Flatness - Causes, symptoms and treatment. MF.
Flattening is the most common deformation of feet. Directly the foot performs the function of human support, movement and depreciation due to a complex structure. In a normal physiological structure, the foot has two arches - a transverse( between the bases of the fingers) and a longitudinal( along the inner edge of the foot).Vaults carry the function of shock absorbers and soften shaking when walking. The bone-ligamentous apparatus of the foot works well when the load that falls on the foot is completely balanced. With the weakening of the muscles and ligaments that connect the 26 bones of the foot, subsidence of the arches and flattening occur, which leads to loss of the spring function. With flatfoot this function goes to the spine, knee, ankle and hip joint. These joints are not designed to perform this function and cope badly with it, and they quickly fail.
The causes of flatfoot formation.
There are quite a few states that lead to flat feet, here are some of them.
- Congenital flat foot is a fairly rare pathology found in 11.5% of the total number of foot diseases. The cause may be various pathologies of intrauterine development of the fetus, due to ionizing radiation, harmful habits of the mother.
- Children with rickets develop a rachitic foot, as a result of a decrease in vitamin D production, the strength of bones decreases under mechanical stress, the musculoskeletal apparatus is weakened.
- Paralytic platypodia develops after a previous history of poliomyelitis, and the degree of flatfoot is directly related to the degree of paralysis.
- Traumatic platypodia develops with fractures of the foot bones or with improperly fused fractures.
- Static flatfoot is one of the most common types of flatfoot. The main reasons for it are reduced muscle tone, excessive fatigue due to prolonged stay on the legs.
Symptoms of flat feet.
Usually a person who spends a lot of time on his feet does not notice the development of flat feet, and the appearance of pain and discomfort in the legs and feet is associated with fatigue. There are several basic signs on which you can suspect the development of this terrible disease in yourself.
• The legs begin to swell by the end of the working day, there are marks from the socks, there may be a feeling of heaviness and convulsions, which may not be long and pass after the massage.
• You begin to notice that the duration of the working day remains the same, and the legs tire faster.
• Shoes start to wear out much faster than before, mostly on the inside.
• Periodically creates a feeling that the leg has increased in length, and because of this, you have to buy shoes for a size larger.
There are several stages of foot deformation, the passage of which leads to complete clinical flat feet. The prodromal stage, the stage of alternating flat foot, the stage of development of the flat foot, the stage of flat-footed foot and the contractual flatfoot are distinguished.
The first stage of flatfoot is manifested by pain in the foot and calf muscle after a long load on the foot, a statistical character, a pronounced feeling of fatigue appears.
In the , the intermittent flatness stage is characterized by increased pain by the end of the day, the pain arises from overexertion of the ligamentous foot apparatus which maintains the optimal position of the foot. Increased fatigue often appears in the middle of the day, and people with flat feet have to change their activities or more often rest. The longitudinal arch of the foot at the end of the working day visually flattened, but after rest, especially in the mornings, the height of the vault is restored.
The stage of development of flat foot occurs when, due to further overfatigue of the leg and foot muscles, the longitudinal arch of the foot is not restored to rest after rest. The patient quickly develops fatigue due to fatigue of the muscles. The pain becomes permanent and aching due to overstretching of the ligamentous apparatus. The height of the longitudinal arch decreases due to the elongation of the foot and the expansion of its longitudinal part. The gait changes, the amount of movement in the foot joint is limited. In this stage of the disease there are three degrees.
Diagnostic measures for flat feet.
In addition to clinical signs, there are several methods that can determine the severity of this pathology. These include planktonography, the analysis of the face line, the dodging and clinical and radiographic methods of diagnosis.
Plantography - a method that allows the determination of the expression of flat feet with the help of prints. The feet are smeared with methylene blue solution, then the footprints are made on a blank sheet of paper, working on the feet evenly with all the weight.
Patternogram
Friedland's method is the determination of the percentage of height of the foot and its length.
The clinical method of measurement is to construct a triangle with a base equal to the distance from the metatarsal head I to the heel of the calcaneus. The vertex of the triangle is at the top of the inner ankle, one leg extends to the apex of the calcaneal angle, the other to the head I of the metatarsal bone. Normally the height of the vault is 55 - 60 cm.
The X-ray method is based on the construction of a triangle on the lateral radiograph of the foot that connects the apex of the heel of the calcaneus with the metatarsal I head, and the vertex of the triangle falls on the lower edge of the scaphoid bone, the vertex angle should normally be 120- 130 degrees.
