Hallux valgus in children. Exercise at 1-1.5-5-10 years old, shoes

Hallux valgus in children Is a type of curvature of the lower extremities that occurs at different stages of a child's life. In orthopedic practice, there are occasional cases when this pathology is diagnosed in a newborn baby while still in the hospital.

Hallux valgus is characterized by a progressive decrease in the height of the arch of the feet, the presence of an X-shaped curvature of their axis. In the process of visual examination of the lower limbs of a child with signs of this pathology, it is found that his toes and heels are turned outward, and the middle part of the foot is turned inside out. Hallux valgus therapy requires regular use of physical exercises, exercise therapy methods, the use of orthopedic shoes and insoles.

What causes hallux valgus in children at different ages

Hallux valgus in children can be congenital or acquired in origin. In the first case, the child is born already with improperly formed limbs, and their pathological condition is associated with the negative impact of a hereditary factor.

The acquired-type hallux valgus appears gradually as the child develops. This disease is easier to eliminate with exercise and timely treatment with orthopedic products.

There are the most common causes of the hallux valgus in children:

• acute vitamin D deficiency, which led to the development of rickets;
• from early childhood, the child wore poor-quality and incorrectly selected shoes;
• progressive osteoporosis;
• dystrophy of the muscle tissues of the legs;
• the consequences of a severe foot injury or surgery;
• diabetes;
• chronic diseases of the thyroid gland and other pathologies of the organs of the endocrine system, which cause hormonal imbalance in the child's body;
• congenital dislocation of the hip joint;
• prolonged stay of the child's foot in a cast after a severe fracture;
• complications of poliomyelitis;
• morbid obesity with constant overweight gain;
• genetic predisposition to deformational changes in the feet.

Hallux valgus can be a consequence of cerebral palsy or birth trauma. Therefore, it is necessary to exclude pathologies of the lower extremities that have a neurological etiology. The reasons that caused the curvature of the plantar part of the leg are necessarily established by an orthopedic doctor at the stage of diagnosing the disease. Elimination of negative factors that disrupt the full development of the child's limb is the key to successful treatment.

Diagnostics of the valgus of the foot in a child 1 year and older

Hallux valgus in children (exercises are selected individually depending on the severity of the pathology) is detected during a visual examination of their lower extremities. Parents or a pediatrician can see clear signs of this pathology when the child is 1-1.5 years old. At the initial stage of diagnosis, the doctor examines the anatomical location of the heel, fingers, the structure of the arch of the feet of a small patient. If there is a suspicion of the occurrence of hallux valgus, the doctor prescribes the child to undergo an additional examination, the methods of which are described in the table below.

Diagnostic method	Characteristics of the survey process
X-ray	Taking an X-ray in 3 projections allows the doctor to confirm the fact of the wrong position of the feet in relation to each other.
Computer podometry	The use of this diagnostic method makes it possible to determine the first signs of hallux valgus, when external symptoms are completely absent. This method of examination is indicated for use in relation to young children who have a hereditary predisposition to this pathology.
Joint ultrasound	The method of ultrasound diagnostics of the joints of the lower extremities of a child is used in the presence of severe deformity of the feet, when the lack of timely treatment has led to the development of concomitant complications.
Computer plantography	Computerized plantography makes it possible to obtain the most accurate dimensions of the child's feet. This diagnostic method allows you to detect the slightest changes in the parameters of the examined tissues.

If a child has a severe form of hallux valgus, additional consultation with a pediatric neurologist may be required. A specialist of this profile examines the patient's lower extremities for the functional state of the peripheral nerves in the lower leg area.

What is the danger of hallux valgus for a child

Hallux valgus in children (exercises to restore the normal shape of the leg are performed child every day) carries a significant danger if there is no timely treatment for this pathology. The curvature of the plantar part of the lower limb, which has signs of mild severity, responds well to orthopedic therapy. After completing the full course of treatment, the child has an anatomically correct foot without signs of deformity. Severe valgus curvature leads to functional disorders of the lower extremities. The child becomes disabled with an awkward gait and pronounced deformation of the plantar part of the leg. The lack of further treatment leads to the development of concomitant diseases of the musculoskeletal system.

How to treat?

Therapy of the valgus foot includes the use of therapeutic massage, exercise therapy techniques, daily gymnastics and physical exercises. In combination, these actions should lead to the restoration of the anatomically correct shape of the leg without signs of curvature.

Massage

Treatment of hallux valgus with massage should be done by a chiropractor or pediatrician. For each child, an individual course of therapy is developed using this method, which includes working out the tissues of the foot and lumbar spine. The treatment plan depends on the stage and severity of the deformity changes in the legs.

