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We draw with palms and hands. Flat feet in children - prevention and causes Drawings from the prints of children's feet

Flat feet is an unpleasant and rather dangerous diagnosis that cannot be ignored. Such a defect causes disturbances in gait, posture, negative changes in the spinal column and a host of other pathologies.

Why flat feet begin in children, how to recognize signs of foot anomalies in a child and how to treat a child, we will tell in this article.


What it is

Flat feet in children is a deformity of the skeleton of the feet. With it, the shape changes, the longitudinal or transverse arch is lowered and flattened. At the same time, in the diameter of the foot, it is deformed in more than half of all cases, and only in 30% of cases, flat feet are longitudinal.


Official medical literature even reports 3% of infants who can be diagnosed with flat feet, but this information is controversial.

The fact is that all babies, without exception, are born with flat feet. Their legs in the first year of life are not adapted to move in space in an upright position, and therefore there is no natural need for the foot to immediately have high and regular arches. Such flat feet is considered quite natural, physiological.


As the load on the lower limbs grows and increases, the real formation of the feet begins. Most often, the first prerequisites for the development of foot pathology are laid at the age of 7-8 months to 1.5-2 years.

The muscles of babies who are just starting to get up are still very weak, the cartilage tissue is elastic, so any violation during the first load on the legs can provoke the development of flat feet.

However, there is nothing wrong with infantile flat feet. If the development of the child proceeds normally, if physical activity on the lower limbs increases gradually, then the feet will normalize by the age of 7-8. Unfortunately, this does not always happen.


Flat feet cannot be considered a harmless disease. The function of the foot provided by nature is support and cushioning. With the flattening of the arches of the foot, they stop absorbing when walking in the required volume, respectively, the load on other parts of the musculoskeletal system increases significantly, and this leads to pathologically rapid wear of the knee and hip joints, and the spine.

Violations of the support system, in turn, have a significant impact on the correct functioning of many internal organs.

It is possible to state with confidence that a child has a flat foot only closer to the age of 7-8, when the main stage of intensive formation of the shape of the support of the lower extremities is completed.


Causes

Congenital flat feet, not physiological, but pathological, is recorded quite rarely. It is connected with the processes that took place in utero, and with the heredity of the baby.

If relatives of the crumbs suffer from flat feet, then the likelihood of a congenital form increases.

Intrauterine causes - underdevelopment or abnormal development of muscles, ligaments that form the longitudinal and transverse arch, lower legs.


Much more often, flat feet are acquired disease. But it can also have congenital causes. Such cases, in particular, include congenital weakness of the connective tissue. In children with such a problem, flat feet are formed due to insufficient connective tissue.

This is far from the only problem. Connective tissue deficiency is accompanied in parallel either by an additional cardiac chord, or myopia, or kinks and deformities of some internal organs (most often the gallbladder).

Often, flat feet develop in children who at an early age suffered rickets that affects the bone and muscle systems. At risk are also guys who have suffered fractures of the ankle, calcaneal bones, since there is a risk of improper bone fusion after injury.

Paralysis of the lower extremities, both complete and partial, can also cause improper development of the foot. Paralysis can be a manifestation of past poliomyelitis, cerebral palsy, as well as frequent convulsive syndrome of the lower extremities, which can occur against the background of certain neurological diseases.

Unfortunately, parents, without suspecting it themselves, often become the culprits for the development of flat feet in their child. This diagnosis can be early verticalization of the baby.

If a baby, who has not yet really learned to crawl confidently, is forcibly placed in walkers and jumpers in order to enjoy the success of the baby, then the load on the spine increases significantly. The child's legs are also not ready for the vertical position of the body, and weak muscles and ligaments eventually form under excessive load incorrectly.


Flat feet also threaten overweight, obese babies, babies whose parents choose the wrong shoes, uncomfortable and unhealthy.

If the child walks too much, runs or stands for a long time, this also contributes to the incorrect formation of the arches of the foot. Flat feet are often diagnosed in children who suffer from planovalgus deformity of the feet.

Despite all the reasons listed above, the most powerful influence on whether a child will have flat feet is still exerted by hereditary factor.

Proper care helps to correct possible violations, but, alas, it is not capable of completely preventing the onset of a problem if it has genetic prerequisites.


Classification and types

Longitudinal flat feet is such a setting of the foot, in which the child rests on almost the entire area of ​​\u200b\u200bthe foot.

Transverse - characterized by support on the metatarsal bones. With a longitudinal stop, it increases in length, with a transverse one, it decreases.


Another type of pathology is combined flat feet. It combines signs of both longitudinal and transverse deformation.

Depending on what mechanism formed the basis for the development of pathology, There are several types of flattening of the feet:

  • congenital;
  • traumatic;
  • paralytic;
  • static.

Pathology innate property usually they are discovered only by the age of 6-7, before it is difficult to distinguish it from physiological, and therefore not a single doctor undertakes this.


traumatic flat feet occurs as a result of fractures of the heel, lower leg, tarsal bones, ankle. Paralytic pathology is associated with paralysis of the lower extremities, especially some muscles - the foot and lower leg.

Most often in about 85% of cases, static flat feet occur. This pathology occurs in close conjunction between hereditary predisposition and external factors (shoes, prolonged standing, overweight, etc.)


Depending on how many degrees the angle of deviation from the norm is expressed, they distinguish four degrees of transverse disease:

  • First degree. The angle between the metatarsal bones No. 1 and 2 does not exceed 10-12 degrees. The thumb is deviated from the normal position by no more than 15-20 degrees.
  • Second degree. Between the metatarsal bones No. 1 and 2, the angle is increased to 15 degrees. The first finger has a deviation of 30 degrees.
  • Third degree. The angle between the above metatarsal bones is within 20 degrees. The deviation of the first finger is 40 degrees.
  • Fourth degree. The angle between the first and second metatarsal bones is quite large - more than 20 degrees. The first finger is deviated by more than 40%.


