Presentation on the topic of flat feet. Presentation on posture and flat feet

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Relevance RELEVANCE Due to the negative trend in the increase in the number of preschoolers with certain posture disorders and foot deformities. Flat feet are more common among weakened children with reduced physical development and a weak musculoskeletal system. completed, so any adverse effects may lead to functional abnormalities.

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Causes of flatfoot CAUSES OF FLATFOOT The load during walking, running, jumping for the arches of the feet of weakened children is excessive. The ligaments and muscles of the feet are overstressed, stretched, and lose their springy properties. The arches of the foot (longitudinal and transverse) are flattened, lowered, and flat feet appear: longitudinal, transverse and transverse-longitudinal. The foot is the support, the foundation of the body, so it is natural that the violation of this foundation necessarily affects the formation of the growing organism.

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Consequences CONSEQUENCES Changing the shape of the foot affects its function, changes the position of the pelvis and spine. age can become a serious obstacle to practicing many sports.

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Prevention and correction of functional insufficiency of the feet based on the integrated use of physical education.

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Hygienic factors HYGIENIC FACTORS Nature of use: hygiene of footwear and its correct selection in accordance with the purpose; Hygienic washing of feet with cool water before going to bed, after walking barefoot.

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NATURAL HEALTH FACTORS NATURAL HEALTH FACTORS Nature of use: walking barefoot along natural dirt paths (grass, sand, pebbles, etc.) equipped in group areas in the warm season, along artificial dirt paths (boxes with washed river pebbles) in the cold season; hardening procedures for the feet (salt path, wiping the feet, contrast douching of the feet, the "Riga" method, intensive hardening of the feet) in accordance with the individual characteristics of children and the absence of contraindications, with medical supervision.

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PHYSICAL EXERCISES Nature of use: special sets of exercises aimed at strengthening the muscles of the foot and lower leg and forming the arches of the foot; a feature is the use of figurative names of exercises (“Kittens”, “Ducklings”, “Merry Zoo”, etc.) and exercises with objects (hoop , ball, rope; one complex is learned for two weeks and performed in physical education classes, and in the next two weeks it is included in morning exercises; the next four weeks another complex is used; then for another two weeks in the process of gymnastics after daytime sleep it is repeated previous complex.

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At the first stage, children perform exercises without objects. At the second stage, children are offered exercises with objects. At the third stage, the child’s motor actions become relatively more complicated, various devices of a universal type are used, and the way the child moves on these projectiles also becomes more complicated.

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NORMAL DEVELOPMENT OF THE FOOT Provided with proper physical education. Inclusion in the content of physical education classes, starting from toddler age, special exercises to form and strengthen the arch of the foot. During the lesson, children should not stand a lot, because. the children's foot is not adapted to static loads, it gets tired quickly and is easily deformed.

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FORMATION OF A RATIONAL GAIT GAIT Forming the walking skill in children, teach them the correct setting of the walking leg on the support (i.e., on the heel, followed by a roll on the entire foot, and not flat, with the entire foot), avoiding shuffling and spanking of the feet, without spreading the socks .Widely apply various types of walking (on the heels, the outer edge of the foot, socks, etc.), including walking on an inclined board (inclination angle of 10 degrees or more), as well as on massage mats, ribbed boards, slats and sticks laid on the floor so that they fall on the middle of the foot, exercises with grabbing objects with the toes; foot massage.

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Use specially selected exercises, some of which should be performed from the initial positions of sitting and lying down, while unloading the feet. Use exercises with figurative names, as well as specially selected outdoor games, dance steps and elements. The experience of folk pedagogy - songs, nursery rhymes, jokes, for example, when preparing a child to master the skills of standing upright and walking, in order to strengthen the muscles of the foot, it was customary to lightly slap him on the soles of the legs, saying:

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Undesirable: long slow run, jumping; restrictions in certain types of walking and jumping (on the recommendation of a doctor), walking on the inside of the feet.

