Surgery for flat feet in an adult: transverse - longitudinal, indications, types, results

May 17, 2021

Useful

Flat feet have very serious consequences for the entire growing organism. Joints, ligaments, spine and even internal organs suffer.

It is foot deformities that can cause chronic pain and serious injuries. How to help your child and prevent problems with growing legs?

Let's start with the fact that children are born flat-footed. The arched instep, the same arches of the foot necessary for shock absorption during walking, running and jumping, begin to form from the moment the baby takes its first steps, and this process ends in adolescence, closer to adulthood. In preschool age, flat-valgus foot alignment is considered a physiological norm.

In the year when the child takes his first steps, the young “pioneer” should be shown to a specialized doctor - a podiatrist. In the future, your visits to him (in the absence of pathology) should be scheduled once every two years until the age of 7 and once a year, starting from school age.

Leave a mark

...The child ran barefoot across the sand and left a chain of footprints. An attentive mother will not only be touched, but will also note whether they are “embellished” enough. If there is the slightest doubt, he will conduct a home test - it is not complicated. It is enough to lubricate the child’s feet with a dye (beetroot juice, watercolor - anything will do) and ask him to stand on a prepared clean sheet of paper.

Is the foot imprinted almost entirely? We can talk about overpronation - the very same flat feet. Is there a uniform taper towards the center in both prints? Great, the foot is working as it should.

However, let’s make a reservation: only a doctor can make a verdict on the existing deviations, using a special device for professional diagnostics - a mirror podoscope with contrast illumination.

Treatment of transverse flatfoot at home

To treat transverse flatfoot at home, as well as eliminate its symptoms, folk remedies in the form of decoctions and tinctures are also used.

With their help, you can get rid of pain and restore muscle ligaments after overexertion. Traditional methods give maximum effect if they are used in complex treatment.

• If a patient suffers from aching joints, wormwood will come to the rescue. It must be washed, placed on the feet and wrapped with a warm cloth.
• A mixture prepared from iodine and citric acid (in a 1:1 ratio) will help cope with the symptoms of transverse flatfoot:
• mix the resulting solution well and add aspirin (two tablets);
• apply to the problem joint and wrap it with warm material;
• Only 3% iodine should be used, no more, otherwise you may get a skin burn.

This procedure must be carried out for three days, after which you should take a break for a week.

To relieve pain and relax the muscles on the feet, it is recommended to regularly use baths with the addition of sea salt or herbal lotions:

• Pour 1 liter of warm water into a basin, add sea salt (1 tbsp), mix well and immerse your feet in it. The duration of the procedure is 10–20 minutes.
• Instead of salt, you can add an infusion made from linden, chamomile, mint, oak bark or sage to the water.
• After completing the procedure, the feet should be thoroughly dried and massaged, applying the cream intended for this purpose.

To increase muscle tone, as well as hardening, baths or contrast showers are required. You can take two containers, pour hot water into one and cold water into the other. Next, the feet are placed in them one by one, which allows you to increase the tone of the muscles and the whole body, as well as improve blood flow.

As for the contrast shower, the mixer lever switches from cold to hot water and back about 3-7 times.

This procedure has a contraindication that applies to the fair sex. They should avoid contrast showers during menstruation.

If transverse flatfoot is in an advanced state, and no massages, lotions or rest help cope with the pain, you should turn to drug treatment:

• Analgesics (aspirin, paracetamol, Flugalin, Indomethacin and Ibuprofen) will help relieve acute manifestations of the disease.
• Ointments (indomethacin, Dolgit, Voltaren gel) can also help get rid of pain.

What's wrong with our children?

Flat feet are one of the most common diseases of the musculoskeletal system in children. However, only in 3% of cases it is hereditary. All other cases are the result of improper formation of the foot against the background of various problems. In particular, in modern children, due to a sedentary lifestyle, the cause is often weakness of the muscles that support the arches of the feet.

At the end of 2021, the World Health Organization published the results of a study on the level of physical activity among children aged 11 to 17 years. The results are depressing - out of 1.6 million children, 80% spend less than 1 hour of active time a day!

Physiotherapy

The central place in the treatment of flat feet is occupied by physical therapy, as it eliminates the causes of deformation. Particular attention is paid to exercises to strengthen the muscles, ligaments and bones of the lower extremities, which should be performed barefoot. It is necessary to rotate your feet, stretch out your toes, bend your toes, roll a ball with your feet, pick up small objects with your toes, walk on your toes, heels, and the outside of your feet.

A set of exercises should be selected by a doctor, taking into account the type, stage and degree of pathology, the patient’s age, the presence of other diseases, and general health.

To get the maximum effect, it is advisable to do gymnastics 2-3 times a day. No interruptions should be allowed. Additionally, you can do yoga and dancing.

