Massage for varus deformity of the legs in children. Children's massage for tibial varus in a child

Massage for varus deformity of the legs (lower legs) is an effective method of treatment. In children, varus curvature of the legs, knee joints, legs, and feet is possible. For the first 3 months after birth, babies maintain a flexor posture and the legs have a varus appearance, but this is not the varus deformity we are talking about. This appearance of varus legs and feet in infants is due to the growth of the skeleton in the fetal position in the mother’s stomach, then everything transforms and straightens out in the first year of life.

The risk of varus curvature appears after a year, when the baby begins to walk and spends a lot of time in an upright position. There are also congenital deformities, such as clubfoot, but a pediatrician or orthopedist will tell you about this, if any.

Foot massage for children

The ultimate causes of acquired varus curvature are gravity and tissue compliance. When a child first stands on his legs, he has no deformities; they are acquired gradually if favorable conditions have developed for them. And the primary causes can be different: genetic, lack of substances needed by the body (rickets), injuries, decreased muscle tone, etc. The most likely cause of varus deformity of the legs is a lack of components to create strength in the bones and cartilage. In rickets, for example, calcium may be present in the body and even be supplied there in excess, but absorption requires active vitamin D, which is formed from ultraviolet radiation.

Causes of flat feet

There are many reasons for the development of flat feet in children aged 2 years And parents should not only know what they look like, but also be able to eliminate them, if possible. If it is not possible to do this on your own, you need to seek help from a doctor who can advise you and tell you about all the reasons why this disease occurs, as well as the consequences that may occur if you do not treat it in time.

The reasons may be as follows:

• weak muscles due to excessive stress or illness;
• various foot injuries;
• incorrectly selected shoes;
• heredity;
• consequence of rickets;
• joint flexibility;
• overweight;
• cerebral palsy;
• polio.

Foot massage for infants. Exercises for leg varus:

• Stretching the inner surface of the knee joint capsule - with one hand we fix the lower third of the thigh from the outside, with the other we apply light springing movements of the lower third of the leg outward. The purpose of the exercise is to slightly stretch the internal (medial) ligament of the knee joint and capsule. This is necessary so that the fabrics are more pliable for straightening the legs.
• Squats with legs wide apart stretches the adductor muscles of the legs. By doing squats at the moment of lifting, the pressure on the articular surfaces in the knee is distributed in the way we need, in addition, the medial ligament of the knee joint is stretched.

Since we have to work with such a childhood problem when the children are still small and cannot perform complex exercises, we use these as the main ones. If you can do something else, good. It is useful to walk on surfaces inclined inwards, i.e. (example: two parallel boards placed end-to-end, with long edges facing each other, and the outer edges raised).

The result or effect after a massage for varus (O-shaped) curvature of the legs is not necessarily visible immediately. It happens that you just need a “push” to correct the tendency. The child may begin to place his legs a little wider when walking (which means the load on the lower limb will be redistributed) and this will lead to a gradual alignment of the legs within 0.5-1.5 years.

What is clubfoot?

Clubfoot

Clubfoot

is a term used to describe an atypical position of the foot in which it is turned inward, sometimes so much that the inner edge of the foot rests on the inner surface of the shin. For a child, this is an absolutely painless condition. However, if the deformity is not treated, he will not be able to walk normally in the future.

The birth rate of a child with clubfoot in Europe and the CIS countries is approximately 1:1000 newborns. Bilateral clubfoot occurs in approximately 30-50% of cases.

It is important for parents to understand that although this is a rather serious condition, clubfoot is not, in fact, a malformation (any deviation from normal physical development, a developmental anomaly that entails gross changes in the structure and function of an organ or tissue).

A normally developing foot turns into a clubfoot during the 2nd trimester of pregnancy. This condition is rarely diagnosed by ultrasound before the 16th week of pregnancy.

Causes:

Despite the achievements of world medicine, the reasons for the development of clubfoot are still not precisely known. There are many theories put forward about this. In some cases, clubfoot is simply a result of the baby's position in the uterus during pregnancy (called positional clubfoot). But most often this pathology is caused by a combination of genetic and environmental factors that are not well understood. If your family has a history of congenital clubfoot, then the likelihood of having a child with this deformity is very high. If parents already have one child with clubfoot, the likelihood of having a second child with the same diagnosis increases.

Clubfoot can be congenital or acquired.
In this section we will consider congenital clubfoot. Kinds:

• primary or idiopathic form (it occurs as an independent disease, there is no characteristic connection with the pathology of the nervous system, systemic congenital diseases and syndromes). This same form is also called typical clubfoot.
• secondary form, occurs against the background of other diseases or defects. This is the so-called atypical clubfoot.

