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Health

Treatment of flat feet: basic methods

, medical expert
Last reviewed: 23.04.2024
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The treatment of flatfoot is an actual problem, since the deformation of the feet in the form of a decrease in the height and damping properties of their arches is a very common and, moreover, very uneasy pathology of the musculoskeletal system.

The static flatfoot, which accounts for more than eight cases out of every ten, can irreversibly change the mutual arrangement of the foot bones (and there are almost three dozen here) and the natural biomechanics of the distribution of body weight to the lower limbs when walking.

If you do not perform flatfoot treatment, which gives yourself quick fatigue in walking, pain and swelling, the process will progress, reducing the ability to move normally and maintain a strictly vertical position of the spine.

Methods of treating flat feet

Specialists note that the methods of treating flatfoot depend on its type: longitudinal, transverse, combined (longitudinal-transverse) or valgus.

Although to date, the ability of orthopedics to treat flat feet in adults conservative methods are limited to physical therapy, massage, physiotherapy procedures and the use of orthopedic insoles. There are no "flat feet" pills: pharmacological preparations can not strengthen muscles that support the optimal height of the arch of the foot, eliminate the weakening of the plantar aponeurosis, Achilles and tibia of the back tendon, or restore the bones of the foot to a normal position.

The foot can become flatter in the elderly or adolescence, during pregnancy, with diabetes and high blood pressure. And, of course, with excess weight. So obese people orthopedists are strongly recommended to lose extra pounds, otherwise the rapid development of flat feet and deformation of the bones and joints of the foot can not be avoided.

It should be borne in mind that the "cure platypodia" in adults - for example, like sore throat or hemorrhoids - medicine is not able. And the treatment of longitudinal flat feet (the most common type of this pathology) is the prevention of further development of the disease, as well as in the coping of emerging pain.

Treatment of flat feet in adults

The main treatment of flatfoot 1 degree (longitudinal, transverse, combined), when there are no obvious signs of bone deformation - exercise, massage (stop, ankle and calf muscles), warm foot basins with salt.

Treatment of transverse flatfoot, as well as treatment of combined flat feet at the initial stage of the disease is carried out by similar methods. In addition, for all types of pathology of the arch of the foot, women should give up heels more than 3-4 cm, as well as footwear with narrowed socks. And categorically you can not wear tight and trampled shoes!

Treatment of flat feet of the 2nd degree in adults, except for special exercises (such as in the section for flatfoot exercises) and massage, includes various physiotherapy procedures: paraffin and ozocerite applications, ultrasound phonophoresis with corticosteroids and electrophoresis with analgesics (with severe pain syndrome); magnetotherapy. With longitudinal flat feet, when the foot begins to "fall" inward (that is, there is a pronation of the foot), it is recommended that the insoles are constantly worn (at least 8 hours a day). And the treatment of transverse flatfoot at this stage involves correction of the shape of the foot with special cuffs for the front of the foot, which helps slow the process of hypertrophy of the head of the first metatarsal bone. In addition, shoes may be needed to treat flatfoot, as with transverse and combined flatfoot there is a discrepancy between the bones of the metatarsus, the deviation of the thumb from the outside, and an increase in the cartilage between the phalanges of the other fingers.

Footwear for the treatment of flat feet is orthopedic footwear, which is most often worn with pronounced flat feet (that is, flat feet 2 and 3 degrees) and which is prescribed by an orthopedic doctor after the examination. The most effective "works" orthopedic shoes, made by specialists for individual orders - based on the impression of the foot.

Treatment of flatfoot of the third degree, in which there is a spring, balancing and jogging dysfunction of the foot, reduces to physiotherapy, wearing orthopedic shoes, as well as relieving the pains that are felt in the ankles, knees, hips, lower back and back. At a given degree of flatfoot, orthopedic surgeons sometimes have to be taken for the job (Operative treatment of flatfoot - see below).

