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In order to understand why the doctor has identified a particular disease and appointed specific corrective measures, it is necessary to be aware of the causes, symptoms, methods of diagnosis and treatment of various diseases. This site helps to understand. We tried to summarize important information about the most common diseases, so that the patient could understand why he or she had certain symptoms, what diagnostic tests the doctor should prescribe and what measures of therapeutic correction of the condition are possible in a particular case. A convenient structured presentation of information will help to understand the features of the clinical symptoms of the disease, as well as the reasons for prescribing certain measures of treatment depending on the characteristics of the course of the disease. The Simptomy--Lechenie.net website contains sections that provide information about the etiology of pathological processes, that is, their causes, clinical manifestations of diseases, methods of diagnostic search and methods of therapy.

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What is flatfoot?

Flatfoot is called the deformation of the foot, in which its longitudinal or transverse arch falls and flattened. There are two forms of flatfoot: transverse and longitudinal. In some cases, both forms are combined.

The most common transverse flatfoot, combined with other deformities of the feet (55.23% of cases). Longitudinal flatfoot and other types of deformities occur in 29.3% of cases.

What happens with flat feet? If the deformity of the foot is transverse, flattening of the transverse arch of the foot occurs. There are five metatarsal bones in the foot, on the heads of which all its anterior section rests. Thus, the metatarsal bones fan-shapedly diverge, the first (thumb) deviates outward, with the middle finger there is a hammer-like deformation (abnormal contraction and flexion), and the length of the foot decreases. Transverse flatfoot is found mainly in 35-50 years.

Longitudinal flatfoot is characterized by flattening of the longitudinal arch of the foot. At the same time its length increases and almost the entire area of ​​the sole comes into contact with the floor. It is noteworthy that longitudinal flatfoot is characteristic mainly for women. It affects body weight: the excess weight increases the load on the foot and the longitudinal flatfoot becomes more pronounced. The age at which longitudinal flatfoot is most common is 16–25 years.

Causes of Flatfoot

Causes of flatfoot depends on its etiology. Foot deformity can be congenital and acquired (traumatic, paralytic, rachitic and static).

Congenital flatfoot. Due to the fact that children up to 5–6 years old have all the signs of a flat foot, it is very difficult to detect congenital flatfoot before this age. This pathology is congenital in approximately 3% of cases. It may occur due to hereditary sapility and insufficiency of the connective tissue.

Traumatic flatfoot. Injuries and fractures of the ankles, ankle, heel, and tarsus bones, damage to the soft tissues that strengthen the arches of the feet, become causes of traumatic flatfoot.

Paralytic flatfoot. Transmitted poliomyelitis can cause the development of paralytic flatfoot (paralytic flat foot). As a result, paralysis of the tibial muscles and the muscles of the foot occurs.

Rachitic flatfoot. Rickets - a disease that violates the normal formation of human bones, including the bones of the foot. The fragile, fragile bones of the foot and weakened muscles and ligaments can not withstand the body, resulting in deformation of the foot and the formation of flatfoot.

Static flatfoot. This type of flatfoot is very common, it accounts for 82.1% of all cases of pathology. The causes of static flatfoot are weakness of the muscles of the foot and lower leg, weakening of the bones and ligaments. Thus, some factors (overweight, standing work, lack of necessary physical activity) can lead to deformation of the foot. The wearing of uncomfortable or poorly made shoes, as well as high-heeled or narrow-toed shoes, also adversely affects the shape of the foot.

Degree flatfoot

Flatfoot has several degrees of severity. For the early stage is characterized by the development of ligamentous apparatus failure. In this case, the foot is not deformed, but the ligaments are stretched, so that the person feels pain. Discomfort occurs mainly after long walks or in the evening, after the working day. It is usually enough to relieve pain.

Weak flatfoot (first stage) is characterized by a feeling of fatigue in the legs that appears after physical exertion. There may also be a decrease in the plasticity of the gait, swelling of the legs. If you press on the foot, the person will feel pain.

Combined flatfoot (second stage) is manifested in the flattening of the foot: the vaults disappear, the foot becomes clearly flat. Pains in the feet intensify and increase. Often they can extend up to the knee joints. Walking is much more difficult.

Pronounced flat-footedness (third stage) becomes a frequent cause of the treatment of a sick person to the doctor. There is severe pain in the feet and legs, swelling of the legs, headache and back pain. At this stage of the disease, a person cannot engage in sports, his working capacity is markedly reduced, and even calm, slow walks pass with difficulty. To move, a person needs to replace ordinary orthopedic shoes.

Flatfoot progresses rather quickly, leading to deformation of the fingers, their curvature, the formation of calluses and so on.

Symptoms of flatfoot

What should pay attention to in time to prevent severe deformity of the feet? An alarming sign is the wear of shoes on the inside. Check out a few old pairs of shoes: if the sole is worn off at the inner edge, you should probably consult with the orthopedic surgeon. Also symptoms of flatfoot are fatigue during walking, fatigue and pain in the legs, swelling and cramps. With flat feet, not only the feet, but also the ankles swell. It becomes very difficult for women to wear heels. Due to the lengthening of the foot, the old shoes become small, you have to buy larger shoes. There may be pain in the lower back, knees, hips, headaches. Gait and posture become wrong, unnatural. Sometimes flatfoot contributes to the ingrown nail.

But it should be remembered that such symptoms are characteristic not only for flat feet. Similar symptoms have varicose veins. Therefore, if you discover any of the above symptoms, be sure to undergo an examination.

Diagnosis of flatfoot is carried out with the help of radiography of the feet and physical examination at the orthopedist.

Treatment of flatfoot

Flatfoot to many seems to be a simple disease, but in fact it is a rather serious and rapidly progressing pathology, difficult to treat. It can be completely cured only in childhood, and in adults treatment is aimed at slowing the progression of the disease to more severe stages. The earlier flatfoot is found, the more favorable its treatment and correction will be. Treatment of flatfoot is complex: the patient is strengthened by the muscles and ligaments of the foot, relieves pain, stops progressive deformity.

The pain is relieved with medication and physiotherapy. The main therapy is therapeutic gymnastics. A special set of exercises must be done daily. When selecting exercises, an orthopedist takes into account the shape and type of flatfoot, stage, age of the patient.

