Today, PlanovalGUS foot deformity is one of the most common problems in traumatology and orthopedics.This pathology occurs in both children and adults.However, it tends to progress over time and cause changes in other joints as well as the spine.This significantly reduces the quality of life and can even lead to the development of arthrosis of the ankle, knee, hip joint, as well as diseases and curvature of the spine.Therefore, it is important not only to immediately diagnose planovalgus foot deformity, but also to start treatment immediately.This will stop the progression of the pathology.But in the last stages of development, the situation can be corrected only by surgery.
What is PlanalGUS foot deformity?
Plano-Valgus, the prominence of the foot, is a change in the structure of the foot, which occurs against the function of the reduction of the size of the longitudinal arch, the impairment of the posterior tibial muscle tendon function.As a result, the axis of the leg is distorted.This is accompanied by lowering the middle part and a turn of the heels with the inner part adjacent to the support surface.In other words, the foot rolls inward, straightens, and in severe cases, an x-shaped curvature of the legs is observed.This can be seen by having a sufficiently large distance between the ankles and the heels that are touching each other.
According to various authors, a similar problem occurs in 15-58% of people.
Plano-Valgus foot deformity is caused not only by the appearance of a pronounced cosmetic defect, but also by the development of a number of complications.These are:
- Bursitis is an inflammation of the synovial bursae of the leg joints.It is accompanied by redness of the affected joint, swelling, projection of pain, and redness of the skin, which tends to be aggravated by mechanical movement.
- Arthrosis - degenerative-dystrophic changes in the cartilage tissue, accompanied by incelitis and gradually increasing pain.Subsequently, the formation of osteophytes is observed on the articular surfaces of the bones until they fuse with each other and immobilize the joint.With Plano-Valgus foot deformity, arthrosis can affect not only the joints of the foot, but also the joints of the ankle, knee and hip.
- A heel spur is the result of overstretching the plantar fascia and the formation of a protrusion next to the heel bone, which leads to sharp pain in the heel area.This is often accompanied by inflammation of the Achilles Tendon.
- Osteochondrosis is a degenerative-dystrophic change in the enlarged discs, which causes them to decrease in size and creates the initial conditions for the formation of protrusions and intervertebral tears.
- Curvature of the spine - can manifest as the development of physiological curves (kyphosis, lordosis) or scoliotic deformation.
Reasons
The central link in the development of the disease is rotation (rotation) of the thallus in the horizontal and planting plane.This causes changes in foot support and arch alignment.There are many factors that can contribute to this, but they are rarely observed in isolation.Often, the causes of plano-valgus foot deformity lie in the combined action of a number of causes.Therefore, the disease can result in:
- congenital connective tissue disorder;
- any kind of straight-leg stride;
- injuries to the bones and ligaments of the lower extremities, especially the legs;
- Osteoporosis, that is, a disease accompanied by a decrease in calcium content in the bones, which leads to increased fragility;
- Endocrine diseases, especially diabetes, hypothyroidism, as well as hormonal imbalance caused by physiological changes during pregnancy and menopause;
- overweight and especially obesity, obesity, obesity caused by overlapping of the leg and muscles and ligaments;
- neurological disorders, including polio, cerebral palsy;
- rickets;
- excessive stress on the legs due to the need to stand for a long time, walk or engage in heavy physical labor;
- Improperly selected shoes, i.e. wearing excessively narrow and / or high heels, which cause the load to rise on the foot;
- foot abnormalities.
The presence of congenital developmental anomalies, hereditarily caused hyperelasticity of the foot, Plano-Valgus feet, can attract attention almost immediately after the birth of the child.However, most pathologies are diagnosed when the baby begins to walk.Often in such cases, disorders quickly worsen as a result of choosing the wrong shoes, lack of physical activity or, conversely, excessive and inappropriate physical activity.
In most cases, Plano-Valgus foot deformity develops in childhood.If the disturbances are not noticed and corrected during this period, the disease remains with the person and tends to progress when favorable conditions arise in the future.In adults, Plano-Valgus foot deformity worsens most during pregnancy or is generally associated with a sedentary lifestyle.
