Prevention of flat feet in preschool children exercises. Ways to prevent flat feet in children

Flat feet are one of the most common diseases of the musculoskeletal system in children. This is a deformation of the foot in which its arch is flattened and the flat sole comes into contact with the floor with its entire surface.

Many parents perceive this disease only as a cosmetic defect or a guarantee that their sons are unfit for military service. But this disease requires closer attention and timely treatment of children. Despite local changes in the bone-supporting apparatus, flat feet are fraught with the occurrence of subsequent diseases of the legs, knee joints, spine and even internal organs.

How is a child's foot formed?

Young children have physiological flat feet.

Normally, all children under 2 years of age have no arch of the foot, that is, physiological flat feet . This is due to the fact that the bone tissue in babies is not yet sufficiently formed and contains insufficient minerals. Ligaments and muscles are also poorly developed.

On the plantar surface of the foot, in place of the arch, a child at this age has a fatty “pad”. It is this that acts as a shock absorber (instead of the arch of the foot) when the child begins to walk.

After a child reaches 2-3 years of age, the bones, muscles and ligaments become stronger, and from this age until about 6 years of age, the process of forming the correct shape of the foot continues. Therefore, only by the age of 6 can one determine whether a child has flat feet.

But during the period of formation of the baby’s foot, it is necessary to consult an orthopedist annually, who can monitor the process. Approximately 3% of children with flat feet have it. congenital defect development, which is detected immediately at birth. In other cases, flat feet are acquired; they form during the development of the child.

The arch of the foot is formed from bones and ligaments. It allows you to distribute body weight evenly on the support and provides shock absorption during running and walking. With a normally formed foot, there are only 3 points of contact between the foot and the floor: the heel, the “ball” at the base of the big toe, and the outer edge of the foot (the part of the foot from the little toe to the heel).

With flat feet, the arch is deformed, and the entire plantar surface of the foot is flattened, adjacent to the ground or floor. The center of gravity of the body shifts, which contributes to poor posture.

Everyone knows that on the plantar surface of the foot there are biologically active points (“representations” of various organs and systems). Constant irritation of these points with flat feet can cause various pathological conditions in the muscles, joints, and internal organs.

Causes of flat feet

There is no single reason for the development of flat feet. There are quite a large number of factors contributing to the development of this pathology.

Factors contributing to the development of flat feet :

• hereditary factor: the child’s predisposition to this pathology, if there are cases of flat feet in close relatives in the family;
• increased loads on the legs (increased body weight; weight lifting for teenagers, etc.);
• congenital weakness of the ligamentous-muscular apparatus of the foot;
• paralysis of the musculo-ligamentous apparatus of the foot (due to or);
• foot injuries.

Scientists have found that children living in the city develop flat feet 3 times more often than rural children who have the opportunity and habit of walking barefoot.

Therefore, for the correct formation of the foot, it is recommended to at least occasionally allow the child to walk barefoot on grass, sand, and small gravel (pebbles). At home, you can train your developing foot by walking your baby in socks on scattered peas.

For the correct formation of the foot, the load on it is important: with little physical activity of the child, the likelihood of developing flat feet is higher. This is especially important nowadays, when children from an early age are “attached” to the computer, TV and spend very little time outside. As a result, not only flat feet are formed, but also poor posture.

No less important for the prevention of flat feet are the child’s shoes: they should have a small heel (0.5 cm), a soft arch support and a hard heel. A child should not wear other children’s shoes, as worn-out shoes do not distribute the load on the foot correctly. “Wrong” shoes are not only very flat (without heels at all) shoes, but also shoes that are too narrow or too wide.

To prevent flat feet, proper nutrition of the child is important, with sufficient levels of phosphorus and vitamin D in foods.

Even if the baby’s foot has formed correctly, the child is not guaranteed to have no flat feet in the future. In some cases, the disease is not detected in preschool age and continues to progress; It is detected in adolescence and even later.

Symptoms of flat feet

There are the following types of flat feet:

According to the time of onset of foot pathology:

• congenital flat feet due to genetic disorders or dysplasia connective tissue;
• acquired flat feet as a result of diseases or pathologies of the musculoskeletal system of the foot.

Due to the occurrence:

• traumatic;
• paralytic (in children with cerebral palsy);
• rachitic (due to disturbances in vitamin and mineral metabolism);
• static (as a result of weakness of the foot muscles, regardless of its cause).

In the direction of spreading:

• transverse (increase in the transverse size of the foot; the most common option in an early age of a child);
• longitudinal (the longitudinal size of the foot increases);
• longitudinal-transverse (with an increase in both the longitudinal and transverse dimensions of the foot; it is extremely rare in children).

Parents may suspect the development of flat feet in a child based on the following signs:

• when walking, the child “clubfoots”: the feet turn inward, whereas the child’s feet should be parallel when walking;
• the child steps on the inner edges of the feet when walking;
• child complaints of fatigue when walking, pain in the back and legs, refusal to walk for long periods of time; the severity of complaints increases with the child’s age;
• uneven trampling of shoe heels (more on the inside) in children after 5 years.

If any of these manifestations are detected in a child, you should consult an orthopedist.

A more visual test for flat feet: the plantar surface of the child’s feet is smeared with paint or oil and placed on a sheet of paper (the legs should be straight and closed). Then they raise the child and examine the printed drawing. If it has the shape of a bean, the arch of the foot is correct, but if the entire foot is imprinted widely, you need to contact an orthopedist. This test is applicable only to children over 5-6 years old, when the foot is already formed.

The orthopedist usually also uses the plantography method - studying the print of the feet on a piece of paper after lubricating the soles with a special solution.

When a child reaches 5 years of age, a mandatory examination by an orthopedist is required, even if there are no complaints.

What are the consequences of flat feet?

Many parents mistakenly think that flat feet do not pose a serious threat to the child’s health, and do not even consider it a disease. Such parents do not take seriously the child’s complaints about fatigue and pain in the legs or back, consider them simply whims, and do not consider it necessary to show the child to an orthopedist.

This attitude is unacceptable, as it can lead to untimely treatment and the development of a number of complications and consequences of flat feet.

The foot acts as a “spring” when walking or running. With flat feet, there is practically no shock absorption from the foot. Therefore, when walking or running, “recoil” or shaking occurs on the lower leg, hip joint and spine, which contributes to the development (dystrophic damage to the joint due to the destruction of intra-articular cartilage).

Often the appearance of scoliosis (curvature of the spine) is associated with the asymmetry of the sacrum that occurs with this pathology. Often with flat feet, ingrown nails and curvature of the toes are observed.

“Harmless” flat feet can lead not only to deformation of the bones of the foot, lameness and clubfoot in the child, increased fatigue when walking, but also cause a vertebral hernia, persistent (inflammation of the joints) in the future.

Activation of biologically active energy points on the sole can, according to some experts, cause many diseases of various organs.

You should not hesitate to see a doctor and receive treatment, because timely treatment makes it possible to prevent further progression of the disease and the development of complications. After all, flat feet will not go away on their own.

Treatment

Regular classes physical therapy will help cope with the problem.

The treatment prescribed by the orthopedist helps to strengthen the muscles of the foot, improve its blood supply, and have a gentle effect on the ligaments and joints to correct existing deformities of the foot and ankle joint.

It is easier to achieve success in childhood when complete ossification of the skeleton has not yet occurred. Treatment should be carried out even with minimal flat feet. The later treatment begins, the more difficult it is to correct existing disorders.

Treatment of flat feet in children is carried out using different methods:

• physical therapy: a set of special exercises selected individually for each child depending on the degree of existing changes;
• physiotherapeutic methods: in the clinic - iontophoresis, electrophoresis; at home - baths with sea salt, herbal decoctions;
• massotherapy;
• manual therapy;
• reflexology;
• wearing special shoes: strictly selected in size, made of natural material, with a small heel and a hard back; insoles and arch supports are also selected individually; shoes and insoles not only help correct the formation of the foot, but also reduce discomfort while walking;
• If necessary, treatment in a sanatorium is recommended.