In addition to regular exercise of special exercises and foot massage, treatment of valgus flatfoot - longitudinal flat feet, complicated by valgus (X-shaped) stop installation - involves the use of individual orthopedic insoles and the wearing of orthopedic shoes with insteps and high backs. This will restrain the discrepancy of the feet and correct the characteristic for this pathology emphasis on their inner sides when walking. Orthopedists attribute this variety of flatfoot to congenital defects associated with the genetically determined weakness of the connective tissue of the tendons and ligaments.

By the way, the treatment of congenital flat feet, which is noted in no more than 3% of cases, is diagnosed rather difficult, in clinical orthopedics is carried out by the methods listed above, which help to strengthen muscles and ligaments.

Treatment of flat feet with arthrosis

Since the feet with flatfoot do not cope well with their function of shock absorbers, a significant part of the ascending dynamic loads that arise during walking have to experience cartilages of the knee and hip joints. Articular cartilages can not withstand the overloads not inherent in them, and then degenerative-dystrophic change of cartilaginous tissue (arthrosis) begins, and after it - deformation of the bone tissue of the joints. With transverse flatfoot often develop arthrosis joints of the big toes and joints of the metatarsal bone.

Continuing to wear insoles and insteps, doing as much exercise therapy, it is necessary to begin treatment of flat feet with arthrosis. In most cases, doctors prescribe non-steroidal anti-inflammatory drugs (NSAIDs) that relieve pain and inflammation in the joints. Means for topical application - ointments and gels Diclofenac, Ibuprofen (Deep Relif), Ketonal (Fastum Gel) - should be applied twice a day to the skin above the joint.

The treatment of pain with flat feet is performed and the intake of NSAIDs inside. These are Diclofenac (Naklofen, Ortophen), Ibuprofen (Ibuprex, Ibuprom, Nurofen), Tenotide, etc. Diclofenac is taken orally in before meals by 1/2 or a whole tablet three times a day; Ibuprofen - 200 mg three times a day. And capsules of Tenoktil take 20 mg (1 capsule) once a day, with exacerbation - 2 capsules once a day for two days, and in the next five days again one capsule per day.

Articular pains that result from flat feet, are removed with the help of compresses with Bishofit, which do for the night - every day for at least 12-14 days. And for rubbing into the area of the affected joint Dikrasin is used - 20 drops per joint, daily or every other day for 15-18 days.

For the treatment of arthrosis with flatfoot and with all degenerative processes in cartilage, such tablets are used as chondroprotectors, such as Arthron flex, Teraflex, Chondroitin complex, etc. Thus, Teraflex capsules are prescribed by orthopaedists for 1 pc. Three times a day - during the first three weeks of treatment, and then - 1 capsule twice a day. The duration of the course of therapy is at least 2 months.

In order to restore cartilaginous tissue in the joints, chondroprotectors for injection into the joint are appointed: Adant (Sodium hyaluronate), Alflutop, Gialgan Phidia, Synokrom, Synvisc, and others.

Treatment of flat feet in children and adolescents

According to pediatric orthopedics, the effective treatment of flat feet in children is possible up to a maximum of six years, since by this time the formation of the foot is completed.

In the first two years of life, in all children, the feet are longitudinally flat, and this is normal. That is why the exact diagnosis of flatfoot can be made no earlier than three to five years, although to detect obvious congenital abnormalities of the musculoskeletal system, the orthopedist should examine the newborns within the first month after birth, year and three years. By the way, congenital valgus flatfoot defines early enough - as soon as the child rises on the legs.

So, when a three-year-old does not stand a 30-40-minute walk and asks his mother to take him "on the handle", then it's time to consult an orthopedist.

The methods of treating flat feet in children are no different from those used in adults, and the emphasis is on therapeutic physical training, massage and proper footwear. The correct footwear for the child should have a hard back, fixing the heel to its full height, an elastically rigid sole and a supinator. This applies to summer shoes. But, as experts emphasize, until the age of two, the child's shoes should be without a pedicle.

