Therapeutic gymnastics of clubfoot in children. Signs and treatment of clubfoot in children: effective exercises. Indications for massage sessions

A set of exercises that you need to perform with your child daily, for a long time. You need to repeat each exercise 5-7 times, with fixation of the foot at the end of the exercise for 15-20 seconds. In this case, the child should lie on his back, on a hard surface (for example, on a changing table).

Exercise 1. Taking the child's shin in one hand, and the middle part of his foot in the other, make the foot move "toward and away from you."

Exercise 2. One hand of an adult holds the child's foot by the heel, and the fingers of the other hand move the toes of the child's foot "away from you and up."

Exercise 3. One hand of an adult fixes the ankle joint of the baby, and the other, clasping the middle part of the foot, moves the foot "from side to side".

Exercise 4. One hand of an adult fixes the middle part of the child's foot, and the thumb of the other hand gently unbends the toes of this foot.

Exercise 5. The position of the adult's hands is the same as in the previous exercise. But extension is carried out only with the big toe of the child.

Exercise 6. One hand of an adult holds the child's foot by the heel, and the fingers of the other hand press on the front and middle departments feet, carrying it out to the side.

Exercise 7. One hand of an adult fixes the child's shin, and the fingers of the other hand press on the outer edge of the foot, bringing it inwards.

Exercise 8. When performing this exercise, the child is placed on the stomach. An adult holds the baby's shin with one hand, pulling his heel with the other hand towards himself.

Exercise 9. One hand of an adult fixes the ankle joint of the baby, and the palm of the other hand is firmly pressed against the child's foot and presses on it, slightly twisting outwards.

Exercise 10. One hand of an adult fixes the ankle joint of the child, while the other grabs the foot and performs an outward movement.

Exercise 11. One hand of an adult holds the child's leg bent at the knee joint, the other hand grabs the foot and carefully pulls it forward, shifting it to its natural position.

For the prevention and treatment of clubfoot, you can use:

1. Walking along the "herringbone path". Draw on the floor with chalk or on paper with bright colors a "Christmas tree" 1-2 m long, with "twigs" at an angle of 15-30 degrees. Invite the baby to walk along such a path, stepping on each “twig”, turning the feet outward. In the summer, you can draw such a path on the sand, lay out planks or bricks, and let the child walk along it several times a day. Gradually, thanks to your perseverance and patience, the correct installation of the feet is developed, the gait is normalized, and the curvature of the legs is corrected.

2. "Rubber". Sitting on the floor, emphasis with hands behind, straightened legs together, put on a wide elastic band on the front sections of the feet. Take the feet to the sides, stretching the elastic band; heels remain closed; try to point your fingers "at yourself" (extension of the feet). Hold this voltage from 10 seconds to 1 minute 1 time. (If at first it is not possible to stretch the elastic band longer, then perform the exercise several times until muscle fatigue).

3. "Bar". Standing with the front sections of the feet on a bar 10 - 15 cm high, the heels hang from the bar, with your hands hold on to the crossbar of the Swedish wall (or to the back of the chair).

1, 2, 3 - springy movements with heels to the floor, stretching the back surfaces of the legs and Achilles tendons. 4 - return to the starting position. 8 times.

4. "Squats". Standing in front of the Swedish wall, hold on to the crossbar in front of you with your hands, feet shoulder-width apart. 1- Sit as deep as possible, connecting the knees, feet turn on the inner arches. 2- Straighten up. 10 times.

5. "Airplane" or "Boat". Lying on the stomach, the legs are straightened and tightly pressed to each other, the feet are in the extension position (toes towards you), hands in front of you.

1- Raise your head, upper shoulder girdle and arms to the sides so that the shoulder blades are connected. At the same time, raise tightly closed legs, stretch the heels back, stretching the spine. Hold this position for 1 minute.

2- Return to ref. position. 1 time.

6. Standing in front of a chair, hands on the belt, legs together.

1- Raise the right leg, bending at the knee, and put it on the chair seat with the foot abducted to the right.

2- Return to starting position.

3- Raise the left leg, bending at the knee, and put it on the chair seat with the foot abducted to the left.

4- Return to starting position. Run 6 times.

7. "Walking goose step" in the squat position with the feet abducted to the sides. Hands free or on the belt. To exhaustion.

8. "Walking on heels" 20 sec.

9. "Bird". Sitting on a chair, legs together, hands on the belt.

1- raise the front sections of the feet with abduction to the sides.

2- return to ref. position. To exhaustion.

10. "Rotation of the foot."

Sitting on a chair, put the right leg on the left knee on the knee, put the hands in the “lock” on the right knee to fix the right leg.

1- With the right foot, “draw” circles clockwise (until slight fatigue).

2- With the left foot, “draw” circles counterclockwise (until slight fatigue).

11. Dance movement. Standing feet together, hands on the belt.

1- Put your right foot in right side on the heel with the abduction of the foot to the right, a light squat on the left leg.

2- Return to ref. position.

3- Put the left leg to the side on the heel with the abduction of the foot to the left, light squat on the right leg.