During treatment, the orthopedist will determine the frequency of visits to the doctor to monitor treatment and correct it (if necessary).

Prevention of flat feet

Flat feet can be diagnosed in a child no earlier than 5-6 years of age, but its prevention must be addressed from the very birth of the child.

• To spot foot problems early, you need to visit a podiatrist regularly. It is necessary to visit him at 1, 3, 6 and 12 months, so as not to miss the appearance of signs of rickets, which contributes to the development of flat feet. After one year, the baby should be seen by an orthopedist at least once a year.
• From birth, the baby needs to have a foot massage every day.
• Use the child to walk on uneven surfaces barefoot (on grass, sand, pebbles or a special massage mat).
• Do a special set of exercises daily (see below).
• Provide the child with correctly selected shoes (in size, made of natural material, with a hard back, flexible sole and small heel). The main criterion for choosing shoes should not be their beauty, but compliance with the above requirements. For a child, shoes should be as comfortable and convenient as possible: so that the toes are freely positioned and the heel is securely fixed.
• Do not allow your child to wear worn out or worn out shoes.
• To improve blood circulation, pour cool water over your feet.
• It is correct to dose physical exercises, walking, and outdoor games, because both insufficient and excessive loads will harm the child.

Special gymnastics complex To strengthen the ligaments and muscles of the foot and prevent flat feet, it includes such exercises.

Flat feet are far from a harmless ailment. Violation of the anatomy of the foot can lead to serious problems with the spine, nervous system, musculoskeletal system. A child’s foot grows and develops until the age of 7-8 years. Only in adolescence can one say with certainty whether a child has flat feet.

From birth, every baby has a flat foot. Prevention of flat feet is especially important in preschool age, when rapid growth occurs. If no total mistakes are made at this time, the likelihood of developing flat feet will be minimal.

About preventive measures

The height of the arch of a person's foot is a genetically inherited feature. What it will be like depends not only on how the parents prevented flat feet, but also on what kind of foot the baby inherited from mom and dad. However, this does not mean that prevention is not needed.

Mild forms and degrees of flat feet can be perfectly corrected with the help of various exercises, properly selected shoes, and massage.

Prevention of flat feet should be done from the very birth of the child. To begin with, it is important to prevent rickets, which contributes to foot disease. To do this, you should follow the pediatrician's recommendations, give the child vitamin D, and ensure that the baby gets enough exposure to fresh air and sunlight.

The baby needs to be seen by an orthopedic doctor at six months and one year. It is clear that he will not be able to say whether the baby has a tendency to flat feet, but he will be able to assess the baby’s development and give recommendations to prevent the development of foot problems.

Prevention falls entirely on the shoulders of parents. There are no special vaccinations against this disease, no “magic” pills that could help prevent the disorder. There is only normal lifestyle, active movement, correct attitude and understanding of moms and dads the essence of flat feet and the mechanisms of its development.

The most critical period is preschool age from 3 to 6-7 years. If during this period, associated with intensive growth of bones, muscles, tendons, joints, the right conditions are created for the child, then development will be normal and flat feet will most likely not occur or it will be easy to correct.

The main directions in which parents will have to move are as follows:

• choice of shoes;
• active physical exercises and special gymnastics;
• proper nutrition;
• foot massage

Shoes or barefoot?

The likelihood of developing flat feet in a child whose parents insist that the baby wear slippers or other shoes at home is higher than in a child who runs around the house barefoot from the first steps. This is explained by the natural feature of this part of the body.

None of the children are born wearing shoes; accordingly, slippers, sandals and boots are a requirement of social norms and civilization, and not of nature. A child's feet need shoes only for protection - from water, dirt, frost, and uneven surfaces.

Thus, walking barefoot around the house, and preferably also on grass, earth, sand at an early age, is the first and very important preventive measure.

Since a child cannot go to kindergarten or for a walk without shoes, parents should very carefully study the issue of the rules for choosing children's shoes.

The memo looks like this:

• After 1 year Buy your child high shoes that will support the foot while learning to walk. The backdrop can be soft, it doesn't play a big role. The sole does not have to be hard, but it should have good shock absorption. The main function of the first shoe is to carefully support the ankle during the first timid steps.
• After 2-3 years, When a child begins to walk confidently, the height of the shoes is not a prerequisite for choosing the right pair. Boots or sandals can be anything as long as the child is comfortable in them.

• In preschool children The foot grows quickly and the desire of parents to buy a pair for growth is partly understandable. There is no need to do this. Shoes that are too large slow down the child’s gait, force him to make efforts when rolling his foot in a step, and his gait can become shuffling.
• Shoes should not be small.
• Orthopedic shoes are needed for treatment diseases of the musculoskeletal system, and not for prevention. If the child does not have an established diagnosis and a doctor’s recommendation to wear orthopedic pairs, heavy and expensive medical shoes are not required.

• It is advisable that the children's pair was equipped with a small heel, this will allow the foot muscles to develop faster. The soft insole-instep supports the foot from the inside, this is also important for the development of healthy legs.
• The shoes that the baby wears during the day in the kindergarten group can be worn insert special Bykov insoles. They should be worn about 6 hours a day. The time that the baby spends in kindergarten approximately corresponds to this requirement.

Preventive exercises and gymnastics

After 1 year, you can introduce a set of exercises to your child on a special massage mat-applicator.

You can buy a one-piece massage mat, or you can choose a puzzle mat, which will be both a fun game for the child and an effective prevention of foot pathology. The rugs are equipped with a special texture - irregularities such as “Shells”, “Pebbles”, “Spikes” and so on. Walking and exercises on squares with different surface textures stimulates different active points of the feet.

Preventative mats are softer than mats for treating flat feet. They are made of elastic materials, walking on them does not cause significant discomfort.

It is important that the child exercises on the mat every day, at least for 20-30 minutes. This will avoid pathological abnormalities in the growth of the ankle and arch of the feet.

If you don’t have a rug, and you don’t have the funds to purchase one, you can make a floor applicator for your child with your own hands. Buttons, shells, large beans, and chestnut fruits are suitable for this. On the applicator self-made or factory production, a child and his mother can practice:

• walking on heels;
• walking on toes;
• moving on the outer edges of the feet;
• rolling from the outer edge to the inner part of the foot;
• steps with your toes curled inward.

Sitting on a chair, the child can make circular movements with his feet, curling his toes, and also pulling his toes towards and away from himself. While standing, lifting on your toes and squats, in which the heels do not come off the floor, are useful.

These simple exercises can be included in daily gymnastics for preschoolers. In most kindergartens, exercises for the prevention of flat feet are included in the list of exercises for morning exercises and physical education minutes.

Effective exercises for preventing flat feet are shown in the following video.

Nutrition

Proper nutrition is of great importance, because the child’s excess weight only contributes to improper formation of the feet, because the load on the lower limbs increases significantly. This does not mean that the child should be put on a strict diet and underfed. There just needs to be enough protein in your baby’s diet. They participate in the formation of tissues. Therefore, a child’s diet must include dairy products, lean fish and meat.

Getting a child to eat jellied meat is not easy. All mothers know about this. But it is possible to teach a child to do this, especially since jellied meat is an excellent food for preventing problems with the musculoskeletal system, joints and cartilage tissue.

The child should eat cereals, fruits and fresh vegetables, butter and vegetable oil, herbs, eggs. Raw food should be consumed 2-3 times more than processed foods.

You should not introduce pure cow's and goat's milk into the diet of children under one year of age. Moreover, there is no need to replace breast milk or formula with whole cow's milk. When taking this product, the ratio of calcium and phosphorus in the body changes, a vitamin D deficiency is created, and rickets may begin, which also affects the subsequent development of flat feet.

Parents should take more seriously the requirement to provide their child with essential vitamins and minerals. After all, an excess or lack of nutrients and minerals causes not only problems with the musculoskeletal system, but also more serious pathologies that can be deadly.

