Article 68 – Flat feet and other foot deformities

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Updated: September 5, 2021
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Young people who are of conscription age and their parents are concerned about whether they will be accepted into the army with flat feet. This physiological deviation is associated with a number of difficulties. A person with this disease cannot withstand standard physical activity and needs specialized shoes.

But in practice, conscripts even with a serious degree of illness can be drafted into the army. To obtain an exemption from service, you must know the current legislation and have medical documents confirming the diagnosis.

Suitability categories

All conscripts are required to undergo a medical commission, which includes military medical specialists. Each of them checks his direction, and based on the results of a general medical examination, admission to service or exemption from it is given. Having flat feet does not guarantee that a guy will be released from duty to serve. It all depends on what kind of diagnosis will be made.

The commission at the military registration and enlistment office cannot independently remove a conscript from the army on the sole grounds that he has complaints.

If there are suspicions of health difficulties that do not allow him to serve, the young man is sent to a medical institution to confirm or refute the diagnosis. The degree of suitability is determined in accordance with Government Decree No. 565, approved on July 4, 2013.

The regulations on military medical examination determine that the assignment of a category determines what a person can or cannot serve.

Suitability categories are divided into 5 types, each of which has its own characteristics:

• Category “A” means that the conscript is fit without restrictions.
• Category “B” implies minor restrictions; a conscript can serve, but not in all branches of the military.
• The letter “B” indicates that the conscript is of limited fitness; he receives an exemption from conscription, but will serve in the event of war.
• Category “G” means that the conscript is temporarily unfit for military service. After a deferment of up to a year and a second medical examination, he may be declared fit and go to serve.
• In category “D”, a young man is completely exempt from military service.

Regardless of the subgroup, all conscripts with category A can serve in various types of elite troops. For example, Marine Corps, GRU special forces, Airborne Forces, Navy, etc.

Treatment: conservative and surgical

Treatment for flat feet should be comprehensive. Individual procedures and activities will not bring the desired result

The easiest way to correct flat feet is to correct them in stages 1-2. At stages 3-4 we are not talking about complete recovery. Sufferers will need to wear insoles and orthopedic shoes throughout their lives to adjust to the condition.

It is possible to completely recover from flat feet only in childhood, since during this period the muscular-ligamentous apparatus continues to form. In adults, we are talking only about stopping the further pathological process and reducing the severity of pain symptoms.

Operation

The operation is necessary for transverse flatfoot and valgus deformity of the foot - deviation of the first toe to the outer part. Women who wear the wrong shoes are most susceptible to hallux valgus: with high heels and narrow toes.

The operation is also prescribed for stage 3-4 flat feet; stages 1-2 are tried to be treated conservatively.

Wearing orthopedic insoles

The main method of correcting the position of the foot is wearing orthopedic insoles. They are best selected on the recommendation of a specialist.

There are many brands and varieties of insoles. But according to the type of problems being solved, they can be divided into 3 categories:

• Preventive. In fact, all ready-made insoles can be called preventive. The manufacturer sets average parameters for the finished insole.
• Children's. Necessary to fix the child's foot in the correct position. Distinctive features of children's orthopedic insoles are a deep heel and high side sides to support the lateral arch of the foot.
• Individual. They are made according to the parameters of the foot, which were obtained from the results of plantography.

An equally important factor is wearing orthopedic shoes. You can determine that shoes are suitable for treating flat feet based on a number of criteria:

• availability of certificates;
• high hard back;
• soft edging;
• hard toe (if the shoes are closed);
• orthopedic insole inside.

It is possible to compensate for flat feet by wearing insoles, but this can be done more efficiently and quickly with the help of orthopedic shoes.

Massage

A prerequisite for treating flat feet is massage. It strengthens and tones the muscles of the lower extremities, improves blood circulation. Massage is necessary for the muscles of the lower leg and plantar surface of the foot.

Our online clinic specialists will tell you how to properly massage your feet if you have flat feet. They will give individual recommendations depending on the severity of the disease and the age of the patient.

Corrective gymnastics

Gymnastic physical therapy creates an optimal motor mode: it trains weakened muscles and strengthens the ligamentous apparatus. The correct shape of the feet is modeled in patients: their balancing and spring function is improved, and the muscle corset as a whole is strengthened.

Orthopedists and chiropractors suggest performing the following exercises for flat feet once a day for 20 minutes.