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MOTOR ACTIVITY Jumping. It is important to teach the child to land softly as early as possible, which prevents the development of flat feet and prevents injuries when jumping on hard ground, when jumping from natural obstacles. The content of jumping exercises available to the child should be carefully selected, and lead-up exercises should be used more widely to form the skill of correct landing - rhythmic squats and straightening, turning into bouncing. Limit the dosage in jumping on one leg, and alternate jumping rope exercises with small rest intervals. Provide a landing site. Toddlers - to jump on the sand, loosened earth, for the elders - a jumping pit, in the gym - gymnastic mats.

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Climbing exercises: on the gymnastic wall, rope ladder, rope help strengthen the muscles of the foot and lower leg, and therefore they should be used more often in the process of training. Swimming and cycling contribute to the prevention and correction of flat feet.

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CREATION OF A PHYSICAL AND GAME ENVIRONMENT Availability of equipment and inventory that helps strengthen the muscles of the foot and lower leg: ribbed and inclined boards, beveled surfaces, a gymnastic wall, rope ladders, hoops, balls, jump ropes, massage mats, gymnastic sticks, gymnastic mats, bicycles; dirt paths (made of sand, pebbles, small gravel, etc.).

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VALEOLOGICAL EDUCATION Task: formation of the necessary knowledge, skills and abilities to use the means of physical education in order to prevent various diseases and functional abnormalities.

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In order to create a positive emotional background, it is recommended: to use musical accompaniment, a variety of visual aids (pictures, toys), as well as appropriate riddles, poems and songs. The greatest effect is achieved when the exercises are performed barefoot. With children who have functional insufficiency of the feet or flat feet, individual work should be carried out, including exercise therapy.

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Exercises for the correction of flat feet 1 Dancing camel I.p. - standing, legs apart, feet parallel, hands behind the back. Walking in place with alternately lifting the heel (do not tear off the socks from the floor).

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2. "Funny bear cub." I.p. - standing on the outer edges of the feet, hands on the belt. Walking in place on the outer edges of the feet. The same with moving forward - back, right - left. The same, circling on the spot to the right and left.

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3. "Laughing groundhog." I.p. - standing, legs together, hands in front of the chest with elbows down, hands pointing fingers down. 1 - 2 - half squat on toes, smile; 3 - 4 - i.p.

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4. "Tiger cub stretches." I.p. - sitting on the heels, hands resting forward. 1 - 2 - straighten your legs, emphasis while standing, bending over;, 3 - 4 - i.p.

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5. "Fidget monkeys." I.p. - sitting in Turkish style (bending legs with knees to the sides, feet criss-cross, the outer edges of the feet equally evenly rest on the floor), arms arbitrarily. 1 - 2 - get up; 3 - 4 - stand: legs are crossed, rest on the outer edges of the feet; 5 - 6 - sit down; 7 - 8 - return to and. while maintaining correct posture.

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6. "Quick bunnies." I.p. - standing, legs together, hands on the belt. 1 - 16 - jumps on toes (heels together).

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Complex with the ball 1. I.p. - sitting, legs bent, hands in support behind, the ball under the feet. Roll the ball back and forth with two feet together and alternately, 2. I.p. - Same. Roll the ball right - left with two feet together and alternately. 3. I.p. - Same. Circular movements of two feet together and alternately rotate the ball to the right and left. 4. I.p. - lying on your back, arms along the body, the ball between the ankles. 1 - 2 - lift the ball with your feet and hold it with your feet; 3 - 4 - i.p. 5. I.p. - Same. 1 - 2 - lift the ball with your feet and hold it with your feet; 3-6 - turn the ball left and right with foot movements; 7 - 8 - i.p. 6. I.p., - sitting, legs apart, the ball lies on the floor at the toe of the right leg on the inside. With the movement of the toe of one foot, roll the ball to the other foot, and vice versa. Note. It is recommended to use rubber balls with a diameter of 8 - 12 cm.

