Such a verdict is distressing for most parents: the beautiful gait of a child is under threat. Ah, if it were only a cosmetic problem … Unfortunately, the flattening arch of the foot is a serious and insidious pathology that can affect almost the entire musculoskeletal system. Why is this disease dangerous? How to recognize it? And is it treatable? My Canadian Pharmacy team will try to answer all these questions.
What is a flat-foot?
Unfortunately, flat-foot is one of the most common abnormalities in the development of the musculoskeletal system. Here is a disappointing statistic: 9,000 children out of 1.5 million children living in Toronto have a flat-foot. About 2 thousand young patients complain of pain in their legs. First of all, let’s see what is meant by this pathology?
Flat-foot is the deformation of the foot, in which the vault is flattened. To better understand the nature of the disease, we will analyze some of the anatomical features of the foot. In the process of evolution, it has acquired a form that allows the body weight to be evenly distributed.
The bones of the foot are interconnected by strong interosseous ligaments (these are fibrous formations from the connective tissue, represented as a bundle connecting the bones) and form a vault that provides amortization of movements during walking and running. Convex arches are oriented in the longitudinal and transverse directions.
Therefore, the foot of an adult person normally rests on three points – the calcaneal tubercle, the head of the 1st metatarsal bone and the 5th metatarsal bone. There are two longitudinal and one transverse arch of the foot. The inner and outer arches form a longitudinal arch of the foot, and the anterior arch forms a transverse arch. Depending on their deformation, scientists distinguish longitudinal and transverse flat-foot types.
- In the case of longitudinal flat-foot, the outer and inner arch of the foot are flattened, its length increases and almost the entire area of the sole contacts the floor.
- In the case of transverse flat-foot, the transverse arch is flattened, the front part of the foot fan diverges and rests on the heads of five metatarsal bones.
All children under the age of two have a flat longitudinal arch of the foot. Such a condition is considered physiological, because the bone tissue in babies is soft and elastic. It contains few minerals that give bone strength, and the muscular system is not developed enough.
At the age of 2-3, the bones acquire enough minerals, the articular surfaces get normal outlines, the ligaments become more durable, and the muscle strength allows you to stay on your feet longer. The process of formation of the foot bones continues up to the age of 5-6 years. Only in this period we can we talk about the presence or absence of flat feet in the child. See a more detailed description of flat-foot.
If the diagnosis was confirmed
Most often, children experience longitudinal flat feet. It is innate and acquired. The congenital form of the disease is rare and is a consequence of intrauterine malformations. The condition is reveal at once in the hospital.
In most cases, one foot is affected, but sometimes both are affected. This pathology is pronounced very noticeably: a convex sole and an outwardly “turned out” outward front of the foot. Treatment is carried out from the first days of the child’s life: the deformation is gradually corrected with plaster bandages. If this does not help, they resort to surgery.
As for the acquired longitudinal flat feet, My Canadian Pharmacy points out the following types:
- Traumatic. Occurs after fractures of the foot and ankle bones. Partial or complete damage to the ligaments in such a trauma, as well as prolonged stay of the child in the plaster bandage, contribute to the flattening of the arches of the foot;
- Paralytic. Occurs on the basis of disorders of the central or peripheral nervous systems (more often – the consequences of poliomyelitis);
- Static. This is the most common form of the pathology. Arises from overloads with a significant increase in body weight, usually with obesity, endocrine disorders;
- Ricky. Occurs with excessive elasticity of ligaments and weakening of the muscles of the arches of the foot. The reason may be a lack of vitamins and trace elements, rickets or general exhaustion, congenital pathology of connective tissue.
So, the foot was deformed. What happens in the body? Bundles send “signals” to the nervous system about trouble at this “area”. In response, the muscles receive an “indication” to enter into a “struggle” with the deforming forces – that is, to tense up properly.
But they can not withstand such a load for a long time, therefore they quickly become exhausted, relax and stretch. A deforming force continues to act on the ligaments and provokes a stretching (especially in the case of an innate pathology of connective tissue), since they can not work for a long time without the support of muscles. Now all the load falls on the bones. When they fail, the deformation begins.
By this time, the ligaments are finally “knocked out”, and the deformation enters a final, irreversible phase. The gait loses its plasticity and smoothness. Children often complain of fatigue when walking, pain in the ankle or shin area and in the lower back.