In longitudinal flat feet, the severity of the disease is measured by deviations from the normal height of the arch of the foot. For healthy children, values ​​\u200b\u200bof 35 mm and above are typical.

Flat feet have stages of development. At the initial stage, pathology is always easier to correct than at a neglected one. In addition, stable deformation is evaluated according to individual criteria.


Distinguish fixed flat feet and flexible(mobile). Fixed flat feet are characterized by the appearance of signs of deformation constantly, mobile appears only at the time of the load on the child's legs. If the child is seated and the load is removed from the legs, then the arch of the foot takes on a normal appearance.

Symptoms and signs

Trying to understand what flat feet look like in babies up to 2-3 years old, worried parents study the medical literature, but they do not find an answer to this question. By and large, until the age of 6-7, all the feet of children look the same - flat.

Only cases of congenital flat feet have distinctive visual features. In this case, usually one foot is affected, not two. The sole of such children is convex, and the upper (back) part is unnaturally concave. The fingers are protruded, when placed in a vertical position, the baby rests on the heel.


Signs that should alert parents of older children are as follows:

  • The child quickly gets tired on a walk when walking, complains of pain in the legs. Pain is lingering in nature and usually worsens in the evening.
  • The legs may swell after a long walk. Puffiness can also be observed in the evenings.
  • A child with flat feet tramples shoes in a special way - the inside of the sole and the heel on the inside are damaged.


If there are such indications, parents can use a regular millimetric ruler to understand how serious the situation is:

  • The height of the arch of the foot in a seven-year-old child is 35 mm - there is no pathology.
  • The height of the arch of the foot in a child of the same age is 25-35 mm - we are talking about longitudinal flat feet of the first degree.
  • Arch height - 17-25 mm - the second degree of longitudinal flat feet.
  • The height of the arch is less than 17 mm - the third degree.



The lower the height of the arch, the more pronounced the symptoms become:

  • heavy gait, clumsiness;
  • complaints of frequent headaches;
  • visual deformation of the feet;
  • pain in the legs and lower back;
  • the occurrence of cramps in the lower extremities.


According to these clinical signs, it is possible to establish, even at home, the fact of the presence of flat feet of almost any kind.

The only exception is mobile flatfoot, which usually proceeds without symptoms at all.

In 80% of children, flexible mobile flat feet tend to pass closer to adolescence, but even if it persists, it absolutely does not manifest itself and does not bother a person. With it you can serve in the army, wear any shoes, play any sport, live without restrictions.

It should be remembered that in the initial stages, all symptoms look smoother. Therefore, for the initial stage, foot deformities are not characteristic, which are visible to the naked eye, but even at the earliest stage they appear. slight pain when walking and moderate swelling of the ankles in the evening.


At the intermittent stage (second), short-term convulsions of the lower extremities may begin, and the feeling of fatigue during exercise increases, pain in the legs, “shooting” into the knee joints.

At the combined stage (third), pain can appear even with minor loads. Visually, the foot changes - the ankle on the inside begins to show through more than on the outside, the heel looks somewhat flattened. The gait is changing.

You can suspect transverse flatfoot by a number of characteristic features:

  • The foot becomes wide. Sometimes this makes the task of buying shoes very difficult.
  • "Painful bone" - the joint connecting the thumb and metatarsal bone is deformed, enlarged, becomes painful.
  • The nail often grows on the thumb.
  • The gait is tense, constrained.


Diagnostics

Parents may suspect that the child has flat feet, or they may not notice anything. Only a narrow specialist, an orthopedic surgeon, can accurately determine if there is a deformity of the feet. It is to him that you should go to the reception.

The doctor will visually examine the child's legs and prescribe several hardware studies, which allow us to state with great accuracy the presence or absence of pathological conditions.

The doctor has no right to make a diagnosis only on the basis of an examination. To do this, you need to take x-rays of the feet with a load (in a standing position) in two projections.


In addition, there are several other diagnostic methods.

plantography

This is a very common diagnostic method, it is widely used. These are some kind of footprints. You can make them on a special device - a plantograph.

The device is a frame with a stretched film. Under it is a layer of gauze with printing ink. They stand on the film with both feet, and the laboratory assistant marks key points on the received footprints, by which the doctor can judge the severity of the disease. This study may be recommended for a normal or overweight adolescent child.

Small children and underweight adolescents are not allowed to plantography, because lack of weight greatly distorts the results of the study, the prints are fuzzy, unreliable.


podometry

In the course of such a study, with the help of a stopometer, individual parts of the foot are measured and general proportions are calculated using special formulas. The stopometer is very accurate, it allows you to take measurements with millimeter accuracy.

This method, combined with measurements with transomometers, which allow one to evaluate the shock-absorbing properties of the foot, is often used to measure children's feet in dynamics, for example, during the correction of flat feet.


Podography

This is a method of recording gait features. It is not an independent diagnostic, but it helps the orthopedic doctor in assessing the nuances of the flat feet of a child.

The patient is put on special shoes with metal plates - contacts. They will have to walk along a special metal path.

The obtained electromagnetic data make it possible to judge the angle of the foot turn, the straightness of the gait, the width of the step, the uniformity of the load on the heel and toe.


Electromyography

This is a method that allows you to assess the state of the muscular system of the legs and feet. The procedure is usually indicated for paralytic flat feet, as well as for some traumatic varieties of foot pathology.

