Massage and exercise therapy for varus deformity. Treatment and prevention of curvature of the legs in a child Massage with x-shaped legs

Normally, if the child's legs are straightened, the knee joints and inner ankles should converge. In the presence of an X-shaped curvature, called hallux valgus by doctors, the crooked legs, touching at the knees, diverge downwards.

Many parents consider this deformity to be hereditary and often start the problem, making it much more difficult to correct it in the future.

However, contrary to popular belief, crooked legs with an X-shaped position are an acquired deformity, not a congenital one. This deformity is usually a sign of rickets. In this disease, the growth and formation of bone tissue is disrupted.

Due to the lack of calcium and its fixation in the bones, which is associated with vitamin D3 deficiency, rickets leads to softening of the bones and weakening of the muscles, which causes curvature and deformity of the spine, chest, skull, and legs. The baby's legs undergo the greatest changes, because they have a big load when the baby begins to stand and walk. It is during this period that the curvature becomes noticeable.

Since bones and muscles are weakened in toddlers with X-shaped crooked legs, in overweight children, the curvature may increase due to excess weight - it creates an additional load. Limit the use of sweet and starchy foods!

The haste of parents who want to quickly see the first steps of their fidget can also aggravate the deformation. Starting to put the baby on his feet before he himself is ready for this, or often putting him in a walker, fathers and mothers heavily load the fragile musculoskeletal system. Do not rush, give the child the opportunity to gather strength.

Crooked legs: to treat or not?

Despite the seeming harmlessness, the X-shaped curvature of the legs is not just a small cosmetic defect. If left untreated, it can cause further problems.

So, with rickets, the baby often develops flat-valgus deformity of the feet, since the muscles of the legs weaken and cannot hold their normal shape. In this case, the X-shaped curvature can significantly worsen the situation. Due to the incorrect position of the legs, there is an additional load on the knee and ankle joints, which over time can lead to pain in the legs (usually they appear at senior school age), as well as curvature of the spine.

Therefore, like any disease, hallux valgus requires treatment.

Fix crooked legs: the sooner the better

It is almost impossible to get rid of this problem by conservative methods in adulthood. An operation will be required. Fortunately, everything is easier with babies, because the child grows and his bones grow.

In order to align the X-shaped crooked legs, you need to eliminate their main enemy - rickets. Therefore, first of all, babies are prescribed procedures to normalize the exchange of calcium and phosphorus in the body. Usually, up to 2.5 years, treatment is carried out with vitamin D3.

If by this age the crooked legs do not acquire a normal shape, special plaster bandages are used. They stretch the lateral external ligaments of the knee joints, which leads to a decrease in the pressure of the femur on the tibia (these bones form the knee joint). As the pressure decreases, the bones begin to grow faster, and the once crooked legs gradually straighten out. This happens as the child grows, so the treatment requires a lot of patience - the process usually takes 1.5-2 years.

Additionally, babies are prescribed procedures that strengthen muscles: massage, therapeutic exercises, physiotherapy.

In addition, children must walk in rigid orthopedic shoes that will securely fix the foot in the correct position.

Fix Crooked Legs: Let's Warm Up

Therapeutic massage, if performed by a specialist, is a very effective method of correcting the shape of crooked legs. It is carried out at least 4 times a year in courses.

In addition to foot massage, each procedure also includes a massage of the back and buttocks of the baby. It is important to strengthen the muscles of the entire musculoskeletal system!

In addition (but not in return), you can do a light home massage yourself. Laying the child on the back, start stroking with the thumb, moving along the inner edge of the foot and lower leg to the knee. Then, in the same direction, perform gentle kneading and light pats.

How to fix crooked legs: get on the exercises!

Equally important is physiotherapy exercises (LFK). It is useful for babies with X-shaped crooked legs to perform exercises with a load on the outer edge of the foot.

And to make it interesting for the baby to do, turn the exercise into a game.

Exercise "Rope walker". Show your child how deftly a circus acrobat walks along a thin rope. Suggest trying to walk in the same way on a plank or path made of bright flat figures on the floor. This exercise will help you learn to put your feet close to each other.

Exercise "Bear clubfoot". Of course, the clumsy gait of a bear is not ideal, but it is very well suited for trampling on the outer sides of the feet. Besides, she's pretty funny. Therefore, the baby will be happy to roll from foot to foot. Do not forget that real bears go barefoot.

Exercise "Visiting the Turkish Sultan." When a baby watches a cartoon about Aladdin or listens to an oriental fairy tale, invite him to turn into a real sultan himself by sitting down in Turkish: connecting his feet and spreading his knees to the sides. Stretch the right muscles!

A good load for the muscles will also provide cycling, wall bars, swimming.

But it’s not worth standing still for a long time, especially with legs wide apart, sitting with your legs turned outward.

How to fix crooked legs: physiotherapy

If, in addition to the X-shaped crooked legs, the baby has flat-valgus deformity of the feet (very often these problems “go in pairs”), in addition to massage and physiotherapy exercises to train weak muscles, the doctor may prescribe a course of electrical stimulation. What is the procedure?

Electrical stimulation occurs with the help of current pulses of various duration, which causes muscle contractions, improves blood circulation in them, and stimulates their motor activity. During pauses, the muscles relax. The procedure is safe, but it cannot be performed if the baby has a temperature, an acute infectious or inflammatory disease, the skin is irritated or injured at the site of the electrodes.

