Orthopedics. Senseless and merciless

2024 Author: Seth Attwood | [email protected]. Last modified: 2023-12-16 15:55

I warn you right away that my opinion is unprofessional, incompetent, emotional and, apparently, unpopular in Russia. I'm just Masha, who can google, analyze information and observe what kind of shoes the children of foreigners wear. And I want to tell you that, in addition to the national school of orthopedics, there are some other points of view and they are very common throughout the civilized world.

You can swear, you can disagree, you can consider me a fool, you can breathe a sigh of relief, you can thank, I still am not responsible for my words)

Every orthopedist in Varina's life said: “flat-valgus placement of the feet. Correct footwear, massage, exercise therapy”. Especially sophisticated ones recommended paraffin wax, electrical stimulation, stand on peas, cut off the soles of the sandals downhill.

Of course, I bought the supposedly correct orthopedic shoes with a high stiff heel, with an instep support, heels and other crap. We did a massage every six months. I have not seen any improvement.

As usual, the truth was born out of doubt

Varina's last right sandals ran out when we were about to go abroad. I did not have time to order ortho shoes in Russia and left on our long journey with the hope of buying shoes there. “There is probably more choice of good shoes abroad,” I thought.

I came to a shopping center in Hong Kong and was like: "Well, why, where do you have normal children's shoes here?" And there were no correct shoes either in the first mall, or in the second, or in the third. I found only the Dr Kong store, but these shoes did not fully meet the precepts of Russian orthopedics.

Meanwhile, 70% of Hong Kong children were driven in crocs, another 20% in New Balance, the rest in unidentified Chinese shoes.

In Bali, I also did not see a single child in preventive or orthopedic shoes. Not a local, not a foreign tourist.

There is such a cool joke, which is actually not a joke at all: abroad, children from Russia can be recognized by their shoes. Indeed, if a child is walking towards him in socks and high sandals with a back, instep support and other conditions, then this is a Russian-speaking kid. In Hong Kong, Indonesia, Singapore and Thailand, all foreign children wear any kind of shoe.

Again, if you order clothes in European or American online stores, you probably noticed that the entire range of their shoes completely contradicts the logic of domestic orthopedics.

And here I finally bring myself to an explanation of my position. There are two schools of orthopedics, roughly speaking, ours and not ours. True, if you read the Medservice forum, you can conclude that some orthopedists are finally emerging from the gloom and leaning towards Western orthopedic thought. Which I am trying to convey in this post.

Overdiagnostics

Why would a podiatrist treat a non-existent problem? Because he has to support a huge industry, which includes manufacturers and sellers of supposedly “correct” shoes and insoles, massage therapists. Because in the event that flat feet or valgus does not go away with age, no one can say that he did nothing. Because moms are often not satisfied with the recommendation “do nothing - everything will pass by itself”.

Most children have no problems with legs (and below I will tell you that neither flat feet, nor valgus, nor clubfoot is something that needs to be corrected), and the tradition of taking a child to an orthopedist until the age of 3 can be abolished.

Okay, not all children are equally healthy. But if the child really has something, then the doctor does not write “the right shoes, massage” on the card, but makes a real therapeutic attack, gives a referral for X-rays, examinations, a prescription for making shoes, and so on. If your child was not sent along this route, then you can relax: everything is normal with him.

When an orthopedist tells some abstract mother (in fact, me) that the child has valgus, her world collapses, she comes home and starts monitoring the Internet for this terrible diagnosis.

There are a lot of articles on the Internet written in beautiful and incomprehensible semi-medical language, which explains in detail why children should wear orthopedic (not even prophylactic) shoes from birth. (For instance). But for some reason, all these articles are posted on the websites of stores of orthopedic shoes, insoles and other priblud. Even I, a person without medical education, am puzzled by the following words:

In the absence of rational footwear - with a rigid sole and a fold line at the level of the metatarsophalangeal joint, fixation of the talocalcaneal joint due to the rigid hind part with lateral tibia and laying out the longitudinal-transverse arch of the foot using an instep support - flat feet are formed, and subsequently - planovalgus deformity stop.

