Irina Nikipelova
Presentation "Prevention of flat feet in preschool children"

« Prevention of flat feet in preschool students».

AT preschool period the child grows and develops rapidly, movements become his need. child suffering flat feet, quickly gets tired of walking and running, does not tolerate static loads. This, in turn, negatively affects his general physical development.

That's why prevention of flat feet and timely detection of flattening of the foot is extremely important during the growth and development of the musculoskeletal system of the body.

The purpose of my work is to create conditions for the organization of work on the prevention and prevention of flat feet in preschool children,

To achieve this goal, I decide the following tasks:

Formation of motor skills of students in accordance with their individual characteristics prevention and correction of flat feet

The use of special physical exercises for prevention of flat feet.

Creation of conditions in the preschool educational institution for diverse in content and forms of cooperation, contributing to the development of constructive interaction with parents.

When implementing the tasks I use the following literature:

1. E. I. Nikolaeva "Health saving and health formation in kindergarten".

2. E. Yu. Aleksandrova “Improving work in preschool educational institutions under the program "Health Island"».

3. Yu. A. Kirillova “Scenarios of physical culture leisure and sports holidays for children speech therapy groups with a diagnosis of ONR and children mass groups of kindergarten from 3 to 7 years.

4. M. Yu. Kartushina "We want to be healthy".

5. E. R. Zheleznova “Improving gymnastics and outdoor games for seniors preschoolers».

Look at the image on the screen, what do you think, which foot is healthy and which is flattened?

What is flat feet?

Participants' responses.

flat feet- change in the shape of the foot, which is characterized by the omission of its longitudinal and transverse arch.

What do you think is the reason flat feet?

Participants' responses.

The reasons flat feet:

Early rising and walking;

Overweight;

genetic predisposition;

foot injury;

Prolonged walking barefoot on a hard, smooth floor;

Poorly matched shoes;

Past illnesses (rickets, complications after poliomyelitis);

Insufficient or excessive physical activity.

What are the signs flat feet.

Participants' responses.

Rapid fatigue of the legs;

By evening, the possible appearance of edema of the feet, which will not be in the morning;

Aching pain when standing or walking in the legs and feet;

Rapid wear of the inner side of the sole;

The child walks with legs wide apart, slightly bending his knees, turning his feet;

The foot has an irregular shape or becomes wider;

What are measures prevention of flat feet?

The answers of the participants (correctly selected shoes, physical activity, preventive exercises).

slide 10, 11.

basis prevention is: strengthening the muscles that preserve the arch of the foot, wearing properly selected shoes, limiting the load on the lower limbs.

The main remedy prevention of flat feet- special gymnastics aimed at strengthening the musculoskeletal apparatus of the feet and lower leg, conducting special exercises, hygiene and foot massage using special items: wooden sticks, sandbags, ropes, balls, cloth.

I propose to practice some exercises for prevention of flat feet.

No wonder a Chinese proverb says: “Tell me and I will forget, show me and I will remember, let me try and I will understand”.

Exercise sitting on the floor.

Capturing small objects with the toes of the feet and shifting them to the other side (also with the toes of the feet of the other leg,

Grabbing and holding a medium-sized ball with two feet, shifting from place to place.

Exercises on a massage mat.

Walking is slow with a deep roll of the foot.

Walking on toes, on the outer edges of the foot.

Rolls from socks to heels and back.

Light jumps and jumping exercises.

Exercise while sitting on a chair.

Picking up small objects or fabrics from the floor with your toes.

Skating sticks, pencils.

An exercise "Painter".

With a pencil clamped with toes, draw various figures on a sheet of paper, holding the sheet with the other foot.

Slides 17-23.

Exercise with new equipment.

Wavy path.

Tactile track.

Nipple clouds.

Massage track.

Working with parents.

In system "Child - family - kindergarten" parents are the main component in prevention of flat feet in children.

I conduct consultations and workshops on the use of special physical exercises for prevention of flat feet.

A gymnastics complex has been developed for use at home:

Slide 25-27.

