
Shoes that are too wide and loose lead to instability of the foot when moving, resulting in impaired gait and even possible subluxations in the ankle joint.
In order to choose shoes, you need to correctly determine the size of your child’s feet. You should know that with load it increases, both in length and width. Therefore, only measure the foot size of a standing child.
Place your baby on a piece of paper large enough so that its edges extend beyond the contours of the feet on all sides. Outline the feet perpendicularly with a pencil or felt-tip pen, starting from the middle of the heel along the inner contour to the end of the big toe, then along the outer contour to the same point (Fig. 1).
The size of the foot is determined by its length, expressed in millimeters. The length is measured with a ruler or millimeter tape from the extreme point of the circled heel to the longest toe, rounded upward.
There is a simpler, but less accurate way to determine whether a shoe fits a child's foot. Unlace or unfasten the boot or shoe and place your baby's foot on top of the shoe, placing only the heel in it. In this case, the heel should touch the back of the shoe (Fig. 2). If the toes match the toe of the shoe, much less hang down, then the shoe is too small.
It is necessary that there is a distance of approximately one centimeter between the end of the longest toe and the toe of the shoe (Fig. 3).
When buying new shoes, be sure to pay attention to the heel, it should be quite rigid. This is especially important for children who are often ill, weakened, children with signs of rickets, or with bowed legs. For such children, it is better to buy high boots with laces that securely fix the ankle joints. In summer, you can choose shoes or sandals with a hard and high back with laces or a strap. And don’t forget, the heel is necessary, wide, up to 2 centimeters high (along with the thickness of the sole).
The sole - this is also important - should be elastic so as not to prevent the foot from swaying when walking. It is better to buy leather shoes, with wide and moderately high toes, solid heels that stabilize the back of the foot and a wide, low heel. Don’t forget that a child’s foot grows very quickly, so it is necessary to measure it at least once every 2-3 months in order to notice changes in time and choose new shoes.
Everyone explains the causes of flat feet in their own way: some - heredity, others - poor nutrition, inappropriate shoes, a sedentary lifestyle or, conversely, working “on your feet”, but few people understand that the origins of the disease are rooted in early childhood.
It is appropriate to note here that cases of congenital flatfoot are very rare (from 3 to 10%), most often this is an acquired disease, and, therefore, it can be prevented.
The most effective and affordable means of preventing flat feet is general strengthening of the body and sufficient physical activity of the child.
Already in infancy, the baby should be provided with the greatest freedom of movement, his muscles should develop correctly. You should not restrict your child’s feet with tight socks or tight rompers; children under one year old should not wear boots. Free, unrestricted movements of the baby’s feet and toes contribute to the proper development of the muscles, ligaments and bones of the feet, which ultimately determines their structure and shape. Massage, gymnastics, and swimming strengthen the child’s body, improve metabolism, promote the development of all organs and systems, especially musculoskeletal, and thus prepare the child well for the upcoming stress. A very important stage is the child getting up on his feet and taking his first steps. Anticipating this moment with understandable impatience, many parents try to speed it up, not realizing that they are causing irreparable harm to their baby. Take your time, let your baby crawl as long as possible; crawling is very useful for harmonious physical development. Well, when the child gets up and walks on his own, do not limit his movements with the playpen. Standing for a long time is too much stress for the still fragile bones, muscles and ligaments of the foot.
When a child begins to walk, he spreads his legs wide, thus increasing the area of support. This is normal, but by 2-3 years a correct gait should be formed, in which the child places his feet almost parallel and at a short distance from each other. If the gait is correct, then the load on the feet will be distributed evenly. Otherwise, there is a high risk of developing flat-valgus feet. To prevent and treat this very common pathological attitude, special massage and therapeutic exercises are widely used.
It is very useful to provide the baby with the opportunity to walk barefoot: in the summer - on the ground, grass, sand or pebbles, at home - on the floor, on rugs with embossed surfaces. It’s good if a child climbs barefoot on the wall bars and ladders. You can fill a canvas bag with sand or small pebbles and offer to “trample” it with your bare feet.
Well, in the summer - hide your shoes away, let your child be Mowgli for a little while. Walking barefoot on warm sand and cool earth, grass wet with dew, small pebbles is an incredibly rich sensation!
During walks, do not restrict your child’s movement, do not force him to stand next to you while waiting for transport or during a long conversation with a random friend. Human feet are given for moving, not for standing.