The electrodes can be applied superficially to the skin, or they can be inserted as very thin needles directly into the desired muscles.

First, their impulse activity is measured at rest, and then under load.


Danger and Consequences

Many parents who have heard the diagnosis “flat feet” from a pediatric orthopedist are interested in how dangerous it is. The answer to this question is obvious - improper depreciation, which flat feet leads to, slowly but surely destroys other parts of the musculoskeletal system, joints, tendons.

First of all, the knee and hip joints are exposed to the negative impact of strong loads that are not provided for by nature, the spine is bent with all the ensuing consequences, up to the onset of disability.

Treatment

Flat feet are treated both conservatively and surgically, however, in pediatric practice, they always try to choose conservative methods that are more gentle and less traumatic. Let's talk about them in more detail.

Orthopedic shoes

Wearing orthopedic shoes is an integral part of the treatment of flat feet. You can buy it in a special orthopedic salon. It is better to go there with the written recommendations of an orthopedic surgeon, who will indicate all the parameters of the child's foot - height, width, points of deviation from the norm, deviation angle, turn angle when walking.

If a pair that matches the exact parameters of the child's foot is not available, it will be made to order according to individual measurements.


There are strict requirements for orthopedic shoes. The initial stages of the disease usually do not need to wear a heavy medical orthopedic pair, it is quite enough to confine oneself to orthopedic insoles, but already a moderate degree of flat feet may be an indication for special corrective shoes.

She usually has a high back that fixes the ankle, soft soles, orthopedic insoles, a wide rounded or square toe, arch supports, and a low heel. This pair gives the leg additional stability and fixation.


Many parents believe that wearing orthopedic shoes helps in the prevention of flat feet. This is a dangerous delusion. Heavy and rather massive orthopedic shoes, designed specifically to correct foot deformities, are not suitable for preventive wear.

It is bought involuntarily when the orthopedist insists on it. Only insoles can be used prophylactically, and even then not all.


Massage and manual therapy

Manual techniques for influencing the child's feet in combination with other methods give very good results, allow you to correct flat feet. This treatment does not have a quick effect, but the benefits of systematic procedures will pleasantly surprise both parents and an orthopedic doctor.

The essence of the impact is on kneading, improving blood circulation, elasticity of the calf muscles, foot muscles, the weakness of which led to the problem. After several courses, the muscles are tightened, the contour of the foot begins to take shape.

A chiropractor and a professional massage therapist will show parents how to properly influence the child's lower limbs and spine in order to continue massage at home.


If the manual effect is difficult enough to reproduce at home, then any mother can master the massage. The session includes several stages:

  • impact on the foot (stroking, kneading);
  • shin massage (movements from the bottom up, and not vice versa, deep enough kneading with an emphasis on the inside of the shin);
  • impact on the hips and buttocks (a shallow, painless vibration technique is best for relieving tension from the knee and hip joint).

The massage can be completed with warm foot baths followed by intense rubbing of the feet with a hard towel.


Physiotherapy

There are dozens of exercises that will help cure flat feet in children and adolescents, making the treatment process interesting and even enjoyable. But only an exercise therapy doctor can recommend specific exercises, which will take into account the type and stage of the anomaly in the development of the feet.

It is desirable to conduct classes in a playful way, especially for children of preschool and primary school age, since classes should be fun.


The following exercises are considered the most useful for foot deformities:

  • walking on toes;
  • walking on heels;
  • walking on the outside of the foot;
  • rolling from toes to heels.

You can do all these exercises not only on a flat floor, but also on a special mat-applicator.


A certain relief pattern, the degree of rigidity of the product will be prompted by an orthopedist who observes the child.

It is better to perform the exercises barefoot. If you experience pain in the legs while exercising on the mat, you should stop, rest and try again. Forcing a child to overcome pain is not the best tactic.


Physiotherapy

Physiotherapy procedures, such as electrophoresis, magnetic therapy sessions, UHF, and so on, are designed to reduce pain in the lower extremities, improve blood circulation, strengthen muscle tissue, so these procedures are an excellent addition to the main treatment - massage, gymnastics, wearing orthopedic shoes.

Correction of pathology becomes more effective. Most children's clinics have their own physiotherapy rooms, parents are only required to follow the schedule for visiting procedures.



Kinesiology taping

The taping method is considered relatively new for orthopedics, while rehabilitation medicine has been familiar with it for a long time. The essence of the method is the imposition of special adhesive tapes that redistribute the load on certain muscles, supporting some muscle groups from the outside, and thereby straining others.

At the same time, the therapeutic effect is present almost constantly - both during classes, and during normal walking, and during rest.

Tape tapes are considered the most effective for children's flat feet, when the leg is still growing. In adults, taping does not show such impressive results, although it is also often prescribed by orthopedists as a maintenance therapy.



You can wear glued tapes for several days, then change them. Self-application of teips, at least at first, is undesirable, since incorrect positioning of the tape can lead to even more significant deformations.

As an independent treatment, the method with ribbons is not considered, but it can be used as part of complex therapy.


Surgical treatment

Surgical treatment helps to get rid of flat feet of stages 3 and 4, when conservative methods fail to correct the anatomy of the foot.

With longitudinal flat feet, a surgical correction of the longitudinal arch is performed with tendon plasty along the inner side of the foot.

Children from the age of 10 can undergo subtalar arthroeresis - a minimally invasive operation with a small incision and a quick recovery period - in a day the child is at home.

Through a small incision, a titanium implant is implanted into the subtalar sinus of the foot. The longitudinal vaults thus change. The implant is removed by the age of 17-18, while the correct position of the arches is preserved.