Consequences of flat feet If the muscles and ligaments of the feet stop working and become weak, then there is a violation of the normal shape of the foot - it settles and becomes completely flat, losing its main function - the spring. In this case, the entire load is distributed on the joints of the legs - the hip, knee, ankle. There are pains in the pelvis, foot, knee, and an abnormal posture develops.

Symptoms of Longitudinal flatfoot Transverse flatfoot - fatigue in the legs, pressure on the feet or the middle of the sole causes pain, the back of the foot swells in the evening; - strong and constant pain in the feet, in the ankles and shins, it becomes very difficult to find the right shoes; -pain in the lower back, the longitudinal arch is no longer visible outwardly, the heel is completely flattened, the foot is edematous, the ankle joint is difficult to move. - the disappearance of the transverse arch of the foot, and as a result, the deformation of the toes; - Pain in the forefoot, callused skin; - the appearance of mallet fingers.

Static flat feet occurs: In people with thin bones of the skeleton from congenital weakness of the ligaments In people prone to obesity Constant wearing of irrational, uncomfortable shoes. Long-term workload associated with a person's professional activity

Pain areas with static flat feet On the sole, in the center of the arch of the foot and the inner edge of the heel; On the sole, in the center of the arch of the foot and the inner edge of the heel; On the back of the foot, in its central part, between the navicular and talus bones; On the back of the foot, in its central part, between the navicular and talus bones; Under the inner and outer ankles; Under the inner and outer ankles; Between the heads of the tarsal bones; Between the heads of the tarsal bones; In the muscles of the ankle due to their overload; In the muscles of the ankle due to their overload; In the knee and hip joints; In the knee and hip joints; In the thigh due to muscle strain; In the thigh due to muscle strain; In the lower back on the basis of compensatory increased lordosis (deflection). In the lower back on the basis of compensatory increased lordosis (deflection). The pains increase in the evening, weaken after rest, sometimes swelling appears on the ankle.

It occurs as a result of trauma, most often fractures of the ankle, calcaneus, tarsus, metatarsus. Diabetic foot Due to the fact that in patients with diabetes, the healing processes of skin processes are disrupted: any scratch or abrasion gets wet for a long time and painfully, festering. Occurs due to the failure of nutritional processes in tissues. Traumatic flat feet

Rickets flatfoot Refers to an acquired form of flat feet as a result of abnormal skeletal development caused by vitamin D deficiency in the body. This type of flat feet can be prevented by prophylaxis of rickets. This is the result of paralysis of the muscles of the lower extremities and most often the consequences of flaccid paralysis of the muscles of the foot and lower leg caused by polio or other neuroinfection. Paralytic flat feet

Self-examination Put the child on a chair so that the lower leg is strictly vertical to the floor, and the foot forms a right angle with it. Feel for the navicular bone on the inner surface of the instep (a noticeable tubercle sticks out above it). Put a dot on this tubercle, then measure the distance from it to the floor with a ruler. Without changing the position of the foot, ask the child to stand up. Measure the height of the arch again. The difference between the height of the arch without load and in the standing position (under load) is an important diagnostic value. A change in this height by more than 3-4 mm indicates weakness of the arch due to insufficient development of the ligamentous and muscular apparatus, instability and, consequently, flat feet in one form or another. The measurement is taken on both legs. Consider the difference between the height of the arch on the left and right legs. Normally, it should not exceed 3-4 mm. Similarly, you can check all family members of any age. Test 1

Self-identification Test 2 1. Take a clean sheet of paper, put it on the floor. 2. Spread a fat cream on the child's feet and put his leaf. 3. An imprint of the feet remains on the sheet. Take a pencil and draw a line connecting the edge of the plantar indentation. 4. Draw a perpendicular to this line, crossing the indentations of the foot at its deepest point. 5. If the imprint in the narrow part is no more than 1/3 of this line, the foot is normal. If it reaches ½ of this line - you have flat feet, consult an orthopedist.