Text: Yulia Shlykova, consultant - Vyacheslav Kolesov, pediatric orthopedist, Ph.D.

X-shaped legs or wheeled legs, although not as common, can be seen in some children under the age of 2-3 years. In any case, it is clear that this is not the norm. Some of the parents take this calmly, thinking that this is temporary and will fix itself, someone immediately sounds the alarm.

To understand how serious the problem is, you need to understand its nature and causes of occurrence, as well as find out what consequences it is fraught with. After that, it is already possible to decide whether it is worth exposing the child to any procedures and additional loads, or, indeed, there is nothing wrong with crooked legs and over time they will straighten naturally.

This is the scientific name for the deformation of the knee joint, as a result of which the legs of a child of 2 years old do not become straight and even, but acquire the shape of the letter X. Any mother can independently diagnose such a pathology. It is enough to put the baby straight and connecting the heels.

If there are no deviations, then the legs will touch each other at three points: at the knees, mid-calf and ankles. With hallux valgus, the child will not be able to connect the ankles - there will be a gap of 4-5 cm (or even more) between them, while the knees will be tightly closed. If the baby still manages to put the ankles together, then his knees will go behind each other.

Why does this disease appear?

There may be several reasons:

• rickets;
• congenital deformity of the pelvic ring;
• flat feet;
• past trauma;
• infections;
• inflammatory process;
• too early attempts of the baby to move in an upright position.

Rickets is the most common cause of curvature of the legs (and any) in children of the first years of life. It is caused by a lack of vitamin D in the body, so do not think that this disease is a thing of the past. Today it is just as relevant, especially in the autumn-winter period.

The fact is that we get vitamin D directly from sunlight. And if a child is born in autumn or winter, it is not surprising that he is deprived of the most valuable substance. With a lack of vitamin D, the bones become soft and the knee joints are deformed.

Children who tend to get up and walk on their own too early are at risk of forming x-shaped legs. In this case, the rule “the sooner the better” is inappropriate. There is a time for everything, and when the baby starts walking too early (even in a walker), the fragile legs become deformed. If at the same time the child is overweight, the problem is exacerbated.

It is widely believed that curvature of the legs is a purely hereditary disease and therefore not treatable. Yes, with a hereditary predisposition, it is very difficult to correct the curvature of the legs and most often it is possible only by surgery. But such a cause is rare, and most cases still do not have a hereditary factor.

The various diseases listed in the list are also individual and single. These are the least likely causes of curvature of the legs in children.

Consequences

Not all parents are wondering what complications the x-shaped legs of a child are fraught with. And if it is also a boy, many believe that, unlike a girl, beauty is not necessary for him. However, if you look, the matter turns out to be much more serious than an unaesthetic appearance.

With hallux valgus, the load is incorrectly distributed to all joints of the lower extremities. This leads to the occurrence of flat-valgus deformity of the feet, when the correct setting of the foot is also violated. In the future - curvature of the spine and other diseases of the musculoskeletal system.

Moreover, pain in the legs will make itself felt not in old age, but much earlier - already in senior school age. Therefore, the question of whether any action should be taken becomes irrelevant. We need it, and as soon as possible!

Early age is a definite advantage. The younger the child, the easier it will be to correct the situation. While the body is only being formed, it is easier to help it.

An adult person has to rely only on surgical intervention. Surgery is rarely prescribed for children, in those extreme cases when complex treatment does not work and when the child has reached the age of 7 years.

How to straighten your legs

You can fix the situation, but you will have to make an effort. The timing of treatment plays an important role. As we have said, if you deal with the problem before 3 years, when the child’s bones are just being formed, the chances of success are greatest. 7 years is the last age when you can still bring the legs back to normal by conservative methods.

Treatment for hallux valgus should be comprehensive and versatile. Parents first of all need to contact a doctor who will give a referral for an examination. Based on the results of the tests, the doctor prescribes a solution of vitamin D (water or oil). When the disease is already developing, an increased dosage is prescribed.

In addition to the drug taken orally, plaster casts on the knee joints are used up to 2.5-3 years. The essence of this method is to reduce the load on the bones, which will grow faster, and gradually the legs will align. In the case of using plaster casts, you should tune in to the duration of treatment - at least 1.5-2 years.

A good aid is orthopedic shoes. It clearly fixes the foot and ankle joint, thus ensuring the correct position of the foot.

An appointment for massage and physiotherapy is necessarily made, recommendations are given on special physical exercises and diet, as well as advice on what parents can additionally do at home. After all, in order to fight the disease, you even have to change your lifestyle.

Massotherapy

It is recommended to take it for 4 or more courses a year and trust only a specialist, since we are talking about treatment, not prevention. However, there are techniques that parents can learn on their own and do in addition to therapeutic massage.

The main task is to strengthen the muscles of the thighs and lower legs from the inside, and relax the muscles from the outside. In addition, you also need to work on the muscles of the back, lower back and buttocks.

The first sessions should last 15-20 minutes. Gradually, the duration can be increased to 30 minutes, but no more.

The main technique is stroking:

• lower back - from the spine to the sides and down;
• buttocks - in a circular motion;
• the back of the thighs - from the popliteal fossa outward and upward;
• back surface of the lower leg - from the ankle joint to the popliteal fossa;
• patella - round;
• anterior lateral surface of the lower leg - from the feet to the knees;
• stop - on the back side from the fingers to the ankle joint.