Slow walking on toes and heels with an increase in the pace of movement;

Walking on the outside of the foot;

Alternate flexion and extension of the toes;

Rotation of the feet, sitting on a chair;

Lifting and shifting objects with the help of the legs;

Rolling the ball with your feet;

Sitting on a chair, crush the newspaper with your toes.

Systematic work on prevention of flat feet in a kindergarten is one of the important factors in promoting health children. The success of its implementation can be ensured only in close contact with the educator, physical education instructor and parents.

And I want to end my speech with one parable. Long ago, there were gods on Mount Olympus. They got bored, and they decided to create a man and populate the planet Earth. Become think: what a person should be. One of the gods said: "A man must be strong", another said: "A person must be healthy", third said: "A person must be smart". And one of the gods said So: “If a person has all this, he will be like us”. And, they decided to hide the main thing that a person has - his health.

They began to think, decide - where to hide it? Some suggested hiding health deep in the blue sea, others behind high mountains. And the wisest of gods said: “Health must be hidden in the person himself. Let him look for it.".

This is how people have been living since ancient times, trying to find their health. But we know that our health and the health of our children depend on us. Take care of him.

Related publications:

Prevention of flat feet "Naughty pencils" Relevance The correct formation of the foot in a child is of exceptional importance. Indeed, in the musculoskeletal system of a person, the foot provides.

Prevention of flat feet in preschool children 1. The role of movement in human life. Can we imagine life without the ability to walk? We can, but only in theory - according to observations.

Presentation "Prevention of flat feet in preschool children" Flat feet is one of the most common diseases of the musculoskeletal system in children. This is a deformity of the foot with a flattening of its arch.

Prevention and correction of flat feet Reminder for parents of preschoolers. Prevention and correction of flat feet by means of physical culture. Physical education instructor.

Presentation on the topic "Flat feet" in biology in powerpoint format. The presentation for schoolchildren contains useful information on the prevention and special exercises for the treatment of flat feet.

Fragments from the presentation

Flat feet can be avoided

flat feet- one of the most common diseases of the musculoskeletal system in children. This is a deformity of the foot with a flattening of its arch (in children, the longitudinal arch is usually deformed, due to which the sole becomes flat and touches the floor with its entire surface).

Foot

• Foot- an organ that provides support and movement of a person. A powerful system of ligaments and muscles ensures the preservation of the shape of the arches of the foot and their function.
• A normal foot has one transverse and two longitudinal arches (inner - spring and outer - support).

Track

Normally, the foot rests on the ground with the calcaneal bone and the heads of the metatarsal bones, its inner part does not touch the ground, which is clearly seen from the print of the sole.

Foot functions

• support
• Spring
• Balancing
• Jogging

The main causes of the development of flat feet

• Weakness of the muscles and ligaments involved in maintaining the arch.
• Tight shoes, especially those with a narrow toe or high heels, thick soles, as they deprive the foot of its natural flexibility.

Prevention

• The basis for the prevention and treatment of flat feet is the strengthening of the muscles that strengthen the arch.
• It is recommended to wear comfortable shoes and avoid excessive stress on the feet.
• Regular exercise has a beneficial effect on the state of the musculoskeletal system. Strengthening of muscles, ligaments, joints on the basis of general strengthening of the body contributes to the prevention of deformities of the musculoskeletal system in general and flat feet in particular.
• Regular skating and skiing can help prevent flat feet in children.
• In the summer, as often as possible, use walking barefoot on the ground, sand, small, not sharp pebbles, and water.
• To strengthen the arch of the foot, climbing the gymnastic ladder, rope, barefoot is useful. Walking on the board, log.
• For those who do not have the opportunity for such training, special exercises are recommended.

A set of special exercises to prevent flat feet.

Before the exercises, you should walk on your toes, then jump on your toes on one, and then on two legs.