During the massage of the lumbar spine, the doctor acts on the peripheral nerves that are connected to the tissues in the feet. Working out these areas of the musculoskeletal system allows for therapeutic stimulation of nerve impulses throughout the lower limb.

Foot massage provides an improvement in local blood circulation, prevents the development of neuropathy of peripheral nerves as a result of their compression due to severe curvature of the legs. Working out limbs with signs of deformation begins with a slow warm-up of the plantar tissues. Then the doctor smoothly moves to the arch of the foot, kneads the heel and toes.

Massage movements are performed by a specialist in such a way as to direct the tissues from the curved leg to the anatomically correct side of its development. This method of therapy is applied daily, 3 or 4 times a week, depending on the stage and severity of hallux valgus. During the massage, all the specialist's actions should be as careful and unhurried as possible in order to prevent injury to the child.

Exercise therapy

Hallux valgus in children (exercises to create anatomically correct leg shape include mandatory implementation of exercise therapy techniques) can be stopped with the help of a properly selected therapeutic techniques.

Classic exercises from 1.5 years and older

For children aged 1.5 years and older, simple physical exercises are used that they are able to perform on their own, or with minimal help from adults.

Walking on heels

Performing this exercise of physiotherapy exercises requires compliance with the following rules:

1. The child stands on a hard floor surface with bare feet.
2. Hands are placed on the belt.
3. At the command of a doctor or one of the parents, the child is 1 min. walks on your heels, and then moves exactly the same amount of time on your toes.

This exercise is performed daily. During one lesson, you will need to do from 5 to 10 repetitions, depending on the severity of the curvature of the feet. This exercise is especially effective if the hallux valgus has led to a pronounced violation of the anatomical position of the big toe.

Finger training

To complete this exercise, you will need to sit the child on a chair, and then ask him to alternately bend and unbend his toes. These actions can be done with both limbs at once or first with the left and then with the right foot. This exercise is performed daily for 5 sets of 10-15 repetitions, depending on the age of the child and the severity of the curvature.

Walking in a straight line

Performing this exercise requires adherence to the following algorithm of actions:

1. With the help of chalk, a straight line is drawn on the floor.
2. The child makes every effort to walk along a given segment without deviating to the side.
3. For older kids, you can use an imaginary line.

This exercise is allowed for exercise in the fresh air. The child should be shod in comfortable shoes, the heel of which is 2-3 cm higher than the height of the toe. To create a greater interest of the child in the therapeutic process, the lesson can be carried out in a playful way.

Squats

The use of squats allows you to prevent further progression of deformational changes in the foot, and also ensures the prevention of complications of this disease.

This exercise is performed as follows:

1. The child stands on a flat surface of the floor.
2. Hands are placed on the belt.
3. On the count of “one”, the child squats to the maximum depth.
4. On the count of two, the child returns to the starting position.

Squats are a heavy and energetically demanding exercise, which is sufficient to perform 3 sets of 7-10 repetitions with breaks of 5 minutes.

Walking on the edge of the foot

To complete this exercise, you must observe the following sequence of actions:

1. The child takes off his shoes.
2. Stands on the edge of the outer side of the foot.
3. At the command of a doctor or parent, he begins to walk around the room with a flat and hard floor.

This lesson to correct the hallux valgus is performed daily. The average duration of a therapeutic procedure is 10-15 minutes. Walking on the ribs of the feet is performed intermittently so that the child does not feel severe fatigue or severe discomfort in the lower extremities.

Gymnastics for the little ones

For the smallest children, it is recommended to use the simplest gymnastics, which helps to get rid of the first signs of hallux valgus. To do this, you need to do the following:

1. Put the baby on its back.
2. Raise his legs up.
3. Move the lower limbs of the child as if he was riding a bicycle.

During these movements, the parent should hold onto the plantar part of the baby's leg or place his fingers in the area of ​​the arch of his feet. This gymnastics is performed daily for 3 sets of 10-15 repetitions.

Exercises for school children

Treatment of hallux valgus in schoolchildren involves the use of more complex exercise therapy exercises.

Ball rolling

The implementation of this exercise of physiotherapy exercises requires compliance with the following algorithm of actions:

1. Sit the child on a chair.
2. Place a small rubber ball under his feet.
3. The child should roll this toy with the entire area of ​​the plantar part of the leg.

Massage of each lower limb lasts from 5 to 15 minutes. depending on the neglect of deformity changes in the foot. This healing exercise must be done daily.

Gripping with toes

This exercise is performed as follows:

1. A handkerchief or any other piece of fabric is placed in front of the child.
2. The child, using the fingers of the lower extremities, must perform a grip on this thing.
3. The handkerchief captured by the legs is thrown forward to the maximum distance.

