Posture and legs experience simultaneous stress when the child's ability to stand or walk appears. The attempts to maintain balance that he makes by placing the body vertically in space, of course, have a certain effect on the entire skeletal system of the body.
Planovalgus deformity of the feet most often manifests itself in children at the age of five, when parents pay attention to the pathological setting of the feet while walking. If manifestations of this pathology are detected, it is necessary to consult a doctor in a timely manner in order to receive adequate and effective treatment.
Synonyms for PVA in the medical literature are: hypermobile, flat, collapsing, valgus, relaxed, weak, flaccid foot of a child. The incidence of such a pathology is 2.7%. It develops in the presence of functional age-related flat feet at 16-28 months or no later than three years of age.
Causes of pathology
- Burdened heredity (the presence of flat feet in the next of kin).
- Rickets.
- Wearing uncomfortable or someone else's shoes.
- Long walk.
- Overweight.
- Hypermobile joints.
- Violationsblood circulation associated with infections.
- Bone pathologies.
- Injuries.
- Endocrine pathologies.
- Dysplasia of connective tissue structures.
- Inactivity.
- Improper nutrition, leading to impaired metabolism of calcium, phosphorus and vitamin D.
- Paresis, paresis of the legs/feet, which are provoked by cerebral palsy, polio and other diseases.
Planovalgus foot deformity clinic in children
- While walking, the foot is reduced inward.
- Complaints of pain in the legs.
- Slouching posture.
- Thick, padded foot.
In addition to the obvious manifestations of this pathology, there are the following signs:
- Increased flexibility in the joints of the feet.
- The arch of the foot is flattened, i.e. the foot index is greater than 0.7.
- Valgus heel has an angle of 5-25 degrees.
- Adduction of the forefoot.
- The center of pressure shifts along the foot to its inner part.
- The amplitude of hindfoot eversion increases.
- Pronation of the foot increases.
- The time of support on the heel decreases, in the phase of standing on the entire surface of the foot, premature heel lift occurs.
- There is no increase in arch when lifting on toes in case of fixed valgus.
- More muscle activity during repulsion.
- Increased body sway while walking.
Degrees of flat feet
- First degree - mild flat feet, looks like a cosmetic defect.
- Seconddegree - moderate or intermittent flat feet. Manifested by signs that are visible to the naked eye. Over time, pain in the ankles and back appears. Gait changes, clubfoot or "heavy" step occurs.
- Third degree - pronounced flat feet, accompanied by complete deformity of the feet, which leads to disturbances in the musculoskeletal system and, as a result, the development of scoliosis, arthrosis, osteochondosis and herniated discs. Pain increases, walking is difficult, and sports are not possible.
Diagnosis
- Collection of complaints, anamnesis (including clarification of the hereditary factor).
- General examination of limbs while walking and at rest.
- Ultrasound.
- Podometry.
- Computer plantography.
- X-ray in three different projections.
Treatment
Therapy of this pathology is reduced to:
- foot baths;
- massage;
- paraffin therapy;
- mud and ozocerite applications;
- electrophoresis;
- magnetic therapy;
- electrical stimulation of the muscles of the legs and feet;
- acupuncture;
- physiotherapy exercises (gymnastics for the feet);
- swimming.
Massage
Massage, like gymnastics for the feet, plays a special role in therapy with this pathology. It contributes to the proper growth and development of the lower limbs of the baby. Massage also helps to strengthen the muscles of the foot and lower legs, normalizes them.tone (relieves tension), improves blood circulation, making the muscles more elastic and strong.
Moreover, to rid a child of PVA, it is necessary to massage: feet, back, muscles and joints of the legs, lower back, buttocks.
Exercise for the foot
The basic rules for practicing this complex are daily and constant (long-term) performance.
For the course "gymnastics with flat feet" you will need: sand or cereals, pencils, pens (that is, small objects), a chair comfortable for the child, a medium-sized ball.
- Starting position: the child is sitting on a chair, both of his feet are on the ball. With strong pressure with both feet, the ball is rolled on the floor. If there is a mechanical massager, it is used instead of a ball.