Physiotherapy

It is used as an additional method of treatment in combination with wearing orthopedic shoes, gymnastics and massage. It improves and consolidates the effect of the therapy.

In the treatment of flat feet and hallux valgus, the following is used:

• electrophoresis;
• paraffin applications;
• electrical stimulation of the muscles of the lower leg and feet.

Overweight patients are advised to adjust their weight, as this leads to the rapid development of flat feet. A diet rich in calcium, magnesium and phosphorus is used, taking medications with vitamin D3.

Methods for determining the degree of flat feet

Only a doctor can determine which flat feet are not accepted into the army. The degree of the disease affects whether the young person will be called up or receive release.

Having flat feet as a diagnosis does not guarantee that the military registration and enlistment office will immediately remove you from the military register. To obtain a certificate of unfitness, you will need to undergo a serious medical examination, during which the degree of the disease will be established.

For a comprehensive and objective assessment, different diagnostic methods are used.

Each person's foot is individual and people with flat feet do not have a single standard. In addition, in addition to the purely physiological structure, one also has to take into account somatic and dermatological diseases, which often accompany this disease.

In medical practice, two main diagnostic methods are used:

1. Clinical – taking an anamnesis through questioning, external examination of the foot, assessment of the condition of the skin, palpation to determine joint mobility and determine points of pain.
2. Instrumental – includes examinations using various medical devices.

As part of the instrumental approach, the patient may be referred for examinations:

• podoscopic;
• podometric;
• plantographic;
• strain gauge;
• X-ray.

Final conclusions are drawn only based on the totality of data. X-rays are considered one of the most important. Using radiographs, the percentage of deviation from the norm is determined and it is found out what type of flatfoot we are talking about: longitudinal or transverse.

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Additionally, the presence of problems in the joints, scoliosis and other associated abnormalities is recorded. The feet are examined in three positions: lying on your back, lying on your stomach and standing. The deformity may be different on the two legs, but the diagnosis is made based on the worst of the indicators.

Diagnostic methods - gold standards

Diagnosis begins with a visual examination of the patient's foot. The doctor may already notice a decrease in the height of the external arch. The doctor also draws attention to the presence of corns in places where they should not be (finger pads). Further, instrumental examination techniques may be prescribed to clarify or refute the diagnosis.

One of the main methods is x-ray of the foot under load to assess the achylocalcaneal angle. There is a more modern examination method - plantography or plantoscopy. During the examination, impressions are taken from the patient’s foot with further processing of the information and its storage on electronic media.

Plantography is prescribed for preventive purposes to the following groups of people:

• conscripts;
• athletes;
• persons with diseases of the musculoskeletal system;
• those recovering from lower limb fractures;
• patients with signs of flat feet.

In the latter case, the study is performed to assess the type and degree of flatfoot, as well as to evaluate the effectiveness of treatment.

With the results of x-rays or plantography, you must contact an orthopedist. In the clinic and during an online consultation, the doctor will write a prescription. You can take it to an orthopedic salon to choose a suitable insole or order shoes.

Will people with 3rd and 4th degree flat feet be accepted into the army in 2021?

Flat feet have 4 degrees of disease severity. All of them are described in detail in medical regulatory documents. The medical commission determines whether or not the guy will be accepted for service in the armed forces, guided by Article 68 of the Decree of the Government of the Russian Federation No. 565 of July 4, 2013. Many changes were made to this document, which were designed to minimize the number of loopholes that would allow one to obtain a deferment from the army.

In accordance with the legislative norms in force in 2021, people are exempt from conscription only if they have the following officially confirmed diagnoses:

1. Unilateral or bilateral longitudinal flatfoot of the 3rd or 4th degree.
2. Transverse flatfoot of the third degree.

Until the end of 2013, the second degree of flatfoot was also considered not “serviceable” in the presence of arthrosis. Since the beginning of 2014, this clause was excluded; it became possible to obtain exemption only with degrees 3 and 4.

Read more about whether people with arthrosis will be allowed to serve.

It is possible to determine which group a conscript belongs to only with the help of x-rays. An image is taken on the device, and then the doctor measures the angle of the internal longitudinal plantar arch. The specialist draws the resulting photo of the foot according to established standards. Incorrectly drawn lines radically change the final result. According to medical standards, the standard angle of the internal plantar arch is 125-130 degrees. If there are small deviations - 131-140 degrees, 1 degree is assigned. Indicators from 141 to 155 degrees indicate the presence of 2 degrees. But everything more than 155 degrees qualifies as 3rd and 4th degree.