By severity

share:

• light form
• moderate severity
• severe form

The severity of clubfoot lies in the possibility of its passive correction and affects the further treatment of this disease. The milder the form, the greater the chance of achieving positive results without the use of aggressive treatment methods.

Symptoms and diagnosis:

The diagnosis of clubfoot is made in the delivery room, immediately after the birth of the child. The feet have a characteristic deformation:

• Equinus foot. In this case, there is a fixed plantar flexion of the foot, the dorsal extension of the foot is sharply limited or completely impossible. When trying to palpate the heel tubercle, this cannot be done. The Achilles tendon is dense and significantly shortened, due to which the heel is pulled up.
• Varus of the heel. The heel bone is turned medially.
• Adduction or adduction of the forefoot.
• Supination. In this case, the inner edge of the foot is turned upward.

In addition, the atypical form of clubfoot is characterized by the presence of signs:

• deep transverse fold on the sole
• feet are short and plump
• all metatarsals have significant plantar flexion
• the big toe is shorter than the others and hyperextended
• severe rigidity

Atypical forms of clubfoot are usually more difficult to treat. Their frequency of occurrence is about 2-3%.

Treatment:

Many methods of correction have been proposed for the treatment of clubfoot. Many of them already have historical significance, while others can be used as a supplement. But let's take things in order.

Massage for club feet.

With clubfoot, the muscle groups of the lower leg are in different states. The outer group is weaker, the muscles are stretched, while the inner and back ones, on the contrary, are shortened and may have increased tone. In this condition, these muscles pull the foot inward, and the outer group cannot counteract this. Massage is used to relax the inner and back muscles of the lower leg. Additionally, before the massage procedure, the muscles can be warmed up using paraffin or ozokerite. This gives additional elasticity to the muscle tissue and it responds better to subsequent manipulations. During work, the massage therapist relaxes the muscles by shaking and stroking, combining his actions with stretching the internal group. If we stretch muscles that are shorter, we need to shorten the stretched muscles. Therefore, kneading, rubbing and effleurage are added to the outer surface to increase muscle tone.

In fact, massage is a procedure with great potential. But, unfortunately, it is not possible to correct clubfoot with massage alone. It can be successfully used in conjunction with other treatment methods.

Physiotherapeutic methods of treatment.

By themselves they cannot be used as the main method of treatment. The use of physiotherapy improves nutrition and blood circulation of soft tissues and muscles, affects the elasticity of muscle tissue. Often the use of a full range of physiotherapeutic methods is limited by the age of the child and his tolerance to the procedures.

Kinesiotherapy.

This is a complex of active therapeutic exercises aimed at stretching muscles.

Bandaging.

The use of soft dressings involves a whole system (for example, Fink-Ettingen). Elastic bandages are applied according to a certain pattern to the entire limb. The prevalence of use is limited by the technical difficulties of applying these dressings and the low percentage of positive results. Can only be used for mild clubfoot and in combination with the methods described above.

Orthotics.

Involves the use of removable devices. The resolution as an independent treatment method is not high. Used to maintain the achieved correction. For example, after a course of plastering, special splints and orthopedic shoes with special insoles are made. The idea of ​​such fixation is to hold it rigidly and create a mechanical obstacle for the foot to return to its previous vicious position. Violation of the regime most often leads to immediate relapse in the shortest possible time.

Plastering.

At one time, many methods of gypsum were proposed both in the CIS countries and abroad.

They all had some kind of “zest”. This is either a special turn of the foot or the duration of plaster casting, or something else. Sometimes children were cast until they were 6 months old. Orthotics were then prescribed. These methods, let's call them “traditional,” did not fully take into account the biomechanics of the foot and the biomechanics of the clubfoot itself. Therefore, the positive outcome of treatment reached barely 60%.

Today, the “gold standard” for the treatment of congenital clubfoot is the Ponseti casting method.

Surgery.

After unsuccessful manipulations or recurrences of deformity, orthopedists moved, as it seemed, to the only method of treatment - surgical correction. All kinds of posteromedial releases were proposed (according to Sturm, Zatsepin, Moroz, etc.). These operations involved cutting the ligaments and joint capsules and lengthening the tendons. The so-called open reduction was performed. Additional fixation with knitting needles and postoperative plaster casts was used. Methods using the Ilizarov apparatus were also proposed, which could be used both as an independent method and in combination with tenoligamentocapsulotomies.

These techniques are not only technically difficult for the doctor, but also leave behind a pronounced scar process for the patient and do not guarantee the absence of pain in the future. After release operations, it is almost impossible to obtain flexible, fully functional feet.

Today, most leading orthopedists accept that treatment of clubfoot begins only conservatively

.
Surgical treatment may be necessary in the future, if residual components of the clubfoot remain. But the volume of surgical intervention will be much less than if treatment begins with surgery. We are waiting for you in our orthopedic center for treatment and answers to all your questions that you will inevitably have, no matter how much information and sites you study.
Author: Serdyuchenko Sergey Nikolaevich Orthopedic traumatologist of the highest category

Give your child a foot massage. Example.