Symptoms of Plano-Valgus Foot Deformity
Plano-Valgus foot deformity is characterized by a gradual increase in the intensity of symptoms.Therefore, if at first the pathology manifests itself only as a minor inconvenience, in the later stages its manifestations can be an obstacle to leading an active lifestyle or simply significantly complicate movement.The disease is characterized by:
- Pain in the leg, especially in the back, worsens after standing for a long time, walking or physical work;
- ankle swelling;
- increased fatigue when walking;
- compression, the formation of corns, clothing and skin, the formation of calluses and pain, the formation of skin in the area of the heads of the small metatarsal bones by wearing shoes with heels and prolonged physical activity;
- X-shaped curvature of the legs, which causes pain in the knees over time;
- Displacement of the first foot gradually causes changes in the other toes (Hallux Valgus);
- gait disorders.
Sometimes patients have an accessory sesamoid bone in the area of the scaphoid bone.
Plano-Valgus foot deformity increases the likelihood of an ingrown toenail.Its deviation to the side with a strong curvature provokes a change in the shape of the remaining fingers.As a result, they become crooked, take the shape of claws, and the joints thicken.This is called a bath deformation.
At the same time, the growth of the joint in the area of the metatarsophalangeal joint is also observed with the formation of a call on its lateral surface, which is called popular or bone.This causes difficulties when choosing shoes and wears those that are already uncomfortable.
Degrees of deformation
During the plano-valgus deformity of the leg, there are 4 stages, each of which is accompanied by a certain set of symptoms.These are:
- Stage 1 - There is no bone deformation in the leg yet, but sometimes pain occurs in the area of the posterior tibial tendon, especially after prolonged walking or walking.It can be complicated by tenosynovitis, that is, inflammation of the posterior tibial tendon.The angle of the heel relative to the axis of the tire is no more than 10-15 °.
- Stage 2 - There is a mild deformation of the foot with the heel bone up to 15-20 °.At the same time, when a person sleeps, his legs take a normal shape.Since there is no rigid deformation yet, therapeutic massage is a very effective treatment method at this stage.However, this does not eliminate the need for other means of conservative therapy.
- Stage 3 - the foot deformity has already been corrected.In this case, the joints of the hindfoot are no longer responsible for passive movements.The heel angle relative to the tire axis is 20-30 °.
- Stage 4 - Foot, completely straight, completely straight, axis of ankle joint changes.When evaluating an X-ray and images, the lateral inclination of the talus can be seen when it is visible.This is a direct sign of deltoid ligament deficiency.The deviation of the heel from the tire axis is 30 ° or more.
There are also degrees of flat feet.To diagnose them, the longitudinal arch angle and the intermetatarsal angle are measured from the radiographic images, as well as the height of the arch in millimeters.
Pathological tends to progress under the influence of factors, especially rapid obesity, frequent lifting and heavy objects, standing for a long time, improper shoes, etc.).
Diagnostics
Signs of planovalgus foot deformation, it is important to consult an orthopedist as soon as possible.Although the disease is diagnosed based on the results of the examination, the doctor always pays close attention to the medical history and the patient's life.The information obtained during the survey provides the doctor with important information, thanks to which it will not be possible to determine not only the causes of the deformity, but also to prepare an optimal treatment plan.
Close attention is paid to the symptoms of the disease, the conditions of its occurrence and the characteristics of its progression.Orthopedist, presence of pain, location and duration, neurological disorders, physical activity limitations, etc.
After that, an orthopedic examination is required.In this procedure, the doctor evaluates the mobility of the patient's tarsal joints, not wanting to perform tiptoes, passive movements and other tests.The orthopedist also assesses the situation:
- vessels of the lower extremities;
- the nature of the legs and feet, its temperature, the distribution of hair;
- tenderness of both legs and feet;
- muscle tone of the lower extremities.
All this helps to determine the possible causes and consequences of the development of plano-valgus foot deformity.This allows you to choose the most effective treatment tactics aimed at eliminating all existing disorders.