Light pats, kneading, rubbing, tingling are also allowed.

Gymnastics

It is desirable to perform exercises after the massage, but if you return to them several times during the day, the benefits will be obvious. Exercises will help to correct the irregular shape of the child's legs, in which the load on the outer edge of the foot increases, and on the knee and ankle joints it decreases.

So that the baby does not refuse therapeutic exercises, you can interest him by turning classes into a game:

1. "Turkish Sultan" This is an ordinary “lotus” pose or its simplified version - spreading the knees and connecting the feet.
2. "Crow's feet". Simultaneous or alternate flexion and extension of the ankle joints.
3. "A bike". A well-known exercise when, lying on your back, you need to rotate your legs, simulating cycling.
4. "Clumsy Bear". Walk, waddling, with a preponderance on the outer side of the feet.
5. "Monkey". With the help of the toes, you need to grab some objects. If you perform the exercise while sitting on the floor, you can do grabs with two feet.
6. "Heron". Tiptoe walking.
7. "Circus Acrobat" You need to walk straight along a narrow path, a curb or just a drawn line. The main thing is that at the same time the child puts his feet as close to each other as possible.
8. "Horse". If the child does not have a toy horse on which he can ride and swing, you can imitate riding, for example, on an adult's knee.

Even if you devote a little time to the exercises, in combination with other types of treatment, they will give a good result. And the game moment will give the child a lot of pleasure and make you want to return to fun activities again and again.

Physiotherapy

Electrical stimulation is prescribed when valgus deformity of the knee joints is complicated by planovalgus deformity of the feet. Electrical impulses of different durations stimulate the motor activity of the muscles and improve blood circulation in the lower extremities. Muscle contraction alternates with small pauses during which the muscles relax.

This type of treatment is contraindicated if the child has open wounds or colds.

Proper nutrition

It should be noted that the child's diet should be given great attention in any case, since nutrition is the basis of health. If the curvature of the legs is already observed, then it is necessary to draw up a special diet.

The most important elements for proper bone formation are calcium and phosphorus. It is their lack that leads to deformation of bones and joints.

Calcium is found in all natural dairy products, eggs and fish. Phosphorus - in meat food, milk, nuts and legumes. And vitamin D, about which we have already written so much above, just helps to assimilate these two beneficial substances.

It is necessary to ensure that the baby's diet is enriched with calcium and phosphorus. All of the listed products should be present in the children's menu every day. And so that the child does not get bored with monotonous food, you can make many variations. For example, add honey, berries or dried fruits to kefir and cottage cheese, and for hot fish and meat dishes, take turns using different cooking methods (stewing, baking, steaming, boiling).

Prevention

Experts say that up to 2 years, a slight curvature of the legs is observed in many children and is not a pathology. However, even if the child's legs are even, it's a good idea to think about prevention, which at the same time will strengthen the whole body.

In addition to a balanced diet, it is necessary to ensure that the weight of the baby is normal. Extra pounds can cause not only problems with the musculoskeletal system, but also have a bad effect on overall development.

When a child begins to walk, you need to take care of good shoes. The heel should be high and sufficiently rigid, fixing the foot, a slight elevation is required on the insole to prevent flat feet.

It will not be useful for a child to stand motionless for a long time, especially with legs wide apart. But to move actively - on the contrary. Wall bars, running, jumping, cycling and especially swimming are the only sports that harmoniously develop all muscle groups and normalize the work of all internal organs.

It is better to beware of skates, roller skates and jumping on trampolines and other soft surfaces. Such types of physical activity are not very useful. But you can walk barefoot on grass, pebbles, a massage mat and any other uneven surface as much as you like.

And of course, sunbathing is good for saturating the body with vitamin D. Starting from 15 minutes a day and gradually increasing the time, avoiding drafts and overheating, in the spring you can accustom your child to the sun. Such prevention will be not only useful for physiology, but also guarantees the baby a lot of positive emotions.

The child began to walk. How much joy this event brings to the baby and his loved ones. But pay attention to his gait: when moving, he spreads his legs wide, and his feet and knees are turned outward. This position of the legs helps him maintain an unstable balance for the time being. It should be remembered that the outward knee deviation characteristic of young children can persist until the age of 3 years, after which it turns into a slight inward deviation, which is observed up to 4-5 years.

This position of the legs is considered the norm, but it is better to immediately, without waiting for a serious diagnosis, begin to strengthen the muscles of the legs and develop proper walking skills. And for this you need to do active prevention of curvature of the legs.

Valgus (x-shaped) deformity of the legs

They speak of hallux valgus when, with straightened and tightly compressed knees, the distance between the legs exceeds 4–5 cm.

But this defect, contrary to popular belief, is not a congenital defect or a negative hereditary quality. This is an acquired defect that appears a few months after the day the child began to walk. The curvature of the legs is explained very simply: an excessive load is placed on the fragile bones and muscular apparatus of the child, and the rapid growth of the baby only exacerbates this situation. In general, rickets suffered in early infancy is considered the main cause of limb curvature, especially those forms that, due to unclear symptoms, could not be diagnosed and treated in a timely manner. In advanced cases, the bones of the lower leg are so deformed that the legs become convex inward. More mild and rare causes include complex foot defects, injuries and diseases of the knee joints, as well as dysplasia and congenital dislocation of the femur.

