Flat feet ✔: symptoms, causes, diagnosis and treatment

general information

The structure of the foot provides natural shock absorption when walking. Normally, bones and ligaments form two arches:

Longitudinal (internal and external): goes from the big toe to the heel tubercle;
transverse: forms an arch along the base of the fingers.

The configuration of the foot is supported by a complex of muscles and ligaments. When walking, running and jumping, the leg springs, softening the blow. This reduces stress on the musculoskeletal system and also helps maintain balance.

If the muscular-ligamentous system weakens, the foot drops down and becomes flatter. The shock-absorbing qualities are reduced, resulting in discomfort and pain in the legs, and the configuration of the joints and posture changes. Only timely help from a doctor can stop the pathological process.

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What is flat feet

A disease of the musculoskeletal system is a change in the shape of the foot with smoothing of its natural arches. Women are almost four times more likely to get the disease. The foot has a complex structure and is a harmonious, well-coordinated mechanism that includes bone elements, tendons and muscles.

The bone frame has 3 sections:

tarsus - includes seven short spongy bones in two rows;
metatarsus - consists of five short tubular bones, the heads of which are connected to the phalanges of the fingers;
fingers - include 3 phalanges: nail, middle, main, with the exception of the thumb, which does not have a nail phalanx.

From birth, a person has an almost flat foot; as it grows, it acquires natural curves - arches. They increase gradually to normal values. After the final formation of the foot, the growth zones close. The arches are an important structural element that ensures the functionality of the foot. Every person has two vaults:

Transverse - less noticeable, looks like an arch at the base of the fingers. It is supported by ligaments, tendons, and the adductor pollicis muscle.
Longitudinal - a curve on the inside from the heel to the joint of the big toe, which is clearly visible.

Due to properly formed arches, the foot performs a number of important functions:

responsible for balance and the ability to walk on uneven surfaces;
acts as a shock absorber and softens shocks when walking;
distributes the load on the body during movements.

The arches help maintain normal movement; if they are properly shaped, the ankle, knee, and hip joints are not overloaded and function fully. Normally, the foot has three points of support: the heel, the head of the 1st and 5th metatarsal bones. With flat feet, they change, which greatly affects the mechanics of walking. This leads to various disorders of the musculoskeletal system.

The spine is also subject to stress when walking, so its work also depends on the condition of the foot and its arches. If they are changed, they can no longer cope with their functions to the required extent. This causes the overlying structures to take over the functions of the foot. But since this is unusual for them due to the additional load on the joints, the spine undergoes various pathological changes much earlier.

Types and reasons

Depending on the location of the changes, orthopedists distinguish three types of flat feet:

longitudinal: flattening of the longitudinal arch of the foot, most often formed at a young age;
transverse: a decrease in the height of the transverse arch that occurs in middle age (35-50 years), often due to wearing uncomfortable shoes and standing work; is the norm under the age of 10 years;
combination: a combination of two options.

Flat feet are divided into types and depending on the main reasons that caused its occurrence:

congenital: change in the shape of the foot due to disorders of intrauterine development; detected immediately after birth and is extremely rare;
acquired: due to external or internal reasons; Within this type, flat feet are distinguished: static: due to increased load on the foot, occurs in 4 out of 5 cases of the disease;
traumatic: develops after injuries to the foot and ankle joint (fractures, dislocations, sprains and torn ligaments, etc.);
paralytic: associated with paralysis of the muscles of the foot, for example, after polio or stroke;
rachitic: changes in the shape of the foot due to a lack of vitamin D, associated with increased softness of the bones.

Static flatfoot is diagnosed most often. It develops both in childhood and in adulthood and can be caused by:

congenital weakness of the ligamentous apparatus; often combined with other types of orthopedic pathology;
excess body weight: creates increased stress on the arch of the foot;
sedentary lifestyle: from lack of load, the ligaments that form the frame of the foot weaken;
professional factors: long work in a standing position, constant lifting of heavy objects, etc.;
pregnancy: flattening of the foot is facilitated by weight gain and a shift in the center of gravity;
wearing the wrong shoes: high heels or lack thereof.

Classification of flat feet

According to the nature of the changes in the arches, transverse, longitudinal and combined flat feet are distinguished. In the latter case, flattening of both the transverse and longitudinal arches is observed. Taking into account the reason that caused the pathology, the following types of flat feet are distinguished:

rickets – applies to children with rickets. During the period of intensive growth, the supply of minerals to the bone tissue is disrupted, it weakens and becomes more pliable. This is reflected in the foot as deformation due to the heaviness of the child’s weight;
traumatic – the result of injuries: bone fractures, damage to joints, tissues of the arch;
paralytic – associated with paralysis of the muscles of the arch;
static – the result of heavy loads that the muscular-ligamentous apparatus cannot cope with;
congenital – occurs against the background of congenital malformations of the elements of the foot.