4- Return to ref. position. 8 times.

When moving the leg to the side, bend the leg at the knee so that there is a dance movement.

12. Stretching the back surfaces of the legs. Sitting on the floor, legs are straightened and closed, hands on the belt.

Stretch your hands to the feet, feet in the extension position (toward yourself), do not bend your legs:

1, 2, 3 - perform springy slopes.

4- Return to ref. position. 6 times.

13. "Rope walker". Walking on a rope or a gymnastic stick with feet abducted to the sides.

14. Crawling in a plastunsky way with moving forward and relying on the feet laid aside.

15. "Taz". Lying on your back, arms along the body, legs bent and shoulder-width apart.

1 - Raise the pelvis, leaving the feet shoulder-width apart, and knees, trying to connect.

2 - Return to starting position. 6 times

16. Game of ghosts

With the help of this game, you can perfectly develop coordination of movements, the muscles of the child's legs become stronger. A white sheet and a large rug with a hard fleecy surface will help the child to play for his own benefit.

One person (adult) throws a sheet over himself, playing the role of a ghost. The child takes off his shoes and repeats all the actions of a ghost that moves around the room. A ghost can run, walk, sit, freeze, the child does the same so that the ghost does not notice him.

The child repeats all the actions of the ghost quietly, on tiptoe, to train the muscles of the legs. When the ghost turns around, the child must "defend" from it by jumping on one leg. It trains and strengthens the leg muscles.

17. "Fishing with your feet"

This exercise is great for clubfoot by training the feet and ankles. It is necessary to put the child on a chair - "river bank", from there he will fish. But not with hands, but with legs. You need to scatter around the child a few objects, such that you can pick up your toes. This is what the child will do, and at the same time, correct the shape of the foot.

Such a game should be played every day, and then the child's clubfoot will level out, and the mobility of the fingers will increase.

clubfoot foot deformity rehabilitation

Clubfoot. Therapeutic gymnastics and massage

Treatment of clubfoot in children Treatment of clubfoot in children

Exercise therapy complex for clubfoot in children:
Important: exercises for clubfoot in children are done without shoes.

1) Walking (done every day):
1. "Step of the ballerina". Put the toe of one leg forward and slightly to the side, then push the heel of the same leg forward as much as possible, take a step, then repeat everything with the other leg. In this case, you need to ensure that the legs are straightened at the knees to the end.
2. "We walk like a clown." Stand up - heels together, toes as far as possible to the sides. Thus, start walking, while trying to maintain the original position.
3. "Toe walking". The toes must be to the sides.
4. "Walking on heels" The same.
5. "Walking X" (for those who do not suffer from X-shaped legs). Try to stand on the inside of the foot. To do this, you need to sit down a little, push your knees forward, raise the outer edge of the foot (toes to the sides). It should be noted that this exercise is difficult, it immediately becomes very difficult for the child.
6. "Walking like soldiers." Raising the knees high (they should be directed only forward parallel to each other), spread the toes to the sides.

2) Exercises for clubfoot in children with a gymnastic stick, you can use any longer stick with a diameter of about 1.5 - 2.0 cm (done every day):
1. Walking across the stick. In this case, the heels must necessarily touch the ground.
2. Walking along the stick like a circus performer.
3. Walking in the same way as in the "Step of the Ballerina", only the toe must be placed on a stick, and the heel must be left on the ground.

3) Squats (can be combined):
1. Regular squats. It is necessary to strive to ensure that the child does them on his own. Arms forward, feet fully on the ground. At first, you can hold the child by the hands. Run 10-15 times.
2. Cross-legged squats. The same thing, but here the child needs the help of a parent. You have to hold his hands.
3. Exercise - "Pussy". The child stands in front of the sofa (chair), makes a tilt, reaches the floor with his hands, and begins to move forward with one hand to the sofa, reaches the sofa. At the same time, the legs are straightened. The parent at this time sits behind and holds the child by the legs (you should try to pull the child's heels as low as possible to the floor). Having reached the sofa, the child does push-ups, then again returns to the starting position with his hands on the floor.

4) Exercises with a gymnastic wall (can be combined with squats):
1. In addition to the wall, either a small wooden slide is purchased or made. The child stands on the hill completely with the whole foot, and moves, holding on to the parent, up. The knees should be fully extended. It is necessary to ensure that the toes are directed to the sides, and the foot is completely touching the slide.
2. Standing on a hill and holding on to one of the steps of the wall, the child can do squats on their own. It is necessary to ensure that the knees are directed only parallel to the front, and not to the sides.
3. Just climbing the ladders of the slide. At the same time, it is good if the child will climb without shoes.
4. Sailor climbing. Imitating a sailor, you need to wrap your hips around one of the supports of the gymnastic wall, put your foot on the lower step so that the foot is turned to the side, then push off, put the other foot as well, etc.

At night, before putting on splints:
1. Lying down, lift the foot up to the stop, then to the side until it stops. Repeat 20 times with each leg.
2. Lying down, the parent raises the leg up and to the side and asks the child to hold the leg in this position for a count of 10. Repeat 3 times with each leg.