With flat feet, blood circulation is impaired, therefore, for its normalization and muscle stimulation, therapeutic massage and foot baths are used.

It is extremely important to use orthopedic insoles to correct deformed foot in the treatment of flatfoot.

Sometimes, with a very strong deformation and curvature of the thumb, they perform a surgical operation.

Expert Editor: Pavel Alexandrovich Mochalov | D.M.N. general practitioner

Education: Moscow Medical Institute. I. M. Sechenov, specialty - “Medicine” in 1991, in 1993 “Occupational diseases”, in 1996 “Therapy”.

What is flatfoot

Human feet have a vaulted elastic construction that forms the longitudinal and transverse arches. In adults, their normal anatomical condition is a deflection; therefore, they are not in contact with the ground from the sole, but from the rear are the rise of the foot, the height of which is individual for each person. The plantar part is supported on 3 points: the heel, the outer side edge and the pad in the area of ​​the thumb. If there is an omission of the arches and an increase in the area of ​​contact of the foot with the ground, a diagnosis of flatfoot is made.

Flat feet can not be ignored - if the arches of the foot are deformed, it is dangerous to health. The function of leveling the load on the body arising during the movement is disturbed, which causes diseases of the spine and leg joints, and at severe stages can lead to disability. Against the background of flat-footedness, valgus deformity can develop (children are given this diagnosis more often than adults): a pathology of the functional position of the foot, in which the central axis is curved. Weight is shifted to the inside, which leads to eversion of the heel.

Types and types of flatfoot

Classification of this problem can be carried out by anatomical features (transverse, longitudinal, combined) and by origin. Additionally, doctors pay attention to the time of occurrence. Congenital flatfoot is difficult to establish in children under 4 years of age: it is connected with developmental disorders in the prenatal period or with the wrong course of childbirth, it can be inherited. Acquired from adults are diagnosed more often and divided into how many species according to the causes:

  • Traumatic - develops due to transferred injuries of the lower extremities associated with fractures of the foot bones, injuries of the ligament-muscular system.
  • Rachitic - is a complication of rickets and other pathologies of bone tissue, transferred in childhood.
  • Paralytic - is considered a complication of child polio: paralysis of the muscles of the leg and plantar.
  • Static - the most common type in adults (according to statistics, it applies to more than 80% of cases), is associated with weakness of the muscles of the lower extremities, bones and ligaments.

Transverse

This type of supination anomaly is predominantly observed in adults aged 35–50 years and is characterized by a shift in weight on all 5 metatarsal bones - in a healthy person, emphasis should occur only on the 1st and 5th. Against this background, the length of the foot decreases, the distal section expands (fan-shaped bone divergence), which can be seen from the deformation of the middle finger and the deviation of the thumb. A home examination of the feet at the initial stage is almost ineffective, therefore, doctors recommend a podometric study to check for transverse flat-footedness:

  1. The doctor measures with a stopometer the length from the edge of the thumb (or index finger - which is larger) to the edge of the heel.
  2. Check the height of the arch to the navicular bone (from the floor).
  3. The ratio of the 2nd indicator to the 1st is calculated and multiplied by 100.
  4. The resulting index is compared with standard indicators for the conclusion about the state of the arches of the foot. Some stoppers additionally help to measure the degree of valging (inward subsidence).

Longitudinal

In contact with the surface of the support of the entire area of ​​the sole, doctors talk about longitudinal flat-footedness: this is the most common type of this anomaly of supination, mostly found in women aged 16-25 years. Due to the flattening of the longitudinal arch of the foot becomes longer. The problem is diagnosed by several methods. The simplest is plantography; it can even be done at home:

  1. The subject is treated with a foot fat cream or vegetable oil.
  2. He stands up with both feet on sheets of paper, with no additional support.
  3. The subject leaves the paper and the mark left (plantogram) is enclosed in a pen or pencil, as the oily stains quickly spread.

In order to evaluate the plantogram along the Chizhin, tangents are carried out from the center of the heel to the outer edge of the thumb (AB) and the base of the index finger (SD), after which they draw a perpendicular to the center of the DM (MN). Dividing the line MN in half, estimate the ratio of the light (MO) and dark (OH) area, using the index Tizhino MO / OH in mm. Longitudinal flatfoot is diagnosed when the index value is 2 units or more. About flattening say if it is 1-2 units.

Severity

Only a doctor can assess the development of pathology on the basis of special diagnostics: in addition to the plantograms and podometry mentioned above, radiography may be required. The initial stage is considered to be general failure of the ligamentous apparatus, in which in the evening or against the background of the load there are pains in the legs, but there is no visual deformation. After flat feet in adults (transverse or longitudinal) is divided into 3 degrees:

  1. The deformity is weak, the legs swell in the afternoon, with pressure on the feet there is pain.
  2. Combined flattening, in which the foot becomes flat (partially or completely). The pain syndrome that is present when walking becomes stronger, affecting not only the plantar part, but also the lower leg. There are difficulties in movement.
  3. Deformation is pronounced, the pain syndrome passes to the spinal column, it is accompanied by frequent migraines. Motor activity is limited and requires the wearing of orthopedic shoes.

Flatfoot 3 degrees

Third degree: characterized by complete deformation. At the same time, dysfunction of the musculoskeletal system with the manifestation of the corresponding diseases is diagnosed. At this stage of the development of the disease, severe pains are felt, sports loads are impossible.

Among the main reasons provoking the development of flatfoot, can be identified in the following:

  • overweight,
  • pregnancy,
  • peculiarities of activity, causing excessive physical exertion,
  • heredity (flatfoot in the next of kin),
  • wearing poor quality shoes, too narrow or small shoes,
  • weakness of the ligaments and muscles of the feet, due to the lack of appropriate loads or age, etc.

In 90% of cases flatfoot is diagnosed in people with poorly developed musculo-ligamentous apparatus of the feet. Regular workout of the muscles of the foot will help to avoid the occurrence of deformities and never face flat-footedness.

