In other words, these are several elements of the anomalous position of the foot that arise during the period of intrauterine development and are present from the very birth. The reasons for clubfoot have not yet been studied to the end, but most of the opinions of specialists converge in one: the most probable cause is possible intrauterine disorders of the formation of the soft tissues of the lower leg and foot. They can be caused by various factors, ranging from mechanical and neuro-impulse to heredity and ecology. Clubfoot is a very common problem and, according to statistics, boys are more exposed to it than girls. Hypospadias and bilateral clubfoot in children - the subject of the article.
The primary signs of a single-plane clubfoot are obvious and noticeable immediately after the birth of the child: the foot is turned inwards, with the inner side turned upwards and as if extended forward. In the case of a multi-plane deformation of the foot, the heel is visibly pulled upward, the foot is curved arched and also deployed on the inner side upward. In both cases, it is not possible to bring the foot to its normal position. This fact is the main distinguishing feature of congenital clubfoot from foot deformities in neuromuscular diseases (where the foot is most often in the correct position). The clubfoot is usually accompanied by changes in the muscles, ligaments, joints and bones of the foot, therefore the secondary signs of congenital club foot are: twisting of the shin bones to the lateral margin (torsion), transverse inflection of the sole (inflection) and varus deformity of the toes. The consequences of this incorrect foot position are disappointing: during standing and walking the pressure of the body's weight on the foot is distributed unevenly, as a result of which one side is overloaded (shortened), the second remains unprocessed (stretched). Its ability to free movements is lost, mobility in the ankle joint is impaired, and the ability of the foot to amortize stepping and jumping blows decreases. If you let things go by themselves, the gait of the baby will be wrong, socks inward, because of this, and coordination of movements suffers. It is difficult for such a child to compete with healthy children in active games, participate in gay starts and other children's games. Ultimately, in addition to physiological disorders, clubfoot can lead to psychological problems in the baby.
Be sure to treat!
Treatment of congenital clubfoot is carried out under the strict supervision of an orthopedic physician. In case of early diagnostics, corrective exercises of the gymnastics and therapeutic massage, plus outpatient physiotherapy procedures, are used to correct the position of the foot. Doctors often prescribe special plaster bandages and rigid tutors, fixing the foot and shin in the position reached by the treatment. At home, you can also practice elements of physiotherapy, therapeutic gymnastics and massage, swimming. In some cases, with severe forms of deformity of the feet, surgical treatment is used, especially in cases of clubfoot running in older children, since with time the problem is usually aggravated. As a rule, treatment begins immediately after discharge from the hospital. As a follow-up prevention, children are recommended to wear special orthopedic shoes and further health and therapeutic gymnastics in accordance with the child's age and physical abilities.
Massotherapy
Because of the unequal state of the muscle fibers on the back and front surface of the shin, as well as the back and plantar side of the foot, a special therapeutic and health massage is performed. The purpose of this massage will be stretching and softening of the strained and contracted muscles - the inner head of the gastrocnemius muscle, the Achilles tendon and the medial arch of the foot. Simultaneously with this procedure, as a rule, a tonic massage of the stretched muscles is carried out: the external head of the gastrocnemius muscle and the lateral arch of the foot.
Preparatory-improving stage
• The kid lies on his stomach
1. Massage of the lumbar region of the back - stroking, rubbing and sawing.
2. Massage the buttocks - active, with pressure, stroking, vigorous rubbing, kneading, tingling and patting.
3. Back massage of the thighs - stroking (from the bottom up, from the popliteal fossa to the buttocks), vigorous rubbing, easy kneading and shaking.
• The kid lies on his back
4. Massage of the abdomen - performed clockwise, without affecting the area of the right hypochondrium.
5. Massage the front surface of the thighs - stroking (from the bottom up, from the knee cap to the groin area), vigorous rubbing, easy kneading and shaking. The region of the patellar itself and the groin area are not massaged.