Also, parents can develop a set of exercises for clubfoot in children and gradually increase the load. An exercise therapist can suggest some useful exercises.
The following may be advised:
The first lesson must begin with a run - preferably in a circle. This will help the child warm up the muscles. I must say that when running speed is not required. The main thing is that the child correctly put the legs. At the next lesson, you need to introduce additional exercises, and then do a "psychological" exercise so that it deliberately distracts the baby from the correct setting of the legs. It is necessary to raise your hands to your chest, clench your fists and twist them in front of you while running. To begin with, you can twist your fists only in one direction, for example, towards yourself, and after a while, after several classes - 10 times in each direction. Parents should pay attention to how the child will put the legs during this exercise.
Walking, running around the hall should be diluted with jumping on toes. In this case, the setting of the legs should be like that of Charlie Chaplin, in other words, heels together and socks apart. In this position, the legs should come off the floor, and then land. Such a gait is good to climb the stairs, best of all, constantly. It is also necessary to include walking "goose step" in the classes. An excellent corrective posture is sitting between the heels on the floor, turning the legs like a frog.
It is also necessary to include exercises for stretching the spine. Thanks to these exercises, the back is unloaded.
I must say that regardless of the cause of clubfoot, children must have a strict daily routine, in which exercise therapy must be given a mandatory place - Physiotherapy with clubfoot in children and swimming. It is also a good prevention of clubfoot in children. If the approach to treatment is correct, all the recommendations of the orthopedist are fulfilled, then the pathological deformity of the foot can be completely eliminated.

Exercise therapy for clubfoot in children http://lfk-gimnastika.com/lfk-dlya-detej/141-lfk-pri-kosolaposti-u-detej
Massage for clubfoot in children is one of the most effective methods treatment.
Massage is used to relax the internal and posterior muscle groups of the lower leg, where there is an increased tone, you need to stroke, shake the muscles, followed by stretching them with vibrating movements.
To strengthen the stretched or weakened anterior and outer muscle groups of the lower leg, other, more active techniques are used - rubbing and kneading, as well as light tapping with the fingers.
Children's massage for clubfoot is most effectively carried out with a general tonic massage of the whole body, without working with the hands. The same is true for massage for clubfoot in adults.
First you need to stroke the entire length of the leg, then the thigh, lower leg, Achilles tendon and sole are massaged in turn.
The thigh is stroked from the bottom up, from the popliteal fossa along the posterior outer surface to the infragluteal fold. Vigorously rubbed and kneaded with a little shaking - for better muscle relaxation.
When massaging the lower leg on the back surface, a differentiated massage is performed.
After stroking from the heel to the popliteal fossa, it is necessary to influence the calf muscle.
Achilles tendon - stroking by pinching, strokes, stretching with vibration.
The position of the foot during the massage is light pronation, that is, the rise of the outer edge. When massaging, you need to stretch the inner edge of the foot and tone the outer edge.
The front surface of the legs is also massaged, after stroking along the entire length, then alternately. Then they move to the back of the foot - during the massage, the foot is at a right angle to the lower leg, with the normal position of the anterior section.
Vigorous rubbing along the edge of a rake, hatching, forceps, kneading along the edge - shifting, pressing, forceps, light percussion techniques.
The ankle is rubbed well, the ankles are rubbed in a circular motion. It is important to keep the foot in the correct position of easy pronation.
When massaging the front surface of the lower leg, you need to vigorously rub, tonic pressure and light blows - chopping and tapping with your fingers.
The knee joint is stroked in a circular motion and rubbed.
The front surface of the thigh is massaged vigorously with the help of certain movements, which are called passive.
With one hand, you need to fix the lower part of the lower leg, and with the other you need to grab the foot so that the palm rests on the sole. Carefully bend at the same time to the back and pressing on the outer edge, slightly turning the foot to the outside. Then you need to fix the ankle joint, gently pressing on the forefoot, moving it outward.
Rotations of the foot outward along the longitudinal axis should be done gently, gradually lowering the inner and raising the outer edge of the foot.
However, it must be remembered that one massage for congenital clubfoot is not enough, therefore, regular therapeutic exercises are needed to improve and consolidate the result obtained.
Yandex.Direct

Clubfoot is a common anomaly in the development of the musculoskeletal system in young children. The disease is expressed in a persistent violation of the physiological location of the bones of the talonavicular joint, which is responsible for flexion and extension of the foot. The lack of timely therapy can lead to the development of muscle atrophy, curvature of the spine, impaired mobility of the lower extremities. Complex treatment of clubfoot in children with exercises is the preferred method for correcting congenital and acquired deformities.

Purpose of training for clubfoot

Almost 12% of infants are diagnosed with clubfoot of varying severity. It has been established that congenital pathology may be the result of a genetic predisposition or excessive mechanical impact on the lower limbs of the fetus during fetal development with oligohydramnios or malpresentation. Acquired clubfoot in children at an early age occurs in about 3-5% of cases and most often develops after injuries or some infectious and inflammatory diseases. As a result of anatomical disorders, a persistent deformity of the feet is formed: the soles turn inward, an inflection is formed in the center of the feet, and the volume of the legs is significantly reduced.