Longitudinal flat feet as a valgus pathology can be effectively eliminated with the help of the so-called Evans operation. Surgeons lengthen the heel bone by implanting part of their own bone into it. The risk of rejection is minimal.

With transverse flat feet, two types of surgical intervention are used - on the tendons and soft tissues and on the bone tissue of the feet.

The second method removes, in particular, the protruding "painful bone", and sometimes several metatarsal bones. After the operation, the child will wear special sandals, which will facilitate faster proper fusion.


Be sure to visit a physiotherapy room, where, in particular, electrophoresis is done according to the SMT method - electrophoresis using painkillers, mineral, anti-inflammatory drugs prescribed by a doctor.

An excellent preventive measure. True, before buying such a floor covering, it is advisable to consult with an orthopedist.

If parents can apply not only efforts, but also imagination to preventive activities, then daily walks along the massage path will turn into an exciting pastime and bring pleasure to the baby.


It will not be superfluous to recall that flat feet will be less likely if parents do not rush their baby in development.

Walkers and jumpers should not be used before 9 months of age. And it is even better to abandon these verticalizing devices altogether, entrusting the development of the child to nature - she knows better when and how he is destined to rise to his feet.

Ideally, if the child, before the first steps, went through all the stages of development of the spine, provided for by evolution, - sitting, crawling, and only then - lifting to a vertical position.

Prevention of flat feet in preschool age is very important, since the foot is intensively formed at this time. Make sure that the child does not wear flip-flops and flat-soled slippers for a long time.

At home, it’s better to walk barefoot in general, and if there is an opportunity to let the child stomp bare heels on grass, sand, earth, then you should definitely use it.


Many parents, and especially representatives of the older generation - grandparents - are categorically against walking barefoot, motivating their position by the fact that a barefoot child will certainly catch a cold and get sick.

In defense of bare feet, we note that it is almost impossible to catch a cold through the feet, because the vessels of the feet (the only ones in the human body!) Have the ability to narrow and retain internal heat. Now, if the child sits on a cold surface with his booty, then hypothermia is very likely, and if the little one stomps barefoot on the floor, nothing bad will happen to him.


A child of 3-4 years old can buy special Bykov insoles. They are invested in shoes for 5-6 hours. You can make it a rule to put such insoles in a removable pair of shoes that the baby puts on in the kindergarten.

The amount of time that children spend in preschool exactly corresponds to the time recommended for wearing Bykov's insoles. You can buy them in an orthopedic salon.


The responsible attitude of parents to the nutrition of the child will help to avoid such a problem (alas, common) as obesity and overweight. Thin children are less likely to develop flat feet than chubby toddlers, and this should not be forgotten.

On the table in the family where the child is growing, there should be regular foods containing calcium, magnesium, potassium, and essential vitamins. It is useful to teach boys and girls to eat jelly or jelly - they contribute to the normal growth of cartilage tissue.

In the diet of a preschooler, lean meat, fish, dairy products, fresh vegetables, fruits, and cereals must be present.


Preventive massage of the feet and lower legs can be performed on a child 1-2 times a week. In this case, special attention should be paid to the toes, the arch of the foot, the inner and outer ribs of the foot.

Contrast foot baths for preventive purposes should be carried out after each bath. Gradually pour cold water into a bowl of warm water. This improves blood circulation in the lower extremities.

In order to prevent the development of strong flat feet in a child, it is important at least visit a pediatric orthopedic surgeon twice a year. This specialist will be able to consider the pathology in time at the very initial stage and prescribe conservative treatment.

Dr. Komarovsky will tell you more about the causes, prevention and methods of treating children's flat feet in the next video.

- a change in the configuration of the skeleton of the foot, associated with the flattening of its arches and leading to a violation of the mechanics of walking. Flat feet in children are manifested by fatigue, pain in the legs during movement and static load, swelling and deformity of the foot, changes in gait, difficulty walking. The diagnosis of flat feet in children is established on the basis of a clinical examination, data from plantography, podometry and radiography of the feet. For the treatment of flat feet in children, conservative methods are used (massage, therapeutic exercises, physiotherapy, plaster casts and orthoses); surgery is performed in extreme cases.

General information

Flat feet in children is the most common orthopedic pathology in pediatrics, manifested by a decrease in the height of the arches of the foot. Flat feet can be detected in a child from birth (in 3% of cases); by 2-4 years it is observed in 24-32% of children, by 7 years - in 40%, by 12 years - in 50% of adolescents.

The active formation of the elements of the arch of the foot in children occurs gradually, with the appearance and increase in the load on the legs. The critical moment in the development of flat feet is the age period from 8 months to 1.5 years, when the child begins to stand up and learn to walk. At an early age, all children have a physiological flat foot, due to age-related anatomical and functional features: cartilaginous bone structure, more elastic and extensible ligaments, weak muscles. With proper development with an increase in muscle strength and endurance, this condition in children returns to normal by the age of 5-6 years. With certain disorders, children develop flat feet, which leads to a sharp decrease in the depreciation potential of the foot, an increase in the load on other elements of the musculoskeletal system with damage to the knee and hip joints, spinal deformity, and disruption of the internal organs.

Classification of flat feet in children

The foot has longitudinal and transverse arches that support muscles and ligaments, provide balance to the body, distribute and mitigate the shock load during walking, running and jumping, as well as increase endurance to axial load. According to the anatomical feature in orthopedics, there are longitudinal, transverse and combined flat feet. In children, longitudinal flat feet are more common with flattening of the longitudinal arch and elongation of the foot, which is in contact with the floor with the entire surface of the sole. With transverse flat feet in children, the length of the foot decreases, its anterior section rests on the heads of all metatarsal bones.