Therapeutic exercise tones muscles, strengthens muscles, increases range of motion, activates blood circulation, and strengthens the immune system.

Why is flat feet dangerous?

The feet are the “foundation” of our entire body. And if it is deformed, the consequences will affect health in general. With flat feet, the spring function of the foot is primarily affected. Errors in shock absorption when running and jumping are very costly for the body: the knee, hip joints and spine suffer. As a result, a child with flat feet, at a minimum, stoops, and at a maximum, has scoliosis. Due to the disturbed position of the pelvis and chest, the internal organs are displaced, which negatively affects their function.

Muscle imbalances caused by improper foot placement cause consistent asymmetries throughout the body. The chain of changes can be very long and lead, for example, to problems with bite. It may seem incredible, but in small patients with flat feet, changes in the position of the skull are diagnosed in 90% of cases.

What are the causes of transverse flatfoot?

The most common reasons that can provoke the development of transverse flatfoot (photo above) are the following:

1. Bad heredity.

In this case, the disease is congenital and is called “aristocratic foot”. It is caused by weak muscles of the arched vault. A person with this pathology can live a full life if he wears comfortable shoes and adheres to a healthy lifestyle.

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1. Anomalies associated with the ligaments and muscles of the foot.

If a person has impaired development of ligaments or muscles, leading to incorrect placement of the phalanges of the fingers, this can cause them to spread and ultimately provoke transverse flatfoot.

1. Excess weight.

The flattening of the foot in this case occurs due to excessive stress on its ligaments and muscles.

1. Professional activities that involve increased pressure on the foot.

If a person has to stand for a long time during the working day, the foot becomes unbalanced, which ultimately leads to acquired flat feet. Most often, this is observed among teachers, lecturers, hairdressers, etc.

1. Injuries.

In most cases, it is injuries that cause flat feet in men, since they (unlike the female part of the population) more often experience bone fractures, sprains and muscles, dislocations, and other similar troubles.

1. Wearing uncomfortable shoes.

Flat feet are often caused by poor foot hygiene, high heels, and improper shoe lasts. When a representative of the fair sex wears high-heeled shoes, she redistributes the weight of her own body so that it falls on the forefoot, which over time leads to bone deformation.

Forewarned - forearmed!

An active lifestyle is already half the battle. If a child gets used to catching a ball, and not balls on the smartphone screen, plays quests with his parents in the yard, and not on the computer, he has a good chance of “pumping up” the muscles of his legs, including those same muscles of the arch of the foot.

In the warm season, having secured the surface (remove debris, twigs, prickly cones), it is good to run barefoot. Moving on an uneven surface ideally trains muscles and ligaments when the child “catches” balance on the lawn or lawn. However, you can also organize a training ground in the apartment. Orthopedic rugs, either purchased or made independently from sea pebbles or chestnut fruits, for example, are suitable for this purpose. It is also useful to go up and down the bars of the wall bars barefoot.

As exercise before going to bed, you can plan to move objects with your toes (for example, collect scattered parts of a construction set in a box).

What to avoid with transverse flatfoot

To prevent complications when diagnosing transverse flatfoot, you should avoid:

• standing on your feet for a long time;
• intense sports;
• strong physical activity;
• wearing flat-soled shoes (heels 3–4 cm high are required);
• using other people's shoes, since each person has an individual foot shape;
• wearing models that are the wrong size (small, large, narrow or wide);
• shoes with a platform, wedge and very thin soles;
• constantly wearing sports models;
• shoes that do not have backs, but only thin straps (the foot must be secured).

Most often, transverse flat feet affect the fair sex, not men (8:2), and this is not at all surprising, since women wear narrow stilettos for several hours in a row every day. Thus, in pursuit of beauty, ladies forget about their own health.

What about sports?

Certain types of sports activity, on the contrary, can provoke flat feet. For example, hockey and figure skating with a shock load on fragile joints (what are these landings on the ice worth!) and constant non-physiological positioning of the foot lead to chronic microtraumas and subsequent deformations.

Both for the feet and for the entire musculoskeletal system, excessive sports with an asymmetrical load are not very good: tennis, high jumping, javelin throwing.

But at the same time, there are a lot of sports activities that are useful for flat feet. These include, in particular, cross-country skiing, any active walking and types of martial arts that help maintain muscle-ligamentous apparatus (karate, taekwondo).

Massage for transverse flat feet

With the help of massage, you can get rid of symptoms of transverse flat feet such as pain, swelling of the feet and inflammation. In addition, it helps speed up lymph flow, improve blood flow, and tone muscles. The positive effect of massage can only be obtained if it is done regularly, that is, 12–15 minutes, 15 sessions per month.