I. Warm up.

1. Walking on high toes.
2. Walking on heels.

II. The main set of exercises.

1. "Window" - a child, standing on the floor, spreads and brings straightened legs without lifting the soles from the floor.
2. "Rink" - a child rolls a ball, rolling pin or bottle back and forth. Exercises are performed first with one, then with the other leg.
3. "Robber" - the child sits on the floor with bent legs. The heels are firmly pressed to the floor and do not come off it during the entire time of the exercise. With the movements of the toes, the child tries to drag the towel (or napkin) on the floor on which the load (stone) lies, first one. Then the other leg.
4. "Collector" - I.P. - too. Picks up various small objects spread out on the floor with the toes of one foot and puts them in a pile, with one foot, then with the other. Avoid dropping items while carrying.
5. "Artist" - I.P. - too. With a pencil clamped toes, draws various figures on a sheet of paper, holding the sheet with the other foot. The exercise is performed first with one, then with the other leg.
6. "Caterpillar" - I.P. - too. Bending the toes, the child pulls the heel forward, then the fingers straighten and the movement is repeated. The exercise is performed with both legs at the same time.
7. "Sickle" - I.P. - too. The soles of the feet are on the floor, the distance between them is 20 cm. The bent toes first approach, and then spread apart in different directions, while the heels remain in one place.
8. "Mill" - I.P. - too. Legs are straightened. Described by the feet of the arc in different directions.
9. "Drummer" - I.P. - too. We knock with the toes of the feet without touching it with the heels.
10. "Funny jumps" - I.P. - sitting, legs tightly pressed to each other. Raise your legs, move them over a bar lying on the floor (height 20 cm), put it on the floor, return to I.P.
11. "Porter" - lift the cube (bag, ball) with both feet, move it to the right, put it on the floor. Return the I.P. die Then move the cube to the left side, return to I.P.
12. I.P. - lying on the stomach with hands in emphasis, legs together. Socks are pulled back, turned inward. Go to point-blank prone. With support on the forefoot and hands.
13. I.P. - lying on the back of the legs apart, slide the foot of the right foot along the shin of the left.
14. I.P. Standing on your toes, lower yourself onto your heels and rise again.

Drama of "standing professions"

• Operating surgeons
• Dentists
• teachers
• Sellers
• cooks
• Machine operators
• and etc…

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There are two types of foot deformity: transverse and longitudinal. With transverse flat feet, the transverse arch of the foot is flattened, its anterior section rests on the heads of all five metatarsal bones, and not on I and V, as is normal, the length of the feet decreases due to the fan-shaped divergence of the metatarsal bones, deviation of the I finger outward and hammer-shaped deformities of the middle finger With longitudinal flat feet, a flattening of the longitudinal arch is observed, and the foot is in contact with the floor with almost the entire area of ​​the sole. In rare cases, a combination of both forms of flat feet is possible.

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In the normal form of the foot, the leg rests on the outer longitudinal arch, and the inner arch serves as a spring that provides the elasticity of the gait. If the muscles that support the arch of the foot weaken, the entire load falls on the ligaments, which, by stretching, flatten the foot.

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With flat feet, the supporting function of the lower extremities is disturbed, their blood supply worsens, which causes pain and sometimes cramps in the legs. The foot becomes sweaty, cold, cyanotic. Flattening of the foot affects the position of the pelvis and spine, which leads to poor posture. Children suffering from flat feet, when walking, swing their arms widely, stomp strongly, bend their legs at the knees and hip joint; their gait is tense, clumsy.

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Flat feet are directly dependent on body weight: the greater the mass and, consequently, the load on the feet, the more pronounced the longitudinal flat feet. This pathology occurs mainly in women. Longitudinal flatfoot occurs most often at the age of 16-25 years, transverse - at 35-50 years. According to the origin of flat feet, there are congenital flat feet, traumatic, paralytic and static. It is not easy to establish congenital flat feet before the age of 5-6, since all the elements of a flat foot are determined in all children younger than this age. However, in approximately 3% of all cases of flat feet, the flat foot is congenital.

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Static flat feet (most common 82.1%) occurs due to weakness of the muscles of the lower leg and foot, ligaments and bones. The reasons for the development of static flat feet can be different - an increase in body weight, work in a standing position, a decrease in muscle strength during physiological aging, a lack of training in people with sedentary professions, etc. The internal causes that contribute to the development of foot deformities also include hereditary predisposition, to external reasons - overload of the feet associated with the profession (a woman with a normal foot structure, spending 7-8 hours at the counter or in a weaving workshop, may eventually acquire this disease), housekeeping, wearing irrational shoes (narrow, uncomfortable). When walking on "stiletto heels", the load is redistributed: from the heel it moves to the region of the transverse arch, which does not withstand it, deforms, which is why transverse flat feet occur.