Method V.A. Yaralov-Yaralyants For a mass examination of preschoolers, plantography is used - obtaining footprints using a plantograph. It is a wooden frame (2 cm high and 40x40 cm in size), on which a canvas (or burlap) is stretched and a polyethylene film is placed on top of it. The bottom of the canvas is wetted with stamp paint. A blank sheet of paper is placed on the floor under the painted side of the plantograph. The child stands with both feet or each in turn in the middle of the frame, covered with plastic wrap. The subject must stand on two legs with a uniform load. The dyed fabric bends, touching the paper in places of pressure, and leaves foot prints on it - a plantogram. The evaluation of the plantogram is done on the basis of an analysis of the position of two lines drawn on the print. The first line connects the middle of the heel with the second interdigital space; the second, drawn from the same point, runs to the middle of the base of the thumb. a) normal foot; b) the foot is flattened; c) flat foot.

Prevention of flat feet includes: Compliance with hygiene rules Rational load on the lower extremities Compliance with the principles of choosing shoes for children Massage and self-massage Water preventive procedures Exercises and games (with and without objects, on sports equipment)

Hygienic rules and a rational mode of loading on the lower limbs 1. Develop a gait without excessive spreading of the feet (daily walking with parallel feet) - walking along a stick or rope lying on the floor. 2. Wash your feet daily with cool water. After drying your feet, collect the towel with your feet. 3. Walk barefoot on sand, gravel, loose soil, grass. 4. Do not walk indoors in insulated shoes. 5. Do not use shoes with a hard insole during physical education classes. 6. Do not walk for a long time barefoot or in soft shoes on a trampled surface. 7. Sitting on a chair, pick up small objects with your feet or roll a wooden rolling pin.

Principles for choosing shoes for children 1. When buying shoes, you should measure them while standing, because when loaded, the size of the foot increases in length and width by 0.5-1 cm. The foot should not only fit into the shoe, but also have appropriate freedom and space in it. 2. It is not recommended to buy used shoes. 3.Shoes should correspond to the season and lifestyle of the child, his age and the individual shape of the foot. 4. The longitudinal axis of the shoe should run along the second toe, its sole should not be curved. 5. Shoes should not change the natural setting of the extreme toes (little toe and thumb), occupied by them under load, of the bare foot. 6. The boot must have a closed and solid heel counter. The sole should be elastic in the area of ​​​​the elevation of the toes. 7. It is desirable that children's shoes be strong, waterproof, made of flexible elastic material. For children, shoes with a hard, rigid sole are completely unsuitable!

Presentation on the topic "Flat feet" in biology in powerpoint format. The presentation for schoolchildren contains useful information on the prevention and special exercises for the treatment of flat feet.

Fragments from the presentation

Flat feet can be avoided

flat feet- one of the most common diseases of the musculoskeletal system in children. This is a deformity of the foot with a flattening of its arch (in children, the longitudinal arch is usually deformed, due to which the sole becomes flat and touches the floor with its entire surface).

Foot

• Foot- an organ that provides support and movement of a person. A powerful system of ligaments and muscles ensures the preservation of the shape of the arches of the foot and their function.
• A normal foot has one transverse and two longitudinal arches (inner - spring and outer - support).

Track

Normally, the foot rests on the ground with the calcaneal bone and the heads of the metatarsal bones, its inner part does not touch the ground, which is clearly seen from the print of the sole.

Foot functions

• support
• Spring
• Balancing
• Jogging

The main causes of the development of flat feet

• Weakness of the muscles and ligaments involved in maintaining the arch.
• Tight shoes, especially those with a narrow toe or high heels, thick soles, as they deprive the foot of its natural flexibility.

Prevention

• The basis for the prevention and treatment of flat feet is the strengthening of the muscles that strengthen the arch.
• It is recommended to wear comfortable shoes and avoid excessive stress on the feet.
• Regular exercise has a beneficial effect on the state of the musculoskeletal system. Strengthening of muscles, ligaments, joints on the basis of general strengthening of the body contributes to the prevention of deformities of the musculoskeletal system in general and flat feet in particular.
• Regular skating and skiing can help prevent flat feet in children.
• In the summer, as often as possible, use walking barefoot on the ground, sand, small, not sharp pebbles, and water.
• To strengthen the arch of the foot, climbing the gymnastic ladder, rope, barefoot is useful. Walking on the board, log.
• For those who do not have the opportunity for such training, special exercises are recommended.