Complications

Flatfoot, as can already be generally understood from the characteristics of the course and progression of this disease, can provoke a number of specific complications, among them we can single out the following:

  • a gradual increase in pain, its non-specific manifestation (that is, pain not only in the feet, but in the hips, knees, in the back, headache),
  • clubfoot,
  • unnatural posture, curvature of the spine, the development of scoliosis and other diseases of the spine (osteochondrosis, hernia, etc.),
  • ingrown nails
  • dystrophic changes in the muscles of the back and legs,
  • the development of diseases directly related to the defeat of the feet (deformities, calluses, curvature of the fingers, neuritis, spurs, etc.).

How to determine flat feet at home?

There are proven methods for determining flatfoot:

  1. Getting a foot print. Take a white sheet, put on the foot fat cream, put the paper on the floor and stand on it. It is important to stand straight and without support. Carefully examine the imprint. There should be a recess on the inside
  2. The study of the foot according to the method of Fridland, based on the study of the subometric index. To do this, measure the height and length of the foot, the height is divided by the length and multiplied by 100. Normal values ​​are from 29 to 31.
  3. Намазать ступни любым красящим и легко смывающимся веществом , и стать на любой белый лист бумаги. Attention! При проведении процедуры нельзя опираться. Нужно стоять только прямо. При просмотре получившейся картинки сделать вывод. Если вся площадь стопы закрашена, то заболевание однозначно имеется.If there is a notch on the inside of the foot and the space between the front part and the heel, then there are no problems with the legs.

These methods allow us to suspect the presence of pathology. But how to determine the degree of flatfoot? Just for this you should contact a specialist.

Diagnostics

The diagnosis of "flat feet" is made on the basis of a radiography of the feet in 2 projections with a load (standing). The preliminary diagnosis of flatfoot can be made by an orthopedist on the basis of a physical examination. Determines the correct location of the anatomical landmarks of the foot and ankle joint, range of motion and angles of deflection of the foot, the response of the arches and muscles to the load, gait features, features of shoe wear.

Pay attention: in women, flat feet are diagnosed 4 times more often than in men. Often, pathology develops during pregnancy due to physiological increase in body weight.

The main methods that orthopedists use to make a diagnosis are as follows:

  1. X-ray. The main diagnostic method, which allows to determine not only the presence, but also the nature and degree of pathology, is radiography in two projections. X-ray examination is carried out with the load, ie, the patient must stand.
  2. Plantography. The method of applying to the feet of fat cream that can be used at home, and was described above. Instead of fat cream, doctors often use lugol, which leaves a more accurate and distinct imprint on paper.
  3. Podometry. This is the measurement of various parameters of the foot and the calculation of various indices to determine the presence of deformities and the degree of pathology.

Orthopedic Insoles

Good results in the treatment of flatfoot in individuals of any age are provided by orthopedic insoles instep supports, individually made for each foot, taking into account all the anatomical features.

Such insoles are usually made of plastic, which is plastic when heated, and at lower temperatures becomes stiff. Such instep supports can be made for shoes with or without a heel.

  1. Wearing orthopedic insoles can completely cure flat feet in children under seven years of age, if you start treatment from two to three years of age. Children need to replace instep supports quite often in accordance with the growth of the foot.
  2. In adolescents and adults, wearing insoles makes walking comfortable, slows or stops the progression of the disease. At first, the insteps may seem inconvenient to wear, however, as you get used to it, a feeling of comfort comes.

Exercises

Exercise is an integral part of the treatment and prevention of flatfoot. They help to strengthen the muscles of the foot, stop the progression of the disease has already begun. To achieve a stable result, you need at least six months. Regularity is important, otherwise there will be no effect.

It is necessary to begin treatment with gymnastics, which can be performed daily at home. The therapeutic type of gymnastics is used to achieve the correction of the arch of the foot, strengthens the muscles, trains the ligamentous apparatus, forms the correct type of gait. There are a large number of exercises that are selected individually and depend on age, complaints, position of the foot and its shape.

Complex gymnastic exercises:

  1. Lifting socks. Enough to do 10-12 reps. To start the exercise you need their main stand: feet parallel to one another, slightly apart.
  2. Riding legs with a small elastic ball or a round stick. Exercise time - 5 minutes of rolling the subject the entire surface of the foot.
  3. Rotation. You need to sit down, stretch your legs forward, rest your heels on the floor, and alternately rotate your feet in different directions. 10 times to the right and 10 times to the left.
  4. Walking on different sides of the foot. 10 steps on the outside, then 10 steps on the inside, then 20 steps with a change of the fulcrum at each step.
  5. Rolls: standing from heel to toe - 10 times.
  6. Flexing and extending the fingers on the legs - 3 minutes.
  7. Holding the feet of a small ball. As an option - shifting from one place to another small objects, holding them with their toes.

The whole complex takes no more than 20-30 minutes daily. After doing the exercises, it is recommended to do a massage.

Walking on uneven surfaces. Exercises are performed barefoot, each 8-12 times.

  1. Walking barefoot in the sand (for sand, you can adjust the box to the size of half a meter per meter) or foam mat (or with a large pile), bending your fingers and leaning on the outer edge of the foot,
  2. Walking on a sloping surface with support on the outer edge,
  3. Walking along the log sideways.

It is very important that the patient performs special exercises for flat feet every day. Muscles and ligaments of the foot as a preventative need to be trained constantly, otherwise they weaken, and as a result symptoms of flatfoot appear.

Massage for flat feet

Massage for flat feet involves the use of a large number of different techniques. This is stroking, kneading, rubbing and other methods. Massaging the foot, you need to move from the fingers to the heel. Shin massage involves moving from the ankle to the knee joint. Both exercises and massage perfectly tone the muscles and ligaments of the foot. Special foot baths can be used in the treatment process.

The basic massage techniques for flat feet are quite simple:

  • to massage the legs from the ankles to the groin need to bottom up (stroking, patting, rubbing),
  • Massaging the foot and its back side (from the fingers to the ankle) should be done by grinding, that is, with circular movements of the tips of the fingers joined together, or the edge of the palm — across the foot,
  • the arch of the foot can also be massaged with a “comb”, which is formed from the joints of the proximal phalanges of four fingers during the compression of the hand into a fist (in other words, “knuckles”),
  • heels (alternately), as well as the base of the toes on the side of the foot, are more convenient to rub, bending the leg at the knee, with four connected toes of both hands (the thumbs of the hands are on the rise).