Pathology does not cause any pain to the baby, but is accompanied by limited mobility of the talonavicular joint and a change in gait. In severe cases, if left untreated, clubfoot can cause disability. As the main method of therapy, therapeutic exercises are used, the main goals of which are:

• Restoration of mobility and physiological structure of the foot;
• Normalization of muscle tone of the lower extremities;
• Prevention of atrophy of the muscles of the lower leg and thighs;
• Activation of local blood flow and tissue nutrition.

Attention!

When diagnosing congenital clubfoot, it is necessary to start therapy from the first days of life. How older child, the less elastic and supple becomes its muscular-ligamentous apparatus, and it takes much more time to restore the natural position of the foot.

Rules for exercise therapy

When performing clubfoot exercises in children of all ages, the following rules must be followed:

• Training is required at least 5-6 times a week. The duration of work with each foot in newborns is 5-7 minutes, in children school age- at least 15-20 minutes;
• All movements should be smooth and painless. If discomfort or fatigue occurs, you need to take a break;
• Classes for children of all ages are carried out without shoes. It is allowed to wear thin socks;
• Exercises for clubfoot should be done after thermal procedures (taking a bath or shower, a warm compress). It is recommended to complete each complex with an intensive foot massage using oil or a special cream. After the end of the workout, it is necessary to avoid hypothermia, and warm the legs with woolen socks or tights;
• To increase the effectiveness of treatment, exercise should be combined with physical therapy, swimming, sports and wearing orthopedic shoes as prescribed by a doctor.

Gymnastics for newborns

Before the start of the lesson, the baby must be undressed and put on his stomach on a changing table or other flat, hard surface. As a warm-up, it is recommended to bend each leg at the knee several times and warm up the muscles with stroking and rubbing movements in the direction from the foot to the thigh. The complex includes:

• Stretching the heel tendon. In the supine position, bend one leg at the knee, holding the lower leg with your left hand. palm right hand with soft springy movements, press on the sole of the baby, directing it to the back;
• Elimination of plantar flexion. Turn the baby on his back, pressing his lower leg firmly against the surface of the changing table. Grasp the foot with the other hand and press on its outer edge towards the back;
• Elimination of adduction of the forefoot. In the supine position, fix the baby's shin with one hand, and with the other, make smooth straightening movements, moving the front arch of the foot to its outer side;
• Relaxation of contracture. Grasping the baby's foot, carefully rotate it with a small amplitude in both directions.

Performing exercises for bilateral clubfoot must be repeated for the other leg. Classes should be postponed if the baby is hungry, naughty or does not feel well.

Exercises for children from 2 years

When the child begins to walk, the training becomes more complex and includes exercises aimed at strengthening the muscular corset, improving blood circulation and correcting the gait. Classes are recommended to be held in game form. Each movement should be repeated 6-8 times:

• Free warm-up (running, marching, jumping);
• Ballet step. Walk in a straight line with the toe outward, trying to push the heel as far inward and forward as possible;
• Soldier step. Walk, raising your knees high and rolling from heel to toe;
• Development of the lateral surfaces of the foot. Stand for 20-40 seconds on the outer, and then on the inner arches of the foot. It is allowed to hold hands on any fixed support;
• Development of the anterior part of the foot. Stand straight, legs together, feet parallel to each other. Holding on to the back of a chair, raise your toes as high as possible, lingering at the top point for 15-20 seconds;
• In the same position, press your fingers without lifting your heels from the floor;
• In a sitting position on a chair, rotate your feet in different directions, roll balls of different diameters, grab with your fingers and move small objects (pencils, shreds, crumpled paper, toys);
• Squat deeply without lifting the sole from the floor surface.

Experts recommend that children with clubfoot walk barefoot on uneven surfaces as often as possible, practice on the Swedish wall, swim in the pool, and ride a bike. If you have free time, you should take a corrective pose "sitting between the heels." To do this, you need to kneel on the floor, spreading your feet with your toes out, then sit between your heels, keeping the position of your legs.

Activities for teenagers

Therapeutic gymnastics for clubfoot in older children includes the performance of all of the listed exercises in random order. Classes should be supplemented with an easy run lasting at least 20-30 minutes. When running and walking, special attention must be paid to the correct positioning of the foot.

In adolescence, it is required to additionally strengthen the muscles of the lower back and shoulder girdle. To do this, it is recommended to train with a heavy gymnastic ball with a diameter of 45-60 cm:

• Squat with a straight back, holding the fitball in front of you with outstretched arms;
• Push up from the floor with your feet on the ball;
• Swing the press, resting your lower back on the surface of the fitball and turning your feet with your toes out;
• Do lunges, placing the knee and shin of one foot on the ball.

