Rus Articles Journal

Diagnosis: flat-footedness of

Such verdict of doctors is distressing for most of parents: beautiful gait of the child under the threat. Ah, if it was talked only of a cosmetic problem... Unfortunately, flattening of the arch of foot - the serious and artful pathology capable to affect practically all oporno - the motive device. What is this disease dangerous by? How to distinguish it? And whether it will respond to treatment?

Unfortunately, flat-footedness is one of the most widespread aberrations in development oporno - the motive device. There is an unfavourable statistics: from 1,5 million children`s population of the city of Moscow it is revealed at 9 thousand children. And about 2 thousand young patients complain of leg pain. First of all let`s understand what is meant by this pathology?

Flat-footedness is a deformation of foot at which there is a decrease (flattening) of its arch. Better to understand the disease nature, we will sort some anatomic features of foot. In the course of evolution it got the form allowing to distribute evenly body weight. Bones of foot are connected among themselves by strong interosseous sheaves (these are the fibrous educations from connecting fabric presented in the form of the bunch connecting bones) and form its arch which provides depreciation of movements during the walking and run. The convex arches are focused in the longitudinal and cross directions. Therefore the adult`s foot normal leans on three points - a calcaneal hillock, a head 1 - y a plusnevy bone and 5 - yu a plusnevy bone. Allocate two longitudinal and one cross arch of foot. Internal and external arches form the longitudinal arch of foot, and a lobby - cross. Depending on their deformation distinguish longitudinal and cross flat-footedness.


At longitudinal flatten external and internal arches of foot, its length increases and almost all area of a sole contacts to a floor.


At cross - flattens a cross arch, the forward department of foot fanlikely disperses and leans on heads of five plusnevy bones.

At all children till two years the longitudinal arch of foot flat. Experts consider such state physiological, a bone tissue at kids soft, elastic. It contains few mineral substances which give to bones durability and muscular system is developed insufficiently. When children begin to get up on legs (in 7 - 9 months) and to go independently (in 10 - 12 months), function of the shock-absorber is undertaken by an “a fatty small pillow“ which settles down on a sole, under skin.

In 2 - 3 years of a bone gather enough mineral substances, articulate surfaces get normal outlines, sheaves become stronger, and force of muscles allows to be longer “standing“. Process of formation of bones of foot continues approximately to 5 - 6 - summer age. Only during this period it is possible to speak about presence or absence of flat-footedness at the child.


When Welcome to go to the doctor

, all parents understand that routine inspections at experts are not a whim of physicians, but a necessary measure. The main thing - not to pass time of visit of the doctor. Inspection at the orthopedist is performed:

  • on the first month of life, needs it for an exception of congenital deformations and diseases of a skeleton including congenital flat-footedness;
  • in 3 - and in 6 - monthly age when it is possible to reveal rickets;
  • in 1 year. It is an important stage in the child`s life when he independently sits, creeps, goes. At this time the doctor checks correctness of natural bends of a backbone, volume of movements in joints;
  • in 3 years. The orthopedist checks a bearing, gait, measures length of extremities, investigates a condition of feet.

Ideally from this age should visit the orthopedist with the child every year - not to miss development of flat-footedness. Parents need to be ready to the fact that the orthopedist (if he doubts statement of the final diagnosis) will direct the little patient to additional survey in it is advisory - the diagnostic center.

If the child goes to a garden, this problem is removed by itself - preschool children in child care facilities are examined rather regularly. And here if the child to 1 - go a class grows at home, parents should remember date of medical examination. Children at whom flat-footedness is revealed are on the dispensary account at the orthopedist till 14 - 15 years. During this time they take courses of physical therapy, medical massage, go on sanatorno - resort treatment, and if necessary it makes special orthopedic footwear.