It turns out that flat feet occurs when the parent has not bought orthopedic shoes for the child.

To begin with, orthopedic shoes are not orthopedic shoes at all:) For some reason, many parents believe (not without the marketing efforts of children's shoe sellers) that a) any shoes that look orthopedic are orthopedic, b) orthopedic shoes are useful.

Although, by the way, ortho shoes are medical shoes, insoles for which are made according to an individual impression or scan of the foot and the purpose of wearing which is to treat various deviations from the normal development of the foot.

Everything that is massively sewn and sold in the store is ordinary footwear that wants to look like orthopedic. For some reason, it is called preventive. These shoes are supposedly a guarantee that the child who wears them will not have flat feet or valgus.

And these shoes seem to work, because by adulthood, children really become okay with their feet. Although this does not happen because of the shoes, but in spite of them. Contrary to the stiff, stiff sole, which prevents the foot from bending. Contrary to the anatomically incorrectly positioned instep support. Contrary to the shackle of the leg. Because a normal active child will in any case overcome parental care of their feet.

The situation with ortho shoes is as if wheelchairs or crutches came into vogue and all healthy people would buy themselves something that looks like a wheelchair or crutches.

People in our country like to buy orthopedic shoes for children just like that, just in case. Ortho shoes for the first step, ortho walking shoes, ortho shoes for home. It's good if this pseudo-orthopedic shoe is just a marketing scam.

Our first orthopedist by the name of Gabisoniya (St. Petersburg, polyclinic No. 112) looked at Varya at the age of 1. He really looked without getting up from his chair, without touching the child with his finger. Varya then did not walk on her own, only by the hand.

With his golden eye, he diagnosed flat-valgus feet (and I do not dispute this fact) and prescribed sandals with a high top, an instep support, a heel. Wear at home all day. (The same orthopedist found dysplasia in my girlfriend's daughter, prescribed a plaster cast and some kind of spacers. At the Research Institute of Orthopedics and Traumatology, doctors twisted their fingers at their temples on this matter and sent my friends home).

Orthopedist Gabisonia showed me an example of “correct” shoes (it seems to me that something like this is given out in hell):

The whole family goes barefoot at home. And the news that Varya needs to walk in uncomfortable sandals all day upset me. It was also not clear to me why a child, who had just gotten to his feet and was still uncertain about taking his first steps, needed to be shackled into shoes. I still don't understand this logic.

The experiment with wearing “orthopedic” shoes at home lasted a couple of days. Varya was uncomfortable, I decided not to torture the child. Shoes were put on only where they were supposed to be put on - on the street.

Flat feet

Well, everything is clear here. 100% of children have physiological flat feet. The feet of a child under 3 years old seem to be flat, because the cavity of the arch is filled with a soft fatty "pad". This form of flat feet does not require treatment, since the arch of the foot, with proper development, normalizes on its own by 5-6 years of a child's life.

Some people believe that instep support shoes are a good prevention of flat feet. This is a lie and a provocation from shoe sellers, more on that below.

Plane-valgus installation of the feet

I will dwell in more detail on the flat-valgus installation of the foot, because that is exactly what Varya says in her card. I deliberately do not call it a diagnosis, because it is not a diagnosis at all, but simply a statement of fact. It's like an optometrist would write "a child has brown eyes."

If the orthopedist writes in the card of a child who is 1 (2, 3, 4 years old) “flat-valgus feet”, then he is Captain Obvious. Because up to 5 years of age, flat-valgus feet are a normal variant and do not require treatment or correction. For a child who leads an active lifestyle, everything will correct itself. If at the age of 5 it has not yet been corrected, then then you need to do something, attack orthopedists, tear your hair, gouge out your eyes.