Do exercises for the treatment of flatfoot should be at least 20 minutes and, if possible, twice a day.

Healing baths with the help of folk remedies

It is established that water procedures are useful for the prevention of the disease. After a hard day of work, especially if he assumes a long stay on his feet, it is recommended to let his feet relax by placing them in a warm bath.

  1. Based on oak bark. Half a liter of boiling water should be added 100 g of dry matter, put on the fire for half an hour, drain and pour into a bowl of warm water.
  2. Salt baths. You can use iodized, and preferably sea salt. One dessert spoon is dissolved in a liter of warm water, dipped in a container with a solution of the foot for ten minutes. Then they need to wipe dry and massage with hands, pre-lubricated moisturizer. Such procedures improve blood circulation, help strengthen bones and perfectly relax.
  3. Bath with a decoction of sage, chamomile or pine needles. Pour one cup of the dried plant with hot water and boil for 15–20 minutes, leave to cool. Dilute ½ with hot water and hold your feet in it for about half an hour.

Prevention of flatfoot

Prevent illness by following these rules:

  1. Need to walk more barefoot. If possible, you should go to nature, and spend a few minutes walking barefoot on the grass, earth, pebbles, conifer needles.
  2. Wearing the right shoes. This is related to the prevention of disorders in children. For them it is necessary to buy shoes that tightly holds the leg, which does not fly off and does not press.
  3. It is necessary to perform exercises from flatfoot. By highlighting a few minutes a day, the development of a disorder can be prevented. As a charge, you can use a massage mat. Also for the foot massage is necessary.
  4. It is necessary to monitor the posture and the correct position of the feet when walking, as well as when standing. The feet should be located almost parallel to each other and rest on the outer edges of the sole.
  5. Good prevention are home baths with anti-inflammatory agents (chamomile, sage, St. John's wort). They help relieve fatigue from the legs after walking, as well as eliminate inflammation and swelling. Such baths before the massage help to prepare the skin for relaxation.
  6. Foot massage improves the blood supply to the foot. At the same time, reflex points are stimulated, of which there are about 90 on the sole. General massage for the prevention of flat foot is also prescribed for children to enhance the body's protection.

Content

With transverse flat foot flattens the transverse arch of the foot, its anterior section rests on the heads of all five metatarsal bones, the foot length is reduced due to fan-shaped divergence of the metatarsal bones, deflection of the first finger outward and hammer-like deformation of the middle finger. With longitudinal flatfoot flattened longitudinal arch, and the foot in contact with the floor almost the entire area of ​​the sole, the foot length increases.

Flatfoot is directly dependent on body weight: the greater the weight and, consequently, the load on the foot, the more pronounced the longitudinal flatfoot. This pathology occurs mainly in women. Longitudinal flatfoot occurs most often at the age of 16-25 years, transverse - at 35-50 years. By origin flatfoot distinguish congenital flat foot, traumatic, paralytic and static. Congenital Flat feet to establish before 5-6 years of age is not easy, since all children younger than this age are determined by all the elements of a flat foot. However, in approximately 3% of all cases of flatfoot, the flat foot is congenital.

Paralytic flat foot - the result of paralysis of the plantar muscles of the foot and muscles that begin on the lower leg (a consequence of polio).

Rachitic flatfoot is caused by the body load on the weakened bones of the foot.

Static flatfoot (most common 82.1%) occurs due to weakness of the muscles of the leg and foot, ligaments and bones. The reasons for the development of static flatfoot can be different - weight gain, work in a standing position, decrease in muscle strength during physiological aging, lack of exercise in sedentary occupations, etc. Hereditary predisposition also belongs to internal causes that contribute to the development of foot deformities, external reasons - overload of the feet associated with the profession (a person with a normal foot structure, spending 7–8 hours behind the counter or in the weaving workshop may eventually acquire this disease), m household irrational wearing shoes (narrow, uncomfortable).

When walking on the "heels" there is a redistribution of the load: from the heel it moves to the area of ​​the transverse arch, which does not withstand it, is deformed, which is why the transverse flatfoot occurs.

Main symptoms longitudinal flatfoot - pain in the foot, change its shape.

The diagnosis of "flat feet" is made on the basis of a radiography of the feet in 2 projections with a load (standing). A preliminary diagnosis of “flat feet” can be made by an orthopedist on the basis of a physical examination or image analysis obtained with a podoscope. Determines the correct location of the anatomical landmarks of the foot and ankle joint, range of motion and angles of deflection of the foot, the response of the arches and muscles to the load, gait features, features of shoe wear.

For the purpose of medical examination of flatfoot, X-rays of both feet in frontal and lateral projections are of decisive importance.

On X-rays in the lateral projection, three straight lines are drawn to determine the degree of transverse flatfoot, corresponding to the longitudinal axes of the I – II metatarsal bones and the main phalanx of the first finger. They form

  • When I degree of deformation angle between the I — II metatarsal bones is 10-12 degrees, and the deviation angle of the first finger - 15-20 degrees,
  • at degree II, these angles respectively increase to 15 and 30 degrees,
  • at the III degree - up to 20 and 40 degrees, and at the IV degree - exceed 20 and 40 degrees.

To determine the severity of longitudinal flat-footedness, a foot X-ray is performed in a straight, lateral projection performed under load (the patient stands on the test leg, lifting the other) [1] [2].

  • In the laboratory process (filming):
    • to obtain the true dimensions of the displayed object and its parts in the side projection, it is necessary to use a focal length in the range of 120-150 cm,
    • foot testing must be carried out at least in 2 projections - straight and lateral, if there are pathological changes in the foot, the research volume must be supplemented with an oblique projection,
    • rigorous performance of only standard styling, with standard beam centering,
    • development of standard physico-technical conditions of exposure of the X-ray film (kV, mAs).
  • In the medical (diagnostic) process:
    • standardization of criteria for evaluating skalogichesky picture (anatomical and functional state),
    • standardization of radiogram tracing (skiagram), estimation of the width of the articular fissures, osteophyte size, severity of subchondral sclerosis,
    • unified design of the radiological examination protocol (formalized protocol), with a clear formulation of the conclusion (s).
  • At the pre-diagnostic stage:
    • the presence of a reasonable, rather than a "formal" direction for x-ray examination,
    • in case of referral for re-examination, the presence of previous images of the conclusion and the patient's out-patient card.