However, if a child complains of fatigue and pain in the feet and legs after playing or walking, you should be concerned and contact a podiatrist for a qualified examination. It is this pain, fatigue or numbness that indicates a decrease in the endurance of the feet - the onset of the disease. At this time, there may still be no changes in the structure of the foot; they appear only after some time has passed. If parents do not pay attention or neglect complaints, further weakening of the plantar muscles and a decrease in the arch of the foot occurs.
Unfortunately, modern urban children do not receive enough physical activity. They are practically immobilized: in kindergarten they play quietly, sitting or standing, at home they sit for hours in front of the TV, walking is limited to going to kindergarten and going shopping with their mother. And as a result, a general weakening of the body, especially the musculoskeletal system, which is in the process of formation.
The lower limbs are “built” over the course of 10-12 years, especially intensively at 3-4 years. And if a child doesn’t walk much, doesn’t run, doesn’t jump, doesn’t climb, his muscles don’t train, are poorly supplied with blood (poorly nourished), and therefore become weak, flabby and even undergo atrophy. The baby is growing, gaining weight, therefore, the load on the feet is increasing all the time. If the muscles weaken, the ligaments connecting the bones of the foot cannot withstand the weight of the body - they are stretched, and the feet are flattened.
This is confirmed by the frequent occurrence of flat feet, both in children and adults who, due to illness, have been in bed for a long time or have quickly gained weight.
So, do not forget - the child must move a lot; Strong, well-developed muscles play a decisive role in the prevention of flat feet.
What can you do to strengthen your foot muscles at home? Not as little as it might seem.
Watch your child's gait both at home and while walking. Allow him to walk around barefoot at home, but not just like that, but to perform various tasks. Teach your child to walk on his toes, on his heels, and on the outer edges of his feet. Encourage him to pick up small objects from the floor with his toes and roll a ball with his feet. These exercises need to be practiced, otherwise both you and your baby will quickly get bored. For example, play with animals: a fox sneaks quietly on tiptoes, a goat loudly knocks its hooves and heels, a bear with clumsy feet walks on the outer edges of its feet. Teach your baby to walk correctly and to evenly distribute body weight on both feet.
The key to healthy feet is proper hygienic care for them. Every day before going to bed, you need to wash your child’s feet and thoroughly dry them, especially the spaces between the toes.
Nails should be trimmed at least once every two weeks. It is better to do this after a general bath or after washing your feet. Nails should be cut crosswise, without rounding them at the sides. Never cut them “to the limit”, to the nail bed, as this is fraught with the development of ingrown nails.
Sometimes you can give your child “sea baths.” Sea salt, 1 dissolved in water, has a beneficial effect on the feet. Pour "sea water" into the bath until it covers the ankles and allow the child to walk along the bottom of the bath. For greater effect, you can lay a relief mat or sprinkle pebbles on the bottom of the bathtub. Why not the Black Sea!
The foot bears a large load when standing, walking, running, jumping and ensures the movement of our body in space. It consists of a large number of bones connected by joints and reinforced ligaments; the movement of which is controlled by muscles and tendons (Fig. 4).
From a biomechanical point of view, the foot has a functionally appropriate anatomical structure, so the smoothness, ease of walking and energy efficiency depend on its condition. As a result of evolutionary development, the human foot has acquired a shape that is optimal for support, balancing, and shock absorption when walking.
Anatomically, the foot consists of three arches, or arches.
The internal longitudinal arch is located from the plantar surface of the calcaneus, passes through the bones of the tarsus, metatarsus and ends on the plantar surface of the head of the first metatarsal bone.
The external longitudinal arch runs from the outer surface of the calcaneus to the head of the fifth metatarsal.
The transverse arch is located from the head of the first to the head of the fifth metatarsal bone.
The inner and transverse arches provide the spring function of the foot, and the outer arch provides support.
Fig 4. Foot, approximate anatomical structure
In the formation of the arches of the foot, an important role is played not only by the optimal relative position of the bones of the tarsus, metatarsus and phalanges of the fingers, but also by the condition of the ligamentous apparatus and the coordinated work of the muscles of the foot and lower leg.
The muscles of the foot, quite numerous, are divided according to their location into two groups: the muscles of the dorsum and plantar surface of the foot. In the second group, the muscles of the eminence of the thumb, the eminence of the little finger and the muscles of the middle group are also distinguished.
The muscles of the dorsum of the foot are involved in the extension of the toes, the soles - in the flexion of the toes, in the adduction and extension of the toes. Of the lower leg muscles, the anterior and posterior tibial muscles and the flexor digitorum longus play a particularly important role in the formation of the arches of the foot.