Taking into account changes in the bone frame, height and angles of the arch, 3 degrees of longitudinal flatfoot are distinguished:

The bones of the foot are not changed, the arch angle is up to 140 °, the height is 3.5-2.5 cm.
The talus is characterized by shortening and increased prominence of its neck. Arch angle up to 155°, height 2.4-1.7 cm.
A large protrusion appears on the heel bone, the heel moves outward, the foot turns inward, and the big toe is retracted outward.

Normal indicators are considered to be an arch angle of 125-130°, height 3.9-3.6 cm.

Transverse flatfoot has 4 degrees, which takes into account the angle between the first and second metatarsal bones and the angle of deviation of the big toe. Normally, these indicators are less than 9 and less than 14, respectively. The higher the indicators, the higher the degree of transverse flatfoot. There are primary and secondary flat feet. The first occurs as an independent disease, the second - as a result of other pathologies.

Degrees

The degree of flatfoot determines its severity and manifestations:

1st degree is characterized by a weakening of the ligamentous-muscular frame of the foot, the external shape is not changed, however, when walking for a long time, a person notices slight discomfort in the legs, which goes away after rest;
Stage 2 is already noticeable visually: the foot seems to be spread out on the floor; the pain becomes stronger and often radiates to the ankle and knee;
Grade 3 – severe deformation of the foot and constant pain; changes affect not only the lower limbs, but also the spine, which leads to severe pain; pathology can affect ability to work, since a person cannot stand or walk for a long time.

Gymnastics for transverse flat feet

We have conditionally divided exercise therapy for transverse flatfoot into exercises with and without a special stretching machine.

Exercises with a special stretching machine

A special stretching machine for the legs helps in the treatment and prevention of transverse flat feet. Its beneficial effect is as follows:

reduction of deformation of the first metatarsophalangeal joints,
slowing down the growth of “bones” on the thumbs,
improving blood circulation and mobility of the joints of the feet,
strengthening the muscles of the foot and ankle,
relieving tension and fatigue in the legs.

Exercise No. 1. Place the stretcher on your big toes and bring your feet together. Keeping your heels connected, slowly point your toes out to the sides, hold this position for a few seconds and return to the starting position. Repeat the exercise 10 times.

Exercise No. 2. Place your feet parallel to each other at a short distance. Raise one foot up, without lifting your heel off the floor. Leave the other foot completely motionless. Hold for a few seconds and then return to the starting position. Repeat this exercise alternately on each leg 10 times. Increase the number of repetitions by 5 times every day

Exercise No. 3. Bring your feet together. Stretch the machine and fix your feet. Make springy movements to the sides, bringing your feet slightly closer to each other with a small amplitude. Repeat the swing several times, rest for a minute, then repeat the exercise.

Exercises for transverse flat feet without a stretching machine

Some of these exercises are performed while sitting on a chair, some while standing. Perform each exercise 15 times on each leg in 2-3 approaches.

“Toe towards you - sock away from you”

Pull your toe toward your shin as tightly as possible and then extend it forward.

"Let's roll the weight"

Take a weight or any other cylindrical “weight”. A bottle filled with water or sand will do. Roll the weight with your right and left legs alternately.

"Let's roll the ball"

Alternately roll the tennis ball with your right or left foot, applying slight pressure to your foot. Instead of a tennis ball, you can use a massage ball.

“Pull the sock towards you”

Use your fingers to either pull the toe of your foot towards you or relax it.

"Rises on an elevated plane"

Stand on a stable stool or chair in this way: one foot is completely on the surface, the other only one-third. Spring up and down.

"Walking from toe to heel"

Walk around the room barefoot, rolling your foot from toe to heel.

Symptoms

The main symptom of flat feet that forces a person to seek treatment is pain. It occurs during physical activity and depends on the degree of the disease. In the first degree, discomfort is localized exclusively in the area of the feet, and in severe cases it spreads far beyond the lower extremities. Periodic pain in the hip joints, lower back, as well as headaches are a common companion for people with severe flat feet.