A set of special exercises to prevent flat feet.

Before the exercises, you should walk on your toes, then jump on your toes on one, and then on two legs.

I. Warm up.

1. Walking on high toes.
2. Walking on heels.

II. The main set of exercises.

1. "Window" - a child, standing on the floor, spreads and brings straightened legs without lifting the soles from the floor.
2. "Rink" - a child rolls a ball, rolling pin or bottle back and forth. Exercises are performed first with one, then with the other leg.
3. "Robber" - the child sits on the floor with bent legs. The heels are firmly pressed to the floor and do not come off it during the entire time of the exercise. With the movements of the toes, the child tries to drag the towel (or napkin) on the floor on which the load (stone) lies, first one. Then the other leg.
4. "Collector" - I.P. - Same. Picks up various small objects spread out on the floor with the toes of one foot and puts them in a pile, with one foot, then with the other. Avoid dropping items while carrying.
5. "Artist" - I.P. - Same. With a pencil clamped toes, draws various figures on a sheet of paper, holding the sheet with the other foot. The exercise is performed first with one, then with the other leg.
6. "Caterpillar" - I.P. - Same. Bending the toes, the child pulls the heel forward, then the fingers straighten and the movement is repeated. The exercise is performed with both legs at the same time.
7. "Sickle" - I.P. - Same. The soles of the feet are on the floor, the distance between them is 20 cm. The bent toes first approach, and then spread apart in different directions, while the heels remain in one place.
8. "Mill" - I.P. - Same. Legs are straightened. Described by the feet of the arc in different directions.
9. "Drummer" - I.P. - Same. We knock with the toes of the feet without touching it with the heels.
10. "Funny jumps" - I.P. - sitting, legs tightly pressed to each other. Raise your legs, move them over a bar lying on the floor (height 20 cm), put it on the floor, return to I.P.
11. "Porter" - lift the cube (bag, ball) with both feet, move it to the right, put it on the floor. Return the I.P. die Then move the cube to the left side, return to I.P.
12. I.P. - lying on the stomach with hands in emphasis, legs together. Socks are pulled back, turned inward. Go to point-blank prone. With support on the forefoot and hands.
13. I.P. - lying on the back of the legs apart, slide the foot of the right foot along the shin of the left.
14. I.P. Standing on your toes, lower yourself onto your heels and rise again.

Drama of "standing professions"

• Operating surgeons
• Dentists
• teachers
• Sellers
• cooks
• Machine operators
• and etc…

Kaliningrad region

Guryevsky municipal district

MBOU "Petrovskaya secondary school named after P.A. Zakharov»

Presentation

Prevention and correction of flat feet

Frolkova Natalya Sergeevna

The work is intended for students in grades 3 - 7

Flat feet is the omission (flattening) of the arches of the foot (longitudinal and transverse); occurs most often due to weakening, overwork or overload of the muscles of the foot and lower leg.

When the arch of the foot is deformed, the spring function and the shock-absorbing role of the arch are gradually lost, and the internal organs are subjected to sharp shocks when walking, running, pain appears, and fatigue quickly sets in.

Flat feet can be detected in the following ways:

The foot must be wetted or oiled, and then stand on a piece of paper to get a footprint.

To prevent the development of flat feet, the following preventive measures must be observed:

1.Do not wear shoes that are too tight, high heels or flats. The optimal heel height is no more than 3-4 cm.

2. To reduce the deformation of the arch of the foot, use arch supports, constantly perform corrective exercises that strengthen the muscles of the foot and lower leg.