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With mild flat feet (I degree), after physical exertion, a feeling of fatigue appears in the legs, with pressure on the foot, pain occurs. The gait becomes less plastic, often in the evening the foot swells. In those suffering from flat feet of the II degree, the pain is concentrated not only in the feet, but also extends to the ankles and lower legs. It is stronger and more frequent. The muscles of the foot largely lose their elasticity, and the gait becomes smooth. Finally, the III degree of flat feet is a pronounced deformity of the foot. Often, patients only at this stage go to the doctor. After all, pain in the feet, legs, which are almost always swollen, in the knee joints is constantly felt. Often the lower back hurts, there is an excruciating headache. With the III degree of flat feet, sports become inaccessible, the ability to work is significantly reduced, even a calm, short walk is difficult. In ordinary shoes, a person can no longer move.

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The consequences of transverse flatfoot should not be underestimated, even if the flattening of the transverse arch of the foot is almost imperceptible. Flat feet refers to those diseases that, having arisen, progress quite quickly. Therefore, soon the transverse arch may not be determined at all. The forefoot is flattened. This causes deformation of the fingers, they acquire a hammer-like shape. For transverse flat feet, pain in the foot is also characteristic, as well as callosity of the skin of the sole under the heads of the metatarsal bones, tension in the extensor tendons of the fingers. The more pronounced it is, the more the thumb deviates from the outside, which leads to subluxations of the head of the first metatarsal bone. Although an external examination can determine the presence of flat feet, however, this applies to severe advanced cases. Those suffering from flat feet walk with their toes turned and legs wide apart, slightly bending them at the knee and hip joints and waving their arms vigorously; they usually wear out the inside of the soles. For a more accurate definition of a flat foot, you should consult an orthopedic doctor.

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traumatic flat feet. As the name implies, this ailment occurs as a result of injury, most often fractures of the ankles, calcaneus, tarsal bones and metatarsus. congenital flat feet. It should not be confused with the "narrow heel" of aristocratic ladies, characteristic of static flat feet. The reason for congenital flat feet is different. In a child, before he firmly stood on his feet, that is, up to 3-4 years old, the foot, due to incomplete formation, is not that weak, but simply flat, like a plank. It is difficult to assess how functional its vaults are. Therefore, the baby must be constantly monitored and, if the position does not change, order corrective insoles for him. Rarely (in 2-3 cases out of a hundred) it happens that the cause of flat feet is an anomaly of the intrauterine development of the child. As a rule, other violations of the skeletal structure are also found in such children. Treatment of this type of flat feet should begin as early as possible. In difficult cases, they resort to surgical intervention. Rachitic flat feet - not congenital, but acquired, is formed as a result of improper development of the skeleton caused by vitamin D deficiency in the body and, as a result, insufficient absorption of calcium - this "cement" for bones. Rickets differs from static flat feet in that it can be prevented by prophylaxis of rickets (sun, fresh air, gymnastics, fish oil). Paralytic flatfoot is the result of paralysis of the muscles of the lower extremities and most often the consequence of flaccid (or peripheral) paralysis of the muscles of the foot and lower leg caused by polio or another neuroinfection.

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Prevention. Education of the correct gait - avoid spreading socks when walking, so as not to overload the inner edge of the foot and the ligaments that support it. Persons whose profession is associated with prolonged standing are recommended to place their feet parallel and from time to time rest on the outer edges of the supinated feet (3-4 times a day, stand on the outer sides of the feet and stay in this position for 30-40 seconds). At the end of the working day, warm baths (water temperature 35-36 C) are recommended, followed by a massage of the arch of the foot and supinating muscles. Massage the front and inner surface of the legs with smooth, but sufficiently strong movements, during the foot massage, pay special attention to the sole. Basic techniques: stroking, rubbing, kneading in different directions, tapping with fingertips.