With an advanced degree of the disease, pronounced deformities of the feet are noted:

with a longitudinal form: the inner side of the ankle joint is tucked inward; due to this, the leg is bent in this area (valgus position of the foot); this position of the foot leads to overload of the talonavicular joint, which leads to arthrosis of this joint.
in the transverse form: from overloads of the forefoot, deforming osteoarthritis of the 2-4 metatarsophalangeal joints is formed, on the projection of these joints on the sole of the foot, corns are formed, the plantar aponeurosis of the flexor fingers is injured, it thickens, shortens, which leads to flexion contracture of the fingers, the second and third toe acquire a hammer-shaped appearance, the back surfaces of these fingers are injured in shoes, forming corns.

Gait with flat feet becomes awkward, stiff and heavy. A person spreads his toes to the sides or clumps, depending on the form of the disorder.

In addition to obvious symptoms, there are a number of indirect signs of flat feet by which a person may suspect a problem:

shoes wear out faster on the inside;
when walking in heels, your legs get tired faster;
the foot seems enlarged, you have to buy shoes a size larger than usual;
There are difficulties maintaining balance when squatting.

All these little things, combined with pain and heaviness in the feet after a long stay on your feet, should be a reason to contact an orthopedist.

What are flat feet like?

Deformation of the foot can lead to flattening of the longitudinal arch, in this case they speak of longitudinal flatfoot

.
Flatness of the forefoot is called transverse flatfoot
. If the deformity affects both arches of the foot, combined flatfoot is diagnosed.

Flat feet can be congenital

.
In this case, improper development of the foot occurs due to intrauterine defects. This is a fairly rare occurrence. Much more common is acquired flatfoot
, which can develop at any age.

Diagnostics

If flat feet are suspected, the orthopedic doctor will prescribe several examinations:

plantography: taking a foot print on paper;
podoscopy: assessment of the static position of the foot in a special apparatus;
podometry: measuring the foot and calculating several indices indicating deviations;
podography: analysis of the biomechanics of walking using special shoes and a walkway;
electromyography of the foot and lower leg: assessment of bioelectrical activity of muscles;
X-ray: the image clearly shows the bone structures of the foot, their changes and pathological formations.

Modern equipment allows you to calculate many parameters and analyze the foot print automatically. This greatly simplifies diagnosis.

Diagnosis of the disease

Identifying flat feet begins with taking a medical history to find out what foot complaints the patient has and when they began. Next, they proceed to the inspection, where special attention is paid to the following points:

foot skin color;
presence of thickened skin, calluses;
position of the big toes when the foot is tightly closed;
the presence of deviations of the foot inward or outward;
changes in the anterior and calcaneal regions.

Even without instrumental diagnostics, based on complaints and examination, flat feet can be suspected based on the following points:

the presence of a protruding “bone” near the thumb;
wear on the inside of shoes;
rapid fatigue in the legs during prolonged walking or standing;
an increase in the volume of the foot - the inability to wear your favorite shoes that previously fit;
swelling, aching pain in the legs, feeling of heaviness at the end of the day;
discomfort when wearing high-heeled shoes;
violation of posture and gait;
Difficulty maintaining balance when squatting.

To make an accurate diagnosis, determine the degree of deformation, and select the most effective treatment tactics, patients are required to undergo a number of studies.

Computer plantography

An improved and accurate method for diagnosing foot diseases using foot prints. The technique is simple, painless and highly informative. Before the examination, the doctor enters all information about the patient into the computer system. The patient stands barefoot on a special platform that looks like glass. The device scans, and in order to obtain more accurate information, the examination is carried out in different planes.

Podometry

A method for diagnosing flat feet with determination of the Friedland index of the longitudinal and transverse arches. It represents the ratio of the height of the foot to its length as a percentage. Normally, the longitudinal arch index is 29-31%. If the indicator decreases, this indicates flat feet. The transverse arch index should not exceed 40%.

Podography

A research method for studying the biomechanics of walking. The procedure is carried out using special equipment - shoes with metal plates and a metal-coated track. During podography, the duration and width of the step, turn of the foot, and gait characteristics are recorded.

X-ray examination

It is necessary to identify changes in the bones of the foot, determine the degree of the disease, and monitor dynamics during treatment. Using X-ray images, you can accurately determine the height of the arch, the angle of the longitudinal arch, and the intermetatarsal angles.

