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.
This may surprise you, but without exception, all newborn babies come into this world with absolutely flat soles of their feet.
In fact, every baby is an example of flat feet! And only over time, very gradually and not quickly (over 5-6, and sometimes 10-12 years) the child’s feet form a special bend.
This bend serves as a powerful shock absorber for our skeleton. Namely: when walking, running, jumping and other movements, enormous pressure is exerted on the bones of our skeleton (and, very importantly, on the spinal column!), which is “damped” precisely thanks to the special structure of the foot - a slight bend, which is commonly called the “arch.” " How developed or underdeveloped the arch of the foot is, the footprint speaks most eloquently.
This arch forms gradually as the child grows, but the most intense period occurs when the baby begins to walk independently.
Doctors do not consider physiological flat feet in children to be a serious defect. However, usually orthopedists keep a vigilant eye on how the arches of their children’s feet develop over time. And they often advise parents on various preventive measures for the timely and correct formation of the arch of the foot, as well as to strengthen the child’s joints and muscles.
The correct arch of the foot is formed under the influence of a certain group of muscles, which are used best when the baby walks barefoot on an uneven surface - for example, a sand or pebble beach, a grassy lawn, wooden stairs, etc.
Since in our time, modern children most often “come across” ideally flat surfaces (asphalt on the streets, parquet, laminate or linoleum indoors), there are very few options left for preventative maneuvers. The most accessible of them:
When doctors announce to a parent that their children have flat feet (which, we repeat, for children under 5-6 years old is not a sign of illness or some kind of developmental disorder), 95% of them immediately “sin” for the wrong or low-quality shoes.
A sedentary lifestyle plays a real negative role in the formation of abnormal feet. In order for the arch of the foot to acquire the desired bend and strength, it is necessary that the muscles of the foot actively “work.” To do this, you need to make sure that the baby moves a lot during the day, especially on uneven surfaces. Don't pass by - children's slides in the yard, wall bars, sand and pebble beaches, etc.
Let us remind you: orthopedists make a diagnosis of “flat feet” for 95% of all children under the age of 2 years, often forgetting, however, to add that this flat feet is an absolutely normal (physiological) phenomenon - after all, the baby’s foot is just beginning to form... If your baby moves actively , then this infant flatfoot will go away on its own (you won’t even notice!).
And only after 6 years, if the child’s foot still has a flat footprint, does it make sense to think about serious prevention and even mild correction of flat feet. But again, even such a “delayed” formation of the arch still remains within the physiological norm. And only at the age of 12 can a doctor make an official diagnosis of the disease “flat feet” and prescribe adequate treatment.
So, as a rule, flat feet in children disappear on their own around the age of 6-10 years. The legs become less flexible and pronounced arches appear. According to statistics, only 1-2 out of 10 children still have flat feet by the age of 12 years. Which at this age is already awarded one degree or another.
There are three main degrees of flat feet in children over 12 years of age:
If a child has simple flexible flatfoot of the first degree, which does not cause him pain when walking, no special treatment is prescribed. However, he is prescribed an active preventive plan: a special massage, exercises for the feet, insoles for shoes, etc. In this case, there is a high probability that the arch of the foot will form properly and there will be no talk of any flat feet in the future.
With the second and third degrees of flat feet, when the arch of the foot remains unformed and is already rigidly fixed in this position, alas, treatment comes down to only relieving the person of the pain symptoms accompanying the disease. Medical science has not yet learned how to form a “healthy” arch in the foot in the second and third stages of flat feet by any artificial means, but it is quite capable of stopping the progressive deformation and relieving a person of pain when walking. For this purpose, various methods of physiotherapy, thermal treatment, as well as surgical intervention are used.
The first and second degrees of flat feet are very common - almost half of the adult population of the planet (residents of large cities - to a greater extent) suffer from them. For some, an insufficiently developed arch of the foot has been preserved since childhood, while for others, the arch of the foot gradually becomes deformed after the age of 40-45 due to a sedentary lifestyle, excess weight and other circumstances. However, doctors believe that the harm from such flat feet is insignificant and does not in any way prevent a person from living a long life, not burdened with serious diseases.
Rickets in infants: signs of the disease, treatment, prevention
Flat feet (longitudinal and transverse) in children worry modern parents almost from the first step the child takes. As a rule, treatment is prescribed if flat feet persist for up to 5 years or more.
Approximately 3-13% of children experience flat feet at a young age. In fact, this condition is physiological until 8-9 years of age. If the arch disappears when standing and appears when rising on your toes or sitting, then we are talking about flexible flat feet. Dr. Komarovsky, in his advice to young mothers, says that in children of 1 year, with a strong desire, any specialist will find a flattening of the foot, since this corresponds to the normal maturation of the limb.