In case of calcium deficiency, the child should be given calcium supplements with the permission of the doctor and in the dosage recommended by him.

For general vitamin deficiency - vitamin complexes that are designed specifically for children of a certain age, taking into account the daily need of their bodies for a particular substance.

Massage

Foot massage, which any mother can master and which can be easily and simply done at home, will help prevent flat feet. Babies up to one year old should spend a few minutes on their feet during a restorative evening massage, smoothing them with their thumbs in the direction from heels to toes.

Preventive foot massage for preschool children is carried out 1-2 times a week; this can be done in a playful way. The child is placed in a lying position. First, they stroke the thighs and legs, then move on to circular movements of these parts of the limbs.

The greatest attention is paid to the calf muscles, since they are responsible for raising the arch of the foot.

Then the impact is intensified and kneading of the legs and feet is added. It is important that the child does not experience pain during this process. The same techniques are repeated by turning the child onto his stomach and placing a small cushion (rolled up towel or small pillow) under his knees.

When acting on the foot itself, special attention should be paid to the lateral ribs - the inner and outer surfaces, the area where the toes bend. The massage begins with 3-4 minutes and gradually increases the duration of the procedure to 15 minutes. After the massage, it is useful to make a contrasting foot bath that strengthens blood vessels - first lower your feet in warm water and then add cold water to it.

To learn how to massage a child to prevent flat feet, see the following video by Alena Grozovskaya.

– a change in the configuration of the foot skeleton associated with the flattening of its arches and leading to disruption of gait mechanics. Flat feet in children are manifested by fatigue, pain in the legs during movement and static load, swelling and deformation of the foot, changes in gait, and difficulty walking. The diagnosis of flat feet in children is established on the basis of a clinical examination, plantography data, podometry and radiography of the feet. To treat flat feet in children, conservative methods are used (massage, therapeutic exercises, physiotherapy, plaster casts and orthoses); surgery carried out 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 feet. 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 elements of the arch of the foot in children occurs gradually, with the appearance and increase of 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: the cartilaginous structure of the bones, more elastic and tensile ligaments, weak muscles. With proper development with increased muscle strength and endurance, this condition in children normalizes on its own by the age of 5-6 years. With certain disorders, children develop flat feet, leading to a sharp decrease in the shock-absorbing potential of the foot, an increase in the load on other elements of the musculoskeletal system with damage to the knee and hip joints, deformation of the spine, and disruption of the functioning of internal organs.

Classification of flat feet in children

The foot has longitudinal and transverse arches, supporting muscles and ligaments that provide balance to the body, distribute and soften the shock load during walking, running and jumping, and also increase endurance to axial load. Based on anatomical characteristics, orthopedics distinguishes between longitudinal, transverse and combined flatfoot. In children, longitudinal flatfoot is 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 flatfoot 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 the bone structures and musculo-ligamentous apparatus of the foot. Acquired flatfoot in children, depending on its origin, can be static, traumatic, rachitic, or paralytic. The most common static flatfoot is more common in school-age children when there is 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 flatfoot in children is observed with intrauterine underdevelopment of bones, muscles, ligaments and tendons of the lower leg and feet. Acquired flatfoot in children also develops against the background of congenital connective tissue deficiency and can be combined with an accessory chord in the heart, inflection of the gallbladder, myopia, etc. In the formation of flatfoot 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 musculo-ligamentous apparatus of the foot, which cannot withstand heavy loads; damage to the musculoskeletal system due to rickets; improperly healed fractures of the ankles, metatarsals, calcaneus and talus; paralysis or paresis of the muscles of the lower leg and foot (including after polio); neurological pathology (encephalopathy).

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

Symptoms of flat feet in children

In most cases of congenital flatfoot in children, one foot is affected, which has the appearance of a rocking chair or “paperweight” with a convex sole and a flattened, even concave, back side. There is a heel position of the foot, sharp pronation with abduction of the toes outward. With the advent of static load, congenital flat feet worsen and become stronger.

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

There are three degrees of longitudinal flatfoot in children, determined by the degree of foot deformation. In grade I, the height of the arch of the foot is 25-35 mm, there is no visible deformation of the foot. With 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 are manifested by an increase in pain in the foot, ankle joint and calf muscles, and difficulty walking. The shape of the foot changes - its length increases, the middle part expands, the gait becomes heavy and awkward; Children experience rapid general fatigue. Flat feet of the third degree is characterized by pronounced deformation 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 cause curvature of the toes, the appearance of calluses, the formation of postural disorders (scoliosis) and spinal diseases in the child (osteochondrosis, herniated intervertebral discs), the development of deforming arthrosis, inflammation of the menisci, etc.

Diagnosis of flat feet in children

Diagnosing flat feet in children under 5-6 years of age is quite problematic. The diagnosis of severe cases of flat feet in children can be made by a pediatric orthopedist during a clinical examination, which reveals 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 an imprint of the footprint on paper and podometry - measuring the “podometric index” of the arch of the foot. The results of x-rays of the feet with a load performed in 2 projections help to clarify the diagnosis of flat feet in children.

Treatment of flat feet in children

Flat feet in children is a progressive disease, and the earlier its treatment is started, the more effective the results. Treatment of congenital flat feet begins in the first weeks of a child’s life, which makes it possible to eliminate all components of the foot deformity. For congenital flat feet in children, special therapeutic exercises, massage of the muscles of the foot and lower leg are performed; The foot is held in the correct position using bandaging, staged plaster casts, and night orthoses (from 6 months of age). When the manifestations of flat feet worsen in children, subtalar arthroeresis surgery is performed.

Treatment of static flat feet in children, aimed at strengthening the musculo-ligamentous apparatus of the foot, includes massage, physiotherapy and exercise therapy. For young children, soft shoes (felt boots, rubber boots, Czech shoes) are excluded; It is recommended to wear boots with hard soles and small heels that provide good support for the ankle joints. For flat feet in older children, it is recommended to wear orthopedic shoes with an insole-instep support, which lifts the lowered arch and returns the foot to the correct position.

deformities of the foot, joints and spine.

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

Prevention of flat feet in preschool children

We have all heard about this disease at least once in our lives. It seems that with flat feet, the foot is somehow curved incorrectly, almost like a clubfoot, only in reverse.

Public opinion is unanimous: is this a real disease? Where is the high temperature, where are the hellish pains that keep you from sleeping at night? So what if a person positions his leg strangely, maybe it’s more convenient for him that way.

Flat feet, as the name suggests, is a disease in which the arch of the foot loses its natural concavity and the leg becomes flattened.

It would seem that such a small defect, but there is a lot of harm from it.

Firstly, a person’s gait immediately changes.

Secondly, the shoes begin to wear down unevenly, the inner part is faster than the outer part, but this is not so bad.

The worst thing is that such “flat” feet lose their ability to spring when walking.

Before we expand on this topic, let’s look at what a foot is.

The human foot is a complex mechanism, which, according to Charles Darwin, was formed over hundreds of millennia through natural selection and the struggle for survival. It is known that no animal has a springy arch of the foot. Even jumping kangaroos and jerboas do without it. According to biologists, the appearance of the arch of the foot in humans is directly related to walking on two legs. The more the primitive ancestor straightened, the more noticeable the notch in his foot became.

The foot is a complex biological organ that resembles a “vaulted” structure. Conventionally, it is believed that a longitudinal arch is formed in the longitudinal direction, and a transverse arch in the transverse direction. In the longitudinal arch, a distinction is made between the outer, supporting part and the inner, or spring part. The bone base of the arch, i.e. the bones of the foot are connected by joints and strengthened by ligaments. The arch of the foot is supported by the long plantar and calcaneonavicular ligaments. Consequently, an active role in maintaining the height of the arch of the foot and its spring function belongs to the muscular-ligamentous, musculoskeletal apparatus of the foot, the muscles of the lower leg, and the ankle joint. The foot as a whole functions according to the laws of biomechanics.