Treatment of flat feet

Effective treatment of flat feet is possible only in childhood, when the bones and ligaments have not yet fully formed. In the future, doctors can only slow down the process of deformation, relieve the person from pain and prevent the development of complications. For this we use:

manual massage of the feet and legs: helps improve blood circulation, strengthen ligaments and muscles;
massage using a special mat or electric massager;
therapeutic exercises: walking on heels and on toes, bending and extending toes, picking up objects from the floor with your feet, rolling round objects; It is recommended to perform exercises daily;
physiotherapy: magnetotherapy, phonophoresis, electrophoresis to stimulate muscles, improve blood supply, and effectively administer medications;
drug treatment: pain relief by taking analgesics, using pain-relieving ointments (as prescribed by a doctor);
wearing orthopedic shoes: special shoes or insoles for regular models help redistribute the load on the foot and relieve pain; in childhood, promotes the correct formation of arches;
surgical treatment: the only way to get rid of flat feet in adulthood.

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Methods for diagnosing flat feet

Diagnosis of flat feet is carried out by an orthopedic traumatologist. The degree of flatfoot is determined using instrumental research methods.

Plantography

Plantography is the determination of flat feet based on the imprint of the plantar surface of the foot obtained using special equipment (plantograph).

Radiography

To diagnose flat feet, radiography of the foot is used. This research method makes it possible to establish a diagnosis and determine the degree of flat feet.

More information about the diagnostic method

Sign up for diagnostics To accurately diagnose the disease, make an appointment with specialists from the Family Doctor network.

Prevention

The most effective way to prevent flat feet is to wear the right shoes. It should be tailored to size, made of high-quality leather and have a flexible sole. Heel height for adults: 4 cm, for children: 0.5 cm.

In addition, orthopedists recommend:

avoid foot injuries;
lead an active lifestyle with moderate physical activity (not professional sports!);
use massage mats, walk barefoot on sand, grass, pebbles;
avoid excess body weight.

Causes

Taking into account statistical data, the pathology is congenital in approximately 3% of all identified cases of the disease. Flat feet can occur at any age due to a variety of reasons. Flattening of the arches can be caused by:

excess body weight;
pregnancy;
heavy physical activity;
wearing uncomfortable, tight shoes, their incorrect selection for sports activities, which can also cause injury;
a sedentary lifestyle with a lack of stress on muscle tissue, which contributes to its weakening and the inability to maintain the correct position of the foot;
work that requires you to constantly stand on your feet;
diseases of the joints and connective tissue, leading to foot deformation;
potassium deficiency and disturbance of its metabolism;
limb injuries.

The cause can also be diseases of the central nervous system, in which sensitivity and movement in the legs are impaired or completely disappear. But shoes still take the leading position among all risk factors. This is confirmed by the fact that women suffer from flat feet much more often than men. Wearing shoes with a heel higher than 4 cm is already a threat to the foot, and the higher it is, the greater the likelihood of developing foot deformity and its complications.

When wearing heels, the center of gravity shifts, the angle of inclination in the ankle increases, which overloads the forefoot. Due to such a load, the transverse arch begins to change, which ultimately leads to flat feet. But not only heels are dangerous, but also shoes with completely flat soles, especially for children when the period of formation of the foot has not yet completed. To eliminate this risk factor, adults need to wear shoes with a heel height of no more than 3-4 cm, and children - 1-1.5 cm.

Complications and consequences

Flat feet only at first glance seem like a harmless disease. Incorrect distribution of the load on the foot and joints, the lack of adequate shock absorption inevitably affects the condition of not only the musculoskeletal system, but also the entire body.

Without treatment, a person develops:

severe clubfoot;
hallux valgus;
arthritis and arthrosis of the ankle, knee, hip joints;
hernias and protrusions of intervertebral discs, pain in the lower back, neck;
headache;
Varicose veins;
heel spur.

Consequences of flat feet

Flat feet lead to a loss of shock-absorbing ability of the foot. As a result, the entire bone apparatus begins to experience harsh shocks when walking. The concussion is transmitted up the skeleton and reaches the brain. With severe flat feet, these excess loads affect various places, causing:

changes in gait and posture. The gait becomes heavy, “clubfooted”;
foot diseases and foot pain;
diseases of the knee joints (arthrosis deformans, inflammation of the menisci, knee joint laxity) and knee pain;
diseases of the hip joint (coxarthrosis);
diseases of the spine (osteochondrosis, scoliosis, herniated discs, radiculitis) and back pain;
headache.

Treatment at the Energy of Health clinic

Traumatologists and orthopedists at the Energy of Health clinic are ready to help with any form of flat feet. We offer patients:

consultations on the selection of shoes, orthopedic insoles and lifestyle correction;
physical therapy classes under the guidance of an instructor and training in basic exercises for home workouts;
selection of painkillers;
physiotherapeutic procedures to alleviate the condition;
therapeutic massage courses.