The picture shows three lines forming a triangle with an obtuse angle directed upwards.

  • The first line is held horizontally, through a point on the plantar surface of the calcaneal tuber, and a point on the head of the 1 metatarsal bone,
  • The second line is drawn from the point of tangency of the 1st line with the calcaneal tubercle to the lower point of the articular fissure of the navicular-sphenoid joint,
  • The third line is drawn from the point of tangency of the 1st line with the head of the 1 metatarsal bone at the same point as the second line.

Normally, the angle of the longitudinal arch of the foot is 125-130 °, the height of the arch is> 35 mm. There are 3 degrees of longitudinal flatfoot

  • 1 degree - the angle of the arch is 130-140 °, the height of the arch is 35-25 mm, there is no deformation of the bones of the foot.
  • 2 degree - the angle of the arch is 141-155 °, the height of the arch is 24-17 mm, there may be signs of deforming arthrosis of the ram-navicular joint 1 - P degrees, characterized by the degree of bone growth in millimeters.
  • 3 degree - the corner of the arch is> 155 °, height [3].

Flat feet - the main symptoms:

  • Headache
  • Lower back pain
  • Foot pain
  • Spasms of the gastrocnemius muscles
  • Muscle weakness
  • Knee pain
  • Rachiocampsis
  • Heaviness in the legs
  • Poor posture
  • Puffiness of the lower limbs
  • Hip pain
  • Finger deformation
  • Foot deformation
  • Increased leg fatigue
  • The appearance of natoptyshy
  • The bump on the thumb
  • Clubfoot

Flat feet - this is the kind of deformity of the foot, in which its arches are subject to lowering, as a result of which there is a complete loss of the inherent damping and spring functions. Flat feet, the symptoms of which lie in such major manifestations as pain in the calf muscles and a feeling of stiffness in them, increased fatigue during walking and prolonged standing, increased pain in the legs to the end of the day, etc., is the most common disease affecting the feet.

general description

In order to understand what this disease is about, it is necessary to dwell on the features that the affected area has, that is, on the arches of the foot and on the foot itself.

The structure of the foot includes many ligaments, joints and bones, due to the peculiarities of their connection with each other, it is possible to walk and hold weight. With this connection, as is clear, the elements of the foot are connected to each other, with the result that two arcs are formed, and it is these arcs in the foot of the foot that act as arches. These arches are located in the region of the bases of the fingers (transverse arch) and in the region of the inner edge of the foot (longitudinal arch). The presence in the foot of such arches allows it to rest on the ground when walking not completely with its entire surface, but only with areas of localization of three main points sufficient for this. The reader, trying to figure out exactly which points in the foot are talking about, will most likely be easily guided by the fact that heel bone is considered as such, the base area is a little distance from the little finger and a similar base area, located just below the big toe. Under the condition of deformation of these arches, the emphasis of the foot occurs in full, as a result of which the shock-absorbing properties of the foot are disturbed, and this, in turn, causes the symptoms of flatfoot.

Let us dwell on the functions performed by the arches of the foot. As we have already outlined, at their expense, weight is maintained when walking (balance), as well as the amortization of shaking that occurs when walking. If the ligaments and muscles in the foot no longer properly provide the functions assigned to them, ceasing to work and losing their intrinsic strength, thereby becoming weak, the normal shape of the foot is also disturbed. В результате происходящего на этом фоне оседания стопы, а также из-за принятия ею полностью плоского положения, утрачивается и уже отмеченная рессорная функция.This leads to the fact that the load, previously imposed on the feet, begins to be compensated by the joints of the legs - in other words, those joints that are higher are already involved, and this is the ankle, knee and hip joints. Naturally, with such a substitution of functions, an even greater load falls on the spine. Taking into account the fact that neither he nor the newly involved joints are in principle intended to directly participate in the functions performed during such deformation, these functions are not very successfully performed by them, which is why failures occur quite quickly in their work as well.

Considering such features of the pathological process associated with flatfoot, it becomes clear why there are pains in the legs and pain in the spine, although not all patients attach one to the other, and certainly not all of these symptoms are attributed to the main root cause, that is, flatfoot.

It should be noted separately that the pain with flat-footedness appears at such a stage, which can be described as a lack of body forces to ensure safe and normal movement, even at the expense of the compensation method so unusual for it. The result of the influence of flatfoot becomes pain in the hip, ankle and knee joints, in addition, due to the load exerted on the spine, posture in patients also becomes pathological. Against the background of the pathological changes associated with the work of the musculoskeletal system, scoliosis and arthrosis can later develop. In addition, it is flatfoot that in many cases causes the development of varicose veins.

As you can see, it is extremely important to maintain the ligaments and muscles in the normal state to perform their functions, that is, in a state of elevation, which eliminates the load that would otherwise fall on the joints of the legs and the spine.

Remarkably, flatfoot has its own interesting feature, and it lies in the fact that this disease can develop not only among people whose professional or general daily activities consist in the need to stay in a standing position, but also in people whose activities fall under the criterion of "sitting", that is, as you know, in the sitting position. This feature is due to the fact that in the sitting position the ligaments and muscles lose their intrinsic strength, becoming, respectively, weak, and in the standing position, on the contrary, the load is too much, which also leads to difficulties - the system of ligaments and foot muscles simply ceases to cope with such a load .

Flatfoot: Causes

Among the main reasons provoking the development of flatfoot, can be identified in the following:

  • overweight,
  • pregnancy,
  • peculiarities of activity, causing excessive physical exertion,
  • heredity (flatfoot in the next of kin),
  • wearing poor quality shoes, too narrow or small shoes,
  • weakness of the ligaments and muscles of the feet, due to the lack of appropriate loads or age, etc.

There is such a type of flatfoot as congenital flatfoot. In this embodiment, the pathology is quite rare, it accounts for about 11% of the total number of pathologies associated with lesions of the foot. Various forms of exposure to the fetus during its prenatal development can provoke congenital flatfoot, in particular, this may be due to the harmful habits of the mother, exposure to radiation, etc.