It is also very important to wear insoles for the treatment of flat feet, a specific type of which should be prescribed by an orthopedic doctor. Correction of the arch of the foot and the cessation of its subsidence in childhood is achieved due to the fact that the orthopedic insoles help to physically position the arch and correctly distribute the load on the feet when walking.

Parents should take into account that it is at the preschool age that all measures taken in the fight against flatfoot can give the most positive result. First of all, because in childhood the elasticity of muscles is much higher, the process of development of muscular innervation (motor nerve endings) is not yet completed, and the relationship between muscles and their tendons makes it possible to strengthen the ligament apparatus of skeletal musculature with the help of purposeful physical action (therapeutic gymnastics).

Treatment of flat feet in adolescents, carried out on the principles already described, allows (as in adults) only to some extent to correct the defect of the arch of the foot. According to many experts, in adolescence, completely eliminated formed, and even more so, inherited "flat foot is not possible. The main reason is that the anatomically formed foot, but continues to grow - like all the bones of the skeleton. But in this case, the joint and ligamentous apparatus, as well as the ratio of muscles and tendons inherent in adults, are already established by the age of 14-15.

Operative treatment of flatfoot

Operative treatment of flatfoot is considered an exit in the presence of extremely complex deformities of the feet, preventing walking. Surgical operations on the foot are complex, and the positive result, that is, the restoration of the anatomical height of the arch of the foot and its functions, is not guaranteed.

Some of the most common surgical operations in the treatment of flatfoot:

  • Correcting osteotomy (dissection) of part of the first metatarsal bone with displacement in the desired direction - performed with transverse flat feet of 1 and 2 degrees;
  • Correcting wedge resection (excision) of the head of the first metatarsal bone (with transverse flat feet);
  • fixation in the state of immobility (arthrodesis) of the first wedge-shaped metatarsal joint (with external deviation of the first finger in transverse flatfoot);
  • tendon-muscle plastic of the transverse arch of the foot (with transverse flat feet);
  • reconstructive tendon plastic (with transverse flat feet).

From this far from complete list it can be seen that the surgical treatment of flatfoot in most cases concerns transverse flatfoot. And this is not accidental: according to medical statistics, patients with this type of foot arch pathology account for more than 60% of patients seeking medical help for flat feet.

Treatment of flat feet at home

Strictly speaking, home treatment of flat feet, that is, the fulfillment of prescriptions of a doctor at home, is not much different from treating a variety of other diseases. The only thing that can not be done at home is hardware physiotherapy: you'll have to go to the clinic.

All the rest of the treatment of flat feet at home does not require medical qualification, because both massage and exercise can be mastered by anyone. The main thing - patience, perseverance and belief that all this will help.

Foot baths with table salt are made from the calculation of a tablespoon of salt per liter of water, the water temperature is not higher than + 40-42 ° C, and the duration of this daily procedure is 15-20 minutes.

Home treatment of flatfoot lies in stimulating the reflex points of the feet, which occurs when walking in summer barefoot on a grassy forest glade, along the sandy river bank or sea pebble, along the yard near a farmhouse or a summer house. And in autumn and winter, especially to strengthen the foot muscles in children, you can use a massage mat to treat flat feet. You can buy it, but you can do it yourself literally from improvised materials, sewing any thick cloth of a button to a piece (90x90 cm) or pasting a dry bean, sea stones, etc. You can buy a massage roller, but it is quite suitable "just in case" removed on the mezzanine wooden abacus. No doubt, it's good to have a suitable massager for flatfoot: they are mechanical, roller, compression, vibrating. However, judging by the reviews of patients with flat feet, no simulators for the treatment of flat feet will replace the traditional manual massage.