Before starting the procedure, it is best to steam your feet in a bath with the addition of herbal infusion or sea salt.

Massage for transverse flat feet is done as follows:

• Warm up the skin on the legs and feet by stroking and rubbing.
• Using kneading, squeezing and tapping techniques, massage the calf muscles.
• Massage the soles of your feet thoroughly.
• Work the thumbs of the lower extremities.

This massage has a positive effect on biologically active points and allows you to get rid of transverse flat feet.

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Diet for feet

A lack of vitamins and microelements in the diet can weaken the muscles of the arches of the foot and provoke its deformation.

In particular, all B vitamins are necessary for the health of the ODA. We include in the diet: raisins, baked potatoes, beans, whole grain bread. We combat the lack of particularly important folic acid (B9) by eating cabbage, lentils and bananas. It is known that the development of joint diseases is inhibited by vitamins:

• C (lemon, rose hips, currants, sweet pepper);
• E (vegetable oils, cereals);
• D (this vitamin is difficult to absorb from food and is often recommended in supplement format).

The child also, of course, needs sufficient proteins to build new tissues. Dairy products are especially useful because they help restore the cartilage tissue that envelops the articular surfaces of bones. Beef is also needed in the diet. It contains more essential amino acids for muscle building than any other meat. Jellied meat, rich in collagen, which ensures the strength of cartilage and bone tissue, will also come in handy. The diet should also include a sufficient amount of fats, without which metabolic processes are inhibited.

Treatment methods for transverse flatfoot

Recently, people aged 23–56 years have been turning to doctors with complaints of leg fatigue, swelling, pain and bone growth on the foot. However, treatment of longitudinal and transverse flatfoot is prescribed to each patient individually depending on the symptoms, degree and severity of the disease.

1. Therapeutic correction.

It is used at the initial stage of development of pathology and involves the use of medical devices, for example, for an inflamed metatarsophalangeal joint, correction is performed with rollers. They are placed between the second and thumb and are fixed to the side, thereby restoring the anatomical position.

If you have transverse flatfoot, you can also choose a device such as orthopedic insoles, which allow you to restore the physiological curve of the foot, reduce the load on the spinal column and ankle joint and stop the progression of the disease.

Often, orthopedic shoes are prescribed to support the foot, usually after surgery for severe cases of the disease.

1. Drug therapy.

In this case, the patient is prescribed non-steroidal anti-inflammatory drugs (NSAIDs) based on Kerotolak, Indomethacin and Diclofenac, which are aimed at eliminating pain in muscles and joints. In case of severe discomfort and inflammation, intravenous or intramuscular administration of drugs is prescribed.

1. Exercise therapy and physiotherapy.

These methods are used as an adjunct to the main treatment of transverse flatfoot in adults. Most often they are prescribed at the first and second stages of the disease, as well as after surgery during rehabilitation.

Physiotherapy is used in the presence of inflammation and includes the following activities:

• electrophoresis;
• mud baths;
• shock wave therapy (UHF).

Thanks to physiotherapy, joint mobility is restored, metabolic processes and microcirculation in muscle tissue are improved.

Shock wave therapy is used to destroy microscopic crystals of calcium salts deposited in tendons, joints and ligaments, as well as to launch regenerative processes in cells and the rejuvenation mechanism. This procedure is very effective in relation to cartilage and bones, since it has a positive effect on them without causing harm to the muscles. In addition, it improves blood flow, that is, it increases it, restores ligaments that help cope with stress on the foot.

Electrophoresis using calcium ensures the delivery of the element to the bones. This procedure is carried out because in tablets or injections it is not always well absorbed by the body.

Heat therapy is also prescribed using paraffin-ozokerite applications, which warm up the disturbing area, eliminate pain, improve metabolism and increase immunity.

1. Surgical treatment.

The most effective way to restore the anatomical structure of the foot with transverse flatfoot is surgery. It is carried out in order to redistribute the tendons and muscle tractions responsible for the position of the toes. In some cases, this requires removing a fragment of bone tissue (with valgus transverse flatfoot).

What will we wear?

It is important to remember that truly therapeutic shoes and insoles are not sold in a salon on the advice of a consultant without specialized medical education and are not selected “by eye.” Store-bought boots with the obligatory hard heel, factory instep support and misleading marketing information will, at best, do no harm, and at worst, provoke additional problems. Such shoes fix the foot in a conditionally “correct” position and essentially block any other movement, atrophying the muscles. But the correct position of the legs of a particular child can only be determined by a doctor. In this case, it is the podiatrist (specialist in the foot) who can produce individual flexible orthoses. Made from modern elastic materials, they are designed to correct not only the position, but also the function of the foot. Thus, insoles for children made of Formax elastic plastic foam imitate wet sand. The child is forced to maintain balance, while physiological training of muscles and ligaments occurs. This is how the correct biomechanics of walking are formed, when the body remembers the optimal movement day after day.