Normally, when supporting the foot, the main load falls on the heel bone, the heads of the first and fifth metatarsal bones and on the outer edge of the foot. With flat feet, the line of support of the foot shifts inward.

A significant role in keeping the foot in the correct position is played by the joint capsule, which connects the bones of the foot with the bones of the lower leg, as well as the lateral ligaments of the ankle joint, internal and external.

The bony arches of the foot are also strengthened by muscles and fascia. Longitudinal muscles shorten the foot, while oblique and transverse muscles narrow it. This bilateral action of the muscles maintains the arched shape of the foot and ensures a springy and elastic gait. And this significantly softens the impact of the foot on the ground during walking, running, jumping, protecting the brain and spinal cord, as well as internal organs from concussion.

Vessels and nerves pass through the thickness of the soft tissues of the foot. It is especially important to remember: on the upper (dorsal) surface of the foot, the vessels pass very superficially, so that the pulse can be counted. Also, under the skin of the dorsum of the foot, the tendons are superficially contoured. On the side of the sole, the vessels and nerves are covered with a thick layer of muscle and a subcutaneous fat layer.

Children's feet differ from adult feet in their structure and function.

First, the foot skeleton goes through a cartilaginous and then a bone stage of development. The process of converting cartilage tissue into bone tissue ends by the age of 15-19. That is why children's feet are very sensitive to both positive and negative influences of external factors.

Children have 1 kg more skin surface than an adult. Therefore, in them the mass of blood flowing through the thickness of the skin represents half of the total blood mass, while in adults it is one third. This explains why children's feet are more susceptible to cooling than those of adults.

A feature of the skeleton of a child's foot is its radial, radial shape (i.e., it is widest at the ends of the toes, and not at the level of the bundles of metatarsophalangeal joints, as in adults).

The bones of a child’s foot, especially at the age of 1-3 years, rapidly increase in size and differentiate in shape and structure. An immature bone apparatus with elastic ligaments and weak muscles causes significant fluctuations in the height of the arch under load.

Flat feet mean deformation of the feet, which is accompanied by flattening of the arches.

Modern man takes an average of ten thousand steps a day. And only the heart will do more physical work than our feet. Add to the colossal load the specifics of work, tight and uncomfortable shoes, excess weight - and you will get a lot of unpleasant surprises, one of which may be flat feet - a violation of the arch of the foot.

With flat feet, the foot flattens and stops “springing” when walking - hence pain and excessive fatigue. Let us remember that in the foot all parts are connected to each other using ligaments and muscles. Ligaments are a kind of connective tissue bands that tighten the bones, which gives the foot its characteristic arched shape. Numerous vessels and nerves feed these anatomical formations.

To walk normally, mobility of all components relative to each other is necessary. Healthy man walks easily, smoothly rolling from heel to toes, thanks to the muscles lining the sole and arch. The weakening of any link in this mechanism leads to deformation of the entire foot. In the future, if flat feet are not treated, it may be accompanied by a herniated lumbar disc, radiculitis and osteochondrosis. With a normal structure of the foot, the leg rests on the outer longitudinal arch, and the inner one has a spring, shock-absorbing function, ensuring the shape of the foot, elasticity of gait, protecting internal organs, the spinal cord and brain from shocks when moving.

With flat feet, the foot lengthens somewhat, which forces the patient to buy shoes one or two sizes larger than would normally be needed. It happens that the foot especially widens at the base of the toes, corns and calluses appear, and a bump grows on the big toe, so any shoe seems narrow.

Deformation of the feet is accompanied by a decrease in the longitudinal and transverse arches, spring properties, and the spring function of the foot in general. Because the muscles supporting the arch of the foot weaken, and the entire load falls on the ligaments. By stretching, they flatten the foot - the foot lengthens, and the toes fan out.

With flat feet, the supporting function is impaired lower limbs, their blood supply deteriorates, causing pain and sometimes cramps in the legs. The foot becomes cyanotic, sweaty, and cold.

The development of flat feet is promoted by the disease rickets, general weakness and decreased physical development, as well as excessive obesity, in which the foot is constantly subject to excessive weight load.

Children who prematurely (before 10-12 months) begin to stand and move around on their legs a lot also develop flat feet. There is no need to force children to try to walk early. As the muscles and other tissues mature functionally, the baby will try to walk on his own. In this regard, crawling is quite natural for him. The long-term opportunity to hold on to the walls of the playpen for a long time has its negative side for the child’s body. Long-term walking of children on hard ground (asphalt) in soft shoes without heels has a harmful effect on the formation of the foot.

A child’s foot at the stage of its formation and development has its own characteristics. Thus, in children under 5 years of age, subcutaneous fatty tissue on the sole is well developed, filling the arch of the foot, which can be mistaken for flat feet. The range of motion of the foot in children is greater than that of the foot in adults.

When the muscular-ligamentous apparatus of the legs, ankle joints, and ligaments is weakened (flaccid), foot deformity develops in children and adolescents. Until approximately 7 years of age, the natural formation of the longitudinal arch of the foot occurs in children. Pathological deformation of their feet was more often determined at the ages of 7 to 16 years, when the most active ossification occurs. During these age periods, intensive bone growth is observed with differentiation of their shape and structure; a disproportion between the growth rates of bones and muscles is possible. This is observed with musculoskeletal dysplasia of the tendon-ligamentous apparatus of the lower extremities, including the feet.

In the age groups of children and adolescents during puberty, when intensive growth and an increase in body weight occur, progression of static flatfoot is observed.

Simple longitudinal flatfoot in children and adolescents most often develops as a result of excessive rotation of the bones of the foot around the transverse axes passing through the Chopart, navicular-wedge, and longitudinal-metatarsal joints. When diagnosing foot diseases (static, planovalgus, varus flatfoot) in children, it is important to know the timing of bone ossification. Complete ossification of the bone nuclei ends by the age of 16-17, and the closure of the epiphyseal zone of the tibia and fibula in the distal section - by the age of 20. Consequently, excessive load on the fulcrum of the foot with weakness of the muscular-ligamentous apparatus of the lower extremities (legs, ankle joints), spine in children and adolescents leads to progression of the normal slight pronation calcaneus, tilt and rotation of the talus of the foot.

The diagnosis of longitudinal flatfoot is based on data from podometry, plantography and radiometry.

The progression of longitudinal flatfoot in children aged 7 to 10 years is accompanied by lowering of the longitudinal arch and pronation of the foot. The navicular bone protrudes on the inner edge of the foot.

Insufficient development of the muscles and ligaments of the foot adversely affects the development of many movements in children. In such cases, it is difficult for the child to roll from heel to toe when walking and to push off vigorously when jumping. Running is performed hard, using the entire foot. All this negatively affects the functional activity of internal organs and systems, leads to disruption of posture and the entire musculoskeletal system, and a decrease in motor activity. Children suffering from flat feet swing their arms widely when walking, stomp heavily, bend their legs at the knees and hip joint; while running and jumping, they experience convulsions and the body shakes, which is not observed with normal anatomical and functional development of the foot; their gait is tense and awkward. At an older age, flat feet or insufficient development of the foot can be a serious obstacle to playing many sports.

A common type of foot deformity is also clubfoot, which is observed in different forms in preschool age. Conventionally, they can be divided into several groups.

In group 1 clubfoot, the outer edge of the foot has a greater curvature. Externally, the foot has a narrowed “horseshoe” appearance. As a result of such clubfoot, walking and posture, coordination between the movements of the arms and legs are impaired, and stability in balance deteriorates. The heaviness of the body in clubfooted children falls most on the heel and the outer edge of the foot, the mobility of the legs is limited, and walking becomes difficult. Such children get tired quickly, when walking they turn their torso to the right and to the left, and they are characterized by “goose walking”. In the second and third group of clubfoot, the legs bend inward slightly. It must be recalled that the external rotation of the foot is a biologically important factor, the violation of which negatively affects a person’s posture and gait. It is necessary to take into account that the formation of static, physiological curves of the spine and posture depends on the condition of the musculo-ligamentous and musculoskeletal system of the lower extremities (including the feet, ankle, knee joints, and leg muscles). The flattening of the foot affects the position of the pelvis and spine, which leads to poor posture.

