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 submitted. 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.

basic information

What is a hollow foot? This is a pathology involving the deformation of the lower extremities. 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 in question 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:

1. At the very beginning of the disease, the soft tissues change (morphological). To eliminate this problem, doctors recommend the patient to provide pressure on the head of the first metatarsal bone.
2. 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.

Causes

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 may 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 the majority of doctors, most often a hollow foot is formed due to the pathology of the neuromuscular system and a number of diseases, as well as muscular dystrophy, polio, spinal dysraphia, Charcot-Marie-Tooth disease, syringomyelia, polyneuropathy, Friedreich's 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 limbs or improperly fused talus and heel bones (after fractures).

In 20% of all cases, factors that provoked a hollow foot remain unclarified.

Symptoms of the disease

In pharmacies and medical centers very often sell insole for a hollow foot. What are they needed for? The fact is that such a disease does not pass for the patient without a trace.

With the increase of the arched arch the patient constantly complains 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 the pathology in question, specialists reveal an increase in the height of the inner and outer arch, spreading, widening, and a 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, in this patient, the marked stiffness of the foot is often noted.

Other signs

A hollow foot that develops as a consequence of poliomyelitis can be accompanied by a blurred one-sided paresis in conjunction with the equinus of the foot. At the same time, muscle tissue tone is reduced, and deformation does not progress.

If a person has cerebral lesions, he may have spastic phenomena, increased muscle tone and increased reflexes (tendons). Such a 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 irregularities. In addition, for this disease are characterized by mildly expressed disorders of sensitivity and lesions of pyramidal pathways.

In the case of Charcot-Marie-Toot disease , a 2-sided and progressive deformity of the feet is noted in man, as well as muscle atrophy, which spreads from the bottom up.

How is it diagnosed?

Exercises with a hollow foot should be carried out necessarily. 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, a large depression of the concave arc of the inner edge and a projection along the outer edge of the foot are revealed on the plankgram. With moderate pathology, concavity is observed up to the outer margin. As for the sharply expressed disease, the imprint of the human sole 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 is neuromuscular disease, the patient is referred to a neurologist. The latter conducts a detailed neurological examination, performs radiographs of the spine, MRI and CT, as well as electromyography and other studies.

With old trauma to the tarsus, the patient may need CT of the foot.

If a hollow foot has been identified for the first time and the patient has no neuromuscular system diseases, 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 pathologies, the patient is prescribed therapeutic physical training, 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 reasons for its development, arthrodesis, osteotomy, crescent or wedge resection of the tarsal bones, tendon transplantation and dissection of the plantar fascia can be performed. Various combinations of these techniques are also used.

Surgical intervention

The operation to restore the foot is carried out in a planned manner 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 plaster is applied to the lower limb, which is not removed for 6-7 weeks.

In the operation of the Chaklin method, the plantar aponeurosis is also ruled 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.

If 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 during the surgical intervention the position of the foot can not be corrected, a plaster is applied to the leg for 3 weeks, after which it is removed and the final correction is made. Then the bandage is applied again for another 4 weeks.

Insoles and Exercises

Is a hollow foot treated? Insoles and properly selected shoes are one of the easiest ways to get rid of leg deformation, as well as its prevention.

According to experts, with a hollow stop, patients need to give their preference to shoes with a wide platform and low heels. This will help fix the leg in the correct position.

It should also be noted that buying orthopedic 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, necessarily use orthoses, that is, special insoles, made to 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:

1. The starting position is sitting. Exercise is carried out freely, then with resistance (apply fixed loads to the foot, gymnastic band).
2. Grasping the fingers and both feet of various objects (wooden, rubber, metal balls of different diameters, rods, etc.) in a certain sequence - their size should be gradually reduced, and the weight - to increase.
3. 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.