- The starting position, as in the first exercise, with force squeeze the ball with the left, then the right foot.
- To perform the third exercise for the feet, you need to sit on the floor and cross your knees ("Turkish"). Performing gymnastics slightly rises and stands on the outer parts of both feet. When performing this exercise, it is necessary to ensure that, if possible, the legs remain straightened, and when returning to the starting position, either she or the other leg is at the top. Repeat the exercise should be at least 15 times.
- To perform the next exercise, you will need to sit back on the chair, and stretch your legs forward and straighten. In this case, it is necessary tocarefully collect small items that are laid out on the floor, and move them to another place. The duration of this exercise is 10 minutes. Alternatively, you can pick up a cloth (say, a napkin or a handkerchief) with your toes.
- Repeat several times: stand on your toes, and then lower to the foot completely.
In addition to those described above, it is recommended to perform such simple exercises for the feet as:
- Rotation of the feet in different directions.
- Turn the feet inward.
- Sole flexion.
- Bend the dorsum of the foot.
- Squeeze-unclench toes.
There is another gymnastic complex (gymnastics with flat feet), used for flat-valgus deformity. It is worth noting that by combining all the described exercises throughout the day, you can achieve a speedy recovery:
- Walking on fine grain or sand for fifteen minutes a day.
- Walking in a warm bath, at the bottom of which a pimply rubber mat or small pebbles is laid out. Moreover, the water in the bath should be above the ankles and have a temperature of about 35 degrees.
- Walking on a horizontally laid ladder or moving on a wall bars.
Bubnovsky exercises
In accordance with the theory and numerous studies of Dr. Bubnovsky, the exercises listed below are excellent for treating pathologies such as flat feet, varicose veins, foot spurs, ankle arthritis, gout, migraine, edemaankle, and are also suitable as rehabilitation measures after injuries or operations on the calcaneal tendon. It is necessary to repeat each exercise according to Bubnovsky at least 15-20 times.
- Repulsion. It is performed in a lying position on the back, while the legs are at a distance from each other (shoulder-width apart), and the arms are extended along the sides of the body. When changing legs, it is necessary to stretch the big toes away from you as much as possible, and then towards you. If performed correctly, the heel will be slightly extended.
- Wipers. The position is the same as for repulsion. The big toes must be spread and reduced to the maximum possible limit. You need to try to put your finger (big) on the bed. When performing the exercise, the lower leg should be slowly twisted.
- Rotation. Performed on the back. The feet rotate clockwise and counterclockwise in turn, while the big toes should describe circles.
- Fist. Perform in the supine position. It is necessary to imagine that the feet are the palms. In this case, it is necessary to clasp an imaginary apple with your fingers. Then you should spread your fingers to the limit.
Recommendations
Besides massage and foot exercises, it is important to wear the right shoes:
Children's shoes should be:
- Made only from natural high quality breathable raw materials, and these requirements apply to both the insole and upper.
- Comfortable, which means not to pinch or rub the child's leg.
- Equipped with a hard high back.
- Fix the leg tightly enough, that is, have lacing or Velcro.
- Equipped with a non-slip, stable sole and a small heel.
The inner edge of the shoes should only be straight so that the first (thumb) toe does not bend inward, the height of the heel is no more than 1-2 centimeters for babies up to two years of age and no more than 4 centimeters from 3 years and older.
Much attention should be paid to orthopedic insoles, with light flat feet it is possible to use serial products, and with severe - only individually made.
The use of special arch supports should not be permanent. So, on the 1st day they are worn for no more than an hour, and then they increase the wearing time daily by half an hour.
When choosing shoes, you should be guided by its spaciousness and depth. It should be remembered that too rigid, tight, narrow shoes reduce the effectiveness of orthopedic insoles and arch supports, and subsequently can even lead to damage to the feet.
You can’t rush a child to start walking or stand up if he is not ready for this, in addition, it is worth limiting the time the children stand.
If you notice any signs of flat feet, you should immediately contact an orthopedist and start treatment as soon as possible.