The extra weight of the child adversely affects the formation of the legs, however, stocky babies are less prone to this pathology than children with asthenic constitution. Mostly girls suffer from curvature of the legs, which is directly related to the structural features of their pelvis.

With valgus curvature of the legs, negative changes occur in the knee and femoral joints. For example, the condyles of the femur and knee develop unevenly (the inner ones grow faster than the outer ones), which causes the joint space to change accordingly. It becomes narrower on the outside and wider on the inside. In addition, the ligaments that strengthen the joint on the inside are stretched, due to which the knee joint loses stability. And if you look from the side at a child with a similar defect, you can find the bending of the knee joints inward.

Together with the knee joint, the feet are also deformed, which acquire a stable flat-valgus installation, in which the heels deviate outward, resulting in the development of flat feet. In advanced cases, even the child's gait suffers: he walks awkwardly, uncertainly, complains of pain in his legs and gets tired quickly. In the event that one of the legs is curved more than the other, scoliosis develops - a curvature of the spine.

Treatment of valgus curvature of the legs is long and difficult, it requires perseverance and close attention to the child from parents. First of all, you need to try to convince the baby of the need for all therapeutic measures that need to be given the form of a game. Only then will he develop a stable habit for them.

First of all, a child with hallux valgus is not recommended to stand still for a long time, legs wide apart. This will increase the deviation of the knee joints inward and the spread of the feet outward. But if the legs are closed, the entire weight of the body will fall on the middle of the knee and the outer side of the foot, the purpose of which is to bear such a load.

A sick child should from time to time rest from walking and refrain from outdoor games. In addition, the baby needs to pick up exercises and games that would stop the effect of the gravity of his body on the ankle and knee joints and at the same time contribute to their strengthening and development.

Leg exercises should be done daily, increasing the load every day. General strengthening exercises for other muscle groups are best performed either sitting or in a Turkish position. It is useful for such children to practice on various gymnastic apparatus - stairs, trapeze and wall bars. Good results are given by cycling and swimming. In addition, it is better for obese children to get rid of excess weight: this will reduce the load on the fragile musculoskeletal apparatus of the feet and knees.

During walks, you need to wear special orthopedic shoes with corrective insoles or outward-sloping heels. However, we repeat, the question of wearing it can only be decided by an orthopedic surgeon. Ordinary shoes should be as comfortable as possible, new and with hard backs. If there is no urgent need to constantly wear orthopedic shoes, you can walk barefoot at home so that the foot muscles are constantly trained. In summer, you need to walk barefoot on grass, pebbles or sand, giving your toes and feet freedom of movement.

The normal functions of the ankle and knee joints depend on the condition of the surrounding muscles. With the help of massage and special exercises, stretched and weakened muscles can be strengthened, and overly tense muscles can be relaxed. Therapeutic massage should be carried out in courses, each of which includes 12-20 procedures with breaks of 2 to 4 weeks. Carry out the procedures every other day or every day, gradually increasing their intensity towards the middle of the course. When performing massage techniques, sudden movements should be avoided, since the child should have a pleasant impression from the massage.

For all techniques, the starting position: the child lies on his stomach with a roller placed under the shin.

1. Back massage: stroking, rubbing with fingertips, comb sawing, kneading and stroking again. The latter should be carried out on the massaged area several times after the end of each more dynamic technique. In addition, at the beginning and at the end of the session, do a general stroking of the body.

2. Massage of the lumbosacral region: stroking, vigorous rubbing and kneading (shifting or pressing), as well as stroking from the middle of the back down and to the sides.

3. Massage of the buttocks: circular or X-shaped stroking, active rubbing with the back of the fingers, kneading with one or both hands and shock techniques (patting, tapping and chopping). You also need to finish the massage with stroking.

4. Back of the thighs: stroking from the popliteal fossa outward and upward, vigorous rubbing, kneading with both hands, percussion techniques (chopping, patting with several fingers) and stroking again.

5. Back surfaces of the legs: stroking from the Achilles tendon to the popliteal fossa, differentiated rubbing (rub the outer surface of the lower leg gently, the inner surface intensively), kneading all muscle groups with one or both hands. On the inner surface of the lower leg - shock techniques, on the outer - vibration in combination with stretching. End the massage also with stroking.

6. In the area of ​​the knee joint - corrective techniques: stroking the lateral surface of the joint, rubbing and gentle pressure on the inner surfaces. In this case, with one hand, you need to press on the inner condyle, and with the other, hold the lower third of the lower leg, trying to pull it to an imaginary midline (Fig. 76).

Rice. 76.

Corrective approach. I stage

7. Achilles tendon: start the massage with stroking, then rub with forceps.

8. Front surfaces of the thighs: starting position - the child lies on his back, under his knees he has a roller. Start the massage with stroking, then gently knead and again stroking in the direction from the knee up and out.

9. Anterior lateral surfaces of the legs: stroking from the foot to the knee, light rubbing and final stroking.

10. Correction of the knee joint: circular stroking of the knee, rubbing its lateral surfaces, pressing on the internal condyle and bringing the lower leg (Fig. 77).

Corrective approach. II stage

11. Feet: stroking the back surfaces in the direction from the fingers to the ankle joints, transverse or rake-like rubbing. Around the ankles - stroking and rubbing, carried out more intensively along the inner edges of the feet. Finish the massage with stroking.