Regular monitoring by our specialists will help you reduce pain and heaviness in your feet and reduce the risk of complications.

Orthopedic insoles for transverse flat feet

To keep your feet healthy, make it easier on them. Orthopedic insoles will help you with this. Unlike conventional flat insoles, orthopedic ones have special elements that keep the foot in the correct position - supporting the arches and activating natural support points.

Special orthopedic insoles for bunions

Orthosoles with “underwires” raise the outer joints of the toes and force the transverse arch of the foot to rest on them. The fact is that the muscles of the foot feel areas of support and reflexively work in such a way that the foot rests on those places where it feels this support. Thus, a correction occurs - the foot “gets used” to resting on the joints of the big toe and little toe.

Exercise insoles simulating barefoot walking

Insoles-simulators are a tool for the prevention of transverse flat feet. Their main task is to prevent your feet from “spreading out” while you are busy with everyday activities.

Orthopedic insoles made of “weightless” material for all types of flat feet

Orthopedic insoles made of “weightless” material are lightweight and quick to get used to. They are made of one-piece flexible and very light material. They keep their shape well even without adding extra weight to them. The longitudinal rise of these insoles is very smooth, so their relief is not pronounced, which means you won’t have to get used to them, and you will immediately feel lightness and comfort when walking.

Advantages of the clinic

The doctors of the Energy of Health clinic are always ready to help the patient. We guarantee everyone:

individual approach to diagnosis and treatment of diseases;
modern equipment for detecting diseases;
consultations with narrow specialists of various profiles;
collection of material for analysis;
all types of medical procedures;
modern medical procedures, physiotherapy, massage and exercise therapy.

Don't let flat feet ruin your life. Bring back the lightness of your gait, make an appointment with an Energy of Health orthopedist.

Self-massage for transverse flat feet

Self-massage of the feet with transverse flatfoot, unfortunately, is not able to change the shape of the foot or reduce the stage of development of the disease. However, it will help you reduce pain and fatigue in your legs, as well as restore normal blood circulation. Here are a few tricks:

Relax your foot: gently stroke it from above, smoothly moving to the ankle. Repeat these movements 5-6 times.
Warm up the foot: rub the sole and back of the foot for 30 seconds from the toes to the ankle.
With both hands: clasp your foot on all sides with both hands and massage from toe to ankle for 30 seconds.
Rotate your big toe: Grasp your big toe with your index finger and thumb and rotate it around its axis.

The video shows several simple self-massage techniques for flat feet from osteopathic doctor Vsevolod Vychuzhin.

“Insoles and shoes affect the shape of a child’s foot in the same way as a hat affects the shape of his head.”

– All parents of babies are tested by a difficult struggle between a hard back and a soft sole. Should shoes have a hard heel when a child learns to walk? Or are Western doctors right when they say that you need to walk barefoot?

– The human foot is designed for walking barefoot. Humanity has been wearing shoes in the current sense of the word for the last 500 years, probably, and in Russia it’s been like this for about 200 years. Until recently, all of Russia walked in bast shoes, they didn’t have any backs - neither high nor low - and people did not die out from flat feet .

The formation of the arch of the foot has nothing to do with shoes at all.

At the Galen Clinic we use ancient Greek statues as an example: the ancient Greeks did not have shoes! Look how beautifully formed their feet are! The arch of the foot is a genetically programmed element of its anatomy. Biologically, the foot is adapted only to walking barefoot

One of the great modern American podiatrists said: “Insoles and shoes affect the shape of a child’s foot just as a hat affects the shape of his head.” That is, no way! It is definitely impossible to change the shape of your feet for the better with shoes!

Where did this high back story come from? There was an empirical postulate that if you set a certain pattern for the growth of the foot in the form of a high heel or arch support, then the foot will develop along this pattern, but this has not been confirmed by any research.

To roughly imagine the analogy, we can recall the story of mustard plasters and jars. If 30 years ago a child started coughing, a pediatrician would come to him and prescribe him mustard plasters or cups, or both. If now a pediatrician comes to your coughing child and prescribes mustard plasters or cupping, then next time you will call another pediatrician.

You don’t wonder why mustard plasters or cans disappeared. But they disappeared because their effectiveness has not been confirmed by anything, and 30 years ago this effectiveness was not discussed at all; it was a priori believed that mustard plasters and cups would be useful for a coughing child. Medicine is changing, it is changing based, first of all, on the principle of evidence.