Health-care stage
1. Shin massage.
• The kid lies on his stomach
Start the massage with the usual stroking, performing gentle movements in the direction from the heel to the popliteal fossa. Then massage the back of the lower leg (mainly the calf muscle). From the inside of the shin, that is, from the side of the curvature, during the massage, the following relaxing techniques are used: easy stroking and rubbing with the pads of the fingers, gentle shaking and kneading, stretching and vibration. On the outside during the massage used mainly toning techniques - intense rubbing, small sawing, vigorous kneading, easy pokolachivanie.
• The kid lies on his back
When massage the front surface of the shin all methods of toning massage are used - vigorous rubbing, kneading, easy finger pressing.
2. Ankle massage.
It consists of grinding the area of the joint and the circular rubbing of the ankles. A massage is also used that combines the techniques of acupressure of the ankle joint and the backside of the foot with simultaneous bending of the foot upwards in the backside. In this case, it is necessary to hold the foot in the correct position, slightly unfolding its outer edge in the direction opposite to the curvature.
Achilles tendon massage.
To stretch and soften the ligaments, stroking, kneading, sawing, stretching and vibration, acupressure with the thumb and forefinger are most often used. A child with clubfoot and the first shoes are needed with insteps
9. Foot massage.
• The kid lies calmly on his stomach
Grab the shin with one hand, bend the baby's leg in the knee joint. Then, while holding the foot, proceed to perform the massage of its plantar side. During the massage, it is necessary to stretch the inner edge (strained muscles) and tone the outer edge of the foot (stretched muscles). Remember that during this massage it is necessary to give the foot the correct position, that is, fixing the leg from the back side, raise its outer edge.
• The kid lies on his back
When performing massage on the back side of the foot, especially on its outer edge, tonic techniques are used - vigorous kneading, sawing, shearing, tingling, pinching. At the same time, gently place the foot in the correct position and bend it to the right angle with respect to the shin.
And again physical education
Therapeutic physical training is inseparable from the corrective gymnastics and is carried out in combination with massage and thermal procedures. Performing these exercises helps stretch the calcaneal tendon and eliminate plantar flexion of the foot, and also helps to minimize the consequences of curvature - lifting and retracting the inner side of the foot. In the first year of a child's life, exercise therapy most often involves only performing passive exercises and reflex gymnastics.
Passive exercise
1. The kid lies on his stomach. With one hand, grasp the child's shin and bend its leg in the knee joint. Then, while holding the shin, with the straight palm of the other hand, perform the pressing movements on the crumb foot, bending it towards the floor, with the toe in the back.
2. The kid lies on his stomach. Continuing to hold the child's shin in a bent position, with a free hand, perform small rotational movements of the foot, gently and gently lowering the inner and lifting the outer edge of the foot.
3. The kid lies on his back or sits with straight legs. With one hand, grab, and press the child's shin to the table surface, fixing it with the fingers in the shape of a ring in the ankle. With the other hand, grasp the foot so that the plantar side rests against your palm. Gently perform the flexion of the foot in the direction upwards in the back side, while pressing on its outer edge, slightly unfolding it inwards.
4. The baby lies on his back or sits with straight legs. Embrace the child's lower leg with the entire palm, fixing it and the foot in the ankle. With the other hand, grasp the baby's foot so that its plantar side rests against your palm. Then gently and very carefully perform unfolding movements, trying to move the foot outward, in the direction opposite to the curvature.
5. Continuing to fix the baby's shin, repeat the unfolding movements of the foot in the outer side, lowering its inner and raising the outer edge.
6. The kid lies or sits. With one hand, grasp the lower leg of the baby from below and fix it in the ankle and heel area. With your other hand, perform light, pressing movements, resting against the sole of the child's foot with a straight palm. With your fingers, gently bend the foot away from yourself in the back side and simultaneously turn its outer edge in the direction opposite to the curvature.