Flat feet in children can be congenital or acquired. The congenital form is quite rare and is associated with malformations of bone structures and the muscular-ligamentous apparatus of the foot. Acquired flat feet in children, depending on the origin, can be static, traumatic, rickets, paralytic. The most common static flatfoot is more common in school-age children with a discrepancy between the static and dynamic load on the foot and muscle tone.

Causes of flat feet in children

Flat feet in children can develop for various reasons. Congenital flat feet in children is observed with intrauterine underdevelopment of bones, muscles, ligaments and tendons of the leg and foot. Acquired flat feet in children also develops against the background of congenital insufficiency of the connective tissue and can be combined with an additional chord in the heart, an inflection of the gallbladder, myopia, etc. In the formation of flat feet in children, the hereditary factor is of great importance - the presence of this pathology in close relatives.

Flat feet in children can be caused by weakness of the musculoskeletal apparatus of the foot, which cannot withstand heavy loads; damage to the musculoskeletal system with rickets; improperly fused fractures of the ankles, metatarsal, calcaneus and talus bones; paralysis or paresis of the muscles of the lower leg and foot (including after poliomyelitis); neurological pathology (encephalopathy).

The occurrence of static flat feet in children is facilitated by wearing improperly selected shoes (tight, worn, with thick soles), overweight and obesity, prolonged continuous walking or standing. Often, flat feet develop in children with planovalgus deformity of the feet.

Symptoms of flat feet in children

In most cases of congenital flat feet in children, one foot is affected, which looks like a rocking chair or "paperweight" with a convex sole and a flattened, even concave back side. There is a calcaneal installation of the foot, a sharp pronation with the abduction of the fingers outward. With the advent of static load, congenital flat feet are aggravated and fixed.

In children of 6-7 years of age, flat feet are manifested by rapid fatigue when walking and standing, trampling shoes along the inner edge of the sole and heel. Clinical symptoms of acquired flat feet in children are aching pains in the foot area, aggravated after a long stay on the legs; swelling of the feet in the evening, fatigue when walking.

There are three degrees of longitudinal flat feet in children, determined by the degree of foot deformity. At the I degree, the height of the arch of the foot is 25-35 mm, there is no visible deformity of the foot. At II degree - the height of the arch is from 25 to 17 mm, the flattening of the foot is visible to the naked eye; flat feet in children is manifested by an increase in pain in the foot, ankle joint and calf muscles, difficulty walking. The shape of the foot changes - its length increases, the middle part expands, the gait becomes heavy and awkward; in children, rapid general fatigue is noted. Flat feet of the III degree is characterized by a pronounced deformity of the foot, a decrease in the height of the arch of less than 17 mm, constant pain in the legs and lower back, headaches, and the inability to walk in ordinary shoes.

Flat feet causes curvature of the toes, the appearance of corns, the formation of postural disorders (scoliosis) and diseases of the spine (osteochondrosis, herniated discs), the development of deforming arthrosis, inflammation of the menisci, etc. in a child.

Diagnosis of flat feet in children

It is rather problematic to establish flat feet in children under 5-6 years of age. The diagnosis of pronounced cases of flat feet in children can be made by a pediatric orthopedist during a clinical examination, which allows to identify changes in the length, width and range of motion of the foot, a violation of the condition of its arches, and features of shoe wear.

Objective methods for assessing flat feet in older children are plantography - obtaining a footprint on paper and podometry - measuring the "podometric index" of the arch of the foot. To clarify the diagnosis of flat feet in children, I help the results of radiography of the feet with a load performed in 2 projections.

Treatment of flat feet in children

Flat feet in children is a progressive disease, and the sooner it is treated, the more effective the results. Treatment of congenital flat feet begins from the first weeks of a child's life, which allows you to eliminate all components of foot deformity. With congenital flat feet in children, special therapeutic exercises are performed, massage of the muscles of the foot and lower leg; the foot is kept in the correct position with the help of bandaging, the application of stage plaster bandages, night orthoses (from 6 months of age). With the aggravation of the manifestations of flat feet in children, the operation of subtalar arthroeresis is performed.

Treatment of static flat feet in children, aimed at strengthening the musculoskeletal apparatus of the foot, includes massage, physiotherapy and exercise therapy. In young children, soft shoes are excluded (felt boots, rubber boots, Czech shoes); it is recommended to wear boots with a hard sole and a small heel, well fixing the ankle joints. With flat feet in older children, wearing orthopedic shoes with an arch support insole, which raises the lowered arch and returns the foot to the correct position, is shown.

deformities of the foot, joints and spine.

Prevention of flat feet in children is the wearing of properly selected shoes; physical education, playing sports (basketball, football) and swimming; walking barefoot on uneven ground, sand, pebbles; normalization of calcium-phosphorus metabolism; body weight control.

For every mother, her baby's heels and hands are the most valuable thing in the world. We always kiss them, we call them “sweets”, and we really want them to stay so small and cute longer. But children grow, and so do their heels. To preserve the memory of these tiny arms and legs, you can take as many photos as possible with them, you can make a plaster or clay cast.

And we want to offer the most creative, in our opinion, way. Let's create decorative pictures with prints of the arms and legs of the child. We offer you 7 of the most original options that can be hung both in the nursery and, for example, in the kitchen. By the way, pastel shades of colors look the most harmonious in such drawings.

An owl whose wings and ears are the imprint of a child's foot.

Butterfly wings made from baby footprints.

Rays of sun from footprints.

Flowers are prints of children's little feet.

Family tree of handprints of dad, mom and baby.

A kind whale with footprint fins.

Flat feet in children is considered a common pathology and is being diagnosed with increasing frequency, which can partly be explained by the global trend towards a sedentary, “computer-television” lifestyle. What other factors are associated with this disease, how dangerous it is and how it is treated, we will consider further.