In a child under 4-5 years of age, the feet even outwardly appear “flat”. A significant layer of fat is not an explanation for this. A study of a large group of children, taking into account age and gender, showed that with growth there is an increase in the percentage of normal feet and a decrease in the number of “flat” ones. A more in-depth examination - study of foot prints, special measurements, x-ray data - gave orthopedists grounds to consider low arches in children as a physiological stage of foot development. This period does not require special orthopedic treatment.

An increase in the indentation in the foot prints every 6 months will indicate arch development. This is on the one hand.

On the other hand, if the baby complains of rapid fatigue, pain, a weakened state in the legs (after any exertion, after severe infectious and other diseases), if his foot often twists, or the heel gets squeezed on the inside - all these are indications for a dispensary observation and application of preventive measures.

Restructuring of foot function with sufficient compensation and timely treatment occurs gradually, very slowly, therefore, prevention of progression of flat feet in children and adolescents should begin as early as possible after diagnosis, taking into account concomitant musculoskeletal pathology.

Upon admission for treatment, the main clinical complaints were: pain in the sole area, in the center of the arch of the foot, at the inner edge of the heel, on the dorsum of the foot (in its central part), between the navicular and talus bones, under the inner and outer ankles, between the heads of the tarsal bones , pain in the lower leg muscles due to their overload.

Complaints of pain in the knees and hip joints were associated with impaired spring function of the foot.

Pain in the hip and lower back is associated with overstrain of the fascia lata of the thigh and compensatory-increased lordosis. In this case, children trample shoes on the inside of the sole and heel.

It is important to maintain proper foot hygiene and to have reasonably designed and properly used footwear.

These rules include:

Skin care (daily hygienic baths with baby soap, soda at a water temperature of +36-37);

Nails (nails should be trimmed once a week. The nail line should be straight, not oval, otherwise the nail may grow into the skin);

Correct selection of stockings, socks and shoes.

Stockings must match your foot size. It is recommended to wear stockings that are highly breathable and absorb sweat. Cotton and wool products best meet these requirements. Children suffering excessive sweating, skin diseases, rheumatism, stockings and socks made of synthetic fibers are not recommended at all.

Now about the shoes.

In boys and girls, the annual growth of the foot (up to 7 years inclusive) averages 11 mm.

It is correct to change shoes every 6 months and take into account not only the size, but also the fullness. The thing is that feet of the same length have different fullness. Therefore, shoes and lasts of the same number are produced in several transverse sizes - completeness. (The fullness of a shoe is understood as the ratio of its transverse dimensions and length.) Shoes for children are usually made in two sizes.

The main purpose of shoes for children in the first year of life is to insulate the feet. That's why booties are made from soft materials.

Children from 1 to 2 years old require shoes with a stronger sole and toe. Even greater strength of the sole and toe in shoes for children from 2 to 7 years old. At this age, the feet of boys and girls do not differ much, and therefore the internal shape and size of shoes are the same for them.

It is recommended to make children's shoes from leather. In addition to leather, textile, wool and fur fabrics are used for the upper of shoes. Shoes must be stable, always have a back and be conveniently fastened to the foot (with laces, lifting straps, buttons, zippers); the heel is stable enough to prevent the foot from slipping, the bottom of the shoe at the level of the fascicles (metatarsophalangeal joints and the root of the toes) is elastic.

Reducing the rigidity of the sole ensures uniform distribution of the load over the entire area of ​​support and the correct mode of movement of the foot.

A smooth, flat, rigid sole, the so-called hard bottom of the shoe, restricts the movements of the big toe and moves it outward. The abductor pollicis muscle suffers from this.

Hard shoes also restrict the movement of the joints of the feet and make walking difficult. Rapid muscle fatigue occurs, which contributes to the development of flat feet.

Too soft a sole during prolonged standing, walking on hard ground, asphalt, or floors leads to rapid muscle fatigue, and, consequently, flattening of the foot. Such shoes are used strictly according to indications (for gymnastics) and for a limited time.

In terms of weight, shoes should be as light as possible, so as not to overload the foot with their weight. Heavy shoes make movement difficult, increase energy consumption, and lead to fatigue.

Children's shoes require a heel. The heel, artificially raising the arch of the foot, prevents flat feet, protects the heel from bruises, and increases the wear resistance of the shoe. The heel height of shoes for preschoolers is from 5 to 10 mm (together with the thickness of the sole). The insole should have a straight inner edge, taking into account the radial shape of the child's foot.

Shoes are selected not only by size (length) and fullness (circumference), but also taking into account the season and purpose. Thus, the size of the shoe must exactly match the shape and individual characteristics of the foot, protect the foot from damage, not impede movement and not cause excessive pressure on the joints, blood vessels and nerves of the foot.

Shoes should not be too tight or roomy.

With flat or even flattened feet, shoes usually wear out faster, especially the inside of the sole and heel.

At the end of the day, children often complain that their shoes are too tight, even though they fit them in the morning. This happens because after prolonged loading, the deformed foot flattens even more, and, consequently, lengthens.

Early recognition of flat feet and its timely treatment through generally available gymnastic exercises will help relieve children of this deficiency or, in any case, reduce it. Therefore, the organization of prevention of flat feet at an early age is of particular importance.

In preschool age, when the body is highly flexible, it is relatively easy to stop the development of flat feet or correct it by strengthening the muscles and ligaments of the foot.

To prevent flat feet, it is necessary to strengthen the muscles that support the arch of the foot, which is achieved by using general developmental and special gymnastic exercises, which are the most active therapeutic agent not only compensating for foot defects, but also correcting its configuration and dramatically increasing functionality.

For this purpose, exercises are used in “plantar flexion” of the foot, as well as movements around the vertical axis of the ankle joint, and they are performed from various starting positions: sitting, lying, standing.

At the same time, in order not to overload the still fragile muscles, at first you need to more often use exercises performed from the starting position while sitting and lying down, and work to prevent flat feet must be carried out systematically, gradually increasing the load.

Preventive exercises that strengthen the arch of the foot should be included in morning hygienic exercises, used in physical education classes, during walks and in outdoor games.

The main purpose of corrective exercises is active pronation of the foot (position of the foot on the outer edge), strengthening the entire ligamentous-muscular apparatus of the foot and lower leg against the background of the general development and strengthening of the child’s body. It is necessary to develop the correct vital motor skills in running, jumping, climbing, throwing, in performing balance exercises, in outdoor and sports games.

It is especially recommended to walk barefoot in the summer on loose, uneven surfaces, since in this case the child involuntarily transfers the weight of the body to the outer edge of the foot and curls his toes, which helps strengthen the arch of the foot.

The child's barefoot time is initially 30-40 minutes a day, and then it increases.

To increase the effectiveness of barefoot walking, it is advisable to simultaneously harden the feet by washing and dousing them, followed by rubbing them with a dry towel.

Pouring your feet is best done using the contrast hardening method. After dousing your feet with cool water and rubbing them dry, several special exercises are required: stepping from heel to toe, stomping, etc.

After physical exercise, you need to relax your leg muscles. For this, in addition to water procedures, it is advisable to use massage, which is carried out in such a sequences: first rub the toes, then massage the plantar and dorsum of the foot, heels, Achilles tendon, ankle joint and finally the lower leg by stroking and rubbing.

By systematically and consistently using special physical exercises, hardening procedures, massage, you can stop the development of flat feet in children and even correct it.

According to M. Kuznetsova, specially selected general strengthening exercises serve as the foundation on which local correction of the foot is built (see Appendix 1). Therapeutic gymnastics and special gymnastic exercises give excellent results, improving the shape and function of the foot. The author also emphasizes that the health of children is largely determined by a rational motor regimen, including habitual motor activity, the organization of physical education and hardening at home and in preschool institutions.