If the diagnosis was confirmed by

Most often longitudinal flat-footedness occurs at children. It happens congenital and acquired. The congenital form of a disease meets seldom and is a consequence of pre-natal malformations. Reveal it already in maternity hospital. One foot is in most cases struck, but also both sometimes are surprised. This pathology is expressed at kids very considerably: a convex sole and the forward department of foot which is “turned out“ outside. Treatment is carried out from the first days of life of the child: deformation is corrected step by step by means of plaster bandages. If it does not help, resort to surgical intervention.

As for the acquired longitudinal flat-footedness, it can be:

  1. Traumatic.

Arises after fractures of bones of foot and ankle joint. Partial or full injury of ligaments at a similar trauma, and also long stay of the child in a plaster bandage promote flattening of the arches of foot.

  1. Paralytic.

Arises because of violations central or peripheral nervous systems (is more often - consequences of poliomyelitis 1 ).


of 1 Poliomyelitis - the acute infectious disease which is characterized by defeat of the central nervous system, covers of a head and spinal cord, sometimes lymphoid fabric of bodies zheludochno - an intestinal path. It is shown by temperature increase, head, muscular pains with the subsequent development of paralyzes of the lower extremities. In the most hard cases damage of a spinal cord leads to respiratory standstill and death. Complications: the atrophy of muscles, i.e. violation of their structure and functions therefore they become weaker, in mild cases arises lameness, in heavy - paralyzes.

  1. Static.

It is the most common form of pathology. Arises from - for overloads at significant increase in body weight, as a rule, at obesity, endocrine violations.

  1. Rachitic.

Arises at excess elasticity of sheaves and weakening of muscles of the arches of foot. As the reason the lack of vitamins and minerals - can serve at rickets 1 or the general exhaustion, and also - at congenital pathology of connecting fabric.


of 1 Rickets - the disease of children of early age which is characterized by a lack of vitamin D therefore the exchange of calcium and phosphorus in an organism is broken. It is shown by violations in formation of bones, disorder of functions of nervous system and internals.

So, foot was deformed. What occurs in an organism? Sheaves send “signals“ to nervous system of trouble on this “site“. In reply muscles receive “instruction“ to enter “fight“ against the deforming forces - that is to strain properly. But long they are not able to sustain such loading therefore quickly are exhausted, relax and stretch. And the deforming force continues to affect now sheaves. Soon and in them there is stretching (in particular if there is congenital pathology of connecting fabric) as without support of muscles they cannot long work. Now all loading lays down on a bone. When also they do not maintain, deformation from compression begins. By this time sheaves finally “leave“ out of operation, and deformation enters a final, irreversible phase. Gait loses plasticity, smoothness. Children often complain of fatigue when walking, pain in the field of ankle joints or shins, and is frequent - in a waist. Some cannot accurately define, where exactly they feel discomfort or pain therefore they do not complain, and just prefer quiet, less outdoor games. There is a deformation of an ankle joint (it still call valgusny or X - figurative). In the presence of one or several such signs, consultation of the orthopedic surgeon is necessary.

Sometimes deformation of foot can exist for many years (up to mature age) without proving in any way. But sooner or later deterioration will happen as compensatory opportunities of an organism are not boundless.

(but not earlier than) can carry out by

At the child of 3 years initial diagnosis of pathology, using the most widespread method - a plantografiya (a foot print). It is simple to make it also in house conditions. Put a clean sheet of paper on a floor, and the kid becomes on it both legs. It is better that soles were damp, then on paper there will be their accurate print. At the same time it is necessary to hold a trunk directly, legs together. The contour of feet in such situation is led round by a pencil. Then perpendicular to the line of a contour the straight line crossing all narrow part of foot is drawn. The easiest extent of deformation - the first. And the heaviest and serious - the third.

the X-ray picture to children at this age does not become. In - the first, foot bones still up to the end did not “ripen“, cartilaginous tissue in a x-ray picture is not visible and it is difficult to estimate the true height of the longitudinal arch. And in - the second, this method of diagnostics is rather harmful to the child therefore it is carried out only at serious indications and a thicket later there are 9 years.