The exercise therapy complex for clubfoot is also recommended to be supplemented with exercises with elastic gymnastic ribbons (can be replaced with a dense wide linen elastic band). The most effective exercise is stretching. To perform it, you need to sit on the floor, stretching straight legs forward, and wrap both feet with tape just below the level of the fingers. Try to spread the feet as wide as possible, lingering in this position for 20-30 seconds. Repeat at least 12 times.

Exercise effectiveness and prognosis

The younger the child and the earlier classes to correct the defect are started, the more favorable the prognosis for the patient. With a mild form of pathology, visible improvements are noticeable after 1-2 months. Experts recommend doing it regularly exercise therapy exercises with clubfoot in children for at least 2-3 years, even with a complete cure.

Therapeutic gymnastics is effective only for mild to moderate clubfoot, when the angle of inclination of the foot does not exceed 45 °, and joint mobility is preserved. In the case of a severe violation, small patients are shown the imposition of plaster casts or surgery.

In almost 90% of cases, clubfoot in children of all ages is completely cured with the help of exercise. To achieve a quick and lasting result, complex therapy is required, taking into account the doctor's prescriptions.

Not always the news of a child's clubfoot should be taken as a sentence for surgery. With mild degrees of foot deformity, conservative methods of treatment will be quite effective. In this case, the discipline, perseverance and attention of the parents will be the decisive success factors.

Who can assess the condition of the child

A congenital pathology of the musculoskeletal system of a child is detected in the maternity hospital, and in some cases even before childbirth by ultrasound. At the slightest suspicion of clubfoot, the mother will definitely be advised to show the baby to an orthopedist-traumatologist. You should not delay the visit to the doctor for a long time, since treatment can be started from the second week of the baby's life.

Mild cases of foot deformity may go unnoticed by maternity hospital pediatricians. Over time, the defect is detected at periodic examinations in the clinic. Vigilant relatives can also pay attention to the inverted feet of the baby.

In addition, clubfoot may appear when the child takes the first steps. Overweight children with weak legs prefer to wrap their toes inward to feel more confident. Such a gait should not cause concern if it does not become habitual. After several months of trials, the baby should learn to put the legs straight.

In any case, parents should not neglect the advice of an orthopedist. He will assess the condition of the baby's foot, identify the cause of the pathology, prescribe a course of treatment and give a preliminary forecast for recovery.

The orthopedist will begin the examination of a small patient with an assessment of the degree of clubfoot. Today, two methods are used for this purpose: the Pirani scale and the Dimeglio scale.

Conclusions about the severity of clubfoot according to Pirani (Fig. 1) are made according to six clinical signs:

• curvature of the outer edge of the foot;
• depth of the medial fold;
• depth of the back fold;
• the possibility of probing the lateral part of the head of the talus;
• the possibility of probing the calcaneus;
• foot mobility.

The severity of clubfoot according to Pirani

Table 1. Scheme calculating points according to the Pirani method

According to Dimeglio, the angles of a possible correction are analyzed in all possible planes, taking into account additional features (Fig. 2):

A - foot equinus;

B - heel varus;

B - internal rotation of the foot relative to the anterior surface of the knee joint;

D - adduction of the forefoot.

Rice. 2 Assessment main signs clubfoot in degrees

Table 2. Definition type foot and degree severity clubfoot

Both methods accurately characterize the severity of the disease and make it possible to predict the success of conservative treatment.

How is foot defect treated?

Orthopedic efforts to treat clubfoot are 96% successful. Another thing is that the path to healthy feet and a beautiful walk lies through hard work, and maybe even surgery. In any case, parents should be patient.

In mild cases of foot deformity, the orthopedist will prescribe:

• massage;
• physiotherapy;
• medical gymnastics;
• orthopedic shoes.

Moderate to severe clubfoot will require:

• bandaging;
• plastering;
• wearing orthoses and brace.

After removing the fixing bandages, children are prescribed rehabilitation procedures.

If conservative methods of treatment turned out to be powerless, Achilloplasty is used, followed by exercise therapy, massage, hardware rehabilitation methods.

Therapeutic gymnastics is included in all therapeutic courses practiced for clubfoot. In cases of mild deformities, along with massage and physiotherapy, it plays a decisive role in recovery. After gypsum or surgery, exercise therapy will be the key to a quick recovery of walking skills and fixing the correct fixation of the foot.

The first classes with children are conducted by a trained trainer. Due to the fact that gymnastics for young patients should become a daily activity, parents are taught the methods of exercise therapy. Exercises are selected taking into account the age of the children and change over time. The decision to move to the next complex of exercise therapy is made by an orthopedist-traumatologist.

The purpose of exercise is to train atonic muscles and relax contractures. In order for classes to be crowned with success, they are carried out 2-3 times a day. Since only a specialist can accurately determine the groups of spasmodic and relaxed muscles, he prescribes a complex of exercise therapy.

Gymnastics for newborns

The fulfillment by parents of all methods of exercise therapy for the first time is controlled by a specialist. Exercises for babies are combined with massage movements. They're in this case are in the nature of passive gymnastics, but the benefits are no less than from independent training of older children.