Individual insoles are worn from one street shoe to another, and are changed as the baby grows. At home, it is better for the child to walk barefoot - this is the maximum physiologically possible for the development of his foot. What you shouldn’t wear at home are slippers or flip-flops that don’t secure your foot – this is simply dangerous!

Diagnosis of transverse flatfoot

Flat feet can be either congenital or acquired. In addition, it varies in degrees:

• Mild transverse flatfoot (1st degree). In this case, the deviation of the thumb is no more than 19°. The patient feels weakness in the legs, there is slight swelling.
• 2nd degree of transverse flatfoot (moderate). The deviation of the thumb here can be up to 30°. The pain becomes stronger, the person finds it difficult to move.
• Severe transverse flatfoot (grade 3). The deviation of the thumb is more than 35°. Deformation of the foot, pain in the legs and lower back are observed. The person moves with great difficulty.

Regardless of age, the symptoms of the disease are the same, but only a specialist can confirm it. What methods will be used for treatment depends on what caused the pathology. Only a doctor can determine them, so you don’t need to diagnose yourself and carry out therapy yourself, otherwise you can only make things worse and cause complications.

• Diagnosis of transverse flatfoot using radiography of the feet.

During this procedure, the patient is in an upright position. In order to obtain more detailed information, photographs are taken from different angles. An x-ray is prescribed for transverse flatfoot only after examining the limbs, checking muscle reactions, taking into account the wear and tear of shoes and gait.

The specialist also conducts computer diagnostics, through which you can obtain information regarding the type of arch of the patient’s foot, as well as the load on it. This procedure allows you to find out which points are subject to excessive pressure from a person’s weight.

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• Studying the foot using a stopometer, ruler, protractor, compass.

The method consists of calculating the podometric index based on data obtained by measuring the foot using instruments and studying the print on paper. Normally, the indicator should be in the range of 29–31. If the ratio of foot width to length increases and is more than 42, the patient is diagnosed with transverse flatfoot.

It is worth noting that with this disease, pathological changes can affect nerve fibers and blood vessels, so the doctor prescribes a consultation with a neurologist and phlebologist surgeon.

Is it possible to cure flat feet in an adult?

Organs and tissues change more easily under external influences while the body grows. Once the cartilaginous growth zones are closed, the shape of body parts cannot be significantly affected. Therefore, it will not be possible to significantly increase the height of the arches in an adult without surgery. By the way, the vast majority of diseases in adults cannot be treated. Only diarrhea or a cold goes away on its own. Hypertension, allergies, diabetes, arthrosis, glomerulonephritis, heart disease, flat feet can be controlled and “put to sleep”, but not completely eliminated.

And the phrase “flat feet cannot be cured” only means that an adult does not yet have the opportunity to make his feet taller. But this does not mean that nothing needs to be done about flat feet. After all, the problem is not the flattening of the arch, but the loss of shock absorption, without which all organs of the body suffer.

“Is it possible to buy shoes to grow in size?”

– However, what exactly in shoes can cause harm?

– Shoes that are too big can cause harm, not globally, but situationally, for example, disrupting the rhythm of gait, or complicating a child’s life. Of course, you have to buy shoes for your child to grow into. This consideration is purely economic, because the child's foot is growing, and it is difficult to keep up with it. The question is often asked: “How long can you buy shoes to grow in size?” – there is no single answer to this question.

Just imagine that you buy shoes for a child a size larger, but children's sizes are slightly different and the proportions are different, and compared to an adult, this is more than a size larger. For example, you got beautiful shoes of size 38.5, and your size is 37. Most likely, you will not be very comfortable in them. Approximately in this paradigm we need to consider shoes for a child.

Very often you can see a picture on postcards and posters in which a little girl is standing in her mother’s shoes - her feet are pointed inward, her knees are bent - the child does this in order to compensate for the inconvenience of wearing large shoes. Or imagine the gait of a person walking on dry land wearing flippers. To control gait, it is necessary that the length of the shoe matches the length of the foot, not necessarily on the inside, but also on the outside. This very often applies to winter shoes. You probably know from your children that they don’t walk well in winter shoes, because they are big and heavy.

Shoes should not be heavy; high heels greatly increase the weight of the shoes. Shoes should not be too hard. How do people walk in ski boots? Not very confident. Imagine the feeling of a child walking in hard, high-backed boots. How much can you walk in ski boots?

- Hell!

“Little children live in approximately the same hell, for whom they put on tall, heavy shoes and a pair of socks.