After completing the procedure, you need to perform the following exercises.

1. Alternate extension and flexion of the ankle joints. If the child cannot do this exercise on his own, he needs to be helped by bending the foot with one hand and fixing his lower leg with the other.

2. Alternate rotation of the feet in both directions. Help the child if needed. It must be remembered that rotations should be very soft and painless.

3. Capturing the toy with the feet. Invite your child to take and hold with their feet a toy that is easy to grab (a ball, a skittle, etc.).

4. Therapeutic exercises should be done 2-3 times a day. The first time immediately after the massage, the second - along with a daily tonic complex. Some exercises for the baby should become a habit, such as Turkish sitting. In this position, the baby should be planted as often as possible.

5. Rise from the Turkish position. The sitting baby should be offered to stand up, relying only on the outer surfaces of the feet. Help the child by supporting him by the arms. When repeating the exercise, you need to change the position of the legs so that the other leg is on top.

6. Squats in the breeding of the knees to the sides. Supporting the baby by the arms or under the armpits, teach him to squat, spreading his knees wide. At the same time, you can squat, carefully watching the position of the feet: at the same time, they should rest on the floor completely and stand parallel.

7. Rise on socks. Invite the baby to stand on tiptoe and stretch up with his whole body, and then lower himself to his full feet.

8. Walking on the outside of the feet. Ask the child to walk, leaning only on the outer sides of the feet, while saying:

“A bear with a clubfoot walks through the forest,

Collects cones, sings a song.

10. Walking on the path. Teach your child to stand and walk with their feet as close together as possible. To do this, you can use walking on a narrow (10-15 cm) board, a strip on a carpet or a path drawn with chalk. Watch for the correct setting of the feet during the walk, drive the baby along the log available at each playground, the curb stone that encloses the sidewalk, etc.

All of the above exercises can be successfully performed in the water during daily bathing (except the last two). Warm water in itself helps to relax tense muscles, thereby making it easier for the child to move. It is useful to lay a corrugated rug on the bathtub floor and let the child walk on it and jump up and down.

Varus (o-shaped) deformity of the legs

Varus (O-shaped) deformity of the legs is easy to notice if you put the child on the floor and ask him to firmly press one foot to the other. At the same time, the baby's knees deviate outward, and between them a gap is clearly visible, the size of which determines the degree of deformation.

Rickets is considered the main cause of varus deformity of the legs. However, a similar defect can also be observed in practically healthy children who began to stand and walk too early. In this case, the weight of the body was still too much load for the fragile and pliable bones of the legs. O-shaped curvature of the legs can also occur in obese babies with overweight.

To prevent rickets and its complications, you need to often walk with your child in the fresh air, do gymnastics and massage. It is impossible to put the baby on fragile legs ahead of time, it is better to wait until he does it himself. You should not leave the child in a crib or playpen for a long time, where his mobility is limited, and then the baby, deprived of the opportunity to crawl, stands for a long time. Crawling on all fours is a great opportunity to develop the muscles of the whole body, gain endurance, strengthen the muscular apparatus and the skeletal system. Only in this way will the child acquire the skills necessary for him to move vertically.

With varus curvature of the legs, the formation of the knee joint occurs unevenly. A decrease in the internal condyle of the femur and an increase in the external condyle provoke a meniscus infringement, and the joint space is formed unevenly: on the inside it becomes narrower, on the outside it is wider. The ligaments that support the joint are stretched, especially on the outside of the knee. In this case, the bones of the legs are often also bent: their convex part is outside. In severe cases, even the thigh turns outward, and the tibia in its lower third turns inward. The described deformation also leads to changes in the feet: they acquire the so-called flat-varus installation, in which the heel and forefoot deviate inward, resulting in the development of clubfoot. In addition, the baby does not fully extend the knees, which becomes especially noticeable if you look at the standing child from the side.

Treatment of varus curvature of the legs should be started as early as possible: in advanced cases, the child's gait is disturbed, he often falls and cannot bear long transitions. In addition, according to the laws of compensation, his spine begins to suffer, postural disorders and scoliosis appear. It is necessary to treat the O-shaped deformity of the legs for a long time, persistently and without fail under the supervision of an orthopedic doctor. As a result, you can significantly reduce the changes that have occurred in the joints and bones, normalize muscle tone and even completely get rid of this unpleasant disease. After all, the child's body is very malleable, so the right method of conservative treatment gives a good result. In addition to special procedures, the treatment complex includes massage and gymnastics, which in mild cases become the basis of treatment.

As for orthopedic shoes, they are selected only on the recommendation of a doctor. In addition, the boots should be new, with stiff heels and a heel that is beveled inward to give good ankle support. Orthopedic insoles are also used, which are made according to individual measurements.

At home, you do not need to let your child walk in soft slippers or slippers, it is better to let him walk barefoot so that the small muscles of the foot develop better. In advanced cases, doctors advise using special styling that is worn during sleep, and during the day they are replaced with special shoes that can be worn all the time.

Regardless of the prescription and the severity of the disease, all children with O-shaped curvature of the legs should have massage and therapeutic exercises, which are considered the most physiological ways to correct bone deformities. They allow taking into account the individual characteristics of each child, his mental and physical development. At the same time, massage and exercise have a general strengthening effect on the body. Neither massage techniques nor special exercises give any side effects, however, before starting to work with a child, you need to consult with your doctor in detail so that the procedures used give the maximum result.

