Treatment of flat feet: basic methods

Treatment of flat feet is a pressing issue, since foot deformation in the form of a decrease in the height and shock-absorbing properties of their arches is a very common and, moreover, very complex pathology of the musculoskeletal system.

Static flatfoot, which accounts for more than eight cases out of every ten, can irreversibly change the relative position of the bones of the foot (and there are almost three dozen of them) and the natural biomechanics of body weight distribution on the lower limbs when walking.

If flat feet, which manifest themselves as rapid fatigue of the legs when walking, pain and swelling, are not treated, the process will progress, reducing the ability to move normally and maintain a strictly vertical position of the spine.

Methods of treating flat feet

Experts note that methods of treating flat feet depend on its type: longitudinal, transverse, combined (longitudinal-transverse) or valgus.

Although today the possibilities of orthopedics to treat flat feet in adults with conservative methods are limited to therapeutic exercise, massage, physiotherapy procedures and the use of orthopedic insoles. There are no "pills for flat feet": pharmacological drugs cannot strengthen the muscles that maintain the optimal height of the arch of the foot, eliminate the weakening of the plantar aponeurosis, Achilles and posterior tibial tendons or return the bones of the foot to their normal position.

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

It should be borne in mind that medicine is unable to "cure flat feet" in adults - for example, like sore throat or hemorrhoids. And the treatment of longitudinal flat feet (the most common type of this pathology) consists of preventing further development of the disease, as well as stopping the pain that arises.

Treatment of flat feet in adults

The main treatment for grade 1 flatfoot (longitudinal, transverse, combined), when there are no obvious signs of bone deformation, is therapeutic exercise, massage (feet, ankle joint and calf muscles), warm foot baths with table salt.

Treatment of transverse flatfoot, as well as treatment of combined flatfoot at the initial stage of the disease is carried out by similar methods. In addition, with all types of pathology of the arch of the foot, women must refuse heels more than 3-4 cm, as well as shoes with tapered toes. And it is strictly forbidden to wear tight and trampled shoes!

Treatment of grade 2 flatfoot in adults, in addition to special exercises (which ones - see below in the section Exercises for the treatment of flatfoot) and massage, includes various physiotherapy procedures: paraffin and ozokerite applications, ultrasound phonophoresis with corticosteroids and electrophoresis with analgesics (in case of severe pain syndrome), magnetotherapy. In case of longitudinal flatfoot, when the foot begins to "fall" inward (i.e. there is pronation of the foot), it is recommended to constantly wear (at least 8 hours a day) insoles-supinators. And treatment of transverse flatfoot at this stage involves correction of the shape of the foot with the help of special cuffs for the front part of the foot, which helps to slow down the process of hypertrophy of the head of the first metatarsal bone. In addition, shoes may be needed to treat flat feet, since with transverse and combined flat feet, there is a divergence of the metatarsal bones, outward deviation of the big toe, as well as an increase in cartilage between the phalanges of the remaining toes.

Shoes for the treatment of flat feet are orthopedic shoes, which are most often worn with pronounced flat feet (i.e. flat feet of 2 and 3 degrees) and which are prescribed by an orthopedic doctor after examination. The most effective "works" orthopedic shoes, made by specialists to order - based on a foot mold.

Treatment of stage 3 flatfoot, which is characterized by spring, balance and push dysfunction of the foot, comes down to physiotherapy, wearing orthopedic shoes, and also relieving pain felt in the ankles, knees, hips, lower back and back. At this stage of flatfoot, orthopedic surgeons sometimes have to take on the case (Surgical treatment of flatfoot - see below).

In addition to regular special exercises and foot massage, treatment of valgus flatfoot - longitudinal flatfoot complicated by valgus (X-shaped) foot placement - includes the use of individual orthopedic insoles and wearing orthopedic shoes with arch supports and high backs. This will restrain the divergence of the feet and correct the emphasis on their inner sides when walking, which is typical for this pathology. Orthopedists classify this type of flatfoot as a congenital defect associated with genetically determined weakness of the connective tissue of the tendons and ligaments.

By the way, treatment of congenital flat feet, which is observed in no more than 3% of cases and is diagnosed quite difficultly, in clinical orthopedics is carried out using the methods listed above, which help strengthen muscles and ligaments.

Treatment of flat feet with arthrosis

Since flat feet do not cope well with their shock absorber function, a significant part of the ascending dynamic loads that occur during walking is experienced by the cartilages of the knee and hip joints. Articular cartilages may not withstand overloads that are not typical for them, and then degenerative-dystrophic changes in cartilage tissue (arthrosis) begin, followed by deformation of the bone tissue of the joints. With transverse flat feet, arthrosis of the joints of the big toes and metatarsal bone joints often develops.