Attention should be paid to children who have a hereditary predisposition to foot diseases, as well as when scoliosis, clubfoot and gait disorders appear. Congenital hip dislocation and muscle dysplasia can cause overexertion and curvature of the foot. Children with established diagnoses are observed additionally.
Foot injuries, rickets, and congenital muscle weakness form the prerequisites for flat feet. The surgeon detects diseases before a year, but after 2 years, the strengthening of bones and ligaments continues, and it must be monitored by a specialist.
The question of whether diseases are treated in children is decided depending on the diagnosis established by the orthopedist. There are the following types of foot deformities:
You should worry about how to treat your child if there is discomfort or pronounced signs:
The child may refuse to walk and run, or not participate in games that require a lot of stress on the legs. If you complain of pain, you should consult an orthopedist.
By looking at the foot with the naked eye, an experienced orthopedist can identify flat feet. He observes the movement of the foot while walking, sitting, standing or doing exercises, and also examines the child's shoes and wear patterns.
In severe cases, you will need to take an x-ray to determine the degree of deformity. The doctor orders a surgeon to examine the child’s knees and hips to rule out the influence of other limb defects on the shape of the foot.
Most children outgrow the problem, and the doctor will advise you to come back for follow-up examinations. To reduce pain, insoles, inserts and orthopedic shoes are used, which are prescribed by a specialist.
Surgeries are rarely performed until the skeleton is completely formed. At this age, tendon plastic surgery does not bring results. Subtalar arthrorrhiza to form an arch is performed only when the pain increases, since a side effect may be degenerative arthritis in the future.
Concerns about how to treat flat feet in children are dispelled by the doctor's answer - strengthen the leg muscles. In case of obvious deformation, the exercise therapy complex should be developed by an instructor and performed under his guidance.
However, a few simple tips can be recommended to every adult to protect the child:
Children diagnosed with flat feet are strictly prohibited from skating, attending ballet, and doing weightlifting.
It is worth taking active action at an early age so that concerns about how to cure the disease in adolescents are not too late.
Home gymnastics for flat feet is the main way to strengthen your legs:
Increasingly, questions arise about how to treat flat feet in adolescents, when the process has started and cascading anomalies have appeared: ankles, knees, hip joints. A child is taken to a surgeon because of a curvature of the spine or pelvis, but they find out about a foot deformity.
The sooner you start prevention, the more noticeable the effect will be. Up to 12-13 years of age, foot deformities can be corrected. Flat feet are dangerous because the poor shock-absorbing function of the plantar arch leads to rapid wear and tear of the spine, osteochondrosis, and this affects the functioning of the internal organs.
Further treatment of flat feet in adolescents involves the use of arch supports and surgical intervention in case of significant pain.
The task of parents is to catch the disease at a stage when correction is still permissible. Therefore, visits to an orthopedist should not be “for show,” and physical activity should be introduced into a child’s life from kindergarten.
Complex conservative therapy for flat feet is carried out mainly at home, since the process of correcting foot deformities is lengthy and requires great responsibility and patience. In addition to wearing orthopedic shoes and special insoles, it is necessary to carry out therapeutic massage and therapeutic exercises. Exercises help correct not only the shape of the foot, but also posture, especially in children. How to get rid of flat feet at home using simple exercises, read our article.
Many people think that flat feet are not such a dangerous disease as, for example, arthritis, but in vain. It is flat feet that are not treated in time that can become one of the causes of dangerous health complications. These include such “adult” diagnoses as curvature of the spine, osteochondrosis, intervertebral hernia, arthrosis, and arthritis among others.
Can flat feet be treated and how effective can treatment be? The answer is simple - flat feet can be completely corrected only until the child is 6-7 years old, and in adults it can only be corrected. That is why treatment and correction of flat feet are relevant for adults and children, and therapeutic exercises are a good help in complex therapy.
Before you start treating flat feet at home, you need to consult a doctor. This must be done to assess the degree and shape of flat feet, as well as to select orthopedic shoes and insoles.
What can you do yourself at home? These are measures aimed at general health promotion, nutritional correction, walking, classes, exercises and much more.
For the treatment and prevention of bunions (Hallux Valgus) and transverse flatfoot, our readers successfully use the technique developed by leading German orthopedic doctors. After carefully studying this method, we decided to bring it to your attention.
How to cure flat feet with simple exercises, you ask? To understand what happens during exercise, it is necessary to recall that flat feet are a disease of the entire musculoskeletal system. A load that is not distributed correctly can lead to dangerous diseases in adulthood. And treating flat feet only with shoes or insoles is simply ineffective, since you need to strengthen the muscles and ligaments of the entire leg and lower spine, because the innervation of the foot begins in the lumbar region.
A set of exercises for flat feet (click to enlarge).
