Flat foot (also called planus or curved bow ) is a postural disorder in which the arch's curve collapses, with all the soles of the feet coming into contact complete or almost complete with soil. It is estimated that 20-30% of the general population has curves that never develop in one or both legs.
There is a functional relationship between the arch structure of the foot and the biomechanics of the lower leg. The arch provides elastic, chewy connection between the forefoot and the hind legs. Security of this association so that most of the force that occurs during the foot load bearing can be lost before the strength reaches the long bones of the legs and thighs.
In the pes planus, the talus bone head shifts medial and distal from the navicular. Consequently, the Plantar calcaneonavicular ligament (spring ligament) and the tibial posterior muscle tendon are stretched, so much so that individuals with pes planus lose the function of the medial longitudinal curve (MLA). If MLA does not exist or does not work in both sitting and standing positions, individuals have stiff legs. If MLA is present and functioning when the individual is sitting or standing on their toes, but this arch disappears when assumed flat-footedness, the individual has a "flexible" foot. This last condition can be fixed with the support of the right curvature.
Three studies (see below excerpt in the military section) of military recruits show no evidence of increased injury, or foot problems, due to flat feet, in populations of people who reached military service age without prior foot problems. However, this study can not be used to assess the likelihood of future damage from this condition when diagnosed at a younger age. They also can not be applied to people whose average leg is associated with foot symptoms, or certain symptoms in other parts of the body (such as legs or back) may refer to the foot.
Video Flat feet
Children
Studies have shown children and adolescents with flat feet are a common occurrence. Human arches develop in infancy and early childhood as part of normal muscle, tendon, ligament and bone growth. Flat arches in children usually become high curves as children develop into adolescence and mature. Children with flat feet have a higher risk of experiencing knee, hip, and back pain. A recent randomized controlled trial found no evidence for the efficacy of flat-foot treatment in children either from costly orthotics prescribed ie (shoe inserts) or less expensive orthotics over-the-counter. As a symptom itself, flat feet usually accompany genetically musculoskeletal conditions such as dyspraxia, ligity ligamentous or hypermobility.
Diagnosis
Since children are unlikely to suspect or identify their own legs, it is important for an adult nurse to check this on their own. In addition to visual examination, caregivers should pay attention when the child's walking style is not normal. Children who complain about calf muscle pain, arching pain, or other pain around the leg area may develop or have developed flat legs.
Treatment
Foot training, utilizing foot exercises and going barefoot in various fields, can facilitate the formation of arches during childhood, with developed curves occurring for most at the age of four to six years. Weakness of the ligaments is also one of the factors known to be associated with flat feet. One medical study in India with a large sample size of children who grow by wearing shoes and others will be barefoot found that the longitudinal arch of the bare feet is generally the strongest and highest as a group, and that flat feet are less common in children. who grew up wearing sandals or sandals than among those who wore closed shoes. Focusing on the effect of footwear on the prevalence of pes planus, a cross-sectional study conducted on children noted that wearing shoes throughout early childhood can adversely affect normal development or high medial longitudinal curvature. The susceptibility to a flat foot among children who wear shoes increases if the child has ligamentous ligament related conditions. The results showed that children were encouraged to play barefoot on various terrain surfaces and that sandals and sandals were less dangerous than closed shoes. It turns out that closed shoes greatly inhibit the development of the arch of the foot more than sandals or sandals. This conclusion may be the result of the idea that intrinsic muscle activity of the arch is necessary to prevent slippers and sandals from falling off the child's legs. In children with some symptoms of orthotics is not recommended.
Maps Flat feet
Adult
Flat feet can also develop as adults ("adult sailors") due to injury, illness, unusual or prolonged pressure to the feet, incorrect biomechanics, or as part of the normal aging process. This is most common in women over 40 years. Known risk factors include obesity, hypertension and diabetes. Flat feet can also occur in pregnant women as a result of temporary changes, due to increased elastin (elasticity) during pregnancy. However, if developed in adulthood, flat feet generally remain flat permanently.
If a young man or an adult looks flat feet while standing in full weight, but the arch appears when the person plantarflexes, or pulls the toes back with the rest of the flat feet on the floor, this condition is called a flexible sailor. This is not a curve that actually collapses, because the medial elongated arch still exists and the mechanism of the tap machine is still operating; this presentation is actually caused by excessive foot pronation (rolled in), although the term 'flat foot' can still be applied because it is a generic term. Muscle foot exercises are helpful and will often lead to increased height of the arch without regard to age.
Pathophysiology
Studies have shown that the tendon specimens from people who suffer from adult flat feet show evidence of increased activity of proteolytic enzymes. This enzyme can break the constituents of the involved tendon and cause the arch of the foot to fall. In the future, this enzyme can be a target for new drug therapy.
Diagnosis
Many medical professionals can diagnose flat feet by checking patients standing or just looking at them. When climbing to the tip of the toe, the deformity will improve when this is a flexible flat foot in the child with saggy joints. Such a correction is not seen in adults with rigid flat feet.