While continuing to wear insoles and arch supports, doing therapeutic exercise as much as possible, it is necessary to begin treatment of flat feet with arthrosis. In most cases, doctors prescribe non-steroidal anti-inflammatory drugs (NSAIDs), which relieve pain and inflammation in the joints. Topical agents - ointments and gels Diclofenac, Ibuprofen (Deep Relief), Ketonal (Fastum gel) - should be applied to the skin above the joint twice a day.

Treatment of pain in flat feet is also carried out by taking NSAIDs orally. These are Diclofenac (Naklofen, Ortofen), Ibuprofen (Ibuprex, Ibuprom, Nurofen), Tenoktid, etc. Diclofenac is taken orally before meals, 1/2 or a whole tablet three times a day; Ibuprofen - 200 mg three times a day. And Tenoktil capsules are taken 20 mg (1 capsule) once a day, in case of exacerbation - 2 capsules once a day for two days, and in the next five days again one capsule per day.

Joint pain caused by flat feet is relieved with the help of compresses with Bischofite, which are done at night - every day for at least 12-14 days. And for rubbing into the area of the affected joint, the drug Dikrasin is used - 20 drops for each joint, daily or every other day for 15-18 days.

For the treatment of arthrosis with flat feet and all degenerative processes in cartilage, such tablet preparations-chondroprotectors as Artron flex, Teraflex, Chondroitin complex, etc. are used. Thus, Teraflex capsules are prescribed by orthopedists 1 piece 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 cartilage tissue in the joints, chondroprotectors are prescribed for injection into the joint: Adant (Sodium hyaluronate), Alflutop, Hyalgan Fidia, Sinocrom, Synvisc, etc.

Treatment of flat feet in children and adolescents

According to pediatric orthopedists, effective treatment of flat feet in children is possible up to the age of six, since by this time the formation of the foot is complete.

In the first two years of life, all children have longitudinally flat feet, and this is normal. That is why an accurate diagnosis of flat feet can be made no earlier than three to five years, although to detect obvious congenital pathologies of the musculoskeletal system, an orthopedist must examine newborns during the first month after birth, at one year and at three years. By the way, congenital valgus flat feet are determined quite early - as soon as the child stands on his feet.

So, when a three-year-old child cannot stand a 30-40-minute walk and asks his mother to pick him up, it’s time to consult an orthopedist.

Treatment methods for flat feet in children are no different from those used in adults, and the emphasis is on therapeutic exercise, massage, and proper footwear. Proper footwear for a child should have a rigid back that fixes the heel to its full height, an elastic-rigid sole, and an instep support. This also applies to summer footwear. But, as experts emphasize, until the age of two, a child's footwear should be without an instep support.

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

Parents should take into account that it is precisely in preschool age that all measures taken to combat flat feet can give the most positive result. First of all, because in childhood the elasticity of muscles is much higher, the process of development of muscle innervation (motor nerve endings) is not yet complete, and the relationship between muscles and their tendons makes it possible to strengthen the ligamentous apparatus of skeletal muscles with the help of targeted physical action (therapeutic gymnastics).

Treatment of flat feet in adolescents, carried out on the principles already described, allows (as in adults) to correct the defect of the arch of the foot only to some extent. According to many specialists, in adolescence it is impossible to completely eliminate the formed, and even more so, the "inherited" flat feet. The main reason is that the foot is anatomically formed, but continues to grow - like all the bones of the skeleton. But at the same time, the articular-ligamentous apparatus, as well as the ratio of muscles and tendons, inherent in adults, are established by 14-15 years.

Surgical treatment of flat feet

Surgical treatment of flat feet is considered a way out in the presence of extremely complex foot deformities that prevent walking. Surgical operations on the foot are considered complex, and a positive result, that is, restoration of the anatomical height of the arch of the foot and its functions, is not guaranteed.

Some of the most common surgical procedures used to treat flat feet include:

• corrective osteotomy (dissection) of part of the first metatarsal bone with displacement in the desired direction - performed for transverse flatfoot of grades 1 and 2;
• corrective wedge resection (excision) of the head of the first metatarsal bone (for transverse flatfoot);
• fixation in a state of immobility (arthrodesis) of the first cuneiform metatarsal joint (with outward deviation of the first toe in transverse flatfoot);
• tendon-muscle plastic surgery of the transverse arch of the foot (for transverse flatfoot);
• reconstructive tendon plastic surgery (for transverse flatfoot).

From this far from complete list it is clear that surgical treatment of flat feet in most cases concerns transverse flat feet. And this is no coincidence: according to medical statistics, patients with this type of pathology of the arch of the foot make up more than 60% of patients who seek medical help for flat feet.

Treatment of flat feet at home

In fact, home treatment of flat feet, that is, following doctor's orders at home, is not much different from the treatment of many other diseases. The only thing that cannot be done at home is hardware physiotherapy procedures: you will have to go to the clinic.

All other treatment of flat feet at home does not require medical qualifications, because massage and therapeutic exercise can be mastered by anyone. The main thing is patience, persistence and faith that all this will help.