While walking:
In a standing position:
In a sitting position:
With your body positioned at a 45 degree angle:
All exercises should be done regularly, for 1.5-2 years, devoting 15-20 minutes a day to this. Each exercise must be done several times.
How to cure flat feet with walking, if in some regions it is only warm for 2-3 months a year? In winter, you can adapt a massage mat for walking. Making a massage mat for flat feet with your own hands is not difficult - just attach small objects (buttons, curlers, glass stones and other small objects) to thick fabric with threads or glue.
Early diagnosis and timely treatment are the key to complete recovery. And therapeutic exercises, carried out regularly, can become an indispensable assistant in successful treatment.
For the treatment and prevention of bunions (Hallux Valgus), our readers successfully use the latest remedy in orthopedics. What is its advantage:
The main difference between this remedy is that its action is aimed not only at straightening the big toe, but also at combating transverse flat feet. Thus, the fight occurs not only with the bone, but also with the cause that causes its appearance.
September 19-30, 2016 reception in Odessa. Accepted by doctor Ignatiev Radion Gennadievich. Visit time is limited. Sign up by phone. +38 099 430-93-00. Read more.
Flat feet ICD-10: M21.4 (Flat foot)
According to statistics, 60% of children aged 6-7 years have manifestations of flat feet, and in adulthood, about 75% of patients already suffer from flat feet.
If you consult a specialist in time, you can forever forget about such a disease as flat feet. Unfortunately, it is possible to slightly improve the condition of the feet only before the age of 12-13 years, when the arch of the foot is not yet fully formed and can be corrected.
At a later age, it is impossible to cure flat feet! And it is necessary to treat concomitant diseases of the musculoskeletal system to prevent their progression and reduce pain.
Dr. Ignatiev’s clinic specializes in the diagnosis and treatment of diseases of the feet and spine. Make an appointment with a pediatric vertebrologist using contact numbers.
Flat feet are often accompanied by diseases such as scoliosis, osteochondrosis, intervertebral hernias, and neurocirculatory dystonia, which indicates the need for comprehensive treatment of flat feet.
Flat feet is a disease of the feet, which is characterized by flattening of the longitudinal and/or transverse arch, which leads to rapid fatigue and pain in the feet when walking and standing . But since our feet serve as the “ foundation ” of the body, pain can manifest itself in the back, legs (knees, hip joints), unsteadiness when walking, poor posture, headaches , and more.
There are the following types of flat feet:
With longitudinal flatfoot, the longitudinal arch is flattened, with transverse - transverse, with mixed - longitudinal and transverse. The diagram shows foot prints in normal conditions (a) and with flat feet (b).
Our feet normally perform 3 functions:
When walking, each step is accompanied by an impact on some surface, thanks to the shock-absorbing function (arches) - the force of the push is evenly distributed over the entire foot. But with flat feet, the “impact impulse” is not compensated by the arches of the foot (they are absent) and causes damage to the knee, hip joints and lumbar spine, causing pain in the knees, pelvis, and spine.
Diagnosis of foot sensitivity. Clinic of Doctor Ignatiev
The balancing function ensures that balance is maintained when moving and standing, but since with flat feet the relative position of the parts of the foot is disturbed, the function is not fully performed, then when walking, unsteadiness, instability, and loss of balance can be observed.
The push function provides acceleration when walking. In this case, there is a redistribution of the load on the forefoot, and then a push. But since flat feet often cause pain, shifting the center of gravity and pushing with one point of the foot certainly leads to severe pain and the function is partially lost.
From this we can conclude that with flat feet, the feet cannot fully perform their functions and the quality of life decreases sharply.
This is why it is important to diagnose and treat the problem promptly. The diagnosis of flat feet can only be made at 5-6 years of age, when there are obvious disturbances in the formation of the feet, but a predisposition can be established already in the first years of life. If you establish a predisposition in time and engage in treatment, you will prevent your child from being diagnosed with flat feet in the future! Take care of your baby and make sure that he does not have a predisposition to flat feet or flat feet.
Color podoscopy (Diagnostics of flat feet): A. Longitudinal flat feet 1st degree. overload of the right foot; B. Longitudinal flatfoot in a child. Clinic of Doctor Ignatiev
Normally, the legs are straight and the heel is located in the center of the midline of the leg, but with pathology, the center of the heel may deviate outward (valgus) or inward (varus).
Both varus and valgus are signs of flat feet. With varus, the legs are O-shaped, and with valgus, they are X-shaped.
As the baby develops, he may periodically exhibit both valgus and varus, but by the age of 5 all manifestations should disappear and the foot should be in the center of the midline of the leg. Until the age of 5, one can only talk about a predisposition to flat feet. In childhood, longitudinally planovalgus feet most often occur; if this disease is not treated in time, it will certainly lead to flat feet .
Why is flat feet dangerous?