Flat feet in children - causes

Thanks to properly formed arches of the feet, their main functions are performed to share the load, mitigate shocks, establish balance, etc. Flat feet in a child are characterized by flattening of the arches, in which the foot is devoid of recesses from the inside and almost completely adheres to the floor surface. The front part gradually widens, and the heel becomes tilted back.

Congenital flat feet is rare, and it is associated with various intrauterine anomalies in the development of the fetus, exposure to ionizing radiation, and bad habits of a pregnant woman. In this case, the disease is often detected immediately after birth and is combined with other defects. Often this is an acquired disease that develops as the baby develops due to the following reasons:

  • increased body weight;
  • insufficient and monotonous physical activity;
  • frequent walking barefoot on a flat hard surface;
  • unsuitable shoes (bought for growth, inherited, having a flat sole, too soft or hard);
  • paralysis of the muscular-ligamentous apparatus of the foot (due to cerebral palsy, poliomyelitis);
  • leg injuries;
  • transferred;
  • heredity, etc.

It is worth knowing that flat feet in children under 6-8 years old is in most cases a physiological phenomenon. When a child is born, his feet are flat, without obvious arches, which is explained by the cartilaginous structure of bone tissues, muscle weakness, and the predominance of fatty tissue on the plantar surface, which acts as a shock absorber. The abundance of soft tissues in the feet is present until about the age of three, and then gradually decreases. At the same time, the development of the ligamentous apparatus occurs, due to which an increase in the height of the arch is observed.

So, undergoing natural physiological changes, the arches of the feet, as well as the shape of the legs and, “mature” by a maximum of ten years of age. If the development of the child proceeds normally, the correct vaults are formed. Further, in adolescence, when there is increased growth and large-scale endocrine changes in the body, the musculoskeletal system of children again becomes vulnerable, prone to deformation, and the risk of developing flat feet increases.

Types of flat feet in children

The foot has two main arches - transverse (between the bases of the phalanges) and longitudinal (along the inner edge). With this in mind, flat feet, the types of which are determined depending on the affected arch, are divided into transverse and longitudinal. The combined form of the disease is less common. In addition, there is a diagnosis of "valgus flatfoot", when there is a deviation of the axis of the limb.

Transverse flat feet in children

With this type of pathology, the transverse arch is lowered, the anterior section rests on the heads of all metatarsal bones. Such flat feet develops with the genetic predisposition of the baby in combination with the action of external adverse factors. Gradually, due to the fan-shaped divergence of the bones, the length of the sole decreases, its width increases, the thumb deviates outward, the middle finger undergoes deformations.


Longitudinal flat feet in children

If a “diagnosis of flat feet of the longitudinal type” is made, the child has a flattening of the longitudinal arch of the foot. As a result, the length of the foot increases, with the entire surface in contact with the floor, clubfoot gradually develops. A characteristic feature is increased wear of the sole of the shoe along the inner edge. The ankle joint with this pathology is inactive.


Valgus flatfoot in children

Often, longitudinal flat feet, in which the deformation of the foot leads to the omission of its middle part, causes. In this case, there is an outward turn of the fingers and calcaneus and a curvature of the axis in the ankle joint (inward displacement). The reason is sometimes the early setting of the baby on the legs, injuries, the wrong choice of shoes.

Degrees of flat feet in children

To diagnose the disease, footprint data is used. Depending on the intensity of the deformation, several stages of the disease are distinguished:

  • flat feet 1 degree- the height of the arch is close to normal, the symptoms are mild, but there is weakening of the ligaments and there are slight pains in the evening;
  • flat feet 2 degrees- there is a "flattening" of the foot, visually noticeable (including in the ankle, knee), there is swelling of the feet, the gait changes;
  • flat feet 3 degrees- characterized by severe deformity of the feet, fingers, it is difficult and painful for the child to walk, there is pain along the entire length of the lower extremities and in the spinal column, severe swelling.

Why is flatfoot dangerous?

It is a mistake to assume that the pathology in question does not pose a serious threat to the child's body, being rather a cosmetic defect. Even if it is the beginning of flat feet, its consequences in the future can be very unfavorable for different body systems. The most common complications are:

  • development of dystrophic lesions of the joints;
  • hernia;
  • osteochondrosis;
  • heel spur;
  • varicose veins;
  • Morton's neuroma.

These pathologies develop with flat feet in children due to an increase in the load on the joints of the legs and the spine in conditions of poor shock-absorbing ability of the feet. Such consequences are distant, but before that, the quality of life of the baby suffers from constant pain in the legs and back, increased fatigue, and his academic performance worsens.

How to determine flat feet in a child?

Parents should know how to identify flat feet in a child, so as not to miss precious time and take timely treatment. The following manifestations should alert:

  • quick wear of the inner part of the sole of the shoe and heels, deformity of the tops of the boots inside;
  • frequent complaints of the baby on fatigue when walking, pain in the legs;
  • the presence of corns, abrasions on the plantar part;
  • turning the feet inward when walking;
  • leg swelling.

As a home test, you can use the method with imprinted traces. To do this, you need to take a clean sheet of paper and, having smeared the plantar parts of the child's feet with fat cream, vegetable oil or watercolors, put it on this sheet. Moreover, the legs should be brought together, the feet should be placed on the same line parallel to each other, the back is even. On prints in the area between the heel and metatarsus, the width of the isthmus is normally a maximum of one third of the total width. Otherwise, there is a possibility of pathology. The final diagnosis is made by an orthopedist or podologist.

How to treat flat feet in children?