Foot baths with table salt are made at the rate of a tablespoon of salt per liter of water, the water temperature is no higher than +40-42°C, and the duration of this daily procedure is 15-20 minutes.

Home treatment of flat feet also involves stimulating the reflex points of the feet, which occurs when walking barefoot in the summer on a grassy forest glade, on a sandy river bank or sea pebbles, in the yard near a country house or summer cottage. And in the fall and winter, especially to strengthen the foot muscles in children, you can use a massage mat to treat flat feet. You can buy it, or you can make it yourself from literally improvised materials, sewing buttons to a piece (90x90 cm) of any thick fabric or gluing dry beans, sea pebbles, etc. You can buy a massage roller, but a wooden abacus stored on the mezzanine will do just in case. Without a doubt, it is a good idea to have a suitable massager for treating flat feet: they can be mechanical, roller, compression, vibration. However, judging by the reviews of patients with flat feet, no exercise machines for the treatment of flat feet can replace traditional manual massage.

Of course, it is better to visit a medical massage therapist several times, and then do it yourself. Especially since the basic massage techniques for flat feet are quite simple:

• you need to massage your legs from the ankles to the groin from the bottom up (stroking, patting, rubbing);
• massage the foot and its back (from the toes to the ankle) by rubbing, that is, with circular movements of the fingertips connected together, or with the edge of the palm - across the foot;
• the arch of the foot can also be massaged with the “comb” that is formed from the joints of the proximal phalanges of the four fingers when clenching the hand into a fist (in simple terms, the “knuckles”);
• It is more convenient to rub the heels (one after the other) and the bases of the toes on the side of the foot by bending the leg at the knee with four fingers of both hands joined together (thumbs on the instep).

Each foot requires no more than 5 minutes, so this massage will not take much time, but it should be done daily, preferably in the evening. But exercises for the treatment of flat feet should be done for at least 20 minutes and, if possible, twice a day.

Exercises for the treatment of flat feet

All exercises to strengthen the ligaments and muscles for flat feet are performed barefoot only. So, first, do the exercises standing: walk on your toes, then on your heels; then move, placing your feet on the inside. Next: standing, “roll” your feet from toe to heel and back (20 times). Stand on a wooden block about a meter long, placing it across your feet (the arch of your feet on the block, your heels and toes on the floor). Remaining in the same position, move along the block with a side step. And finally, standing on the floor, squat 6-8 times without rising on your toes (heels on the floor).

While sitting, perform the following exercises (10 times):

• raise your legs above the floor and rotate your feet to the right and left;
• raise your feet, which are on the floor, up towards your shins, resting your heels on the floor;
• feet on the floor, without lifting your toes off the floor, lift your heels up, straining your instep and calf muscles;
• feet on the floor, without lifting your heels off the floor, press your toes inward - towards your heels;
• feet on the floor, without lifting the pads from the floor, lift all the toes up;
• the position is the same, raise only the thumbs;
• the position is the same, roll a small ball back and forth with your foot (from the heel to the base of the toes);
• in the same position, grab a larger ball with your feet, hold it above the floor for 5 seconds, and lower it back into place;
• in the same position, without lifting your heels, use the toes of both feet (bending them under the foot) to collect a towel or any piece of fabric spread on the floor.

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Treatment of flat feet with folk remedies

The best treatment for flat feet with folk remedies is riding a bicycle barefoot! Because neither decoctions nor tinctures of medicinal herbs are powerless in this case. But pedaling is a massage, and a trainer, and, in part, therapeutic exercise...

As a folk remedy for the treatment of flat feet with arthrosis, compresses on the sore joint at night are offered - from cabbage leaves, from birch leaves steamed in boiling water, from clay, from honey with salt or black radish juice, as well as from rye flour with ammonia.

There is a recipe for an ointment for joint pain based on table salt (200 g) and mustard powder (100 g), which need to be mixed with a small amount of kerosene - to get a gruel of medium thickness. Traditional healers recommend using this ointment at night, rubbing it into the area above the joint until completely absorbed.

Another recipe for an ointment for joint pain: take dry St. John's wort, yarrow and sage in a 2:1:1 ratio, grind in a coffee grinder and mix with Vaseline or lard. Apply 1-2 times a day and wrap the joint warmly.

Our feet - thanks to their arched structure - perform the most important functions during walking. At the same time, the foot is the most "load-bearing" element of the human musculoskeletal system, and treatment of flat feet allows us to minimize excess loads on the lower limbs and spine, and, therefore, to preserve the supporting structure of the body.

P.S. The problems of flat feet are the subject of many scientific studies. In particular, the studies of a group of American orthopedists have shown that in samples of tendon tissue obtained during operations on the tendons of the arch of the foot in adult patients with acquired flat feet, the content of proteolytic enzymes is increased, which are capable of breaking down elastin and collagen - the main proteins of connective tissues, including tendons and ligaments. Perhaps this is the way to discover the true causes of weakening of the ligaments of the foot, and then, finally, an effective treatment for flat feet will be found.