The easy and traditional home diagnosis is a "wet trail" test, done by wetting the feet in water and then standing on a smooth surface, such as soft concrete or thin cardboard or heavy paper. Usually, the more footprints that make contact (leaving a trail), flattering the legs. In a more extreme case, known as a wrinkled sailor, the entire inner edge of the trail may actually stand out, where in the normal curvature to the height of this section the sole of the foot does not make contact with the soil at all.
In plain radiographs, flat feet can be diagnosed and assessed by several measures, the most important in adults is the talonavicular coverage angle, the calcaneal pitch, and the talar-1 metatarsal angle (Meary angle). The angle of talonavicular coverage is abnormally rotated laterally with the leg flat. Usually up to 7 degrees is rotated laterally, so larger rotations show flat feet. Radiography in general needs to be taken on the burdening leg to detect misalignment.
Treatment
The most flexible flat feet are asymptomatic, and do not cause pain. In this case, there is usually no reason to worry. Flat feet were once a physical-health reason for denial-of-service in many military. However, three military studies in asymptomatic adults (see below), show that people with asymptomatic flat feet are at least as tolerant of foot stress as populations with varying degrees of arch. Asymptomatic flat feet are no longer a disqualification service in the US military.
In a study conducted to analyze tibial posterior muscle activation in adults with plaqueus, it was noted that this muscle tendon may be dysfunctional and cause weight symptoms associated with flat foot deformities obtained. The results showed that when barefoot, the subject activated the lower leg muscles additionally to complete exercises that retained adduction of the foot. However, when the same subject does the exercise while wearing orthotics and arch support shoes, the posterior tibialis is selectively switched on. Such findings indicate that the use of shoes with appropriate and appropriate supportive ortors will increase selective activation of the posterior tibialis muscle to act as an adequate treatment for undesirable pesplicus symptoms.
Rigid bloated feet, a condition where the soles of the feet are very stiff even when a person is not standing, often show significant problems in the affected leg bone, and can cause pain in about a quarter of those affected. Conditions associated with other sailors, such as various forms of tarsal coalition (two or more midfoot bones or abnormally abbreviated hindfoot) or navicular accessories (extra bones on the inner side of the foot) should be addressed, usually by early teenage years, before the structure the child's bones rise permanently as young adults. Both the tarsal coalition and the navicular accessory can be confirmed with X-rays. Rheumatoid arthritis can destroy tendons in the legs (or both legs) that can cause this condition, and untreated can lead to deformity and early onset of osteoarthritis joints. Such conditions can cause severe pain and greatly reduced ability to walk, even with orthosis. Ankles are usually recommended.
Flat foot care may also be appropriate if there is an associated leg or lower leg pain, or if the condition affects the knee or lower back. Treatment may include using orthoses such as arch support, foot exercises or other exercises as recommended by podiatrist/orthotist or physical therapist. In the case of severe flat feet, orthoses should be used through a gradual process to reduce discomfort. For a few weeks, a little more material is added to the orthosis to raise the arch. This small change allows the structure of the foot to adjust gradually, as well as giving the patient time to adjust to the sensation of using orthoses. Once prescribed, orthosis is generally used for the rest of the patient's life. In some cases, surgery can provide lasting assistance, and even create curves where none existed before; it should be regarded as a last resort, as it is usually very time consuming and expensive.
Athletic performance
Throughout history, flat feet are seen as a sign of low class and poor health, and high arches are seen as high-class and vigorous. Research has shown that the two differences are far from the case. The effects of flat feet fall under two categories, which are asymptomatic and symptomatic. Individuals with rigid flat feet tend to exhibit symptoms such as tendinitis of the feet and knees, and it is advisable to consider surgical options when managing the symptoms. Individuals with flexible flats generally exhibit an asymptomatic effect in response to their flat feet.
According to AAP news and journal gateways, being flexible with flat feet does not preclude athletic performance.
Generally assumed by working professionals (mainly including some physical trainers, podiatrists, and shoe manufacturers) that someone with flat feet tends to overpronate in the form of running. However, some also assert that people with flat feet may have underpronating if they are not a neutral walking style. With standard running shoes, these professionals claim, a person who overpronates in his running form may be more susceptible to shin splints, back problems, and tendonitis in the knee. Running shoes with additional medial support or using special shoe inserts, orthoses, can help improve one's running form by reducing pronation and can reduce the risk of injury.
Military performance
Studies analyzing the correlation between flat feet and physical injuries to soldiers have been reassuring, but none indicate that flat feet are obstacles, at least in soldiers who reach the age of military recruitment without prior foot problems. In contrast, in this population, there are more suggestions of injuries in high arched legs. A 2005 study of Australian Air Force recruits that tracked people recruited during their basic training found that flat feet and high arched legs had no impact on physical functioning, injury or foot health. If anything, there is a tendency for those with flat feet to have fewer injuries. Another study of 295 members of the Israeli Defense Forces found that those with high arches suffered nearly four times as many stress fractures as compared to those with the lowest arch. Further studies of 449 US Navy special war training participants found no significant difference in the incidence of stress fractures between mariners and marines with different curved elevations.
See also
- Marfan syndrome
- Ehlers-Danlos syndrome
- Comparison of orthotics
References
External links
Source of the article : Wikipedia
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