I. Sergeenya, candidate of pedagogical sciences, offers special exercises to strengthen the muscles and ligaments of the foot, which he recommends including in morning exercises (2-3 exercises), in physical education classes (3-4 exercises), in complexes for special classes with children those with flat feet (8-10 exercises each), and also use while walking. Moreover, the greatest effect is achieved when the exercises are performed barefoot (see Appendix 2).

T. Sulimtsev, Candidate of Medical Sciences, T. Shanina, suggest, when working with children who have disorders of the spring apparatus of the foot, to use tasks such as: “Who can collect buttons faster with their toes”, “Walk across a stream on a stick”, “Walk on tiptoes", "Clubfooted bear", "Don't drop the ball", etc. In the morning or evening hours, carry out a set of special exercises (6-10 minutes): collect a rope with your toes, walk on your toes, heels, on the outside of the arch of the foot, roll a stick along the floor with your feet, etc. For this purpose, in the summer, area, organize barefoot walking on loose, uneven surfaces, on grass and sand. During physical education classes, the introductory or final part must include walking on toes, heels, on a rope, or with a hoop. Use small-sized physical education equipment: gymnastic sticks, tennis balls, cubes, ropes, jump ropes, ribbed boards, which contribute to more correct execution physical exercise.

To prevent and correct flat feet and clubfoot in preschool children, A. Sargsyan and G. Hovakimyan offer exercises that are carried out in a certain sequence in three stages.

At the first stage, children perform exercises without objects. Various movements are made with the toes and toes - up - down, right - left; from the position of the main stance, the weight of the body is transferred to different parts of the foot, turns, circles, springing movements of the toes are performed with a deep roll from heel to toe and vice versa.

In order to increase the tone and function of the triceps surae muscle, exercises with resistance, weights, and varied walking on flat and inclined terrain are used. To improve peripheral blood circulation, a variety of general developmental exercises are offered to strengthen the muscles of the thigh and lower leg, covering all muscle groups, dorsal and plantar flexion of the foot, pronation and supination of the foot, etc. All this not only contributes to the development of the muscles of the limbs, the formation of the arch of the foot, the prevention or correction of flat feet, but also the correct formation of posture and gait.

At the second stage, children are offered exercises with objects: grabbing small objects with their toes, holding them and throwing them away (pebbles different sizes, round sticks, rods, ropes of different thicknesses, sandbags, etc.), rolling a medicine ball with the foot; in addition, pressing the foot on the rubber massager and walking on the rubber track - the massager. For correct and symmetrical placement of the feet, wooden planks and templates with foot prints are used, which are made taking into account age characteristics, length and width, depth of the outer and inner arch of the feet, the angle of rotation of the toes, their direction, etc.

At the third stage, the child’s motor actions become relatively more complicated, various universal-type devices are used, and the way the child moves on these apparatuses also becomes more complicated: children walk on an inclined board (the angle of inclination of which gradually increases), along paths, a ladder, a bridge - a swing, ribbed boards, slats gymnastic ladder, bricks, etc. all of the above exercises are focused on the correct formation of the ankle joint, as well as on the prevention and correction of clubfoot and flat feet.

How to determine whether children have flat feet or not?

There are several methods for diagnosing flat feet.

The examination of the feet should begin with an external examination of the shoes. Abrupt wear of the heel indicates an increased load in the area of ​​the rear foot; hanging of the upper part of the shoe over the sole from the inside or outside indicates an incorrect gait, a lateral curvature of the foot.

Footprints help determine the degree of flatfoot.

To obtain foot prints, a technique is used - ichnography.

A thin layer of chalk powder is applied to one end of a dark-colored linoleum path 12-14 m long and 130 cm wide. The child stands on this section of the path and, at the direction of the teacher, “rubs” his feet, i.e. paints the soles with chalk. Then he is asked to walk along the path and bring the toy. In this simple way, each child's foot prints are recorded (see figure). The resulting prints are analyzed and the following indicators are recorded in the questionnaire: straightness and uniformity of walking, length, width of steps, angle of toes, shuffling of feet, clubfoot and flat feet.

On the path, children 2-7 years old take 20-30 steps. Using measuring instruments, the above data, as well as violations and deformation, are recorded.

After this, norms and indicators are given for modeling a track with foot prints, which can be widely used to correct and eliminate deficiencies in children (see Appendix 3).

Another method for diagnosing flat feet is Friedland method.

You need to measure the height of the foot (that is, the distance from the floor to the upper edge of the navicular bone - this is the highest place on the foot). Then measure the length of your foot. Next, multiply the height of the foot by 100 and divide by the length. The resulting figure is called the "podometric index". The normal index is from 31 to 29. If it is within 27-29, there is flatfoot. If below 25, flat feet are significant.

You can make a more accurate diagnosis and determine the degree of flatfoot using x-ray examination. X-rays are usually taken while standing. Lateral photographs show which bones of the foot are responsible for the flatness of the longitudinal arch and why the heads of the bones are positioned incorrectly.

In preschool institutions, the most accessible and simple method is mainly used - plantography.

To obtain foot prints, a plantograph is used, consisting of a base and a double frame attached to it with straps. Two layers of gauze and plastic film are stretched and fastened between the frames so that the gauze (which absorbs well and protects the paint from drying out) faces inward, towards the base of the plantograph, and the film, which protects the sole from contamination with paint, faces outward, towards the foot. A layer of printing ink diluted in kerosene is applied to the gauze, a blank sheet of paper is placed on the base of the plantograph, and the frame is lowered. The child stands with both feet on the plantograph film to obtain an imprint (plantogram). This method allows you to analyze the condition of the foot over time. The assessment of the plantogram is based on the examination of two lines drawn on the print and connecting the middle of the heel with the base of the big toe and the second interdigital space.

Normally, the internal bend of the contour of the print is outside these lines, when flattened it is located between them, and with flat feet it extends into the second line from the outer edge.

Children who have been diagnosed with disorders of the spring apparatus of the foot are under special supervision.

Using the plantography method, in a preschool institution, I examined children of the preparatory group. Of the 19 children diagnosed: 1 child has flattened feet, 1 has flat feet, which is 10.5% of the entire group. The majority of children have normal feet.

Syunyaeva Dilya has a flattened foot on her right leg. The child’s shoes meet the requirements: they fit the foot tightly, have a hard back, insoles - arch supports, elastic soles and a small heel. When walking and running, the girl has a slight limp.

Ilya Dolgov suffers from flat feet. The child’s shoes do not meet the requirements: an open toe in the form of straps, no heel, hard sole, no heel. The inner side of the sole and part of the straps are worn out. The child's gait is awkward and tense. Ilya stomps heavily and waves his arms, runs on his entire foot, does not push off vigorously when jumping, and often complains of pain in the ankle area when walking. Ilya is inactive and prefers minor roles in games. For a boy, there is still an opportunity to improve the shape and function of his feet if he chooses the right shoes, then engages in therapeutic exercises and performs special gymnastic exercises not only in a preschool institution, but also at home. It is necessary to have an individual conversation with the parents about the serious situation and illness that their child is suffering from. Recommend daily special exercises, make massage paths from waste material for walking on them at home barefoot. In summer, walk barefoot on the ground, on loose, uneven surfaces, on grass, sand. Explain what such exercises do and why they are necessary.

In a preschool attended by diagnosed children , priority area - physical education and recreation.

Morning hygienic gymnastics, during physical education classes, in the morning and evening hours, in all age groups, include special exercises for the prevention of flat feet: walking on toes, on heels, on the outer edges of the feet, on a rope, on gymnastic sticks (additional step), on ribbed boards, on an inclined plane, rolling the ball with your feet. Walking barefoot on massage mats, which are also performed after a nap. Such exercises help strengthen the arch of the foot, because... a child, stepping on an uneven surface, involuntarily transfers the weight of the body to the outer edge of the foot and curls his toes.