Determination of the degree of flatfoot by X-ray.
Flat-footedness is one of those diseases with which young people are not called to military service( service in the army).II and III degrees of the disease are an absolute contraindication for service in the armed forces. This is due to the large power loads that a man with a flatfoot can not bear. Otherwise, the pain syndrome may increase, and in the future, with the preservation of this load, go to one of many complications.
Flat feet in children.
Newborns are characterized by well-defined arches of feet, but the children's foot is filled with fatty tissue, and when viewed it appears flat. Since 3 years, there has been a significant strengthening and development of the ligamentous apparatus, due to which there is a significant increase in the height of the arch and the foot begins to acquire the appearance of the foot of an adult person. The older the child, the more pronounced the vaulted structure. Thus, the external flat feet of a child can not be taken as a true disease.
The development of flat feet in children is promoted by congenital disorders of the ligamentous apparatus, muscle weakness, obesity, endocrine diseases, improperly selected footwear. Due to its anatomical features, the definition of flat feet in children by the fingerprint method is not always informative and can give a false result.
Very often, children can not complain about leg pain or discomfort, so periodic examination by an orthopedic doctor is an integral part of the annual medical check-up. Treatment of flat feet in children is reduced to rest, temporary prohibition of exercise, massage of the plantar part and walking barefoot on uneven surfaces, it is possible to design orthopedic insoles.
Treatment of flat feet.
Treat flat feet is difficult, and it will not be possible to say with certainty after a period of time that this disease is a thing of the past. Completely get rid of this pathology can only be in childhood, because the ligamentous apparatus and the bone system is pliable enough. In adult patients, this disease can only be stopped with the help of special rehabilitation measures.
Parents need to remember - "the earlier the symptoms of flatfoot, the more favorable conditions for stopping the progression."
Treatment should be combined and include removal of the pain syndrome, strengthening of the ligamentous apparatus and the muscles of the foot. To relieve the pain, you need to use anesthetic ointments with a relaxing effect and physiotherapy.
To begin the treatment is necessary with gymnastics, which can be performed daily at home. The therapeutic form of gymnastics is used to achieve correction of the arch of the foot, strengthens the muscles, trains the ligament apparatus, forms the correct type of gait. There is a large number of exercises that are selected individually and depend on age, complaints, position of the foot and its shape. All exercises and their intensity to you will be picked up by an orthopedist.
Treatment in the stage of flat deformation of the foot should be strictly differentiated, along with exercise therapy and massage it is necessary to wear insoles in order to relieve the painful areas and correct the deficiencies in the initial stage of the disease and orthopedic footwear at grade II, and at grade III it is often shownsurgical treatment.
In case of congenital planal deformity of foot of easy degree, children are treated with foot and shin massage, physiotherapy exercises. When a child begins to walk, it is necessary to make orthopedic shoes for him. With insufficiently effective treatment and late treatment, surgical treatment is indicated.
The correct choice of shoes is of great importance in the treatment of flat feet. Beautiful shoes with high heels, of course, decorate the legs of any fashionista, but do not wear them all the time. Otherwise, after a short time you will only need to wear orthopedic shoes. When choosing shoes, pay special attention to the flexibility and comfort of the sole, the height of the heel( not more than 3-4 cm), it is better to avoid shoes on the platform and excessively wide or narrow.
Complications of flatfoot.
• Squint during walking, curvature of the spine, unnatural posture.
• Pain in the knees, hips, back and feet.
• Dystrophic changes in the muscles of the legs and back.
• Disease of the feet( deformation, curvature of fingers, calluses, spurs, neuritis)
• Diseases of the spine( herniated discs, osteochondrosis), hip and knee joint diseases.
• Growth of nails.
Prevention of flatfoot.
To exclude the development of flat feet, it is necessary to carry out preventive measures every week. The priority that needs to be done is to choose the right footwear, exclude the wearing of shoes with high heels, the optimal height is 3 - 4 cm. Periodically conduct an examination with an orthopedic doctor, at least once a year. People who have any problems with their legs should be examined more often. It is also necessary to do gymnastics and do physical exercises for the feet. Foot baths and massage will help relax the muscles and relieve tension after a hard day. It is necessary to get rid of excess weight, as it contributes to an additional burden on the spine and legs.
Doctor therapist Zhumagaziev E.N.