When diagnosing, the problem is that the level of inclination may change throughout the day. A difference of 1 degree can easily lead to the fact that category A will be assigned and the young man will go to serve, or vice versa will be released from service. In the morning, after a night's rest, the slope is less. But after a long walk, especially in uncomfortable shoes, it increases. If the x-ray is done with a load, the degree may also decrease.

How is the examination carried out?

Most disagreements among doctors arise regarding violations from lists “B” and “D”. If applicants for service in the FSB or those wishing to take a position in the police department undergo a medical examination, difficulties with the health of the lower extremities cannot be hidden or kept silent. It is in the interests of employers and personal safety to conduct the inspection and examination efficiently.

Examination by a specialist

You shouldn't be silent if your legs hurt. It is better to list your complaints to the doctor than to later ruin your health due to professional incompetence and say goodbye to career growth.

Providing doctors with a complete package of information about the problem organ guarantees the correct diagnosis. The traumatologist's records in the outpatient card, X-ray diagnostics, and extracts from previous studies are important. This will help speed up the results of the IVC and make it possible to understand whether a person is hired for service. Having discovered the symptoms of flat feet, the surgeon must:

• Issues a referral for x-rays of the feet;
• Gives the orthopedist two forms for health examination reports to fill out.

Flat feet 2nd degree

Those with second-degree flat feet are accepted into the army. Although this adjustment is quite controversial, it has been in effect for almost 10 years. People with such deviations from the norm need to constantly take care of their feet, in particular, wear special insoles or even order orthopedic shoes. It is clear that no one in the army provides them with such things. But, unfortunately, this does not help avoid conscription.

ATTENTION. The problem with flat feet is that during active physical activity, the feet begin to hurt.

Constantly being on your feet leads to complications with the musculoskeletal system and the spine, which can provoke the development of a variety of diseases. Of course, the employee will be sent to the hospital if complications are detected, but no one will take comprehensive care of his health. Therefore, if you have problems, you need to devote enough effort and time to undergo a full medical examination and make a correct diagnosis.

The second degree of illness does not exempt you from conscription, but does not give you the right to join the elite troops. Such guys will not be able to serve in the airborne troops, marines, border troops and special and special forces units.

Don't crunch!

Even in the presence of stage 2 flat feet without progression, they are hired by the Ministry of Internal Affairs. If the disease develops over time, the applicant can switch to another specialty at the end of the academic year.

If foot pathology at stage 2 is accompanied by osteoarthritis, then the candidate will not be hired for work or training. Due to the fact that physical activity and the need to wear special shoes contribute to the development of the disease, applicants with flat feet are periodically examined.

• Due to the fact that physical activity and the need to wear special shoes contribute to the development of the disease, applicants with flat feet are periodically examined.
• If foot pathology at stage 2 of development is accompanied by osteoarthritis, then the candidate will not be hired or trained.

Flat feet 1st degree

Flat feet of the first degree as a medical diagnosis is recognized as a problem, but for the army it is not such. It is believed that there is no limitation from this disease. Even if there is an additional diagnosis, for example, arthrosis of the fingers or other joints, one cannot count on release or even a delay.

Such stringent requirements are associated with a huge number of people who have certain foot abnormalities. The government is aware that issuing exemptions for grade 1 flat feet threatens serious shortfalls in the army. Therefore, it was regulated that only degrees 3 and 4 give the right to exemption from service.

How is X-ray diagnostics performed?

The photo must be taken under natural load in a standing position. Both legs are removed simultaneously in a lateral view. On x-ray, the specialist builds an isosceles acute triangle, the apex of which will be the lower part of the sphenavicular joint. The sides are drawn to it from the edge of the tubercle of the calcaneus and from the plantar surface of the head of the metatarsal bone of the big toe. The height of the triangle (normal is 39 mm) determines the degree of arch. The angle at the apex is also important; normally it is 125-130 degrees.

Errors that affect the final result of X-ray diagnostics and admission to the Ministry of Internal Affairs occur more often at the stage of describing radiographs. An inaccurate diagram will give false information about the disease. You will get different degrees of flat feet, described in Article 68 (subparagraphs c and d) of the resolution.