Massage should be carried out in courses of 12-20 procedures every other day or daily. After each of them you need to take a 2-4-week break. By the middle of each course, the intensity of the procedures should be gradually increased. Massage should be combined with special exercises aimed at correcting the incorrect position of the feet.

Starting position: the child lies on his stomach, a small soft roller is placed under his shins.

1. Back massage: stroking the entire surface of the back up from the waist to the neck and to the sides of the armpits, rubbing with pads or the back of bent fingers, sawing, kneading and stroking again.

2. Lumbar and sacral area: stroking, stimulating rubbing kneading and again stroking from the middle of the back to the sides and down.

3. Buttocks area: circular or X-shaped stroking, rubbing with the knuckles of bent fingers, stimulating kneading, toning shock techniques (patting, tapping and chopping) and stroking at the end.

4. Back surfaces of the thighs: stroking, gentle rubbing, slight kneading (felting) and stroking again. If bending the knee joint is difficult, use more strokes in combination with vibration and shaking of the back muscles of the legs and thighs.

5. Back surfaces of the legs: sparing massage techniques - stroking, soft rubbing, felting, shaking and again stroking the inner parts of the calf muscles. Massage the outer surfaces of the legs more vigorously, without affecting the area of ​​the Achilles tendon.

6. Knee joint: corrective techniques, that is, stroking the lateral surface of the joint, rubbing and pressing on the external condyle.

Starting position: the child lies on his back, a roller is placed under his knees.

1. Front surfaces of the thighs: stroking from the knee up and out, intense kneading, rubbing, stimulating shock techniques, in conclusion - stroking.

2. Anterior and lateral surfaces of the legs: stroking from the foot to the outer part of the knees, vigorous kneading, rubbing and stroking again. For correction - rhythmic pressure on the outer surface of the lower leg and thigh (Fig. 78).

Calf correction

3. Zone of the knee joint: stroking along the contour of the joint with the pads of the thumbs, rubbing and kneading the joint, which consists in shifting the patella in the transverse and longitudinal directions. Corrective reception - pressure on the external condyle.

4. Feet: stroking on the outer surface of the feet from the base of the fingers to the ankle joint, raking and transverse rubbing, stroking, rubbing the ankles and stroking again.

In the process of massage and therapeutic exercises for the feet, you need to make sure that the knee joints with their cups are oriented strictly upwards. Try to observe the same position as often as possible, for example during sleep. It is useful to put a dense roller at the feet of the child (in the crib) to support the feet in a dream. If the baby prefers to sleep on his stomach, his feet should hang down from the bed.

A child suffering from varus curvature should not stand or walk for a long time, so activities and games for him must be selected taking into account these features. It is useful for such a baby to crawl: you should try to keep this skill as long as possible. The fact is that a child moving on all fours, without loading his legs, trains the muscles of the whole body. At a later age, some children move on all fours like a bear - leaning on the feet and palms. This position is also considered useful.

When the baby is sitting on a chair, control the position of his knees: they should lie strictly parallel. For games with the baby, a very good pose, called "sitting between the feet." Over time, you need to teach your child to ride a bike. Buy a three-wheeled “car” for your baby and let him ride “it” not only during a walk, but also at home.

A children's pedal car will also help strengthen the legs, since riding on such a “technique” will strengthen your child’s legs without the inevitable axial load when walking. In addition, such toys develop creative imagination and coordination of movements.

Any child needs swimming for harmonious development. Children with O-shaped curvature of the legs especially need it. Water has a very gentle effect on the child's body, relieving muscle tension and calming the nervous system. In this case, movements are given easier and in greater volume than on land.

Swimming strengthens and develops the muscles of the whole body, trains the cardiovascular and respiratory systems of the body, and also improves immunity and normalizes metabolic processes. Children with leg varus may benefit from swimming on their backs. At the same time, it is important that the baby's limbs work alternately, as when swimming with a crawl. If there is no opportunity to visit the pool, you can work with the child in the bath. Of course, he will not be able to swim in it, but the baby will be able to perform special therapeutic exercises in it.

1. Flexion of the foot at the ankle joint. Sit your baby in a chair so that he can lean with his arms outstretched back. Ask him to straighten his legs so that the feet are extended parallel to each other, and the kneecaps “look” up. Then the child must bend first one foot, then the other, then both together. When performing this exercise, you need to help him bend the joint to the back.

2. Foot rotation. Starting position: the same. Ask the baby to perform circular rotations with the feet to the outside, first alternately, then together.

3. Raising straightened legs. Starting position: the child lies on his back. Ask him to raise his straight legs, first alternately, then simultaneously. At the same time, he should reach with his socks to the toy or your palm.

4. Exercise "bike". Starting position: the child lies on his back. Ask him to raise his legs up and imitate the movement, as when riding a bicycle. During this and the previous exercises, you need to make sure that the knees do not turn outward, and the feet do not turn inward.

5. Sitting between the feet. Option 1: starting position: the child is on his knees, socks apart, feet slightly apart. Ask the baby to lower himself and sit between his heels. Option 2: starting position: the child is on all fours. Rocking back and forth, he should sit down between his heels. This exercise is especially useful for O-shaped curvature of the legs. Try to seat the baby in this position as often as possible under the pretext of classes or games. In addition, while standing or walking, make sure that the child puts his feet parallel to each other.