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No matter how beautiful and fashionable shoes are, discard them if they are, even a little, cramped, narrow. Heel height should be 3-4 cm, outsole made of elastic material. Undoubtedly, high-heeled shoes look very nice on the foot, but do not wear them everyday. Otherwise, it may happen that after a while you will be doomed to wear only orthopedic shoes. To prevent flat feet or relieve pain, a large number of inserts and special shoes are offered.

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With less complex deformations, it is good to use removable insoles - cork, plastic or metal. Complex deformities require the manufacture of shoes or orthopedic insoles from plaster casts. In severe forms of flat feet, causing constant severe pain, surgical treatment is indicated.

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Orthopedic correction of the feet is necessarily carried out in combination with other methods of treatment: physiotherapy, massage and therapeutic exercises. Physiotherapeutic procedures in the treatment of flat feet are prescribed quite widely and are carried out mainly in polyclinics. The exception is thermal procedures that can be carried out at home. Paraffin, ozocerite and mud applications can be applied to the entire lower leg and foot, but it is desirable to emphasize the thermal effect on the anterior outer surface of the lower leg and the back of the foot. Massage is a necessary part of the complex treatment of flat feet. It allows you to normalize the tone of the muscles of the foot and lower leg: strengthen weakened, stretched muscles and relax tense ones, and this is very important for restoring their coordinated work.

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o o Our feet normally perform 3 functions: cushioning, balancing and pushing. When walking, each step is accompanied by an impact on some surface, thanks to the shock-absorbing function (arches) - the force of the push is evenly distributed throughout the foot. But with flat feet, the “shock impulse” is not compensated by the arches of the foot (they are absent) and causes damage to the knee, hip joints and lumbar spine, pain in the knees, pelvis, and spine occurs. The balancing function ensures that the balance is maintained during movement and standing, but since the relative position of the parts of the foot is disturbed with flat feet, the function is not fully performed and when walking, unsteadiness, instability, and loss of balance can be observed. The jog function provides acceleration when walking. In this case, the load is redistributed to the forefoot and then the push. But since soreness is often noted with flat feet, the transfer of the center of gravity and the push with one point of the foot will certainly lead to sharp pain and the function is partially lost.

o There are two arches of the foot: transverse (arc from I to V of the metacarpal bone) and longitudinal (arc in the region of the inner edge of the foot).

o o o o There are several factors that contribute to the development of flat feet, these include: Increased body weight Heavy physical activity Pregnancy Activities associated with prolonged standing Presence of flat feet in relatives Weakening of the muscles and ligaments of the foot associated with age or lack of training for the feet others

o With transverse flatfoot, the transverse arch of the foot is flattened, so that its anterior section rests on the heads of all five metatarsal bones, and not just I and V, as is normal. The relationship of the bones of the foot is normal (left) and with transverse flat feet (right).

Transverse flatfoot The proportion of transverse flatfoot, according to various sources, ranges from 55% to 80%. The disease usually develops in middle-aged people (35-50 years). Women suffer from transverse flat feet 20 times more often than men.

o This type of flatfoot is characterized by a decrease in the length of the foot, a fan-shaped divergence of the bones of the metatarsus, deformity of the first finger (Hallux valgus) and hammer toes.

o o The support is redistributed to the heads of all metatarsal bones, while the load on the head of the I metatarsal bone decreases, and the load on the heads of the II-IV metatarsal bones increases sharply. I finger deviates outward, the head of the I metatarsal bone and the I finger form an angle. Osteoarthritis occurs in the I metatarsophalangeal joint. Pain appears, the range of motion in the joint decreases. The increased pressure of the metatarsal heads causes thinning of the subcutaneous fat layer on the plantar surface of the foot, causing a further decrease in the cushioning function of the foot. On the sole in the area of ​​​​the heads of the metatarsal bones, corns are formed.

o o Depending on the severity of the angle between the 1st finger and the 1st metatarsal bone, the following degrees of transverse flatfoot are distinguished: I degree. Angle less than 20 degrees. Mild flat feet. II degree. Angle from 20 to 35 degrees. Moderately pronounced flat feet. III degree. Angle greater than 35 degrees. Pronounced flat feet.