Valgus (and varus) occurs when some muscles are underdeveloped. In Varino's case, this is the inner part of the calf. Will shoes fix this situation? Have any of your friends pumped up any muscle simply because they were wearing some special clothes or shoes? Only active classes and physical training, only hardcore!

What to do?

Buy shoes that won't cripple. (More on that below).

Let the child run, jump, crawl on climbing frames, and climb stairs.

Jump - on mats, on a trampoline, on a bed.

Climb the Swedish wall, stand on the bar.

Ride a bicycle.

From a certain age, you can send your child to choreography or dancing. Or swimming. Or everywhere.

Please don't waste money on “orthopedic” or “preventative” shoes. Use the money saved to buy a wall bars, mat or trampoline.

Buy special massage mats with irregularities and spread them at home in your child's favorite hangout places.

Allow your child to walk barefoot on grass, sand, stones - on any unevenness.

Collect stones and pebbles outside and take baths with walking on these stones (you can add sea salt to the water).

Contrast foot shower.

Massage for very little ones.

Meanwhile, paraffin wax and electrical stimulation have not been proven to be effective.

What kind of shoes should you buy?

Just comfortable, beautiful shoes made of natural materials with a flat insole and a flexible sole, without an instep support.

What specific brands can I recommend? Based on this opinion, I will name Little blue lamb, Jack & Lily, Pediped, See Kai Run. I'll add Birkenstock and Ecco on my own. Now I bought Vara Little blue lamb sandals and they are very cool:

Without instep support

Everyday children's shoes should not have an instep support. For some reason, everyone thinks that the instep support is such a thing that will “push” the foot in the right place and there will be no flat feet. Bullshield! An instep support is a piece that absorbs during physical activity.

If a child has been prescribed shoes or insoles with an instep support, then it must necessarily be an insole / shoes made to order from a cast or photograph. Because the instep support must be positioned correctly. Karochi, for a specific child - a specific instep support. But! Most children do not need an instep support at all.

Almost all domestic children's shoes already have an instep support. In most cases, however, this is only his appearance and dummy. In fact, it squeezes through after a week, does not cushion, and is a marketing bait for ortho shoe lovers.

An instep support is needed when the foot cannot cope with shock absorption on its own. Then the instep support helps to relieve the leg. So, the instep support is necessary in sports shoes for children and adults. At the same time, in children's everyday shoes, a really acting instep support can harm the fact that:

1. the area of the foot, where the shock-absorbing arch should form, does not exercise and does not develop properly (since the instep support is in the shoe),
2. when buying shoes for growth, the instep support is not in the right place, and instead of cushioning, it interferes with the development of the longitudinal arches of the foot.

No hard soles the sole should bend.

Shoes must be made from natural materials (crocs are an exception to the ears).

Wide toeso that your fingers are not squeezed.

The heel should be stable, securely fixing the heel

Ideally, the shoes should be as if they are not there and the child is walking barefoot.

So, the summary of this huge post

• There are two diametrically opposite directions in orthopedics. Whom to believe is up to you.
• It is not necessary to "treat" with shoes and wear instep supports, this can suspend the process of forming arches and flat feet will remain for life.
• Any correction should be individual. A wrong or unprofessional fix can lead to even bigger problems. Here is a review of a mother who treated a child with shoes and instep supports.
• Instep supports in the form of soft "pillows" in ordinary shoes are not effective, because they are too soft (therefore, they cannot support anything).
• Most of the "foot problems" noticed by parents are part of the natural development of a child's foot, which ends by age 6.
• The “improvements” noticed by the parents are not the result of wearing “the right shoes”, but just the natural development of the children's foot.
• The need for obligatory instep supports in children's shoes (unless they are recommended by an orthopedic doctor individually) is nothing more than a myth unconfirmed by official medicine and is used by shoe manufacturers to increase shoe sales.

PS. Varyula is 2 years old, and her hallux valgus has decreased significantly. I attribute this to the beginning of an active period of running and jumping, walking on uneven surfaces and giving up the “right” shoes.

Masha Buzanova