If you look at your palm, you will see that there is a notch on your palmar surface, the so-called “arch of the hand.” Have you ever worn gloves with high, hard cuffs? No? How did your hand form if you never wore hand supports? Where did you get this dimple on your hand? You are evolutionarily programmed to have it. The size of this notch is different for everyone. I have it a little more, you have it a little less.

Little of! As a rule, if we put a hard glove on a hand (as my colleague cites in the article), we will significantly worsen the function of the hand, for example, in a hard glove you will not be able to draw or sculpt.

It's highly likely that I have a slightly larger arch than you. It is possible that you have a tendency to flatten the arch of your feet, do you personally?

- Maybe. And children have it.

– Children have a slightly different story. When children are born, they have two fat bodies: one on the cheek to facilitate sucking, the so-called “Bishat fat pad”, the other is the fat pad on the foot, this is a built-in arch support that gradually dissolves. If you look at a newborn baby's foot, it is slightly arched and springy. And this “built-in arch support” is not needed to form the arch of the foot, the arch of the foot is formed according to other laws, it is needed to soften the load. If this lump experiences excessive pressure, it may dissolve faster.

But there is a nuance regarding arch support in shoes. Can you imagine a car steering wheel? When you take the steering wheel, it is more comfortable for you when it is not smooth, but has a texture on it. It follows the shape of your brush. It’s a similar story with shoes – the most comfortable shoes are those that, to one degree or another, follow the topography of your foot, so good, comfortable, convenient shoes always have a plantar surface lining. There, as a rule, there are instep supports. The same applies to sports shoes, on which the result of competitions largely depends - they always have an instep support. But not so that the athlete’s arch is formed, but so that the foot feels as comfortable and stable as possible.

There is one more nuance. In children under three years of age, foot propulsion is not sufficiently developed. Children under three years old walk as if waddling. There is an English word that is typical for children from one to two - two and a half years old, this word toddler, roughly translated as “stomper,” that is, a child who does not yet walk confidently. There is no single word in the Russian language that would describe such a gait. In these children, indeed, due to their age, the function of the ankle joint is not yet sufficiently formed.

I call this gait “bear-toed.” Slightly waddle, swaying from side to side

So these kids, at least in theory, have some justification for wearing taller shoes to improve stability. If a child walks unsteadily barefoot or in low-backed shoes, and you put high-backed shoes on him, and he walks more steadily in them and falls less, then for this situation there is at least some biological basis for high-backed shoes - for situational improvement of resilience. The maximum when this is biologically necessary is up to three years.

Unfair marketing tactics

– So, it’s all the same as with cans and mustard plasters? But orthopedic shoes are expensive!

– I wouldn’t like to suspect someone of using some dishonest marketing tactics, but when I come to the store to buy shampoo for myself, and there are two shampoos next to me – one regular, inexpensive, and the other for preventing hair loss – and I have small problems – my hand will reach out to the one for improvement, this is psychology. Although, as a doctor, I understand that it does not improve anything, because if it were so, then the balding male half of humanity would not suffer from complexes.

I completely agree! Orthopedic shoes are needed for children with orthopedic pathology! Nobody prescribes glasses for prevention! Here is another article on our website https://www.galen.by/articles/46-pervaya-obuv-rebenka

So my mother comes to the store to buy shoes, and next to them there are two pairs - one pink, light, comfortable - ordinary, and next to them - shoes that are tall, heavy, scary and expensive, but it says on it that they are for the prevention of flat feet.

Most likely, the hand of a modern Internet-addicted mother will reach for those shoes on which it is written that they are preventative. Consciousness works like this: I want to do everything for my child before it’s too late. This hypothetical “before it’s too late” concept works very well. This is a large marketing niche where consciousness can be manipulated.

And in general it is a question of trust. If, relatively speaking, in Finland a doctor tells a patient that this and that needs to be done, then the patient does it. If in Russia a doctor says that something needs to be done, then 99% of patients, especially mothers, will go online and double-check his opinion. Is it true?

- Certainly!

– Your answer “of course” is very revealing. I'm not even talking about the degree of mutual distrust, this does not concern anyone personally, this concerns the atmosphere. The degree of mistrust in society is too great.

– By the way, now a lot of things are passed from child to child, this is in any country, including shoes. Is it normal to wear shoes after having another baby?

– Shoes are clothes for the feet and nothing more. When you buy panties, do you go to the doctor to consult? Sorry for the question. Probably not. And there are so many fancy things with shoes!

