What is a hollow foot? Treatment of the hollow foot: insoles, exercises
What is a hollow foot? Photos of this pathology you can find in the article. Also, the disease under consideration we will give a definition, identify the causes of its occurrence, list the symptoms and tell you about the treatment.
What is a hollow foot? This is a pathology involving the deformation of the lower limbs. It is characterized by the lowering of the fingertips downwards and the raising of the heel upwards. Due to this deformation, the size of the arched arch considerably increases in the patient.
A hollow foot can be a hereditary disease, and also develop with age (from 35 years). The disease under consideration is the opposite flat foot.
Stages of deformation
What determines the treatment of the hollow foot? Experts argue that the choice of a particular therapy is directly related to the stage at which this disease is located. Specialists distinguish 2 stages of deformation:
- At the very beginning of the disease, soft tissues change (morphological). To eliminate this problem, doctors recommend the patient to provide pressure on the head of the first metatarsal bone.
- If measures to treat the deformity that has developed have not been taken, then a stable phase of the disease arises that requires urgent medical intervention.
Why develop a hollow foot? The reasons and the exact mechanism for increasing the arched arch have not yet been elucidated. However, doctors suggest that such a pathology can arise due to imbalance (muscular) on the background of hypertonic or weakening (paretic) separate muscles of the foot and shin. By the way, some experts note that sometimes when examining a patient with the deformation in question, confirm a noticeable decrease or, conversely, an increase in the tone of muscle tissue is not possible.
According to the opinion of most doctors, most oftena hollow foot is formed due to the pathology of the neuromuscular system and a number of diseases, as well as muscular dystrophy, poliomyelitis, spinal dysraphia, Charcot-Marie-Tooth disease, syringomyelia, polyneuropathy, Friedreich ataxia, cerebral palsy, meningitis, meningoencephalitis, benign and malignant tumors of the spinal cord.
Very rarely, such a pathology develops because of burns of the lower extremities or improperly fused talus and heel bones (after fractures).
In 20% of all cases, the factors that provoked the hollow foot remain unclear.
Symptoms of the disease
In pharmacies and medical centers, insoles for the hollow foot are often sold. What are they needed for? The fact is that such a disease does not pass for the patient without a trace.
When the arched arch becomes larger, the patient constantlycomplains of pain in the feet, rapid fatigue during walking and unpleasant sensations in the ankles. Also, some patients note that they have great difficulty in choosing comfortable shoes.
When examining a person with a considered pathologyexperts reveal an increase in the height of the inner and outer arch, spreading, widening and slight reduction of the anterior parts of the sole, painful calluses (for example, at the base of the first finger and in the region of the little finger), and also deformation of the fingers. In addition, such a patient is often marked by severe stiff foot.
The hollow foot, which developed as a result of poliomyelitis,can be accompanied by a sharp unilateral paresis in combination with the equinus of the foot. The tonus of muscle tissue is reduced, and the deformation does not progress.
If a person has cerebrallesions, then he may have spastic phenomena, increased muscle tone and increased reflexes (tendons). This process is not progressive and one-sided.
In congenital malformations, the pathology is usually bilateral. It is prone to progression, especially during periods of active growth (for example, at 5-8 years and at 11-15).
With the diagnosis of "Friedreich's disease" the hollow foot is 2-sided and progressive. Usually, members of the patient's family also have cases of this disease.
An increase in the arch of the foot is often combined with ataxia and gait disorders. In addition, for this disease characterized by mild disorders of sensitivity and damage to pyramidal pathways.
With Charcot-Marie-Toot disease, a 2-sided and progressive deformity of the feet, as well as muscle atrophy, which is spreading from the bottom upwards, is observed in humans.
How is it diagnosed?
Exercises with a hollow foot should be performedcertainly. However, it is necessary to do this only after the diagnosis is verified by an experienced doctor. As a rule, for this purpose the patient is sent to the planography and the radiograph of the foot.
