Rus Articles Journal

Gait, natoptysh and wear of footwear - cause and effect of

Ineradicable “dry“ callosities and natoptysh is a sure sign of considerable deformations of foot. The pedicure technician should face this problem daily. However these external manifestations - the last link prichinno - an investigative chain.

Can clean off some natoptysh, they will arise again and again. Besides, cleaning natoptysh, we risk to provoke emergence and/or strengthening of pains in foot. Being formed as a result of local overloads, natoptysh, at the same time, as the board, covers the structures lying under it from excessive pressure. Helplessness of attempts of the master “to finish“ with chronic natoptysha can cause only negative reaction of clients. A key to the decision is the understanding of the prime causes of a problem.

All of us it is from the childhood: defects of a structure of feet and violation of gait of adults are, as a rule, the aggravated defects of development of the childhood and youth. If deviations rather obvious, then them it is possible to notice and try to correct at teenage age. However by the nature the part of them cannot disappear completely, and they follow the person in his adulthood.

Many hardly noticeable defects and asymptomatic violations in youth usually find themselves only under the influence of functional stresses of the next years of life. Though the main complaints of patients are, as a rule, concentrated in forward department of foot, sources of these pathologies should be looked for in initial installation of heels, the first plusnevy bone and a thumb. Position of a heel, in turn, depends on as far as a supinirovana or a pronirovana of stop at the beginning and the middle of the period of a support. Supination and the pro-nation is two opposite on an orientation natural the movements of foot - the lower extremity. At a supination there is “turn“ of foot of a knaruzha and increase in height of the internal longitudinal arch. On the contrary, the pro-nation leads to flattening of the arch of foot. Supination causes fixing (“short circuit“) of joints of foot - a shin - a knee that provides the increased stability of a leg at the time of a landing, and also gives necessary rigidity to the “foot-the lower extremity“ lever at pushing away. In return, the pro-nation “disconnects“ joints that provides smoothing of blow at statement of a leg on soil and facilitates adaptation of foot to roughnesses of a support. Changes of volume and/or time of a supination and the pro-nation cause violations of “drawing“ of gait of the person and distribution of loading on a basic surface of foot that leads to emergence of zones of the local overloads proving first of all in the form of callosities and natoptyshy, places of the increased wear and intensive dying off of layers of skin. As it was already told by

to p, the general drawing of gait is in many respects programmed by a starting position of a heel at the time of its contact of soil. At various deformations of foot the heel can be superfluous a supinirovana or a pronirovana. Normal at the time of a soil contact a heel slightly a supinirovana. During the first moments all “force“ of loading lays down on external department of a heel (in the English literature this phase of gait and is called shock heel - blow of a heel). The subsequent pro-nation of a heel and all foot is urged to provide smoothing of loading by its dispersal on a sole. At the pro-nation the curve of peak loading deviates to the internal, medial party of foot. Preparing for pushing away, foot comes back to neutral situation (resupinirutsya), and the maximum of loading is again displaced to lateral edge, on area V - a plusnevy head. In general normal at movement the following sequence of movements of foot is observed: easy supination (at the time of a heel contact) - a neutral position - the pro-nation (to the middle of the basic period) - a resupination (return to a neutral position before pushing away) - pushing away (through I-III fingers).

Thus, during movement, in each subsequent timepoint the peak pressure upon a plantar surface of foot changes the localization, as allows to disperse evenly loading on structures of foot. Ideally it is a smooth rift from a heel to a sock and a soft “cat`s“ gait. Heavy, “shuffling“, or “duck“, gait is inherent in people with the flattened and giperpronirovanny foot. The rigid, “caracoling“ gait with “driving in“ of a heel in soil is characteristic of owners of foot with excessively high longitudinal arch (hyper - supinirovanny, varusny foot). And at the last cross flat-footedness is often observed. However usually the person can tell about features of the gait little, can report nature of wear of its footwear, and also an arrangement natoptyshy on foot much more.