Also in the preschool institution there are consultations for parents And parent meetings, dedicated to the problem of preventing flat feet, in which the head nurse always takes part. Conversations with parents about being attentive to the child’s shoes, about the inadmissibility of constantly walking in Czech, worn-out or oversized slippers have a good effect.

In the reception areas of age groups for parents, on sliding folders, there is information: “Attention, flat feet!”, which contains images of foot prints of regular and irregular shapes, and sets of special physical exercises for doing at home. Consultations are organized for parents on the topics: “What kind of shoes should be,” “Dress your children correctly.”

In the preschool institution, coordinated work is underway to prevent flat feet between teachers, physical education worker, nurse and parents. Children diagnosed with flat feet are prescribed special exercises and have conversations with their parents. Responsible parents try to cooperate with the staff of the preschool institution attended by the child and positive results are achieved. Therefore, as can be seen from the diagnostic results, almost all children going to school have correctly formed feet.

At the end of the above, let's make a conclusion.

To prevent flat feet in children, it is necessary to conduct dynamic examinations in order to recognize flat feet as early as possible.

In this regard, prescribe special exercises. Timely treatment of it with generally available exercises will help rid children of this deficiency or reduce it. Carry out general corrective therapeutic exercises, under the supervision of medical personnel. Conduct conversations with parents whose children have been diagnosed with flat feet on the topics of what shoes should be worn, selection and special exercises, at home. In a preschool institution, carry out specially selected general strengthening exercises that contribute to the correction of the feet.

Since the correct posture, gait, and motor activity of the child largely depend on the formation of the foot, it is necessary to constantly use exercises to prevent flat feet when working with children.

Annex 1

Exercises for foot correction

Walk on your toes at an average pace for 1-3 minutes.

1. Walk on the outer edges of the feet at an average pace for 2-5 minutes.

2. Slow walking on toes on an inclined plane.

3. Walking on a stick.

4. Rolling the ball alternately with one and the other foot.

5. Roll the hoop with your toes (alternately) for 2-4 minutes.

6. Slow squats on a gymnastic stick supported by a chair.

7. Slow squats on a ball, leaning on a chair or balancing with your arms spread to the side.

8. Flexion and extension of the feet while sitting on a chair.

10. Grabbing, lifting and shifting sticks, cubes or small paper or cloth napkins with your toes for 1-3 minutes (the exercise is performed alternately with one and the other leg).

Appendix 2

Exercises to prevent flat feet

1. I.p.: sitting on a chair, legs slightly apart. Alternately raising your toes and heels (6-8 times).

2. I.p.: the same, but the legs are together, bent at a right angle. 1- actively bend your toes (see how much the length of the foot has decreased); 2- return to IP.

3. I. p.: the same. Raising and lowering your socks, while pressing your fingers on the floor, imitate raking up sand (6-8 times). 4. I. p.: the same, but straighten your legs and slightly raise them. Turns and rotations of the foot with extremely bent toes (8-10 times). 5. Exercise "Funny legs". Children sit on chairs, hands on their belts. On “one” - place your right foot on the heel, bending it strongly in the instep (toe points up), on “two” - straighten the instep and touch the floor with the ends of your toes; on “three” - foot on heel; on "four" - put your foot. The same with the other leg. Make sure that when placing their feet on their toes, children do not turn their foot inward (clubfoot). Keep your back and head straight (4-8 times).

6. I.p.: sitting on a chair (or standing). Rolling a small ball, gymnastic stick, block of wood, etc. with your foot (10-15 seconds with each foot).

7. I.p.: the same, but the ball is sandwiched between the feet. Bending and straightening the legs at the knees (6-8 times).

8. I.p.: sitting on a chair, bending your knees. Use the toes of one foot to grab a small object, lift it and hold it in this position for 5-10 seconds. The same with the other leg. (Can be held in the form of a competition: who can hold on longer.)

9. I.p.: sitting position. Active flexion and extension of the feet (10-12 times).

10. I.p.: the same. Bend your left leg and place it on your toes behind the knee of your right leg. The same with the other leg (6-8 times).

11. I.p.: lying on your stomach. Rotation of the lower leg in and out (pronation and supination).

12. I.p.: the same. 1- bend your left leg, actively take your toes; 2-i.p. 3-4 - the same on the other leg (8-10 times).

13. I.p.: kneeling, hands on the belt. 1-2 - sitting on the heels. 3-4 - IP (6-8 times).

14. I.p.: standing hands on the belt. Walking in place without lifting your toes off the floor (15-20 seconds).

15. I.p.: the same. Roll from heels to toes and back (8-10 times).

16. I.p.: standing at the gymnastics wall. Walking in place, raising the thigh high with “plantar flexion” of the foot (15 sec.).

17. Walking with a fixed roll from heel to toe (15-20 sec).

18. Walking with your toes bent (10 sec).

19. I.p.: o.s. 1-4-four steps on toes, arms up (look at hands). 5-8-four steps in a half-squat (squat), hands on the belt (game "Giants-Dwarfs"). 4-8 times.

20. Walking with straight feet and a fixed heel-to-toe roll along a narrow corridor marked on the floor.

21. Walking on a ribbed board.

22. Walking sideways on a rope. The same on the narrow side of the bench (exercise for children of older preschool age).

23. Walking along a lying ladder while grasping the rung with your toes.

24. Walking stealthily (silent walking) with the foot planted from the toe to the entire foot.

25. Stepping over medicine balls, gymnastic sticks, cubes.

26. Jumping in place and with a slight forward movement (silently, on your toes).

27. Exercise "Sparrow". Children perform three springy jumps, the fourth energetic jump is up, arms to the sides. Repeat 4-6 times.

28. Jumping from low objects, landing on the toes with the transition to the entire foot, elastically bending the legs at the knees (height for younger schoolchildren 10-15 cm, children 4-5 years old - 20-25 cm, for older preschoolers - 30-35 cm ).

29. The same, but jumping into a circle and then vigorously jumping out of it.

30. Jumping while reaching for a landmark.

31. Balancing on a medicine ball (for older preschool age).

32. Standing on a medicine ball, stepping on your feet, move forward (for older preschool age).

33. Grabbing small objects (pebbles, cones, cubes specially prepared for this purpose, etc.) with your toes and then throwing them. This exercise is interesting to do in the form of a competition.

Appendix 3

Metrics for modeling tracks with footprints

Foot pattern, cm	Tracks with prints
Foot length	Foot width	arch of the foot	steps, cm	Amount of toe turn (in degrees)	Step width, cm	Arch depth, cm

Literature

1. Golinskaya M.S., Nosova N.G., Kontorovich A.E. Principles of preventing the progression of flat feet in children and adolescents // medical assistance.-2003.-No. 5.-p.41-45

2. Kramarenko G. How to care for the feet of preschool children //D/V.-1976.- No. 6.-p.38-39

3. Kuznetsova M. Motor activity of children. Flat feet //D/V.-1993.-No. 9.-p.31-33

4. Sargsyan A., Hovakimyan G. Children’s flat feet and clubfoot //D/V.-1991.-No. 7.-p.19-25

5. Sergeenya I. Prevention of flat feet // D/V.-1985.-No. 6.-p.58-60

6. Sulimtsev T., Shanina T. Detection and prevention of flat feet in preschool children //D/V.-1986.-No.6.-p.13-14

7. Chabovskaya A.P., Golubev V.V., Egorova T.I. Fundamentals of pediatrics and hygiene of preschool children // M.: Education, 1987.-pp.65-66

8. Sharkova O. Heels together, toes apart // Family healer. - 2003. - No. 10 (62). -p.14

Hello dear readers. Today we will talk about a condition called flat feet in preschool children. IN Lately This problem is quite relevant among young parents. They are especially concerned about the issue of preventive measures aimed at preventing such deviations. In this article we will talk about this, as well as about treatment methods, degrees of flat feet and the reasons for its development.