Main principles:

• the complex is performed after thermal procedures;
• take care not to cause pain;
• all movements should be smooth and soft;
• activities should be fun.

Shortened muscles and ligaments are stretched by rubbing, hypertonicity is removed by stroking, patting, light vibration. Atony is resisted by intense flexion-extension, rotation.

The duration of work with the feet is at least 5-7 minutes. Each technique is performed 10-12 times for one leg and the same number for the other. First, the baby is placed on the changing table on the back. To warm up, bend and unbend the legs alternately at the knees, raise the straight lines at an angle of 90 ° together and one at a time.

• Exercise 1

Starting position "on the stomach", the leg is bent at the knee (Fig. 3). With one hand, hold the shin, and with the palm of the other hand, gently press on the child's foot, directing it to the back. This exercise helps to stretch the calcaneal tendon and eliminate plantar flexion of the foot.

Rice. 3 Exercise 1

• Exercise 2

For the same purpose, an exercise is carried out in the position of the child on the back (Fig. 4). With one hand, press the child's shin against the surface of the table, fixing it at the ankles. Grab the other foot so that the palm rests on the sole. Gently bend the foot to the back while pressing on its outer edge. The combination of foot flexion with simultaneous acupressure at the transition point of the rear of the foot to the lower leg is effective.

Rice. 4 Exercise 2

• Exercise 3

It is prescribed to eliminate adduction of the forefoot.

Starting position "lying on your back" (Fig. 5). Fix the child's foot in the ankle joint. With the other hand, gently make straightening movements, gradually moving the forefoot outward.

Rice. 5 Exercise 3

• Exercise 4

Rotational movements of the foot outward along the longitudinal axis (Fig. 6). The outward rotational movements of the foot are carried out very carefully, gradually lowering the inner and raising the outer edge of the foot.

Rice. 6 Exercise 4

If the baby can walk

For children from 2 to 3 years old, a special exercise therapy course has been developed, aimed at general strengthening of muscles and ligaments, and improving blood circulation. It takes into account the increased abilities of the child and his desire to play. Exercises are performed at home without shoes. At the initial stage, do the exercises three times, bringing the number of repetitions to eight over time.

Rice. 7 Warm-up before gymnastics

As a warm-up (Fig. 7), walking options are used, each of which lasts 1-3 minutes:

• "ballet step" - with the sock retracted to the side and the heel pushed forward;
• "clown step" - walking from the position of the heels together, socks far to the sides while maintaining the direction of the feet;
• "on the heels" - with the breeding of socks to the sides;
• "on the inside of the foot";
• "soldier's step" - with high knees.

After warm-up:

• Exercise 1

For 20-40 seconds, the child should stand on the outer and inner sides of the feet. The first tests can be done with the support of parents.

• Exercise 2

The kid puts his feet in parallel and, without lifting his heels from the floor, raises his toes as high as possible (Fig. 8).

Rice. 8 Heel exercise

• Exercise 3

Starting position as in exercise 1. You should tighten your fingers without lifting your heels from the floor.

• Exercise 4

With each foot separately, it is necessary to lift a pebble, rope or flap from the floor.

• Exercise 5

Learning to walk backwards. From the “legs together” stand, put the right foot on the toe far behind. We transfer the weight of the body to the set aside leg, while lowering the foot to the heel. We repeat the movement with the left leg.

• Exercise 6

In the "sitting" position, the child alternately rotates the feet outward (Fig. 9)

Rice. 9 Foot rotation

• Exercise 7

Corrective posture "sitting between the heels" (Fig. 10). The child is on his knees, the feet are separated to the sides with toes apart. Slowly lower yourself and sit between your heels. Sitting in this way, the child can play for quite a long time.

Rice. 10 Landing "between the heels"

• Exercise 8

The child squats without lifting the heel off the floor (Fig. 11). Alternatively, you can practice cross-legged squats. To maintain balance, the first tests are done by holding the hands of the parents or the back of the chair.

Figure 11 Support Squat

• Exercise 9

For training and massage of the arch of the foot, they walk across a gymnastic stick with a diameter of up to 2 cm. The heels touch the floor.

• Exercise 10

Walking on a stick with arms outstretched to the side.

It is good to practice on the Swedish wall. Even simple climbing on the bars trains the legs well.

In bed in the morning and before going to bed in the “lying on their back” position, children can move and rotate their feet to the sides, opposite to the deformation.

Preschooler fixes the result

At the age of 5-6 years, children can start their daily activities with a light jog. In this case, attention should not be focused on speed, but on the correct setting of the legs. If clear progress has been made, and the child does not forget to monitor the position of the feet, the task can be complicated. To do this, the complex includes exercises for the shoulder girdle, which are performed on the go.

Older children will be happy to play with a ball, lift objects with their toes, sit “like a frog”, exercise with a stick, swim, ride a bicycle.

At this age, all the exercises described above are performed 20-40 times, and the total duration of classes is adjusted to 30-45 minutes. The following exercises can be added to the complex:

• Exercise 11

Wall squats. The leg rests on a full foot (Fig. 12).