Only for elimination of the expressed pain use of anesthetics of preparations is admissible



Signs of development of flat-footedness

Signs of development of flat-footedness attentive parents can already notice

at two - the three-year-old kid.

  1. After short walking (30 minutes and more) the child quickly gets tired, asks on hands or prefers to move in a carriage.
  2. New boots in 1 - 2 month got out of the initial shape (for example, the inner edge of a sole or a heel on an inner edge was worn out, the top was deformed inside).

In these cases needs to see the orthopedic surgeon urgently.

Treatment of flat-footedness

Unfortunately to count on full disposal of flat-footedness, especially at far come pathology, it is not necessary. But it is necessary to be treated carefully, regularly and honestly. What revealed symptoms of a disease, than less deformation of foot earlier, especially conditions for a stop of progressing of flat-footedness and its correction are favorable.

At an initial stage of pain in legs can be liquidated within 1 - 2 months by means of warm daily foot trays with sea salt, manual medical massage and gymnastics. As for trays - requirements to them simple: water temperature +40 - 50 “With, procedure duration - 15 - 20 minutes, and proportions of their components are specified on packing and happen different depending on concentration of solid.

Very useful impact will be made by self-massage - the benefit, for it there is a set of devices (special rugs, rollers, balls). Exercises with them are carried out randomly (to go on massage s to a rug, to roll feet the massage roller etc.) . As a result blood circulation improves, the tone of muscles is normalized. It is better to carry out gymnastics in the morning when muscles are not tired yet. (See gymnastics at flat-footedness) it is better to show equipment and rate of exercises to the kid on own example. The room should not be stuffy, or with drafts, and it is necessary to be engaged to the child in the convenient clothes which are not constraining his movements.

Medical massage the certified specialist - the physiotherapy exercises and massage instructor surely has to carry out


In treatment flat-footedness also the physical therapy is quite often applied (parafinoozokeritovy applications, an electrophoresis, etc.) that improves exchange processes and blood circulation in fabrics and indirectly strengthens the arches of feet. Massage and physiotreatment are appointed courses, usually on 10 - 15 procedures. It is desirable to conduct 2 - 3 courses a year.


we Choose by


“Culprit“ of the acquired flat-footedness there can be incorrectly picked up footwear. As soon as the child begins to get up means, came it is time to buy to him the first high overshoes. Usually it occurs during the period from 7 - 8 months. Criteria of the “correct“ children`s obuvka are designated quite accurately. The first boots have to:

  • it is dense to p to fix foot and an ankle joint by means of a lacing or “flypapers“, but not to squeeze a leg at all and not to be too free.
  • to Have the minimum quantity of internal seams that the kid did not rub skin around ankle joints.
  • by
  • In their production (including insoles) natural materials have to be used.
  • the Back has to be high, rigid, reaching border of the lower or average third of a shin. It is necessary to avoid a lateral curvature in an ankle joint.
  • it is better than
  • if the surface a boot is punched that legs could “breathe“.
  • the Sole has to be steady and nonslipping, with small (1 - 1,5 cm) a heel. Besides, it has to be rigid. It interferes with reextension in joints of foot and to resprain. And for the house the kid quite will be suitable boots on a leather sole.
  • In footwear for children till two years. Function of the shock-absorber is carried out by those “a fatty small pillow“, otherwise it will interfere with normal formation of the arches of foot. However, all very individually. Perhaps, some kids should choose footwear without instep support and at advanced age. It is better to discuss this question with the doctor.
  • When fitting should be considered that the footwear was with the stock which is not preventing the child to go, - about 1,5 cm
  • After walk should pay attention to a leg of the kid: if on skin the relief of tights or internal seams of a boot imprinted, - the footwear needs to be replaced.
  • the stock of replaceable footwear for the kid is better to have
  • . It will give the chance to small legs to have a rest from habitual situation and if legs at the child sweat, - properly to dry crude boots without prejudice to the following walk.