Some can not clearly determine where exactly they experience discomfort or pain, so they do not complain, but simply prefer quiet, less moving games. There is a deformation of the ankle joint (it is also called valgus or X-shaped). In the presence of one or more of these signs, consultation of an orthopedic physician is necessary.
Sometimes deformation of the foot can exist for many years (up to adulthood) without manifesting. But sooner or later deterioration will occur, since the compensatory possibilities of the organism are not unlimited.
At the age of 3 (but not earlier), the child can get some initial diagnostics of a pathology, using the most widespread method – a planography (a stamp of a foot). This can be easily done at home. A blank sheet of paper is put on the floor, and the toddler stands on it with both feet. The soles should be wet, so that we could see their clear imprint on the paper. The trunk must be kept straight, legs together. The contour of the feet is marked by a pencil in this position. Then a straight line perpendicular to the contour line intersects the entire narrow part of the foot. The easiest degree of deformation is the first. But the heaviest and most serious is the third one.
Children of this age are not examined by X-rays. First, the bones of the foot are not yet “ripe” to the end, the cartilaginous tissue on the X-ray image is not visible and it is difficult to estimate the true height of the longitudinal arch. And secondly, this method of diagnosis is harmful enough for the child, therefore it is performed only with serious indications and more often after the age of 9.
Use of anesthetic drugs is only acceptable for elimination of severe pain.
Treatment of flat-foot
My Canadian Pharmacy specialists inform that one can’t count on a complete elimination of flat-foot, especially with far-gone pathology. But you need to be treated carefully, regularly and in good faith. The earlier the signs of the disease are revealed, the less deformation of the foot the patient will have.
At the initial stage, pain in the legs can be eliminated within 1-2 months by means of warm daily foot baths with sea salt, manual therapeutic massage and gymnastics. As for the baths, the requirements are simple: the water temperature + 40-50 “C, the duration of the procedure is 15-20 minutes, and the proportions of their constituents are indicated on the package and vary depending on the concentration of dry matter.
- Self-massage is a very useful practice, there are many devices for it (special mats, rollers, balls). Exercises are performed arbitrarily (walk on a massage mat, roll a massage roll, etc.). As a result, blood circulation improves, muscle tone normalizes.
- Gymnastics should be done in the morning, when the muscles are not tired. The best option is to show the baby the technique and pace of the exercises by your own example. The room should not be stuffy, or with drafts, and the child should wear comfortable clothes, not constraining his movements.
- Therapeutic massage must necessarily be carried out by a specialist in physiotherapy and massage.
Physiotherapy (paraffinoseocerite applications, electrophoresis, etc.) can also help in the treatment of flat-foot. It improves metabolic processes and blood circulation in the tissues and indirectly strengthens the arches of the feet. Massage and physiotherapy are prescribed courses, usually for 10-15 procedures. They should be carried out 2-3 times per year.
A special role in the treatment and prevention of flat-foot progression is given to orthopedic insoles, which are prescribed to fix all degrees of the pathology. They help to relieve the painful areas of the foot and correct the revealed deformities. The height of the arch of the arches of the foot in the insole depends on the degree of flattening. You need to insert them in both street shoes and home shoes to make life easier for a child.
As the child grows, the shape and size of the insoles must be changed. And here you can not do without repeated doctor’s consultations. You’d better buy insoles in prosthetic and orthopedic plants, orthopedic centers or order individual ones. Only in this case such products are guaranteed to meet the necessary standards. And more: it is not necessary to use orthopedic insoles “just in case”. If you wear them constantly without objective necessity, the arches of the foot will become relaxed, and flat-foot can develop even in a healthy child.
If the baby has a third degree of longitudinal flat-foot, especially in combination with valgus deformity of the ankle joint, the treatment can’t be limited to the insoles. The kid will have to wear orthopedic shoes – boots with lacing and stiff inner lateral support of the foot.
Complications of flat-foot
What are the complications of flat-foot? Unfortunately, they are very different. First of all, this is flattening of the transverse arch of the foot with the subluxation of the 1st finger outward in adolescence. If the foot stays long in the wrong position, and especially if there is a valgus deformity of the ankle, this can lead to deformation of the joints of the foot and even to a change in the ratio of the articular surfaces of the knee and hip joints. This is accompanied by pain in the legs, especially in the evening hours, and a decrease in depreciation functions leads to pain in the spine. In the future, this can lead to scoliosis, that is, an arcuate deformation of the spine to the right or left, or to its curvature with the formation of a bulge posteriorly – kyphosis.