Also, the diagnosis of plano-valgus foot deformity, instrumental and laboratory research methods are definitely prescribed to accurately determine the degree of changes in the foot and to specify the nature of the required therapeutic measures.This:
- X-rays in 3 projections;
- plantography;
- pedometry;
- UAC and OAM;
- Ultrasound of joints.
In difficult diagnostic cases, CT or MRI can be prescribed.These are modern methods of studying bones and soft tissues, respectively, giving the most accurate and detailed information about their condition.
Conservative treatment of planovalgus foot deformity
Almost always, the treatment of planovalgus foot deformity begins with the appointment of conservative, i.e., non-surgical therapy.Only in stage 3-4 of the disease, patients can be recommended for immediate surgical intervention.
Thus, conservative treatment of flat-valgus foot is always complicated.This consists of:
- the use of individual orthopedic traces;
- wear comfortable or orthopedic shoes;
- drug treatment;
- exercise therapy;
- therapeutic massage;
- Kinesio tape;
- Physiotherapy.
In addition, patients will be advised to take measures to lose weight if they have signs of obesity and to avoid wearing tight shoes or high heels.From this moment-Valgus foot deformity is diagnosed, you should choose and wear a comfortable shoe up to 3 cm with a wide enough foot and a comfortable wide toe.They should be made of natural materials and do not squeeze the leg.
Shoes with a completely flat sole such as ballet flats, Crocs or uggs are also contraindicated.
All these methods aim to relieve symptoms, improve the quality of life of patients and stop the progression of the deformity.However, if this disease is diagnosed in the 1st stage in children, it is possible to completely treat flat-valgus foot.
If a leg has a boat valgus deformity, special means can be prescribed to move it into the correct position.
All patients should understand that the course of planovalgus foot deformity has a negative effect:
- smoking;
- the presence of chronic diseases that reduce immunity;
- violation of the doctor's recommendations regarding the physical regime, choice of shoes, etc.;
- hypothermia and overheating;
- the presence of other orthopedic disorders that negatively affect the biomechanics of the legs;
- osteoporosis;
- infectious diseases.
Therefore, patients should not be exposed to these factors to increase the effectiveness of therapy.Moreover, 3 months after the start of conservative treatment and 3 months after the implementation of all measures prescribed by the doctor, patients are in pain and there is no positive dynamics, which may be a reason to consider the issue of surgery.
Special orthopedic prints and shoes
When diagnosing Plano-Valgus foot deformity of any degree, patients are required to wear separate orthopedic assemblies.Those who are with them and in the later stages of pathological development should be placed in regular shoes instead of those in special orthotics.
They are made according to the separate structural features of the patient's left and right leg, allowing them to be given the most anatomically correct position.This is the key to restoring normal biomechanics of movements, relieving leg fatigue, swelling and pain.In addition, the restoration of the normal axis of the arteries, which can significantly reduce the risk of complications.
Conventional mass-produced orthotic casts are not used for Plano-Valgus foot deformities.
Thus, individual orthopedic traces help to properly distribute the load on the foot.This directly affects the relaxation of overstretched muscles and overstretched ones, which is the root cause of developing flat feet.
In the first days, it is necessary to walk with orthopedic traces for 2-3 hours.As this will cause discomfort at first, the foot needs to be adjusted to the correct position.Gradually, the duration of the wearer increases, reaching the maximum possible.In most cases, patients get used to them and can wear them all day after 2 weeks without problems.
If the bearings become deformed or worn, they must be replaced with new ones.To do this, you need to contact an orthopedist who will once again take individual measurements and send the production with his comments.
Drug therapy
In the absence of complications of PlanovalGUS foot deformity, drug therapy is symptomatic.In other words, it aims to reduce the intensity of pain.For this purpose, patients are sometimes advised to use NSAIDs in the form of products for internal use or ointments, gels and creams.They will help to quickly relieve pain and improve your well-being.
If undesirable consequences of straight-valgus foot occur, drug therapy is also determined.It may consist of:
- corticosteroids - severe inflammation, characteristics of bursitis, etc.;
- means that improves blood circulation - the appearance of signs of clogging processes and varicose veins in the legs;
- Chondroprotectors - degenerative-dystrophic changes in joints, etc.