When flat feet are found in children, treatment is prescribed at any age, it is complex and depends on the degree of damage. For this, first of all, diagnostics is carried out by means of plantography, podometry, radiography of the foot. Methods for the treatment of flat feet in children are aimed at strengthening the muscle structures of the legs, improving blood circulation, correcting foot and ankle deformities through a gentle physical impact on the ligaments and joints.

Exercises for flat feet in children


Depending on the degree of existing changes, the child is recommended a set of exercises for the legs, which can be done at home. Flat feet in children require regular treatment - only in this case, you can count on a positive result. Therefore, classes should be carried out daily, once or twice a day. The exercise therapy complex for flat feet in children often includes exercises.

Sitting on a chair:

  • flexion-extension of the toes;
  • circular movements of the feet clockwise and counterclockwise;
  • pulling socks away from you and in the opposite direction;
  • alternately raising the toes and heels from the floor surface;
  • grabbing and moving small objects with toes (balls, cubes, pencils);
  • grasping and lifting a small ball between the feet;
  • rolling the feet back and forth with a gymnastic stick, a ball with spikes;

Standing position:

  • raising-lowering on toes;
  • squatting without taking your heels off the floor;
  • walking on toes, heels, ribs of the outer and inner parts of the sole;
  • walking sideways left and right on a gymnastic stick.

You need to do it barefoot, repeating everything 10-12 times. For preschoolers, all physical activities can be carried out in a playful way, clearly demonstrating the correctness of the exercises. In addition, it is useful for children with such a diagnosis to walk sideways on a log, climb a rope, exercise on a gymnastic ladder, ride a bike, and swim.

Massage for flat feet in children


If a child has flat feet, the doctor will tell you what to do to correct the situation. In most cases, the prescribed therapeutic measures include professional foot massage, aimed at increasing muscle tone, improving metabolic processes. Flat feet in children through massage is treated with periodic courses of 10 to 15 sessions performed by a professional. Using kneading, stroking and rubbing, the foot is massaged from the heel to the toes, the lower leg on the back side.

Orthopedic mat-puzzle for children from flat feet


At home, an excellent therapeutic and prophylactic method for flat feet is walking on a special rug, the surface of which imitates reliefs of pebbles of various sizes and grass, covered with small massaging spikes. Such a mat for flat feet for children is made from a foamed polymer and is a set of several square parts that are connected in the form of a track, snake or in the form of a rectangle. An orthopedic rug is quite capable of replacing the carpet in the children's room, which will ensure regular massage of the legs.

Similar accessories can be made independently from a piece of carpet, to which are attached:

  • flat pebbles;
  • chestnuts;
  • old pencils;
  • plastic caps;
  • buttons, etc.

Orthopedic insoles for children with flat feet

Unstarted flat feet in children, which are treated at home taking into account all the doctor's recommendations, are effectively corrected. One of the appointments is often the wearing of special ones, designed to properly distribute the load on the feet when walking, correct deformities and stop their progression. These products, selected or made individually, are recommended to be worn both on the street and at home.

Methods for the prevention of flat feet in children

Parents who are attentive to the health of their child are able to prevent the development of this disease at an early stage. Prevention of flat feet in children is based on following a few simple recommendations:

  1. The child should regularly walk and run barefoot on uneven surfaces (pebbles, grass, sand, massage mat).
  2. must be correctly selected (new, appropriate to the measurements of the foot, fixing the foot well, with a flexible sole and a small heel).
  3. Physical activity should be regular and dosed (neither too little activity nor excessive sports are welcome).

As soon as the child takes his first independent steps, parents immediately ask themselves the question - how to avoid the occurrence of flat feet in a child, what shoes are best suited for the prevention of this disease, whether it is necessary to somehow train the baby’s legs in a special way ... In fact, flat feet in children - the disease is rather speculative: in fact, to one degree or another, it is present in all babies, but in no case should this worry their parents. Why?

Every baby is a sample of flat feet

In fact, every baby is a model of flat feet! And only over time, very gradually and not quickly (within 5-6, and sometimes 10-12 years), the child's feet form a special bend.

This bend serves as a powerful shock absorber on our skeleton. Namely: when walking, running, jumping and other movements on the bones of our skeleton (and what is very important - on the spinal column!) There is enormous pressure, which is “quenched” precisely due to the special structure of the foot - a slight bend, which is commonly called the “arch ". How developed or underdeveloped the arch of the foot is, most eloquently speaks of the footprint.

1 - normally formed arch of the foot; 2 - too high arch of the foot; 3 - flat feet. All three situations are well “read” along the trail - dip the baby’s foot in gouache, and then put it on whatman paper: you will immediately see how developed or not the arch of the child’s foot is.

This arch is formed gradually as the child grows, but the most intense period occurs at the time when the baby begins to walk independently.

The arch of the foot is completely and completely formed in a boy and girl at the age of about 12 years. And until the moment of its final formation, doctors recognize any position of the foot as absolutely correctable and physiological. That is why the very term "flat feet in children" is somewhat absurd as a diagnosis.

Prevention of flat feet in children

Doctors do not consider physiological flat feet in children to be some serious flaw. However, usually orthopedists are vigilantly watching how the arch of the foot is formed in their wards children over time. And often they advise parents on various preventive measures for the timely and correct formation of the arch of the foot, as well as to strengthen the joints and muscles of the child.

The correct bend of the foot is formed under the influence of a certain group of muscles, which are best used at the moment when the baby walks barefoot on an uneven surface - for example, a sand or pebble beach, a grassy lawn, wooden ladders, etc.