The boy's parents contacted the Happy Baby children's center when the baby was 1 year and 2 months old. The child has legs like the letter O, so scary to look at. We did a massage course of 10 procedures. The knees were thoroughly massaged. We did a general one. Gymnastics to strengthen the main muscle groups, plus special exercises described above. After working on the knees, the legs were wrapped with an elastic bandage in the area of ​​the knee joints. A soft insert was placed between the ankles (the medial surfaces of the ankle joint). The purpose of bandaging was to stretch the inner edge of the knee joint capsule so that it was more elastic and pliable for straightening the legs. After the first ten massage sessions, parents noted positive dynamics.

After this course, they did not give massages anymore. Mom received recommendations for gymnastics, as well as recommendations from the regional children's clinic. According to the mother, they did primitive exercises: “bicycles,” “raised their legs,” etc., but not for long. The child simply lived a normal schedule. I walked on the street by myself, without support. The legs were slowly, but corrected, under the pressure of gravity, when the legs are positioned wide while walking, the bones and joints of the lower extremities are transformed, it is important to create conditions, to help the body start the process, which is what we tried to do with massage and stretching. Take a look at the before and after correction (treatment) of varus O-shaped deformity of the legs in a child. Overall, this is a credit to the child’s body; we just helped him a little.

Symptoms of flat feet

Parents should be very careful when recognizing the symptoms of flat feet in order to stop further destruction of the child’s foot in time and avoid possible problems in the future.

Symptoms of flat feet can vary greatly. As a rule, it is worth paying attention to the following points:

• pain in the legs or calf muscles when the child walks;
• poor posture;
• increased fatigue;
• headache;
• refusal of outdoor games where you need to run a lot;
• tired legs;
• change in gait;
• flattening of the foot;
• swelling of the legs;
• uneven wear of shoe soles;
• wide leg spacing when walking
• the appearance of calluses on the feet and fingers;
• ingrown nails into the skin of the fingers.

flat feet in children foot massage

Diagnosis of bursitis

Diagnosis of pathology is carried out by a pediatric orthopedist based on a comprehensive examination. Initially, the doctor gets to know the little patient and his parents, clarifies what their complaints are and when specific symptoms appeared. Attention is paid to the course of pregnancy and childbirth, past illnesses and injuries. Then the specialist proceeds to a visual examination of the child, assessing posture, foot placement and identifying other characteristic signs. To confirm the diagnosis the following are used:

• plantography: assessment of the distribution of load on the foot when standing;
• foot x-ray;
• CT or MRI of feet, lower extremities.

If necessary, the list of examinations is expanded.

Description of the equinus foot, code according to ICD 10

There are a huge number of pathologies of the musculoskeletal system that theoretically can develop in children. This includes varus, flat feet, and valgus deviations. The bone structure, primarily the fingers, may be subject to deformation. Displacement of the support axis is a serious symptom, which often becomes the main reason for negative changes.

A significant part of such deviations can be diagnosed at an early stage. Some even while still in the womb. For this purpose, ultrasonic surveys are carried out.

But the culprit of our review today can be noticed much later. Only at the moment when your child begins to try to walk. Then the incorrect position of the limbs will be clearly visible.

In most cases, pathogenesis is based on problems with muscle tone. Their incorrect development leads to the fact that the part is simply not used. As a result, it develops into a habit. Unless the reasons lie deeper. For example, a consequence of a certain form of cerebral palsy.

Sometimes, if there are no physiological prerequisites, the child can, over time, get rid of the bad habit. But you shouldn’t count on this; it’s better to worry about preventive methods and treatment in advance. The later the stage, the more difficult the process of treatment and subsequent recovery will be.

So, let's look at the ICD 10 code for equinus placement of feet in children - this is Q66. It is by these symbols that the disease can be classified. Naturally, this area is the musculoskeletal system.

As a result, the process of bending the fingers is disrupted and the bone frame is bent. The baby cannot step forward normally and the emphasis shifts to the front. This is where the name comes from - ballerina syndrome. After all, visually the patient begins to walk as if on tiptoe. The entire plantar part does not come into contact with the surface.

Differences with equinovarus installation

Varus pathology has several key differences. In principle, these are different diseases. Although, ordinary people often consider them identical. This is fundamentally wrong. The difference is observed in symptoms, causes, influence of negative consequences, and, importantly, in visual aspects.

According to ICD 10, equinovarus foot deformity has the same code. This is Q66. Only the fractions differ depending on the specifics that the doctor voices.

How is it different from equinovarus pathology?

Let's look at these aspects in tabular form.