In addition, flatfoot may be due to rickets. In this case, it is associated with the previous development of rachitic foot in children, which, in turn, occurs against the background of vitamin D deficiency, which provokes a decrease in bone strength in response to the exerted mechanical load. Because of this, the musculo-ligamentous apparatus is subject to weakening, which, as we have already considered, is the direct cause of the development of flatfoot.

Flatfoot can also be paralytic. Paralytic flat-footedness develops against the background of previous transmission of a disease such as polio, the degree of flat-footedness in this case is directly determined by the intensity of the severity of the manifestation of concurrent paralysis.

Fracture of the bones can cause flatfoot. In this case, its variant is considered as traumatic flatfoot, its symptoms are manifested in fractures affecting the bones of the foot. In addition, this type of flatfoot may develop as a result of improper fusion of the bones, again, against the background of previous transfer of fractures.

And, finally, flatfoot can be static, and this variant of flatfoot is most often diagnosed. Static flat-footedness, the symptoms of which are caused by an actual decrease in muscle tone, develops as a result of too much overwork, developing due to prolonged exertion of the legs.

Flatfoot: species

Considering that the foot, as we have already identified, has two arches, respectively, the deformation in any of them already determines the corresponding types of flatfoot. In particular this longitudinal flatfoot, at which the deformation (reduction) is subject to a longitudinal arch, and transverse flatfoot, at which, accordingly, the transverse arch is subject to deformation. Given this, an increase in the foot occurs both in length and in width. If the transverse and longitudinal arch is flattened simultaneously, then this is combined flatfoot (in other words, it can be designated as longitudinal-transverse flatfoot). The first two variants of flatfoot are detected quite often, but the prevailing positions in terms of prevalence are assigned to the transverse form of deformation.

In addition, flat feet can be congenital or acquired. Congenital flatfoot, diagnosed in children, is quite rare, here, as we have considered above, the main influence was made by malformations that directly affect the development of the tissues of the fetus. Such flat feet can be treated from the very first days of the birth of the child. Acquired flat-footedness, in turn, is diagnosed in the overwhelming majority of cases, its main forms are those options that we associated above with the influence of specific causal factors, that is, it is traumatic, rachitic, paralytic and static flat-footedness.

Flatfoot: Symptoms

Let us dwell on those basic variants that, when considering flat feet, are distinguished in accordance with the characteristics of the lesion, that is, on the longitudinal, transverse, and combined flat feet, as well as on the symptoms inherent in them.

Longitudinal Flatfoot: Symptoms

Longitudinal flatfoot is accompanied by contact with the floor surface of the foot completely, which causes an increase in its length. The main feature, corresponding to the manifestation of the longitudinal flat-footedness, is the reduction of the distance that normally forms between the floor surface and the foot from its inner edge. Longitudinal flat-footedness also becomes the cause of the development of clubfoot, as a result of which shoe wear follows a certain “pattern”: on its inner side along the length of the heel and the sole.

The degree of deformation of the foot determines the appropriate degree of flatfoot, there are three of them.

  • First degree flatfoot It is characterized by the absence of visible deformation, which is caused by the still weak expression of the accompanying changes. Flat feet, the symptoms of which at this stage manifest as fatigue, marked in the legs after experiencing significant physical exertion, for example, after a long run or overcoming significant foot distances. Pressing on the foot area is accompanied by the occurrence of pain. Towards evening, symptoms may be supplemented by a disturbance in the smoothness of the gait against the background of accompanying sensations, as well as swelling of the feet.
  • Second degree flatfoot characterized by moderate severity of flatfoot. The arch of the foot at this stage of the progression of the disease disappears, the symptoms intensify. Thus, the pain becomes more severe, manifests itself much more often, in addition to this, its spread to the ankle area, as well as to the tibia is noted. The smoothness of the gait at this stage of the manifestation of the disease is lost, the foot muscles lose their inherent elasticity.
  • Third degree flatfoot manifests itself in an even more pronounced form, which is also accompanied by increased strain. Puffiness and pain in the feet become constant companions of the general condition of the patients; in addition, there is a very severe headache. Of pain also present pain in the lumbar region. There is a decrease in the ability to work, difficulties arise even if it is necessary to overcome small distances. Grade 3 flat-footedness of this form makes it impossible for a person to walk with her while being shod in ordinary shoes due to the extreme degree of deformation processes.

Transverse flatfoot: symptoms

Transverse flatfoot is accompanied by a decrease in the length of the foot, which is due to the divergence of the bones located in it. Also, the deviation outwards of the thumb with the concomitant deformation of the middle finger becomes relevant, besides this, it changes in its own form - it becomes molotoreobrazny. In addition to this, the appearance of a bone thickening in the base of the thumb, which has a lump shape and is accompanied by a manifestation of pain, is noted.

This form of flatfoot is also accompanied by various stages of progression, on the basis of which, accordingly, the degrees of transverse flatfoot are distinguished, similar to the previous variant of the disease, there are three of them.

  • Transverse flatfoot, first degree. This degree of flatfoot is characterized by a weak manifestation of changes relevant to the disease. For the angle of deviation corresponding to the position of the first finger, a limit is determined, not exceeding 20 degrees. Long standing or walking are accompanied by fatigue. In the area of ​​the location of 2-4 fingers, characteristic thickening of the skin is formed - these are natoptysh, in addition, there is a slight soreness and redness, detected from the side of the first finger on the foot.
  • Transverse flatfoot, second degree. At this stage of the progression of the disease, the accompanying changes can be defined as moderately pronounced. For the angle of deviation corresponding to the position of the first finger, a somewhat different limit is already defined - from 20 to 35 degrees. Exposure to stress leads to a burning sensation in the area of ​​the foot, as well as to pain in it, these sensations are also noted in the area of ​​the first finger (especially if the person is in the shoe). The educated natoptyshs at this stage of the course of the disease increase in their own dimensions, the area of ​​the toes of the foot changes to their characteristic spreading.
  • Transverse flatfoot, third degree. With the progression of the disease to this stage of its manifestation, the deformation process is most pronounced in its own manifestations, the actual angle of deviation corresponds in position to a figure of 35 degrees or more. The load is accompanied by the emergence of constant and severe pain from the foot area, its front section is spread out strongly. Belltoes, formed in the area of ​​the fingers, reach significant sizes. The position of the first toe sharply changes, resembling a dislocation, 2-4 toes of the foot are subject to severe deformity, bursitis may also develop (this disease is accompanied by inflammation of the region of the paraarticular bag).