3. Perform general developmental exercises and exercises for the lower extremities.

Exercises for the prevention and correction of flat feet

sitting and lying

(Without foot support)

1. Pulling the foot. Bend and unbend your toes to the limit.

2. Taking the foot over, bend and unbend the toes to the limit.

3. Raise your thumbs, lowering the rest.

Pulling the foot, bend and unbend the toes to the limit.

sitting and standing

With support on the foot

Sitting on a chair, alternately raise your toes and heels. Straighten your legs, alternately bend and unbend your feet. Make slow circular movements with the feet inward, outward.

Used Books:

Physical culture and health work at school V.S. Kuznetsov, G. A. Kolodnitsky M "Publishing house of NTs ENAS" 2003.

o o Our feet normally perform 3 functions: cushioning, balancing and pushing. When walking, each step is accompanied by an impact on some surface, thanks to the shock-absorbing function (arches) - the force of the push is evenly distributed throughout the foot. But with flat feet, the “shock impulse” is not compensated by the arches of the foot (they are absent) and causes damage to the knee, hip joints and lumbar spine, pain in the knees, pelvis, and spine occurs. The balancing function ensures that the balance is maintained during movement and standing, but since the relative position of the parts of the foot is disturbed with flat feet, the function is not fully performed and when walking, unsteadiness, instability, and loss of balance can be observed. The jog function provides acceleration when walking. In this case, the load is redistributed to the forefoot and then the push. But since soreness is often noted with flat feet, the transfer of the center of gravity and the push with one point of the foot will certainly lead to sharp pain and the function is partially lost.

o There are two arches of the foot: transverse (arc from I to V of the metacarpal bone) and longitudinal (arc in the region of the inner edge of the foot).

o o o o There are several factors that contribute to the development of flat feet, these include: Increased body weight Heavy physical activity Pregnancy Activities associated with prolonged standing Presence of flat feet in relatives Weakening of the muscles and ligaments of the foot associated with age or lack of training for the feet others

o With transverse flatfoot, the transverse arch of the foot is flattened, so that its anterior section rests on the heads of all five metatarsal bones, and not just I and V, as is normal. The relationship of the bones of the foot is normal (left) and with transverse flat feet (right).

Transverse flatfoot The proportion of transverse flatfoot, according to various sources, ranges from 55% to 80%. The disease usually develops in middle-aged people (35-50 years). Women suffer from transverse flat feet 20 times more often than men.

o This type of flatfoot is characterized by a decrease in the length of the foot, a fan-shaped divergence of the bones of the metatarsus, deformity of the first finger (Hallux valgus) and hammer toes.

o o The support is redistributed to the heads of all metatarsal bones, while the load on the head of the I metatarsal bone decreases, and the load on the heads of the II-IV metatarsal bones increases sharply. I finger deviates outwards, the head of the I metatarsal bone and the I finger form an angle. Osteoarthritis occurs in the I metatarsophalangeal joint. Pain appears, the range of motion in the joint decreases. The increased pressure of the metatarsal heads causes thinning of the subcutaneous fat layer on the plantar surface of the foot, causing a further decrease in the cushioning function of the foot. On the sole in the area of ​​​​the heads of the metatarsal bones, corns are formed.

o o Depending on the severity of the angle between the 1st finger and the 1st metatarsal bone, the following degrees of transverse flatfoot are distinguished: I degree. Angle less than 20 degrees. Mild flat feet. II degree. Angle from 20 to 35 degrees. Moderately pronounced flat feet. III degree. Angle greater than 35 degrees. Pronounced flat feet.

Symptoms of transverse flatfoot o o As a rule, patients with transverse flatfoot go to the doctor about a cosmetic defect of the foot, less often about pain during walking, corns on the sole, rough skin growths or inflammation in the I metatarsophalangeal joint. However, during the survey, it usually turns out that a patient with flat feet for a long time is disturbed by more or less pronounced burning or aching pain in the foot while walking. On examination, flattening of the transverse arch of the foot, a characteristic deformity of the I metatarsophalangeal joint, with pronounced flat feet - hammer toes.