Symptoms of transverse flatfoot o o As a rule, patients with transverse flatfoot go to the doctor about a cosmetic defect of the foot, less often about pain during walking, corns on the sole, rough skin growths or inflammation in the I metatarsophalangeal joint. However, during the survey, it usually turns out that a patient with flat feet for a long time is disturbed by more or less pronounced burning or aching pain in the foot while walking. On examination, flattening of the transverse arch of the foot, a characteristic deformity of the I metatarsophalangeal joint, with pronounced flat feet - hammer toes.

Treatment of transverse flatfoot o o Conservative therapy is effective only at stage I of flatfoot. The patient is advised to reduce body weight, choose comfortable shoes without heels, and reduce static loads on the foot. The wearing of special insoles and rollers is shown. With flat feet of the III degree, surgical treatment is performed. There are many methods for correcting the deformity of the first toe, however, not a single operation eliminates the cause of transverse flatfoot - weakness of the ligaments and muscles of the foot. Possible isolated surgery (resection of the protruding part of the bone Hallux valgus) and surgical treatment, including resection of the bone in combination with joint capsule plasty and tendon grafting. In the postoperative period, a patient with flat feet is recommended to constantly wear arch supports or shoes with special insoles.

o Longitudinal flatfoot is the most common, characterized by flattening of the longitudinal arch of the foot. The relationship of the bones of the foot is normal (above) and longitudinal flat feet (below).

o The foot lengthens, spreads out and touches the support with almost the entire sole. The proportion of longitudinal flat feet ranges from 20 to 29%. The disease often develops in young patients (16-25 years).

o The bones, muscles and ligaments of the foot and lower leg are involved in the process. The bones of the foot move in such a way that the calcaneus turns inward and the forefoot deviates outward. The tension in the tendons of the peroneal muscles increases, and the tendons of the anterior tibial muscle decrease. The midfoot expands. The patient's gait becomes clumsy; when walking, he strongly spreads his socks to the sides.

o o o There are four stages of longitudinal flat feet: the stage of predisease (prodromal stage); intermittent flat feet; flat foot; flat foot.

o o o At the pre-illness stage, a patient with flat feet is worried about fatigue when walking, pain in the upper part of the arch of the foot and calf muscles after prolonged static loads. In the stage of intermittent flat feet, pain appears not only by the end of the working day, but also after prolonged standing or long walking. Tension of the muscles of the lower leg is revealed, sometimes their temporary contractures develop. The longitudinal arch of the foot has a normal shape in the morning, but becomes flattened in the evening. During the development of a flat foot, pain appears even after small static loads. The foot flattens, the height of its arch decreases. Gradually, the gait begins to change.

o o There are three degrees of flat feet: I degree. Stage of the beginning of formation. The height of the arch of the foot is less than 35 mm; II degree. The height of the vault is 25-17 mm. Osteoarthritis begins to develop in the joints of the foot; III degree. The vault height is less than 17 mm. The forefoot unfolds and flattens out. Deviation of the I finger outwards is revealed. At the same time, pain in the foot temporarily decreases.

Treatment of longitudinal flat feet o o o In the pre-disease stage, the patient is recommended to develop a correct gait (without dilution of socks), walk barefoot on sand or uneven surfaces and regularly unload the muscles of the arch of the foot, periodically transferring the load to the outer surfaces of the feet while standing. A patient with flat feet is prescribed exercise therapy, massage and physiotherapy: magnetotherapy, hydromassage, etc. In the stage of intermittent flat feet, a recommendation is added to the listed measures to change working conditions to reduce the static load on the feet. With a flat foot, orthopedists prescribe wearing orthopedic shoes and special insoles to the complex of therapeutic measures. With further progression of flat feet, surgical treatment is indicated.

o Static flat feet. A common form of flat feet (more than 80%). The cause of the development of pathology is the weakness of the bones, muscles and ligaments of the foot and lower leg. The risk of developing flat feet increases with an increase in body weight, insufficient physical activity in people of sedentary professions, "standing work", wearing uncomfortable shoes. Static flat feet can also develop as a result of the constant wearing of high-heeled shoes (due to excessive load on the forefoot).

o o o Traumatic flat feet. It develops after a fracture of the bones of the foot, calcaneus and ankles. Rachitic flat feet. Occurs after rickets. The reason for the development is a decrease in bone strength and a violation of the formation of the skeleton of the foot. Paralytic flat feet. Develops after poliomyelitis. The cause of flat feet is paralysis of the tibial muscles and plantar muscles of the foot.