The key role here is given to the first or second stages of arthrosis, which are difficult to differentiate even after taking an X-ray correctly. They decide the fate of future FSB employees who are recruited for particularly important tasks that require sufficient load on the skeletal departments, endurance, and work in extreme conditions.

Can a disease be cured in military service?

Flat feet as a diagnosis appears either in childhood or in adulthood. There are a huge number of reasons for its development. Often this deviation is genetic in nature. But in any case, the problem must be solved with the help of individually selected treatment. It may include the following activities:

• production and wearing of special orthopedic insoles;
• purchasing individual shoes that are made to measure;
• performing special exercises on a daily basis;
• prescribing courses of exercise therapy and physiotherapy.

Even following a strict medical schedule does not lead to improvement. If there is a constantly developing progression, surgical intervention may be prescribed.

Adults who have varying degrees of flat feet are prescribed maintenance therapy and are additionally recommended to reduce the load on the feet. In particular, excessive exercise is not recommended.

The army is not a medical and preventive sanatorium. Everyone there lives according to the same strict laws, which are geared towards unquestioning discipline and daily physical activity. No one will listen to the complaints of conscripts, especially when it comes to pain. In practice, young people endure unpleasant sensations for a long time until they receive obvious complications, which lead them to a hospital bed. If a person had difficulties with the load before being drafted, his feet and legs quickly tired, one should not hope that the army will successfully cope with this issue. Most likely the problem will get worse.

Foot diagnostics

With the help of an X-ray examination, you can not only detect an injury or some kind of deviation, but also obtain detailed information about the structure of the foot, the condition of each bone and joint, as well as some features of the anatomy. Today, this is one of the few techniques that allows you to make an accurate diagnosis and select the optimal treatment methods.

Using an x-ray of the foot, performed with a load, the following disorders are diagnosed: - flat feet, osteophytes, hallux valgus; - arthrosis, arthritis, gout; — pathological changes in the bone and joint structures of the foot, congenital anomalies; - dislocations, fractures, cracks, injuries.

How to get exemption from the army due to flat feet

Even with 3-4 degrees of flat feet, a person will have to make a lot of effort to get exemption from the army. It is advisable to start preparing for the military medical commission in advance and not hope that they will be on the side of the conscript. It’s easier and more convenient for doctors to establish a guy’s fitness than to remove him from the health register.

You should go to the military registration and enlistment office with ready-made medical reports. They can be obtained from any health care institution that is accredited to issue the relevant certificates. Many go directly to the clinic where they were previously registered. This is not always the right approach, because high-quality X-ray machines are not available everywhere. Obtaining images of poor or average quality threatens with an incorrect diagnosis, which means the army cannot be avoided. It is also important how competent the doctor is who will calculate the degree of deviation from the norm.

Ivan Golubkin

Legal specialist and manager. Experience in the legal field - more than 10 years, in the field of assistance to conscripts - more than 3 years. Writes useful articles for conscripts.

Summary of the contents of documents considering suitability for admission to the Ministry of Internal Affairs

The order of the Ministry of Internal Affairs of the Russian Federation states that control over the state of health, initial examination or re-examination of citizens upon entry into the military and equivalent service is carried out by regular or non-staff (temporary) military medical commissions.

The document provides a clear description in additional tables of diseases that affect decision-making, methods of diagnosing them, and fitness categories. Article 68 clearly regulates fixed acquired bone deformities. According to the article, a foot with high arches of 115-125° and correct placement on the surface is considered normal.

The pathology is considered to be a sharply “twisted” foot with supination of the posterior part and pronation of the anterior part, high internal and external arches. Each type of pathology in the article is described point by point with detailed instructions.

Flat feet

• Group “a” includes severe types of post-traumatic, acquired or hereditary changes that do not allow the use of military-made shoes.
• Point “b” - considers forms of longitudinal or transverse flatfoot of the 3rd degree with severe symptoms and aggravated by arthrosis of the joints, persistent contracture. Traumatic deviations of the heel bones are noted with a reduced Böhler angle of more than 10°, high pain and arthrosis of the subtalar joints of stage II.
• Clause “c” of Article 68 classifies moderately severe deformation with slight pain and minimal static disturbances. These are cases where it is possible to adapt the shoes.
• Point “d” - the presence of transverse and longitudinal flatfoot of the II degree. With similar arthrosis manifestations of a lesser degree.