6. For the treatment and prevention of clubfoot, walking along the herringbone path is often used. Draw with chalk on the floor a “herringbone” 1–2 m long and “branches” located at an angle of 15–30 °. Let the child walk along this path, trying to step only on the "branches" so that his feet turn outward. In summer, such a path can be drawn on asphalt, sand, or laid out of bricks, planks, etc. Let the baby walk along it many times a day. Gradually, your perseverance and patience will give results: the child will develop the correct installation of the foot, the curvature of the legs will straighten out and the gait will normalize.

Newborns often have a slight curvature of the legs. If by three, by a maximum of five years, the defect does not disappear, it must be corrected. In addition to the psychological factor, a person also has physical problems. When the legs are deformed, the load on the knee joint is distributed unevenly, which leads to osteoarthritis and flat feet.

Why does a child have legs with an X or a wheel. We analyze the causes of curvature

Orthopedists distinguish 2 main types of deformity of the lower extremities - O-shaped and X-shaped.

The cause of the curvature of the legs in a child can be factors such as:

Even our grandmothers, in order for the child's legs to be straight, used tight swaddling. However, it has been scientifically proven that this is not true. Actually, with a tight contraction of the legs of a newborn, a dangerous disease can occur - .

How to independently determine the curvature of the legs in children

If the baby's legs are curved strongly enough, then this can be seen with the naked eye. To determine even slight deviations from the norm, ask the child to stand up straight and connect the heels together.

Compare the baby's legs with the diagram below:

As can be seen from the drawings, the child's legs can be normal, X-shaped or O-shaped. If your child is not yet 3 years old, then his legs may be in the shape of the letter "O". At an older age, X-shaped deformities of the lower extremities are more often observed.

We treat the X-shaped curvature of the child's legs

Doctors advise starting the correction of the legs in the form of the letter "X" as early as possible.

Pathological abnormalities are completely cured if the child has not yet reached school age, and treatment should begin no later than 2 years.

For the correction of the lower extremities, methods such as:

To keep your child interested, turn morning exercises with exercises that help correct the shape of the legs into a fun game:

1. Invite the baby to walk like a clumsy bear. This will allow the child to stomp on the outside of the foot.
2. Let the kid try himself as a tightrope walker . Walking along a narrow plank or path of flat figures, the baby will put his feet closer to one another.
3. Remind your child of a familiar oriental tale and offer to sit like a Turkish sultan .

Important! With an X-shaped curvature of the legs, it is not recommended to stand for a long time, especially with legs wide apart. This position increases the displacement of the knees inward and the breeding of the feet outward.

Features of the treatment of O-shaped (varus) deformity of the legs in children

Deformity of the legs in the form of the letter "O" should be treated as soon as the first signs of pathology appear. Otherwise, the child has a violation of gait, he often falls, cannot walk long distances. In addition, the baby's spine suffers and the posture is bent.

Varus deformity of the limbs causes:

Uneven development knee joints.
squeezing inner meniscus.
Extension joint space on the outside and narrows on the inside.
Development clubfoot.
stretching ligaments that strengthen the knee joint.

Treatment of O-shaped deformity takes a lot of time, so parents need to be patient and follow all the instructions of the orthopedic doctor.

In the treatment, a whole range of measures are used, which are carried out as directed and under the supervision of specialists:

Gymnastics with X-shaped and O-shaped curvature of the legs in children

If a child has a pronounced curvature of the legs in the form of the letter X or O, you should not hope that with age everything will go away and the legs will take on a normal shape. Curvature can and should be fought. One of the effective ways is therapeutic exercises. A simple set of exercises will help to cope with the irregular shape of children's legs.

Exercise 1 . Alternate walking on toes and heelsX . Designate a short path for the child, for example, from wall to wall in the room. To make it more interesting for the child, let the baby first walk in one direction on his toes, and in the opposite direction - on his heels. Then - half the track on the toes, half on the heels. By the end of the exercise, you can alternate 5 steps on the heels and 5 on the toes. The total duration is 2-3 minutes.

Exercise 2 . bear clumsy . Show your child how to walk using only the outside or inside of the foot. You can perform the exercise in the same way as walking on toes and heels - alternating leg positions. The duration of the lesson is no more than 3 minutes.

Exercise 3 . We dangle our legs . IP (starting position) - sitting on a chair. The arms rest on the waist, the legs should reach the floor. First, pull the fingers up, then bend down. We repeat several times. We put the feet alternately on the outer and inner side. The total duration of the exercise is 1-2 minutes.

Exercise 4 . Rubbing foot to foot . IP - sitting on a chair, legs slightly raised. With the foot of the left foot, we try to wipe the right foot from the bottom up, then with the foot of the right foot - the left. Repeat the exercise 6-8 times with each leg.

Exercise 5 . We perform captures . IP - sitting on a chair. Small objects are laid out next to the chair, under the feet - pencils, pebbles, small soft toys and rags. You need to grab any object with your toes and hold it for as long as possible. You need to perform the exercise alternately with the left, then with the right foot, and then with both legs at once. The duration of the exercise is 2-4 minutes.

Exercise 6 . You will need a ball to complete the task. . IP - sitting on a chair. The ball is placed under the feet. First with the left, then with the right foot, they roll the ball forward - backward, left - right. After several repetitions, they grab the ball with the insides of the feet and try to lift and hold it above the floor. The total duration of the exercise is 2-3 minutes.