As for such a form as mixed flat feet,then it is accompanied by the manifestation of symptoms inherent in both considered forms, that is, the symptoms of the transverse, and the symptoms of the longitudinal flatfoot. Note also that the manifestations of symptoms of a mixed form are characterized by a greater degree of severity.

In addition, it is also possible to consider the signs of flatfoot not only from the side of the sensations accompanying this disease, but also from a slightly different side, they consist in the following:

  • shoes began to wear out too quickly, in particular, this is noticeable if she has a heel,
  • physical stress began to accompany sore feet,
  • standing work and regular walking were accompanied by rapid exhaustion of the legs,
  • walking in heels has become difficult
  • by the end of the day, there are characteristic symptoms of flatfoot (heaviness and swelling in the legs, feeling of “filled with lead”, cramps),
  • there is a feeling of an increase in the foot in size (which, in fact, practically is), both in length and in width, which is why there is a need to buy shoes that are larger than usual size, and it is no longer possible to get into old shoes.

Flatfoot in children: symptoms

On the basis of exemplary statistics, it can be pointed out that when examining children of preschool age, approximately 65% ​​of cases show flat feet, while completing the school is accompanied by an even greater increase in this figure. Often parents treat flat feet with less seriousness than they should, believing that if there are no special changes and there is no disability for this disease, then it is not so dangerous and will pass with time. Meanwhile, flat-footedness itself never passes, moreover, the neglected cases of its course are accompanied by additional difficulties, the treatment becomes not only expensive, but more serious in terms of intervention. Thus, with this pattern of “neglect” of the disease, an operation can be performed.

What, besides possible treatment only due to surgery, is dangerous flat-footedness? At least by the fact that it can lead to the development of a number of other equally serious diseases, namely scoliosis, arthrosis, radiculitis, osteochondrosis, varicose veins and arthritis, and this is not the whole list. In addition, flatfoot is one of the reasons for the development of an accelerated scenario for the wear of the musculoskeletal system.

The formation of the foot in a child occurs before he reaches the age of three. Like any other disease, the sooner flat feet are diagnosed, the easier it will be to ensure its treatment. All children are born with so-called imaginary flat-footedness, it is imaginary for the reason that there is a significant amount of subcutaneous fat in the foot.

As one of the features, and, at the same time, and as one of the advantages of this disease in children in terms of its reversibility, is the fact that gradual maturity is accompanied by a natural elimination of flat feet. This happens in a natural way, with the gradual training of the child walking and running, which is also accompanied by the development of muscles. Against the background of the changes in the child’s life, the structure of his foot changes, and she has familiar outlines. Considering the age already noted, to which the full formation of the foot of the child takes place, it can be added that in children under three years of age it is simply impossible to attribute flat foot to flatfoot.

Flat feet, as we have already identified, can be congenital or acquired, while the development of congenital flatfoot is preceded by the urgency of developmental defects in the period of intrauterine development of the fetus.

As causes provoking the development of flatfoot in a child, problems can be identified that are similar to those that provoke flatfoot in adults:

  • wearing shoes of inadequate quality and parameters (size, width, etc.),
  • overweight,
  • wrong fusion of the foot bones after a fracture,
  • rickets in a child, disorders in the exchange of phosphorus and calcium,
  • prolonged muscle spasm against the background of hormonal changes in the body during puberty,
  • long stay in bed rest during disease transmission,
  • ballet classes
  • weightlifting
  • too intense joint mobility.

Symptoms of flatfoot in children are similar to those of adults; fatigue and pain in the legs are also present. The appearance of a headache within the framework of a deeper form of the manifestation of the disease may cause a reduced performance of the child in school. On the background of prolonged articular irritation caused by flat-footedness, their inflammation may develop, which is defined as arthrosis. If it affects the spine, its curvature may later develop, and this, in turn, already determines the diagnosis of scoliosis for a child.

Diagnosing

Flat feet can be determined not only on the basis of the clinical manifestations of the disease, but also on the basis of certain methods, on the basis of the results of which it is possible to understand what stage the pathological process is at. As such methods, in particular, plantography, podometry, and also the method of Faith analysis, X-ray and clinical diagnostic methods are used. Так, плантография дает возможность определить степень выраженности рассматриваемого нами заболевания на основании результатов отпечатков стоп, для чего их смазывают специальным раствором, а после делают на бумаге отпечатки при опоре на нее всем весом. Проведение подометрии дает возможность определить процентное соотношение между длиной стопы и ее высотой.

The basis for the clinical method is the construction of a triangle having a base corresponding to the distance between the location of the I metatarsal bone (in particular its head) and the calcaneal tubercle. The location of the top of such a triangle is marked from the top of the location of the inner ankle when one leg reaches the site of the top of the calcaneal angle, and the other leg - the location of the metatarsal bone (its head). Under normal conditions, the foot of the arch is about 55-60 centimeters high.

The main purpose for which the treatment of flat-footedness is focused is to eliminate the pain that accompanies this disease in the affected area, that is, in the foot. In addition, it is important to strengthen the ligaments and muscles of the leg, along with restoring the inherent functions of the foot. Treatment of flatfoot can be conservative, that is, using various medications, procedures and other methods, or surgical, that is, this treatment is due to the surgical intervention directly in the affected area.

Conservative treatment is the implementation of measures of physiotherapy, in the implementation of certain exercises of therapeutic gymnastics. In addition, special orthopedic insoles and shoes are selected. Foot baths, massage are recommended. As a sufficiently effective at first, treatment options for flatfoot in a child are, again, baths with the addition of river pebbles to them. Here he needs to roll the stones with his feet, which is associated with a corresponding positive impact on the feet.

At an early stage, the treatment of flat-footedness in children, due to the failure of the ligaments of the foot, is to ensure rest, if necessary, stop playing sports.