“Magic“ insoles

the Special role in treatment and prevention of progressing of flat-footedness is allocated by

for orthopedic insoles which are appointed already at the first degree of pathology. They help to unload painful sites of foot and correct the revealed deformations at initial symptoms of flat-footedness. Height of the calculation of the arches of foot in insoles depends on flattening degree. It is necessary to put them in street and in slippers to facilitate life to the baby when he most long is standing. As the child grows, the form and the sizes of insoles - inserts need to be changed. And here not to do without repeated consultations at the orthopedic surgeon. It is the best of all to get insoles in protezno - the orthopedic enterprises, the orthopedic centers or to order individualno.

Only in this case similar products with guarantee conform to necessary standards. And still: you should not use orthopedic insoles “just in case“. If to carry them it is constant without objective need, then the arches of foot will become weakened, and flat-footedness can develop even at the child, healthy from the orthopedic point of view.

If the kid has the third degree of longitudinal flat-footedness, especially in combination with valgusny deformation of an ankle joint, business will not be limited to insoles. He should “sport“ in orthopedic footwear - boots with a lacing and rigid internal lateral support of foot.


Gymnastics at flat-footedness the Complex 1

the Starting position - sitting on a chair, a foot - on a floor. To draw in fingers of feet. To repeat 3 - 5 times, without tearing off heels from a floor. To raise serially a foot on itself (3 - 5 times). To develop at the same time a foot on an external edge (3 - 5 times). To serially raise only thumbs of feet (3 - 5 times). To serially raise all fingers, a foot at the same time are slightly turned inside, not to tear off a heel from a floor (3 - 5 times).

the Complex 2

the Starting position - sitting on a chair, a foot - on a floor. A thumb of the right leg to run over a forward surface of a shin of the left leg from below up (3 - 5 times). To repeat the same a thumb of the left leg (3 - 5 times). It is possible to complicate exercise and to try to pull a thumb of the right leg golf on a shin of the left leg. Then to change legs.

the Complex 3

the Starting position - sitting on a chair, one foot - on a ball, another on - a floor. The foot which is on a ball to shake it to the left - to the right, forward - back, (3 - 5) times. To change legs and to repeat exercise. Further - to take a ball legs and to hold it several seconds on weight, to lower on “a floor, and then again to lift (3 - 5 times).

the Complex 4

the Starting position - sitting on a chair. Under feet or about them it is possible to put a piece of fabric, small objects (checkers, meccano elements, river pebble, etc.) rolling pin. Task: to collect by finger-tips fabric, to take and move small objects, to take for a drive a rolling pin, it is possible - all feet.

the Complex 5 the Starting position - costing to

. To rise on finger-tips (to rise on mysochka) (3 - 5 times). To turn feet in (3 - 5 times). To make walking on the place. To pass forward on outer edges of feet. To pass on line.

the Complex 6
the Starting position - costing to

. To squat, without tearing off heels from a floor (3 - 5 times). At an opportunity to walk on crossbeams or to go on an uneven, hilly surface. It is also possible to balance on a ball. (Attention! Adults have to insure the child!)

the Complex 7
the Starting position - costing to

on the whetstone put on a floor. To squat on whetstone (3 - 5 times). To stand on whetstone on right, on the left leg. Feet at the same time, it is necessary to have across, and then along whetstone. It is also possible to pass several times added steps across whetstone and to pass along it.

of Complication

What complications of flat-footedness happen? Unfortunately, the most different. First of all this flattening of the cross arch of foot with an incomplete dislocation 1 - go a finger outside at teenage age. If foot long was in the wrong situation, and especially if valgusny deformation of an ankle joint takes place, it can lead to deformation in joints of foot and even to change of ratios of articulate surfaces of knee and coxofemoral joints. It is followed by leg pain, especially in the evening, and decrease in functions of depreciation leads to backbone pain. Further it can lead to scoliosis, that is the arc-shaped deformation of a backbone to the right or to the left, or to its curvature with formation of camber of a kzada - to a kifoz.