Since today’s children most often “get in the way” of just perfectly flat surfaces (asphalt on the streets, parquet, laminate or linoleum indoors), there are very few options for preventive maneuvers. The most accessible of them:

  • 1 In order to prevent flat feet, the baby should be placed on an uneven surface at every opportunity - sand on the beach, grass on the lawn, slides and climbing frames on the playground, etc.
  • 2 Uneven surfaces can also be arranged at home - for example, sprinkle nuts on the carpet (chestnuts or hazelnuts are ideal), on which the baby should walk with bare feet. You can also stuff a fabric bag or pillowcase with nuts - while supporting the baby, let him stomp or jump on this bag. Finally, you can purchase a special orthopedic rug in a children's store.

Walking barefoot on uneven surfaces is the best way to prevent potential flat feet!

  • 3 Buy, with a small prophylactic arch support (a special insert in shoes that delicately helps to form the correct arch of the foot).
  • 4 Spend some time doing specific leg exercises. For example, a child can walk alternately on toes and heels, on the inside of the foot and on the outside. Another exercise is to stand still, roll from toe to heel (when rolling onto heels, lift your toes up). The most common and effective exercise is with a sports stick. You need to put a stick on the floor, put the baby on it (barefoot or in socks, most importantly - without shoes), and perform side steps on it sideways. In this case, you need to ensure that the stick is always strictly across the foot.

Flat feet and shoes: what's the connection?

When doctors announce to parents that their children have flat feet (which, we repeat, for children under 5-6 years old is not a sign of illness or some kind of developmental abnormality), 95% of them instantly “sin” for wrong or low-quality shoes.

In fact, flat feet and shoes have nothing to do with each other. Except, perhaps, one thing: sometimes, in rare cases, with some forms of flat feet, you can somewhat correct the situation for the better by wearing special orthopedic shoes. But if the foot is healthy, it is almost impossible to make it “flat-footed” with the help of any kind of footwear.

A sedentary lifestyle plays a real negative role in the formation of the wrong foot. In order for the arch of the foot to acquire the desired bend and become stronger, it is necessary that the muscles of the foot actively “work”. To do this, you need to make sure that the baby moves a lot during the day, especially on uneven surfaces. Do not pass by - children's slides in the yard, Swedish wall, sand and pebble beach, etc.

Recall: the diagnosis of "flat feet" is made by orthopedists in 95% of all children under the age of 2 years, forgetting, however, often to add that this flat foot is an absolutely normal (physiological) phenomenon - after all, the baby's foot is just beginning to form ... If your baby will actively move , then this infant flatfoot will go away on its own (you won't even notice!).

And only after 6 years, if the child's foot still has a flat footprint, it makes sense to think about serious prevention and even mild correction of flat feet. But then again - even such a "belated" formation of the arch still remains within the physiological norm. And only at the age of 12 can a doctor make an official diagnosis of the disease "flat feet" and prescribe adequate treatment.

Degrees of flat feet in children over 12 years old

So, as a rule, flat feet in children disappear by themselves by about the age of 6-10 years. The legs become less flexible, pronounced arches of the feet appear. According to statistics, only 1-2 out of 10 children still have flat feet by the age of 12. Which at this age is already assigned this or that degree.

Distinguish three main degrees of flat feet in children over 12 years of age:

  • 1st degree (flexible flat feet). In fact, we can say that all small children with flat soles just have this degree of flat feet. This is a completely non-painful condition, occurs equally in both legs, does not lead to disability and does not need any serious treatment. Both babies and children over 12 years of age with the first degree of flat feet are recommended, as a rule, only preventive measures.
  • 2nd degree (in other words - flexible flat feet with a short Achilles tendon). This form is extremely rare in young children. Usually, it is characterized by mild pain when walking and running. It is observed, as a rule, on both legs and, in the absence of proper treatment and prevention, can lead to a more advanced and severe stage of flat feet.
  • 3 The third degree (stiff flat feet) is the least common type of disease. Rigid flat feet are most often seen in people with congenital defects in the bones of the legs (especially in the area of ​​the tarsus). About one in four people with stiff flat feet experience severe pain when walking. Rigid flat feet can "hit" as only one leg, or both at once. As a rule, the third degree of flat feet is accompanied by a whole "bouquet" of related problems with the musculoskeletal system. For example: scoliosis of varying severity, herniated discs, growth of heel spurs, etc.

The most dangerous scenario is progressive flat feet. In this case, over the years, the foot not only does not form the correct arch, but vice versa - it deforms even more, which is why the negative impact on the spine and spinal cord is constantly increasing.

Treatment methods for flat feet

If a child has a simple flexible flat feet of the first degree, which does not cause him pain when walking, no special treatment is prescribed. However, he is prescribed an active preventive plan: special massage, foot exercises, shoe insoles, etc. In this case, there is a high probability that the arch of the foot will form properly and there will be no talk of any flat feet in the future.

With the second and third degrees of flat feet, when the arch of the foot remained unformed and was already rigidly fixed in this position, alas, the treatment comes down only to saving the person from the pain symptoms that accompany the disease. Medical science has not yet learned how to form a “healthy” arch in the foot with the second and third stages of flat feet in any artificial way, but it is quite capable of stopping progressive deformity and relieving a person from pain when walking. For this, various methods of physiotherapy, thermal treatment, as well as surgical intervention are used.

The first and second degrees of flat feet are very common - almost half of the adult population of the planet (residents of large cities - to a greater extent) suffer from them. In some, the underdeveloped arch of the foot has been preserved since childhood, in others, the bend of the foot is gradually deformed already after the age of 40-45 years with a sedentary lifestyle, excess weight and other circumstances. However, doctors believe that the harm from such flat feet is insignificant and does not prevent a person from living a long life, not burdened with serious diseases.