Of course, it's better to go to the massage therapist several times, and then do it yourself. Especially since the basic methods of massage with flat feet are simple enough:

  • massage feet from the ankles to the groin from the bottom up (stroking, patting, rubbing);
  • massage the foot and its back side (from the fingers to the ankle) by rubbing, that is, by circular movements of the fingertips connected together, or by 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 phalanx of four fingers when the hand is compressed into a fist (in other words, "knuckles");
  • heels (alternately), as well as the bases of the toes on the side of the foot, are more conveniently triturated by bending the leg in the knee, four connected fingers of both hands (thumbs on the rise).

On each foot it takes no more than 5 minutes, so a lot of time this massage does not take, but it needs to be done daily, best of all - in the evening. But to perform exercises to treat flat feet should be at least 20 minutes and, if possible, twice a day.

Exercises for the treatment of flat feet

All exercises for strengthening ligaments and muscles with flat feet are performed only barefoot. So, first we do the exercises standing: we are like socks, and then heels; then we move, placing stops on the inner sides. The next: standing "rolling" the feet from the toe on the heel and in the opposite direction (20 times). We stand on a wooden bar about a meter long, by placing it across the foot (the arch of the feet on the bar, the heels and fingers on the floor). Staying in the same position, step by step we move along the bar. And, finally, standing on the floor, 6-8 times crouching, not rising to the toes (heels on the floor).

Sitting are performed such exercises (10 times):

  • legs lift above the floor to perform the rotation of the feet right-left;
  • feet, standing on the floor, lift up towards the lower leg, resting on the floor with heels;
  • feet on the floor, without lifting your fingers from the floor, lift the heels up, straining the ascent and the muscles of the lower leg;
  • feet on the floor, do not tear off the heels from the floor to press your fingers inwards - towards the heels;
  • feet on the floor, without lifting the cushions from the floor to lift all the fingers up;
  • position is the same, lift only the thumbs;
  • the position is the same, a small ball is rolled back and forth from the heel to the base of the fingers;
  • in the same position, with the feet to grab a bigger ball, hold it over the floor for 5 seconds, and lower it into place;
  • in the same position, without tearing off the heels, with the fingers of both feet (bending them under the foot) to collect a bed-towel on the floor or any piece of cloth.

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Treatment of flat feet by alternative means

The best treatment of flatfoot by alternative means - bicycling barefoot! Because no decoctions, no tinctures of medicinal herbs in this case are powerless. But pedaling is a massage, a simulator and, in part, a physical therapy ...

As an alternative for the treatment of flat feet with arthrosis, compresses are offered on the diseased joint at night - from cabbage leaves, from birch leaves, heated from boiling water, from clay, from honey with salt or black radish juice, and from rye flour with ammonia.

There is a prescription ointment for pain in the joints based on table salt (200 g) and mustard powder (100 g), which must be mixed with a small amount of kerosene - to get a medium density gruel. This ointment alternative healers are recommended to apply at night, rubbing into place over the joint until completely absorbed.

Another recipe for ointment from joint pain: take dry St. John's wort, yarrows and sage in a proportion of 2: 1: 1, grind in a coffee grinder and mix with vaseline or pork smaltz. Spread 1-2 times a day and heat the joint.

Our feet - thanks to the vaulted structure - perform the most important functions in the process of walking. In this case, the foot is the most "lifting" element of the human musculoskeletal system, and flatfoot treatment allows to minimize excess loads on the lower limbs and spine, and, therefore, maintain the supporting structure of the body.

PS Flatfoot problems are the subject of many scientific researches. In particular, studies of a group of American orthopedists have shown that in samples of tendon tissues obtained during operations on the tendon of the arch of the foot in adult patients with acquired flatfoot, the content of proteolytic enzymes that cleaves elastin and collagen, the main proteins of connective tissue, including tendons and ligaments. Perhaps this is the way to discover the true causes of weakening of the ligament of the foot, and then, at last, an effective treatment of flatfoot will be found.

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