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to Each type of deformation of foot there corresponds a certain arrangement and a type of natoptyshy. At so-called varusny deformation of forward department in a neutral position of foot I-III plusnevy bones and a thumb are slightly raised over soil. According to some information (B. Rotbart, 2003, 2004), about 80% of the population in a varying degree possess similar deformation. At the owner of such foot in the period of a support loading too long, up to a heel separation from soil, concentrates on the outer side of foot. In the finishing phase of pushing away of stop from the provision of a gipersupination with big delay it is forced to pronirovatsya and lower urgently the I finger on soil. At the same time all weight of a body is hastily thrown on inner (medial) edge of a thumb. The heel at this moment, on the contrary, is taken away knaruzh. At fast walking arises “kosolapy“ forward department of foot at the time of pushing away. The excessive “getting“ movement of fingers and a zabryzgivaniye of trousers is noticeable during walking by wet. According to the specified features of gait in areas of “shifts“ of a curve of pressure there are also overload zones, and at a certain age natoptysh are formed. Especially integuments of the outer edge of a heel, forward department of foot (under heads II, I plusnevy bones), and also an inner edge of a thumb suffer. There is an excessive wear of footwear.

the Similar picture of violations of gait takes place and at rigidity of a plusnefalangovy joint of the I finger (under “stone“). Restriction of mobility (rigidnost) results from injuries, incomplete dislocations or a chronic inflammation of a joint of the I finger. As a result “hire“ through a thumb becomes impossible, and the vector of force of pushing away is displaced to external department of foot. As a result in the finishing phase of pushing away of stop of the person it is superfluous it supinirutsya and also slightly “pigeontoes“. At similar violations of gait under the V plusnevy head, as a rule, develops pronounced natoptysh, and on top of footwear slanting wrinkles - “zaloma“ are formed.

In a case plainly - valgusny foot at statement of foot on soil the excessive pro-nation of a heel and a curve of peak loading occurs it is superfluous it is displaced on internal department of foot, and the contact period drags on on time. The internal longitudinal arch, being constantly overloaded, it is over the years flattened. In plainly - valgusny foot, as well as in Morton`s foot (the distinctive sign - the II finger is longer than the first), the thumb and the I plusnevy bone are, as a rule, too mobile and cannot serve as the reliable lever for pushing away. As a result the main share of loading is kompensatorno redistributed on II-III plusnevy bones, and completion of pushing away happens through an inner edge of the main phalanx of a thumb to its assignment and simultaneous “podkruchivaniye“ of a heel of a knutra.

On edge of a thumb the increased “wear“ of layers of skin occurs and resistant natoptysh develop. The pachkanye of trousers a heel of an opposite leg is possible. Drawing of wear of footwear is rather characteristic: the sminaniye of a back of footwear of a knutra is observed. The footwear sole is also erased and rumpled from the medial party of foot. Besides, the expressed attrition of a sole can be observed in the central zone, under heads II-III plusnevy bones, and also under a final phalanx of a thumb.

Thus, the majority of complaints of patients of pedicure salons is a direct consequence of certain defects of foot. But the patient mainly is interested in disposal of specific problems, but not their etiology. However it is necessary to understand communication between external defects of skin and the corresponding violations of a structure of foot - gait. Effective correction of problems of foot provides several directions:

Krom of well-known cosmetology methods of processing of feet and massage, the first direction has to include use of the corresponding resolvents of external application (lotions, ointments, gels, creams, etc.) . The second direction means recommendations about individual selection of the convenient, not injuring footwear, to use various protectively - unloading orthopedic inserts and other special devices for foot. In many cases the radical solution of the discussed problems is use of individual orthopedic insoles. As a last resort - the surgeon`s knife. The specialist in care of foot has to know possibilities of surgical correction of the most widespread deformations of foot, pluses and minuses of such intervention and to be able to state them to the patient. In all situations efficiency of correction of the discussed problems can be considerably increased by cooperation of the pedicure master and doctor - a podiatra, the specialist in foot.