Rice. 12 Wall Squats

• Exercise 12

Lowering the heels from the step (Fig. 13). These exercises are more convenient to do, holding on to a support located at chest level, or with the help of an adult.

Rice. Step 12

With clubfoot, the chances of a complete recovery of children are very high. Physiotherapy plays an important role in this process. In addition to the impact of physical activity, an exciting game and the desire to be beautiful will help in the treatment.

Clubfoot in children is one of the varieties of deformation of the musculoskeletal system. It is relatively common - out of 1000 children it is found in 1 baby.

Deformation of the feet, heels and joints of the lower extremities - those visual pathologies, without treatment of which there are restrictions on mobility when walking, disability. Why and what is the danger of delay in the elimination of such a disease?

Such a violation of the musculoskeletal system in a child, like clubfoot, requires mandatory long-term treatment under the supervision of a doctor.

Clubfoot classification

There are several classifications of clubfoot, but taking into account the latest data, it is customary to subdivide the pathology into 3 categories:

• the nature of the manifestation - typical and atypical;
• origin - congenital and acquired;
• the manifestation is one- or two-sided, that is, it is diagnosed on one or both feet.

There is also a division according to the severity of clubfoot, taking into account certain signs:

• Light. The ankle is mobile, there is no deformation of the bones. Can be treated at home.
• Average. There are deformations of bone, muscle tissues and ligaments, the ankle joint. Requires professional treatment in a hospital.
• Heavy. Congenital deformity of the musculoskeletal system on both feet.
• Very heavy. Dangerous disability of the child. Often resistant to surgery.

Reasons for the appearance of deformation

Orthopedists are able to determine the cause that provoked clubfoot in a child only in 20% of cases. More often these are congenital forms of pathology, but there are also those that have developed after the age of 2 years due to external factors.

The first group of causes of pathology:

• genetics;
• heredity;
• mistakes in the behavior of a pregnant woman;
• violations in the intrauterine formation and development of the fetus, when there is pressure on the walls of the uterus and umbilical cord on the feet;
• multiple pregnancy;
• oligohydramnios and uterine hypertonicity;
• severe toxicosis;
• the location of the fetus before childbirth does not correspond to the physiological;
• pathology of the development of muscle and nerve tissues, tendons, ligaments, joints, vascular system fetus;
• beriberi in pregnancy.

Fetal clubfoot is sometimes diagnosed while still in the womb.

If the child was born healthy, but in the first years of life or adolescence, he clubfoot, the cause of the problem may be as follows:

• the consequences of polio, rickets (we recommend reading:);
• incorrectly fused places after fractures;
• severe bruises, burns, injuries of the ankle area, including sprains, ruptures, damage to muscle tissue;
• consequences of dysplasia hip joints, valgus pathology (we recommend reading:);
• diseases of the spine - scoliosis;
• hypertonicity of the muscles of the lumbar;
• increased physical activity;
• development of neoplasms in the area of ​​the foot;
• parents' mistakes when choosing shoes, when it excessively squeezes children's feet when walking.

Symptoms of clubfoot in a child

The doctor is the first to see the prerequisites for the development of clubfoot in a child at a planned ultrasound examination at the 16th week of pregnancy.

After birth, visual changes in the foot or both feet of the crumbs, which make it possible to suspect a pathology in him, are expressed as follows:

• small and swollen foot, different from its size for the corresponding age;
• the difference in the length of the legs, if the pathology affected one foot;
• fingers tucked in or only the thumb;
• an arch on the inside of the foot and a deep longitudinal wrinkle on it;
• the heel is above the level of the toe, which looks down;
• the line of the outer surface of the foot is located significantly lower or higher than the inner;
• torsion of the ankle joints outward;
• low mobility of the lower leg and joint;
• adduction, or complete turn of the foot so that it is in the same plane as the knee.

For an adult child, the symptoms of pathology will be:

• wrong gait, when the child clubfoot, walks, as if raking in, wraps the foot;
• the location of the knees towards each other;
• trampling shoes;
• wrong prints of the baby's feet in the sand;
• deformity of the ankle joint in a relaxed state;
• corns, corns or bumps under the thumb due to the fact that the baby tucks it inside;
• baby complaints when walking.

Parents who constantly monitor the behavior of their child will be able to notice the deformation of the feet in a child. The external manifestation of clubfoot in children is in the photo above.

Treatment methods for clubfoot

Depending on the type and origin of pathological foot deformity in a child, orthopedists select methods of its treatment. To correct the pathological condition of the ankles help:

• tight bandages;
• applying plaster (the so-called plaster boot);
• therapeutic massages;
• physiotherapy;
• exercise therapy, gymnastics, corrective exercises;
• paraffin applications;
• baths with aromatic pine needles oil;
• wearing orthopedic shoes, braces, insoles;
• medical methods;
• surgery.

The positive effect of treating an illness in children is a combination of methods that a specialist determines. Sometimes he appoints their replacement if the previous scheme did not give the expected result.