Treatment of transverse flatfoot o o Conservative therapy is effective only at stage I of flatfoot. The patient is advised to reduce body weight, choose comfortable shoes without heels, and reduce static loads on the foot. The wearing of special insoles and rollers is shown. With flat feet of the III degree, surgical treatment is performed. There are many methods for correcting the deformity of the first toe, however, not a single operation eliminates the cause of transverse flatfoot - weakness of the ligaments and muscles of the foot. Possible isolated surgery (resection of the protruding part of the bone Hallux valgus) and surgical treatment, including resection of the bone in combination with joint capsule plasty and tendon grafting. In the postoperative period, a patient with flat feet is recommended to constantly wear arch supports or shoes with special insoles.

o Longitudinal flatfoot is the most common, characterized by flattening of the longitudinal arch of the foot. The relationship of the bones of the foot is normal (above) and longitudinal flat feet (below).

o The foot lengthens, spreads out and touches the support with almost the entire sole. The proportion of longitudinal flat feet ranges from 20 to 29%. The disease often develops in young patients (16-25 years).

o The bones, muscles and ligaments of the foot and lower leg are involved in the process. The bones of the foot move in such a way that the calcaneus turns inward and the forefoot deviates outward. The tension in the tendons of the peroneal muscles increases, and the tendons of the anterior tibial muscle decrease. The midfoot expands. The patient's gait becomes clumsy; when walking, he strongly spreads his socks to the sides.

o o o There are four stages of longitudinal flat feet: the stage of predisease (prodromal stage); intermittent flat feet; flat foot; flat foot.

o o o At the pre-illness stage, a patient with flat feet is worried about fatigue when walking, pain in the upper part of the arch of the foot and calf muscles after prolonged static loads. In the stage of intermittent flat feet, pain appears not only by the end of the working day, but also after prolonged standing or long walking. Tension of the muscles of the lower leg is revealed, sometimes their temporary contractures develop. The longitudinal arch of the foot has a normal shape in the morning, but becomes flattened in the evening. During the development of a flat foot, pain appears even after small static loads. The foot flattens, the height of its arch decreases. Gradually, the gait begins to change.

o o There are three degrees of flat feet: I degree. Stage of the beginning of formation. The height of the arch of the foot is less than 35 mm; II degree. The height of the vault is 25-17 mm. Osteoarthritis begins to develop in the joints of the foot; III degree. The vault height is less than 17 mm. The forefoot unfolds and flattens out. Deviation of the I finger outwards is revealed. At the same time, pain in the foot temporarily decreases.

Treatment of longitudinal flat feet o o o In the pre-disease stage, the patient is recommended to develop a correct gait (without dilution of socks), walk barefoot on sand or uneven surfaces and regularly unload the muscles of the arch of the foot, periodically transferring the load to the outer surfaces of the feet while standing. A patient with flat feet is prescribed exercise therapy, massage and physiotherapy: magnetotherapy, hydromassage, etc. In the stage of intermittent flat feet, a recommendation is added to the listed measures to change working conditions to reduce the static load on the feet. With a flat foot, orthopedists prescribe wearing orthopedic shoes and special insoles to the complex of therapeutic measures. With further progression of flat feet, surgical treatment is indicated.

o Static flat feet. A common form of flat feet (more than 80%). The cause of the development of pathology is the weakness of the bones, muscles and ligaments of the foot and lower leg. The risk of developing flat feet increases with an increase in body weight, insufficient physical activity in people of sedentary professions, "standing work", wearing uncomfortable shoes. Static flat feet can also develop as a result of the constant wearing of high-heeled shoes (due to excessive load on the forefoot).

o o o Traumatic flat feet. It develops after a fracture of the bones of the foot, calcaneus and ankles. Rachitic flat feet. Occurs after rickets. The reason for the development is a decrease in bone strength and a violation of the formation of the skeleton of the foot. Paralytic flat feet. Develops after poliomyelitis. The cause of flat feet is paralysis of the tibial muscles and plantar muscles of the foot.