And everything is very simple, shoes are clothes for the feet. The criteria for choosing shoes for children are simple - comfort, lightness, beautiful appearance and true to size.

If you take shoes anywhere, even from a trash heap, and they meet these criteria, then do what you want with basic hygiene. In Russia, and not only in Russia, it is customary that from generation to generation the younger ones wear after the elders, including shoes. Therefore, there is no need to complicate simple things.

Conclusion: life without transverse flatfoot

As we have already said, flat feet cannot be cured completely; you can only stop the process of its development and reduce the dangerous effect on the body.

If you already have flat feet:

Are there any signs of flat feet? Let's run to the doctor! The doctor will determine the degree of transverse flatfoot and select the correct treatment.
Do massage and gymnastics. It's effective and free.
Wear the right shoes. Comfortable low-heeled boots that do not put pressure on your toes are suitable.
Use orthopedic insoles. This is a good and affordable way to prevent the development of the disease.
Use foot products. Correctors, pads and ties will strengthen the muscles of the feet, reduce discomfort, and relieve pain.

Longitudinal-transverse flatfoot: who is suitable for surgical treatment?

The method of surgical treatment of longitudinal-transverse flatfoot depends on the stage of the disease. Indications for surgical treatment should be made quite discreetly, since this disease can be treated conservatively. Due to the dynamic situation in the arch of the foot, good results can be achieved through regular training and special exercises aimed at developing muscles.

Surgical treatment of longitudinal-transverse flatfoot is recommended only if the patient experiences severe pain for a longer period of time, and also if this pathology has a negative impact on the patient’s quality of life. Chronic tendon inflammation or rupture of the tibialis posterior tendon makes surgery inevitable. It will also be necessary to operate on spasmodic deformities of the hindfoot, accompanied by arthrosis of the ankle joints.

The bitter consequences of transverse flatfoot: why you need to start treatment now

If the degree of flatfoot is slight, you may not even be aware of its presence. However, if the foot has become severely deformed, the bitter consequences of transverse flatfoot appear:

Legs get tired quickly during physical activity;
Swelling and pain appear;
Knee and hip joints are overloaded;
The spine suffers;
The gait is deformed, “clubfoot” appears;
Longitudinal flatfoot worsens;
Other foot deformities also appear: bunions, heel spurs, calluses and corns;
Blood flow in the legs is disrupted.

Therefore, as soon as you suspect that you have transverse flatfoot, run to the doctor. The sooner you start fighting transverse flatfoot, the greater your chances of preventing its terrible consequences.

How is the operation of longitudinal-transverse flatfoot performed at the Gelenk Clinic?

Surgical treatment of longitudinal-transverse flatfoot with inflammation of the tendon of the tibialis posterior muscle

The method of performing surgery for longitudinal-transverse flatfoot depends on the original cause of the disease. In cases of mild inflammation of the tibialis posterior tendon, only the inflamed connective tissue around it is removed (synovectomy). If necessary, the tibialis posterior tendon can be shortened and re-sutured.

At a progressive stage of tendon destruction or when it ruptures, doctors use an autogenous graft. The main condition for successful transplantation is the healthy condition of the tibialis posterior muscle (Musculus tibialis). The transplanted tissue (graft) is taken from the foot area. The nearby long toe flexor tendon (flexor digitorum longus tendon or Musculus flexor digitorum longus) is well suited for this procedure. The limitation of the patient's mobility due to tendon displacement is almost imperceptible - only the mobility of the toes can decrease slightly. Often, muscle strain due to tendon displacement may be associated with additional interventions to maintain bone health.

Image of longitudinal-transverse flatfoot with weakened tibialis posterior tendon (yellow). This tendon is responsible for the normal condition of the longitudinal arch of the foot. Rice. right: operated longitudinal-transverse flatfoot. A taut tibialis posterior tendon and autogenous bone graft straightens the longitudinal arch of the foot again. © joint-surgeon

Osteotomy of the calcaneus

If the development of longitudinal-transverse flatfoot is caused by damage to the calcaneus, surgeons at the Gelenk Clinic in Germany perform displacement surgery (corrective osteotomy). The inward deviation of the heel bone changes the direction of the Achilles tendon, which promotes full straightening of the foot.

An arched method for correcting longitudinal-transverse flatfoot is the implantation of a special bone wedge into the heel bone, which holds the desired correction in the correct position. This insert is often taken from the iliac crest (Hinterman technique or Evans procedure).