Soft bandages and elastic orthopedic constructions

From the 3rd week of life of newborn babies diagnosed with clubfoot, treatment begins with the application of bandages from a bandage after a set of exercises and massage conducted by a doctor. With mild forms of foot deformities, this method shows a positive result.

Children's plaster boots are used as follows: the baby wears them for a week, then the doctor removes and kneads the ankles, again applies bandages for the next 7 days. The duration of wearing the structure is 1.5-2 months, followed by a break.

Ponseti Method

This method shows its effectiveness in almost 90% of cases of congenital forms of clubfoot in children. It is prescribed for babies aged 9 months - 2 years.

Treatment according to the Ponseti method has 3 stages:

• the imposition of plaster bandages, which change every week for 2 months;
• surgery to truncate the Achilles tendon;
• wearing braces.

Plastering the legs of a newborn using the Ponseti method

Physiotherapy

Physiotherapy helps to speed up the return of mobility to the ankle in conjunction with other methods. It normalizes the blood circulation of the affected areas and the condition of the muscle fibers. The doctor may prescribe for your child:

• electrophoresis - indicated in severe forms in order to reduce pain;
• magnetotherapy - to relax muscle tone after walking, improve blood flow and useful substances to tissues;
• electrical stimulation to strengthen ligaments and muscles;
• paraffin applications are prescribed for small children to gently fix the joint.

Use of drugs

One of the methods successfully practiced by orthopedists is the injection of Botox into the calf muscle. She relaxes, and the foot takes the correct position. Therapeutic effect after one injection, it lasts 6 months, then a repeat is required. The method is good for the treatment of clubfoot in the initial stages of manifestation.

Also, medications can be used in therapy to improve nerve impulse conduction. They are necessary if the cause of the disease is a nervous pathology.

The preparations often contain prozerin, strychnine and are taken for 2 weeks.

Choice of orthopedic shoes and insoles

Buying orthopedic shoes for a child involves contacting specialized stores. When choosing it, be guided by a number of features and characteristics:

• hard back;
• the height of the product reaches a third of the leg;
• lacing system or Velcro for fixing the legs;
• supinator.

If the doctor prescribed braces from the first months of a child's life, buy them in stores with orthopedic shoes. In the first 90 days, the child should wear them for days, with the exception of a bathing break. Subsequently, they are dressed either for daytime or main sleep and are completely removed closer to 3 years.

When a series of measures to treat the deformity has been successfully completed, it is important to consolidate the result. Special insoles will help in the prevention of relapses.

After braces, a child with clubfoot will need specialized orthopedic shoes

Surgical intervention

Severe forms of ankle deformity developed after injuries are partially or completely eliminated after surgical operations. Their goal is to make an incision in the Achilles tendon that holds the foot in the wrong position, or to replace it.

In some cases, one operation is not enough. Therefore, regular visits and observations by specialists of a child with clubfoot are a prerequisite effective treatment and restoring the normal state of the feet.

Correction of pathology at home

Mild forms of clubfoot in childhood fixable at home. These include therapeutic massage and special exercises that activate the work of the muscles and the ankle joint. When prescribing such events, check with the doctor about the possibility of exercising at home, and also agree on a schedule of visits to the clinic for follow-up examinations.

Gymnastics and corrective exercises

For babies, the first sessions of therapeutic exercises are carried out by a medical specialist. Then they are repeated by the parents at home.

The first sessions of exercise therapy for clubfoot should be carried out by a qualified medical professional

The main points that an adult must take into account:

• the duration of work with each leg of the baby is 5-7 minutes;
• monitoring the foot so that the baby does not turn it inward;
• the number of approaches in the exercise on each leg 10-12 times;
• warming up the muscles with a massage warm water in the bath;
• warm-up for flexion and extension at the knees.

In the complex of corrective exercises in the treatment of clubfoot, there are:

• foot rotation;
• walking on heels, squatting;
• flexion and extension of the feet;
• lifting both legs at a right angle;
• drawings with a pencil or a stick sandwiched between the fingers of the lower limb;
• pulling up the towel with your toes.

Performing a massage

After prescribing a massage for a child, parents spend it with a specialist for a month and adopt the tactics of the procedure (we recommend reading:). Kinds therapeutic massage are selected taking into account the condition of the patient's muscles: with a tone they are relaxed, with flabbiness they are toned (we recommend reading:).

The masseur performs the following types of movements:

• stroking;
• light and moderate pressure;
• tingling;
• light vibration.

Possible Complications

In spite of clear signs foot deformities in a baby, sometimes there is negligence and inattention on the part of adults who do not turn to a specialist in time or do not follow his instructions. Therefore, the child is faced with complications:

• starts walking later
• often injures the feet (dislocations, sprains);
• muscle atrophy develops;
• there is a roughening of the skin on the outside of the foot;
• flat feet develop (more in the article:);
• concerned about diseases of the knee joints;
• the axes of the legs are bent;
• there is a deformation of the spinal column;
• stagnant processes are formed in the veins;
• possible disability and movement on crutches due to lack of treatment at an early age.

The video below shows the comments of a specialist and a number of massage exercises for this pathology.