Flatfoot: complications

Flatfoot, as can already be generally understood from the characteristics of the course and progression of this disease, can provoke a number of specific complications, among them we can single out the following:

  • a gradual increase in pain, its non-specific manifestation (that is, pain not only in the feet, but in the hips, knees, in the back, headache),
  • clubfoot,
  • unnatural posture, curvature of the spine, the development of scoliosis and other diseases of the spine (osteochondrosis, hernia, etc.),
  • ingrown nails
  • dystrophic changes in the muscles of the back and legs,
  • the development of diseases directly related to the defeat of the feet (deformities, calluses, curvature of the fingers, neuritis, spurs, etc.).

As for the issue of prevention of flatfoot, it is primarily in the selection of appropriate shoes. High heels are excluded, as its optimal variant is considered its height not exceeding 4 centimeters. It is systematically important to visit the doctor to control the general condition of the legs, in the presence of any kind of problems associated with the legs, the examination by a specialist is carried out more often. As an additional measure of prevention of flatfoot, the need for physical exercise and gymnastics is considered. To relax the muscles and to relieve the overall tension of the legs that have accumulated during the day, baths are recommended. If there are problems with excess weight, care should be taken to solve this problem, because overweight and obesity are among the main problems contributing to the development of flatfoot, as well as putting additional strain on the legs and spine.

When symptoms appear, indicating the possible relevance of flatfoot, it is necessary to visit the orthopedic surgeon.

If you think you have Flat feet and the symptoms characteristic of this disease, the orthopedic surgeon can help you.

We also suggest using our online disease diagnostics service, which selects possible diseases based on the entered symptoms.

Transverse flatfoot - acts as a pathological condition, which is characterized by the spreading of the forefoot and the deviation of the thumb. It is noteworthy that female representatives often suffer from the disease - in men it is diagnosed 20 times less.

Varicose veins (varicose veins) is such a chronic disease in which the veins are subject to nodular expansion, which occurs simultaneously with a violation in the process of blood outflow and with its stagnation within the venous system. Varicose veins, whose symptoms develop in accordance with the effects of a number of predisposing causes, manifest as the development of characteristic protrusion of large, sinuous and thick veins, affects the lower limbs, because this particular area of ​​the lesion will be discussed in our today's article.

Diabetes mellitus is a chronic disease in which the endocrine system is affected. Diabetes mellitus, the symptoms of which are based on a prolonged increase in blood glucose concentration and on processes accompanying an altered state of metabolism, develops in particular due to insulin deficiency, like a hormone produced by the pancreas, which regulates glucose processing in body tissues in the body and in his cells.

Osteoarthritis is a fairly common disease in which joints are subjected to degenerative-dystrophic lesions. Osteoarthritis, the symptoms of which are initially associated with the gradual disintegration of cartilage tissue, and later with the collapse of the subchondral bone and other structural components of the joint, develops against the background of lack of oxygen in them and can manifest in various forms with different areas of localization of the pathological process. Basically, this disease is diagnosed in patients aged 40 to 60 years.

Diabetic foot is one of the complications of diabetes, in general, this complication is seen as a syndrome, accompanied by a whole group of different manifestations affecting the peripheral nervous system, foot joints, bones and blood vessels. Diabetic foot, the symptoms of which are in the form of necrotizing lesions, otherwise referred to as foot gangrene and develops on average in 5-10% of patients with diabetes.

With exercise and temperance, most people can do without medicine.

What causes flat feet

If the degree of flatfoot is small, then it does not cause inconvenience. But if the foot is severely deformed, the unpleasant consequences are manifested: the legs quickly get tired and swell up and start to hurt.

As mentioned above, foot arches are needed to spring up and distribute the load when walking and in a vertical position. When the foot does not do this, the load rests on the other joints: knee, hip. They hurt, the person's gait changes. The spine also suffers. Flat feet can lead to serious problems up to herniation of intervertebral discs.

That is why with flat feet do not take the army: high physical exertion during service can lead to spinal injuries.

If flat feet are not treated, deformity of the feet increases, heel spurs appear, painful bones on the thumbs, corns.

How to detect flat feet

Flatfoot is longitudinal and transverse. But in its pure form, this is rare. To find out if you have problems, you need to look at the curves of the arches of the foot.

To do this, conduct an elementary test. Such a measurement is conditional and approximate, but does not require calculations. Lubricate the foot with dye (for example, children's finger paints, which are easily washed off) or with a thick cream. Then stand with both feet on a sheet of paper (feet should be at a distance of 10-15 cm from each other) and analyze the imprint.

To begin, draw a straight line between the protruding parts of the inner edge of the foot. Then find the middle of this line and lower the perpendicular to the opposite edge of the foot. Divide the resulting line into three equal segments.

Normally, the imprint of the vault should occupy one third of the line, the maximum - half. If the print has passed for these values, then it is time to get ready for a doctor who will conduct a more accurate diagnosis, refer to x-rays and make recommendations.

How to treat flat feet

It is almost impossible to completely get rid of flat-footedness, especially if you notice it late: deformation affects the bones, and you cannot simply redo them. But the treatment restrains the disease, does not allow it to develop. What helps with flat feet:

  1. Operation. Surgical treatment is required in severe cases.
  2. Medication. They are prescribed by a doctor to relieve pain and tension.
  3. Physiotherapy. The direction to the course also gives the doctor.
  4. Massage. Knead your feet on your own and do not forget to take therapeutic massage courses several times a year.
  5. Special footwear and insoles-instep supports. With a slight degree of flatfoot, they help to slow down the progression of the disease. But they can not always wear for prevention, so as not to weaken the muscles. For difficult cases orthopedic shoes are made to order.
  6. Physiotherapy. This is an effective way to correct flat feet, but you need to do it regularly.

How to prevent flat feet

The surgeon regularly examines the children, so do not miss the obligatory techniques: the doctor will notice if there is something wrong with the development of the child.

Adults will have to watch their feet on their own. This is not so difficult: dose the load on the legs, maintain a healthy weight and wear comfortable shoes. The right shoes are firm and fairly loose so as not to pinch the foot. It has a small heel (up to 3 cm), a high and solid heel.

And if you can’t do without beautiful, but uncomfortable shoes, then at least don’t wear it from morning to evening and do warm-ups for the feet more often.

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