Classification

1. Normal foot.
2. Flat feet.

This orthopedic disorder has various types. The classification is based on the time of acquisition of the disease, causes, and direction of spreading.

1. Based on predisposing factors, there are:

• traumatic;
• rachitic - a consequence of a violation of mineral or vitamin metabolism;
• paralytic – observed in children with cerebral palsy;
• static - weakness of the muscle fibers of the foot.

1. Based on when they occur:

• congenital - is a consequence of genetic disorders;
• acquired - the result of diseases or abnormalities in the development of muscle or bone tissue of the foot.

1. In direction of expansion:

• Longitudinal - flat feet expand, increasing in longitudinal size;
• transverse - increases in the transverse direction, most often observed in children in early childhood;
• mixed (longitudinal-transverse) - very rarely observed in children.

There are also different degrees of flat feet in children. There are three species in total, characterized by specific characteristics.

1. First degree:

• weakening of the ligamentous apparatus;
• changes in the shape of the foot are not observed;
• gait gradually changes;
• there is discomfort when walking;
• the child complains of fatigue and pain in the legs as a result of prolonged exercise;
• after rest, the pain disappears.

1. Second degree:

• the spreading of the foot becomes visually noticeable;
• the pain is constant and more intense;
• the feeling of pain extends to the knee joint;
• You may have difficulty walking;
• clubfoot will develop.

1. Third degree:

• severe changes in the foot;
• the disease is accompanied by pathologies such as scoliosis, intervertebral hernia, arthrosis;
• when examining the limb, you can notice that the thumb protrudes outward;
• the feeling of soreness can even extend to the pelvis;
• characterized by frequent headaches;
• there are serious problems with independent movement;
• There is absolutely no possibility of wearing standard shoes.

Possible reasons

Wearing bad shoes contributes to the development of flat feet

When the question arises about what should be the treatment for flat feet in children, it is very important to identify the probable causes of the development of such a condition. In very rare cases, it is congenital. But the following predisposing factors are much more common:

• heredity;
• excess body weight;
• injury to the lower extremities;
• wearing bad shoes;
• excessive physical exercise that do not correspond to the age characteristics of the child;
• frequent, regular walking on hard, smooth surfaces without shoes;
• premature rise of the baby to his feet and the beginning of walking;
• complications after suffering from rickets or polio.

Sometimes parents make a big mistake by buying shoes to grow into or choosing a pair that is too tight. This is what most often leads to the development of flat feet.

Signs

In most cases, flat feet do not have any characteristic symptoms. It is often diagnosed by visual examination. However, there may also be characteristic features orthopedic problems.

1. Painful sensations in the lower extremities, especially in the feet, sometimes accompanied by cramps.
2. Backache.
3. Feeling of discomfort when walking.
4. Change in gait.
5. Severe pain after physical activity.
6. A child's shoes wear out unevenly, usually on one side.
7. Feeling tired when walking.
8. Obvious clubfoot.
9. When your baby walks, you may notice that he steps on the inner edges of the foot.

Diagnostics

Test for flat feet. Normal foot

1. Personal examination by an orthopedist, collecting complaints, checking the soles of shoes.
2. Plantography, which allows you to determine the range of movements and identify the nature of gait.
3. The doctor may prescribe comparative analysis, which will allow you to see the dynamics of changes in the arch of the foot. So the child will need to be observed and visit an orthopedist’s office every six months.
4. When the diagnosis is confirmed, it becomes necessary to determine the degree of flatfoot. For this purpose, an x-ray is prescribed, which is done in two projections.

In addition, for children over six years of age who have developed feet, parents can conduct a flatfoot test at home. To do this, you will need to oil or paint the surface of your baby's foot, and ask the child to place his foot on a piece of paper. Then you need to study the resulting drawing. If the picture is similar to the image of a bean, then the arch of the foot is normal; if not, most likely, flat feet occur.

Consequences

Scoliosis - a possible consequence

Parents should understand that this orthopedic disorder can have serious complications for the child's health. Therefore, it is so important to diagnose the disease in a timely manner and begin its treatment, and even better, take care of compliance with preventive measures to prevent the development of flat feet.

This may result in the following consequences:

• the formation of scoliosis;
• development of arthrosis;
• curvature of the fingers on the lower extremities;
• ingrown nails;
• lameness;
• clubfoot;
• bone deformation;
• development of vertebral hernia;
• radiculitis;
• arthritis;
• osteochondrosis.

Treatment

Massotherapy

1. Physiotherapy.
2. Physiotherapy, in particular electrophoresis, iontophoresis, baths with herbal decoctions or sea salt.
3. Manual therapy.
4. Massotherapy.
5. Reflexology.
6. Sanatorium treatment, if necessary.
7. Wearing orthopedic shoes or insoles.

Precautionary measures

Prevention of flat feet in preschool children includes the following:

• Frequent visits to an orthopedist at an early age, after one year of age are allowed once a year;
• foot massage from the first months of life;
• performing preventive exercises;
• taking into account materials and quality, according to foot size;
• walking barefoot on uneven surfaces, such as sand, grass, pebbles or a special rug;
• pouring water on the legs at room temperature to improve blood circulation in the lower extremities;
• choose the right physical activity according to the child’s age;
• do not overload the baby.

Warm-up

Before performing gymnastic exercises, it is important to first perform simple steps to warm up your legs. Be sure to warm up without shoes, in socks, but only thin ones, and walk on a non-slip surface. All exercises are performed in a circle:

• On the socks;
• we walk on our heels;
• we use the inner surface of the foot, while the legs bend at the knees;
• move to the outside of the foot;
• we walk on an inclined surface;
• We switch to uneven.

Exercises at home

Special mat for the prevention of flat feet

If you are interested in preventing flat feet in children, then you need to understand that parents can do certain exercises at home to prevent this disease.

1. It is necessary to draw with the legs one by one on a piece of paper, holding the pencil with the fingers of the lower limb.
2. Let the baby try to collect small parts into a specific box using his fingers.
3. Place a small ball or cube in front of the child and ask him to use his foot to move it first to the left, then to the right and put it in place.
4. Sit your baby down and tell him to keep his heels firmly on the floor, while keeping his toes raised. Your task is to place a piece of fabric in front of him, which the child must hook with his fingers and pull towards himself.
5. Place your child on a low chair. Set the task to raise your legs one by one (as high as possible), stretching your toes. You must hold your limbs in a raised position for up to 15 seconds, then lower them.

It is very important that the exercises are performed when the baby is in a good mood and not done against his will. Do not overexert your child; alternate classes with other activities.

Physiotherapy

Let's look at effective exercises for flat feet in children.

1. Claps. The child sits on a gymnastic bench, with his legs on the floor and his toes pointed in opposite directions. At a certain signal, the baby must connect them, and a characteristic clap will be heard. After the clap, the legs are again retracted in different directions.
2. Swing. The child is on a bench, and it is necessary that the legs are extended and the heels rest on the floor. At a special count, the baby will pull the socks towards him and gradually release them back.
3. Ballet. Sitting on a bench, the baby leans on it with two arms, while stretching his legs. The exercise consists of gradually stretching the lower limbs, while leaning on your fingers. It ends with the toes turned inward.
4. Drummer. While sitting, the child tries to beat out the rhythm of any poem with his toes.
5. Artist. The baby stands, puts his hands on his belt. In this position, he must depict various figures with the help of his toes, and he must not move from his place.
6. Snail. In a standing position, the baby raises the fingers of the lower extremities, bends them, and rests on the floor. This exercise must be done while moving gradually. Then you will need to stand on your heels, while raising your toes, then completely lower yourself onto your foot.
7. Painter. The baby is lying on his back. It is necessary to move one or the other leg along the opposite one.

Now you know what flat feet are. Remember that it is better to prevent a disease than to treat it later. Therefore, you should not be lazy and do preventive exercises. Parents must remember possible consequences in the absence of proper treatment. Do not delay contacting a doctor; respond to questionable symptoms in a timely manner.