Arthrodesis (creating immobility) of the talus

If prolonged improper loads have caused painful arthrosis of the ankle joints in elderly patients, and if this pain is associated with tendon deformation, often only a technique such as arthrodesis will help restore the original healthy function of the joints. In some cases, triple arthrodesis is recommended. During this operation, all joints of the talus are immobilized: back/down to the calcaneus, forward to the scaphoid, as well as the connection between the calcaneus and the cuboid bone.

Conditions of accommodation at the Gelenk Clinic

Orthopedic Clinic Gelenk Klinik in Gundelfingen near Freiburg, private room
As a rule, during an inpatient stay at the clinic you are in a separate room with shower and toilet. In addition, we provide you with towels, a robe and slippers. You can also use the minibar and safe. In addition, each room has a TV. You only need to bring your own medications, comfortable clothes and nightwear. After longitudinal-transverse flatfoot surgery, we guarantee round-the-clock care by qualified nursing staff and experienced physiotherapists. Basically, the length of hospital stay after surgical treatment of longitudinal-transverse flatfoot is three days. Your family members can stay at a hotel that is a few steps away from the clinic. We will be happy to take care of your hotel room reservation.

Will there be pain after surgery for longitudinal transverse flatfoot?

Each surgical intervention is associated with certain pain sensations. As a rule, we try to reduce pain after surgical treatment of longitudinal transverse flatfoot to a minimum. Typically, before surgery, the anesthesiologist administers a drug block that numbs the foot for about 30 hours. After this, the worst wave of pain is over and treatment of longitudinal transverse flatfoot can be carried out using conventional medications. We will do everything possible to relieve the patient from pain.

Stages of flat feet

In its development, the disease goes through several stages:

pre-disease;
intermittent flat feet;
first, second and third degrees of severity.

At the pre-disease stage, the foot retains its shape, but if it is necessary to walk or stand for a long time, it begins to hurt.

At the stage of intermittent flatfoot, the foot becomes deformed under load, but after rest it restores its previous shape.

With the first degree of flatfoot, a slight deformation of the foot becomes noticeable (the height of the arch is more than 25 millimeters), and the gait changes. Possible pain, rapid fatigue, swelling.

In the second degree, the height of the arch is less than 18 millimeters. A person constantly experiences pain in the feet, which can spread to the knee. Walking becomes significantly more difficult.

In the third degree, the foot is severely deformed and the arch almost completely disappears. A feeling of pain accompanies even short-term walking. The feet and legs become very swollen. Pain in the lower back and headaches are possible.

Dysplasia, treatment by position

– There are a lot of questions about dysplasia.

– This is a much more serious topic, since undertreated or missed dysplasia can lead to disabling consequences. Here we need to be specific.

– Is it possible to carry a child in a sling or ergo-backpack with first-degree dysplasia, while the child is in a Freiki pillow.

– Firstly, it is no longer customary to talk about the degrees of dysplasia in children, but there is a classification of types of development of the hip joint according to Graf. These types are determined by ultrasound. Often, ultrasound doctors, especially those not directly involved in orthopedics, do not find the ossification nucleus of the femoral head in children during the first 6-8 months of life and make a diagnosis of dysplasia. This is a fundamentally wrong approach. Dysplasia may be accompanied by a delay in the appearance of ossification nuclei, but this delay in itself is not a basis for the diagnosis of dysplasia. For example, pneumonia is usually accompanied by a cough, but this does not mean that every child who coughs has pneumonia.

Once the diagnosis of hip dysplasia is established, the main treatment is positional treatment. Regardless of what gives the hips relative to the pelvis the correct position, with the femoral head centered in the acetabulum, this principle works if this position is respected. The Freiki pillow gives your legs this correct position. If you are a child with hip dysplasia, who is wearing a Freiki pillow, additionally place it in any position, in any condition, in any design, but at the same time the femur will maintain the correct position in relation to the pelvis, then you can wear it as you like and in anything. The principle of treating dysplasia is long-term centering of the femoral head in the acetabulum.

– So there could be tires, stirrups, and a Freika pillow?

– There are a lot of designs, most of their authors or organizations that sell each specific design claim that their model is the best. To date, there is no consensus regarding which design is better. Therefore, different clinics and different schools use different products with fairly comparable results. Of course, if the diagnosis is made correctly, if treatment is started on time and if the child’s legs occupy the optimal position in this structure, the legs will not dangle, if everything is selected according to size, according to age, if all the rules are followed. That is, this is all treatment by position. Neither the cushions nor the stirrups emit any healing rays that cure hip dysplasia. For hip dysplasia, the main treatment is the correct position of the hip in relation to the pelvis.