Flat feet, in addition to pain and disorders in the feet, causes a number of serious changes in the spine, joints and internal organs.
The feet, as the “foundation” of our body, are responsible for symmetry.
With flat feet, disturbances cascade across the entire body, damaging the ankle, knee, and hip joints, pelvic distortion occurs, and scoliosis forms. The lack of shock-absorbing function of the feet leads to rapid aging of the spine, osteochondrosis, and disorders in the spine are reflected in the functioning of the internal organs.
If flat feet occur, it can be almost completely eliminated by the age of 6-7 years, and slightly improved by the age of 11-13 years.
Diagnosis of foot condition
The longitudinal arch is pronounced. Clinic of Doctor Ignatiev
Foot manipulation in adults
At a later age, lifelong use of special insoles (arch supports) or surgical intervention may be necessary.
But remember, insoles and even surgery on the feet will never cure the problems that have arisen throughout the body due to flat feet. Timely prevention and treatment are the key to health.
Flat feet in children is usually a reversible pathology, which is characterized by deformation of the bony arches of the foot. The causes of the disease are diverse, most of them are acquired. The disease can be detected by an orthopedist in a newborn or infant, but is more often detected at the age of 5 years and older.
Treatment of the pathology is usually conservative, but in advanced cases, surgery can be used to stop the destruction of the joints of the legs and spine, which was caused by flat feet. Prevention of the disease should be carried out for all children, but special attention should be paid to it if the child is at risk.
The human foot is a complex combination of bones, ligaments, muscles and their tendons.
Its task is to accept and support the weight of the entire human body, correctly distribute the load when moving, and maintain balance when walking on an uneven surface.
It is the foot that performs the task of shock absorber when walking. All these functions become possible thanks to the structure of this structure, namely the vaults:
In the physiological position, the arches are held in place by ligaments and muscles. Ligaments are passive fasteners that provide strong fixation. The muscles, stretching, change the angles and height of the arches, adapting to the conditions that arise when walking.
The longitudinal arch is a shock absorber that is important during standing and walking. When its angle and height change, longitudinal flatfoot develops. If the angle between the big toe and the first metatarsal bone increases, or between the first and second metatarsal bones becomes more than 10°, they say that the flatfoot is transverse.
As a result of flat feet, the support points of the foot change, which normally are the heel bone, 1st and 5th metatarsals. This alters gait mechanics, promoting the development of degenerative changes in the overlying joints.
The disease has non-fatal, but nevertheless dangerous consequences. This:
Depending on the causes of the disease, it can be congenital or acquired.
Such flat feet develop when the genes passed on from parents contain incorrect information about the strength of the ligaments, the extensibility of the foot muscles, or the relationships of the bones of the foot. The disease can be detected in infants (more often it is detected at 2-3 years old, when the baby is actively walking); it is often combined with other developmental defects.
How to identify it at such an early age? Only an orthopedist can do this. This is explained by the fact that until the age of 5, the instep of the foot is filled with adipose tissue, which is why a colored print on paper will not provide the necessary information.
This type of flatfoot is diagnosed in preschool children, adolescents and adults as a result of various factors:
Depending on the reasons, the following forms of acquired flatfoot are distinguished:
Flat feet occur in many children at an early age. As the baby grows, the situation often normalizes on its own, but sometimes the disorder persists and significantly worsens the patient’s quality of life.
If this disease is discovered in a child only in adolescence, it can be extremely difficult to cure. Moreover, after 12-13 years, some deformities can no longer be corrected. In this article we will tell you how to treat flat feet in adolescents in order to prevent further development of the pathological process.
Classification of severity of the disease
The tactics of action, as well as whether flat feet in adolescents can be cured, depend on how severely the foot is deformed. There are several degrees of severity of this disease:
It is completely impossible to cure grade 3 flat feet, however, medical workers can significantly alleviate the patient’s condition and reduce the intensity of unpleasant symptoms. Measures to correct grade 1 and 2 deformities can be quite effective, but even at this stage there is no guarantee that the teenager will be able to completely overcome the disease.
Treatment of grade 1 and 2 flat feet in a teenager can be carried out both in a hospital hospital and at home. If the child’s foot is not too severely deformed, special gymnastics, massage and wearing orthopedic shoes are used.
If there are indications, additional physiotherapeutic procedures and special orthopedic devices are prescribed - insoles and semi-insoles, orthoses, correctors, inserts and cuffs. Finally, in the most advanced cases, surgery can be used.
For different children, prescriptions may differ significantly, depending on the severity of the disease and the individual characteristics of the child’s body, therefore all treatment should be carried out under the strict supervision of a specialist doctor.
At the same time, it is very important to do special exercises at home for flat feet for teenagers, which will help stop the further progression of the disease. In particular, the following complex shows good results:
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.