Diagnostics o o o Podometry - measurement of the height of the arch of the foot from the floor. Plantography is the study of footprints left on paper. X-ray of the foot in direct and lateral projection.

Podometry (Frinland method) o o the subject is placed on a sheet of paper so that his feet form a right angle with respect to the shins; the height of the foot is determined by measuring the distance from the upper surface of the scaphoid bone (palpable on the transverse finger anterior to the ankle fold) to the floor with a compass. Each of the feet is circled on paper with a pencil, holding it strictly perpendicular. Along the contour, measure with a ruler (in millimeters) the length of the foot from the tip of the first toe to the rear edge of the heel. The foot height data is multiplied by 100 and divided by the length of the foot (podometric index). The foot index normally ranges from 29 to 31.

Plantography is a method of obtaining a graphic "imprint" of the plantar surface of the foot on paper. The imprint is obtained on a special device - a plantograph, which is a frame covered with a rubber membrane. Before each measurement, the lower surface of the membrane is smeared with printing ink. Then a sheet of paper is placed under the membrane, the patient stands on the membrane, and the doctor outlines the perimeter of the foot with a special “spatula”.

o o o On the resulting print, certain reference points are manually connected and indicators are calculated that quantitatively characterize the condition of the patient's feet. This method is simple, does not require expensive equipment and is indispensable for surveys in the "field" conditions. However, in this case, the state of only the supporting surface of the foot is assessed without taking into account its deformations in the sagittal and frontal planes. In addition, the quality of the resulting prints does not always meet the requirements necessary for subsequent calculations. Despite the above disadvantages, today plantography is the most common method for quantifying the arch of the feet.

o FOOT RADIOGRAPHY X-rays of both feet are taken in frontal and lateral projection under load, while the patient is standing.

o o Principles of treatment of flat feet Conservative treatment Remedial gymnastics is prescribed, aimed at strengthening the muscles that support the arch of the foot and contributing to the tension of its ligamentous apparatus, correcting the vicious installation of the feet, cultivating the stereotype of the correct position of the whole body and lower extremities when standing and walking, acting tonic on the body. The leading place in exercise therapy is occupied by special exercises aimed at correcting foot deformities. Exercise therapy classes must be performed several times a day (at least three times). Strengthening the ligamentous-muscular apparatus of the feet and legs is promoted by massage and, especially, self-massage of the arch of the foot and the muscles supinating the foot. Muscle electrical stimulation is prescribed in courses of 20-25 sessions, repeated after a month break. To improve tissue trophism, physiotherapy is carried out. Orthopedic insoles are ordered with the calculation of the transverse and longitudinal arches. With transverse flat feet, bandage rubber cuffs with a special tab are used to maintain the transverse arch. With pronounced forms of flat feet, it is necessary to provide the patient with orthopedic shoes with an arch tab (according to plaster casts) and raising the inner edge of the heel. A rigid heel counter should wrap around the heel and midfoot to the middle of the metatarsals, keeping the heel upright and preventing it from turning in.

Surgical treatment o o o More than 300 methods of surgical intervention have been developed for the treatment of transverse flatfoot, depending on its stage and form. Therefore, in order to avoid recurrence of the disease, it is necessary to choose the optimal surgical technique for correcting foot deformities and accurate preoperative planning. All operations on the feet are divided into three types: operations on soft tissues (operations of Silver, McBride, Shede), on bones and combined operations. The first are carried out most often in young people with a normal or slight increase in the first intermetatarsal angle. With this operation, the tendon of the adductor muscle of the first finger is cut off, which can be combined with subsequent transposition and capsuloplasty, and, if necessary, supplemented by the removal of the inflamed subcutaneous mucosal bursa and the osteochondral outgrowth, which form a painful lump. Operations on the bones and combined operations are performed in cases of a strong increase in the first intermetatarsal angle, the patient has rigid feet or an elongated first metatarsal bone. Although there are a lot of varieties of such surgical intervention, various types of osteotomy (bone dissection) are most often used.