This exercise can be performed daily for an unlimited number of repetitions. The implementation of grips with the toes allows you to speed up the process of getting rid of hallux valgus, as well as to strengthen the tendons of the lower extremities.

Leg curl

Hallux valgus in children (exercise therapy exercises strengthen all tissues of the lower extremities) becomes the cause of gait disturbance.

To carry out this therapeutic lesson, the following sequence of actions must be followed:

1. The child lies down on a flat surface of the floor.
2. Stretches legs forward.
3. Alternately bends the lower limbs at the ankle joint.

This exercise is performed daily for 10-15 minutes. During this lesson, slight discomfort may be felt in the ankle joint, which is a normal reaction of the body to active warm-up of deformed tissues.

Stick squats

The implementation of this exercise exercise therapy is as follows:

1. A gymnastic stick is placed in front of the child, on which he stands with both legs.
2. Hands are fixed on the belt.
3. Legs are placed shoulder-width apart.
4. A deep squat is performed on the count of "one".
5. On the count of two, the child returns to the starting position.

The effectiveness of this exercise exercise therapy lies in the fact that the correction of the curved foot occurs under the influence of the child's own weight at the time of squatting. This lesson to get rid of hallux valgus is allowed to be done daily for 3 sets of 10 repetitions.

Shoes and insoles

Special shoe models and insoles for hallux valgus correction are selected individually for the parameters of each child's foot. In especially severe cases, products of this type are made according to a separate order. The selection of footwear and insoles for children with hallux valgus is handled by a pediatric orthopedic surgeon.

As the child's physical development progresses, periodic replacement of orthopedic products is performed to continue corrective restoration of the anatomically correct shape of the foot. In the presence of a mild form of hallux valgus, wearing special shoes and insoles lasts about 6 months. Severe forms of this pathology require the use of orthopedic products for 1-2 years, depending on the dynamics of recovery.

Taping

The main goal of taping a child's legs with hallux valgus is to improve the quality of the shock-absorbing properties of the foot by increasing the amplitude mobility of the longitudinal arch. The kinesiological patch should only be applied by a specialist. The tape is fixed on the front side of the lower leg, covers the upper surface of the foot and runs along the center of the plantar part of the leg.

The kinesiology tape supports the tissues of the lower extremity that show signs of deformity, and also guides them for anatomically correct development. It is important to remember that poor-quality taping of the feet will not bring a positive therapeutic effect, and can also lead to an aggravation of the pathology.

Consequences if untreated

The complete absence of a properly formed course of therapy to eliminate the signs of hallux valgus leads to the development of the following consequences:

• arthrosis of the joints of the lower extremities;
• violation of posture, which is expressed by a strong stoop;
• curvature of the thoracic or lumbar spine;
• shortening of one or two lower limbs at once;
• attacks of aching pain in the area of ​​the plantar part of the leg, which intensify after walking;
• chronic osteochondrosis;
• deformational changes in the pelvic bones (this complication is especially dangerous for girls, since in the future it may negatively affect reproductive function);
• destruction of the connective tissue of the knee and ankle joints.

In order to prevent the development of complications of hallux valgus, it is necessary to start treatment of this pathology from the first days after its detection by a pediatrician or pediatric orthopedist. To prevent curvature of the legs, it is recommended to pay increased attention to the prevention of the disease. For example, buying high-quality shoes for a child, not putting a newborn on his feet earlier than 9 months, including vitamin D in the infant's diet, and also giving him a daily foot massage.

How to determine the effectiveness of exercise and when to agree to surgery

The therapeutic effectiveness of therapeutic exercises for getting rid of hallux valgus can be determined only by a pediatric orthopedist or an experienced pediatrician. The decision to use a surgical operation to restore the anatomically correct shape of the child's legs is made by the attending physician together with the patient's parents.

Surgery is a radical method of therapy, the use of which is necessary if physical exercises, massage, wearing orthopedic shoes and exercise therapy programs do not bring a positive result, and hallux valgus continues to progress.

Hallux valgus in children is a dangerous pathology of the musculoskeletal system, which is congenital or acquired in origin. The main signs of this disease are the expanded position of the toes and heels of the newborn. In this case, the arch of the foot is turned inward in the X-curvature of the legs.

Hallux valgus is caused by chronic diseases of the child's endocrine system, acute vitamin D deficiency, wearing poor-quality shoes, and a hereditary predisposition to curvature of the legs. This disease is treated by a pediatric orthopedic surgeon.

The general course of therapy necessarily includes therapeutic massage, exercise therapy programs, daily exercise for the plantar part of the leg. In the absence of a positive effect, a radical method of treatment in the form of a surgical operation is used.

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