With a mild deformation on the plankreveals a large depression of the concave arc of the inner edge, as well as a projection along the outer edge of the foot. With moderate pathology, concavity is observed up to the outer margin. With regard to a pronounced disease, the imprint of the sole of a person is divided into 2 parts.
Also, there are neglected cases when the finger contours disappear from the footprint. This is due to their clawlike deformation.
If the doctor believes that the cause of the problem isneuromuscular disease, the patient is referred to a neurologist. The latter conducts a detailed neurological examination, performs radiography of the spine, MRI and CT, as well as electromyography and other studies.
In old bone injuries, the patient may need CT of the foot.
If the hollow foot was first detected and at the same timethe patient has no diseases of the neuromuscular system, and there are no previous injuries, this indicates a possible occurrence of a tumor of the spinal cord. In this case, the person is referred for examination to an oncologist.
How to treat?
The tactics of the therapy of the hollow foot are determined by the cause of its development, as well as the degree of increase in the arched arch and the age of the patient.
With moderately and poorly expressed pathologiesThe patient is prescribed physical therapy, physiotherapy and massage. Non-fixed forms of this disease are amenable to conservative correction by wearing special shoes with an elevated inner edge.
Strongly expressed fixed disease, especially in adults, is subject to surgical treatment.
Depending on the type of pathology and the causes of itdevelopment can be performed arthrodesis, osteotomy, crescent or wedge resection of the tarsal bones, transplanting tendons and dissection of the plantar fascia. Various combinations of these techniques are also used.
The operation to restore the foot is carried out inplanned procedure under conductor anesthesia. The optimal option is a combined surgical procedure for Chaklin or Kuslik. The latter method involves an open dissection or redression of plantar aponeurosis in conjunction with sickle-shaped or cuneate resection of the cuboid bone. Once the resected portion is removed, the rear portions of the feet are folded in the direction of the sole, and the front sections are bent toward the rear. After that, the wound is sutured, drained, and a plaster is placed on the lower limb, which is not removed for 6-7 weeks.
At operation on a method Chaklin aponeurosisPlantar also is processed or dissected. Next, the tarsal bones are exposed. In this case the extensor tendons are diverted to the sides, and then a wedge-shaped resection of a part of the cuboid bone and the head of the talus is performed.
As for the scaphoid bone, it is removed partially or completely, depending on the severity of the deformity.
When the first metatarsal bone is strongly lowered, (in addition) its osteotomy is performed. When observing the equinus, a tenotomy of the Achilles tendon is carried out.
In the event that in the process of surgicalinterference position of the foot could not be corrected, a plaster was applied to the leg for 3 weeks, after which it was removed and the final correction was made. Then the bandage is applied again for another 4 weeks.
Insoles and Exercises
Is a hollow foot treated? Insoles and properly selected shoes - this is one of the easiest ways to get rid of deformities of the foot, as well as its prevention.
According to the experts, at hollowpatients need to give their preference to shoes with a wide platform and low heels. This will help fix the leg in the correct position.
Also it should be noted that buyingOrthopedic shoes should only be under the supervision of the treating doctor. By the way, the latter can recommend shoes with an elevated inner edge. To ensure proper support of the arch of the foot, it is obligatory to use orthoses, that is, special insoles, manufactured by individual order.
How to reduce the pain that causes a hollow foot? Exercises and physiological procedures for the treatment of such a disease are selected individually, on the recommendation of the treating doctor. Let's give some examples:
- The starting position is sitting. Exercise is performed freely, then with resistance (apply fixed loads to the foot, gymnastic band).
- Grasping movements with fingers and both feetvarious items (wooden, rubber, metal balls of different diameters, rods, etc.) in a certain sequence - their size should be gradually reduced, and the weight - to increase.
- Standing position standing. Socks inward, heels to the sides, maximum external rotation of the shins, then transition to the outer edge of the foot. Next - lowering to the surface of the soles.
Also, to eliminate discomfort, the patient is prescribed paraffin baths, warm baths and manual correction of deformations in the form of a massage.