Diagnostics o o o Podometry - measurement of the height of the arch of the foot from the floor. Plantography is the study of footprints left on paper. X-ray of the foot in direct and lateral projection.

Podometry (Frinland method) o o the subject is placed on a sheet of paper so that his feet form a right angle with respect to the shins; the height of the foot is determined by measuring the distance from the upper surface of the scaphoid bone (palpable on the transverse finger anterior to the ankle fold) to the floor with a compass. Each of the feet is circled on paper with a pencil, holding it strictly perpendicular. Along the contour, measure with a ruler (in millimeters) the length of the foot from the tip of the first toe to the rear edge of the heel. The foot height data is multiplied by 100 and divided by the length of the foot (podometric index). The foot index normally ranges from 29 to 31.

Plantography is a method of obtaining a graphic "imprint" of the plantar surface of the foot on paper. The imprint is obtained on a special device - a plantograph, which is a frame covered with a rubber membrane. Before each measurement, the lower surface of the membrane is smeared with printing ink. Then a sheet of paper is placed under the membrane, the patient stands on the membrane, and the doctor outlines the perimeter of the foot with a special “spatula”.

o o o On the resulting print, certain reference points are manually connected and indicators are calculated that quantitatively characterize the condition of the patient's feet. This method is simple, does not require expensive equipment and is indispensable for surveys in the "field" conditions. However, in this case, the state of only the supporting surface of the foot is assessed without taking into account its deformations in the sagittal and frontal planes. In addition, the quality of the resulting prints does not always meet the requirements necessary for subsequent calculations. Despite the above disadvantages, today plantography is the most common method for quantifying the arch of the feet.

o FOOT RADIOGRAPHY X-rays of both feet are taken in frontal and lateral projection under load, while the patient is standing.

o o Principles of treatment of flat feet Conservative treatment Remedial gymnastics is prescribed, aimed at strengthening the muscles that support the arch of the foot and contributing to the tension of its ligamentous apparatus, correcting the vicious installation of the feet, cultivating the stereotype of the correct position of the whole body and lower extremities when standing and walking, acting tonic on the body. The leading place in exercise therapy is occupied by special exercises aimed at correcting foot deformities. Exercise therapy classes must be performed several times a day (at least three times). Strengthening the ligamentous-muscular apparatus of the feet and legs is promoted by massage and, especially, self-massage of the arch of the foot and the muscles supinating the foot. Muscle electrical stimulation is prescribed in courses of 20-25 sessions, repeated after a month break. To improve tissue trophism, physiotherapy is carried out. Orthopedic insoles are ordered with the calculation of the transverse and longitudinal arches. With transverse flat feet, bandage rubber cuffs with a special tab are used to maintain the transverse arch. With pronounced forms of flat feet, it is necessary to provide the patient with orthopedic shoes with an arch tab (according to plaster casts) and raising the inner edge of the heel. A rigid heel counter should wrap around the heel and midfoot to the middle of the metatarsals, keeping the heel upright and preventing it from turning in.

Surgical treatment o o o More than 300 methods of surgical intervention have been developed for the treatment of transverse flatfoot, depending on its stage and form. Therefore, in order to avoid recurrence of the disease, it is necessary to choose the optimal surgical technique for correcting foot deformities and accurate preoperative planning. All operations on the feet are divided into three types: operations on soft tissues (operations of Silver, McBride, Shede), on bones and combined operations. The first are carried out most often in young people with a normal or slight increase in the first intermetatarsal angle. With this operation, the tendon of the adductor muscle of the first finger is cut off, which can be combined with subsequent transposition and capsuloplasty, and, if necessary, supplemented by the removal of the inflamed subcutaneous mucosal bursa and the osteochondral outgrowth, which form a painful lump. Operations on the bones and combined operations are performed in cases of a strong increase in the first intermetatarsal angle, the patient has rigid feet or an elongated first metatarsal bone. Although there are a lot of varieties of such surgical intervention, various types of osteotomy (bone dissection) are most often used.