Therapy
Physical therapy is an integral part of the treatment of planovalgus foot deformity.It is aimed at strengthening the posterior and anterior tibial muscles, peroneal muscle group and gastrocnemius.
The necessary set of exercises for each patient is selected individually, taking into account the degree of pathological changes, age and other factors.As a rule, the following exercises are prescribed:
- Roll any cylindrical or round object, such as a floor pin or ball;
- walking on the toes and then on the outer parts of the feet;
- climbing an inclined board;
- work on an exercise bike or bicycle barefoot;
- grasping and lifting small objects from the floor with your fingers;
- holding and folding a newspaper or towel like an accordion on your toes;
- Performing sliding movements with the foot of one leg on the tire of the other;
- Sitting in the "Turkish" position and getting up from it.
Swimming has a very good effect on the condition of the legs.Therefore, if the patient has the opportunity, it is recommended to visit the pool at least 2-3 times a week.
However, exercise therapy should be done systematically.Therefore, classes should be conducted daily in a comfortable environment without haste.It does not hurt to take off your shoes and roll the ball with your foot at any convenient time, for example, while working on the computer.This will help relieve stress from your feet and improve your well-being.
Physiotherapy
Courses of physiotherapeutic procedures are prescribed to increase the efficiency of conservative treatment of flat valgus foot.They are indicated for foot deformities of the 2nd degree or higher and help not only to reduce the severity of the disease, but also to develop a therapeutic effect.
In case of Plano-Valgus-Valgus foot deformity, procedures with anti-inflammatory, analgesic and e-andesic effects are indicated.But they can start only if there is no acute inflammatory process.As a rule, they are designated:
- Electrophoresis;
- magnetic therapy;
- diadynamic therapy;
- Uvt;
- electrical stimulation of the muscles of the lower leg and foot;
- ozokerite and paraffin applications;
- mud therapy.
Kinesio taping
Kinesio Tainting is a new method of treating orthopedic disorders and the results of injuries in medicine, which involves attaching special elastic tapes to the skin.They help to relieve the necessary muscles and support others, as well as properly distribute the load to the supporting points of the foot.However, for tape to work, the doctor applying the tapes must have a good understanding of technique and anatomy.
Bands are made of hypoallergenic materials and are applied for an average of 5 days.You can wear any shoes, play sports, take a shower, etc. with them.At the same time, the material of the tapes breathes, which eliminates the risk of developing skin diseases.
Therapeutic massage
Massage for Plano-Valgus foot deformity is aimed at normalizing the muscle tone of the lower extremities, improving the cup by developing joints and activating blood circulation.Thus, during a therapeutic massage session, the doctor will focus not only on the feet and plantar muscles, but also on the muscles of the lower leg and thigh.
As a rule, it is recommended to undergo a course of therapeutic massage, consisting of 15-20 sessions, 4 times a year.Thanks to them, there is an expected improvement in the condition of patients, the elimination of the most uncomfortable symptoms of planaljus foot deformity or at least a decrease in their intensity.
An additional bonus will be the purchase of a special massage mat.Today there are many models, among which you can choose the right one for both adults and children.These rugs are distinguished by the presence of convexities of different shapes.Therefore, walking them barefoot helps to train the foot muscles and activate blood circulation.This has a positive effect on the condition of the legs and increases the efficiency of conservative treatment of planovalgus deformity.
Thus, planovalgus foot deformity is a common orthopedic disease.It can significantly reduce a person's quality of life and lead to the development of severe complications.Therefore, it is important to diagnose a deviation from the norm as early as possible and treat it thoroughly.But if the Plano-Valgus foot is diagnosed in adulthood, conservative therapy will only help prevent the progression of the deformity.But in the initial forms of the disease, this is quite enough to restore the normal quality of life and maintain the ability to lead an active lifestyle.In other cases, when conservative treatment is ineffective, the correct anatomy of the foot can be restored surgically.