For good arch support, different toe lengths are important. With the Egyptian type of foot, the first toe is the longest and the likelihood of transverse flatfoot is greater, since the supporting point of the first metatarsal changes. With the Greek type of foot, the second toe is the longest, and the development of longitudinal flatfoot is possible. With this option, the heel bone experiences the main overload. Intermediate foot type - the first and second toes are equal in length, the most resistant to the disease.
Parents should know that a child’s foot is not a smaller copy of an adult’s foot, but has its own anatomical and functional characteristics.
The bone apparatus of a still immature child's foot has a mainly cartilaginous structure; muscles and ligaments are more susceptible to stretching.
Compared to the regular, graceful feet of an adult, a child's feet appear heavy and awkward, and, which often worries parents, flat. If your baby is not yet three years old, then there is no need to worry. The fact is that in a toddler, the vault cavity is filled with a soft fat pad, which masks the correct bone base. You can verify that this flatfoot is imaginary in a simple way: place the child on a table or floor and try to place a finger under his foot from the inner edge. A loose toe will convince you that the bony structure of the foot is separated from the hard surface of the table or floor by a layer of fat.
In addition, in children the ratio of total weight to foot size is much greater than in adults. Therefore, more significant loads fall on the entire supporting surface, especially on the arch area.
The arches of the foot are finally formed by the age of 3-4 years, although relative weakness of the musculo-ligamentous apparatus is observed before 6-7 years of age even in healthy children.
So, a child under three years of age has only a flat foot, without signs of outward deviation of the heel - not a disease, but a physiological phenomenon.
In a child over three or four years old, having flat feet is already a pathology. If you doubt the severity of the longitudinal arches, you can check your foot prints. This is not difficult to do. To do this, just place the child on a sheet of paper with wet bare feet. There will be imprints on the sheet that can be assessed.
Once you've traced your print, you can save it and compare it with another one you took some time later.
To obtain high-quality prints, paint or Vaseline (baby cream) is sometimes used. In any case, the mark on the paper must be outlined so that the contours do not blur.
Voevodskaya V.I., physical education instructor at MBDOU No. 34
Goal: consolidate play exercises to strengthen the foot in a playful way; continue to develop large and small muscles of the legs; perform movements to music; learn to enter an imaginary situation and work in a team.
Using health-saving technologies: breathing exercises, barefooting, reflection
Equipment: hedgehog massage balls, cubes of different colors, Kinder surprise toys, pencils, plastic bottle caps, 2 baskets, cones, skittles, medium-sized balls, handkerchiefs, 2 basins,
Instructor: Guys, do you like to travel? (Yes)
—Have you ever been to a desert island? (Children's answers)
- How can you get there? (children's answers)
— Did you want to go there? (Children's answers)
— In order for us to get to a desert island today, we need to prepare our feet for a difficult journey: get a foot massage (hedgehog massage balls) , walk along the “Health” path (massage path) . Track 1 (Music Barcod - Dooh)
Walking on one knee after another, on toes, (“giants”) , in a column, (“hogs”) on the heels, (“horses”) with high knees, in a column.
Running in a column one after another, along a narrow path (1.5 min) , walking, breathing exercises: “Rainbow, hug me.” (3-4r)
- Guys, we found ourselves on a desert island. Track 2 (Song from the film “Little Red Riding Hood, Desert Island”)
Sounds Music of the Sea Track 3.
Instructor: What should we do on a desert island? (Make yourself a hut) .
1. Instructor: It's time to build yourself a hut.
"Builders". Each child is given 4 cubes of the same color. Whoever builds the hut (“towers” cube by cube) with his feet, pressing the cubes with his feet, wins. Track 5 (Happy Music)
2. Instructor: While we were building our house, a lot of waste building material accumulated in our place. We need to put them in one place.
"Cleaning". Kinder surprise toys, pencils, and caps from plastic bottles are scattered on the carpet. Whose team collects the most “garbage” into their basket by squeezing it with their toes wins. Track 6 (Song “Chunga - changa”)
3. Instructor: Guys, while we were carrying construction materials, building a house, collecting coconuts, our clothes became dirty. You need to wash it.
"Wash". Carry one handkerchief, holding the toes of each foot, walk to the basin on your heels and throw these handkerchiefs into it. Who will carry the handkerchiefs forward? Track 9 (Song “Big Wash”)
Educator: Guys, how do you get off a desert island? (Children's answers) We have a chance to go home to mom and dad. We need to say the magic words “Cribly, crabble, boom” and we will get to kindergarten.
Rhythm: “At the Giraffe” - children lining up scattered.
Reflection: Children tell where they were and why they did foot exercises.
Instructor: To have healthy legs, you need to do foot massage, exercise, and drink vitamins.
(Each participant is given one vitamin “REVIT” - “life”).