Exercise 7 . IP - sitting on a chair . Put a stick of small thickness under your feet (you can use a regular rolling pin). Put your feet on it and roll the stick back and forth. In this case, the entire foot should be involved - from the heel to the fingers. The duration of the lesson is 1-2 minutes.

Atexercise 8 . IP - sitting on the floor in Turkish . At first, the child sits in a yoga position (left foot on the right) for no more than 2 minutes. The task of the child is to rise from the floor, relying only on the legs. At the same time, an adult stands behind him, supporting him by the hands. Changing the position of the legs (right to left), the exercise is repeated. The duration of the lesson is 2-3 minutes.

Exercise 9 . Walking on a log . In the cool season at home, and in the summer on the street, the child should walk barefoot on a log. At the same time, parents are nearby and insure the baby. The duration of the exercise is 2-4 minutes.

Exercise 10 . We use the Swedish wall . The child rises and falls barefoot on the sports equipment for 2-3 minutes. For the safety of the child, adults must insure.

Possible Complications – When is Surgery Necessary?

The intervention of a surgeon in the pathology of the shape of the legs in children is used in only 7% of cases of the total number of pathologies. The operation is prescribed when conservative methods of treatment have not led to the desired result or when the form of the disease is advanced.

With a valgus foot, modern medicine after surgery allows you to do without gypsum and metal devices. The surgeon changes the angle between the bones and straightens the ligaments. Already on the second day after such an operation, the child can walk independently. Surgical intervention is resorted to no earlier than the child reaches 6-7 years of age .

In order not to bring the situation to the point of surgery, contact an orthopedist at the first sign of a curvature of the baby's legs.

Rickets is a disease characterized by metabolic disorders, a consequence of a lack of vitamin D in the body, leading to a violation of the phosphorus-calcium balance. The bones become soft, thinned, easily twisted and brittle. With rickets, not only the bone, but also the muscular and nervous systems suffer. The causes of the disease are: vitamin D deficiency, lack of calcium, phosphorus, protein in the child's body. More often, premature babies, with intrauterine or postpartum hypoxia, with low physical activity, often sick children, are predisposed to rickets. Inadequate exposure of the child to the fresh air can also lead to the development of rickets. In the body of a child, vitamin "D" is produced under the influence of ultraviolet rays, therefore, in winter, it is useful to carry out preventive quartzing, and in summer, a long stay of the child in the fresh air is recommended. Practice shows that of the preparations containing vitamin D, fish oil is the most effective.

Three degrees of severity of rickets

There are 3 degrees of severity of the disease. At grade 1, functional changes in the autonomic nervous system begin (excessive sweating, the child is restless, more capricious), the hair on the back of the head is wiped off. Symptoms of the 2nd degree are changes in the skeletal system. Parietal, frontal tubercles appear, chest deformity - "rachitic rosary". At grade 3, violations occur both on the part of the skeletal system and on the part of the internal organs, there is a curvature of the spine (scoliosis), deformity of the limbs.

Treatment of rickets

A complex treatment is prescribed, which includes: a long stay of the child in the fresh air, quartz treatment, vitamin therapy, physiotherapy exercises, and massage. Massage occupies one of the leading places in the treatment of rickets, as it activates metabolic processes, strengthens the muscular and skeletal systems, and improves tissue trophism.

Massage

With rickets, the bones soften, become brittle, therefore, at the beginning of treatment and during the height of the disease, massage is carried out in a gentle mode.

By their nature, violations can be divided into:

1. Chest disorders. These violations can have one of two varieties - "chicken breast" (ribs protrude forward at an acute angle), or "shoemaker's chest" (sunken);
2. Deformity of the lower extremities. One of two types is possible - O-shaped curvature of the legs (accompanied by flat-varus feet), X-shaped curvature (in combination with flat-valgus feet);
3. In some cases, "rachitic coxavar" is possible (change in the cervical-diaphyseal angle);
4. Weakening of the abdominal muscles (referred to as "frog belly").

These disorders can be present in a child in various combinations. Next, massage techniques specific to each of these disorders are considered.

It should be noted that the causes of leg deformity can be not only rickets, but also the early rise of the child to his feet, when the musculoskeletal system has not yet strengthened, defects in the development of the foot, hip dysplasia and dislocation, as well as overweight in the child. The child should avoid prolonged standing on his feet, give rest to his legs more often, and do not take long walks.

"Chicken Breast"

A strengthening massage is done according to the general scheme, but more attention is paid to the chest, intercostal muscles, which must be intensively rubbed with fingertips along the intercostal muscles for 2-3 minutes (Fig. 1). From behind, emphasis should be placed on the interscapular region, the extensors of the back (Fig. 2, 3, 4). From the front - on deformed ribs using pressure on the sternum with a delay of up to 10 seconds (Fig. 5). Repeat the last technique 2-3 times, and with a large deformation 6-8 times.

"Chest Shoemaker"

With the "shoemaker's chest", from behind - the emphasis is on the interscapular region and extensors of the back (Fig. 2, 3, 4), and in front - on stretching the chest along the costal arches (Fig. 1). Massage is carried out in a gentle mode, because. the pectoralis major muscles are spasmodic and the child may feel pain. Passive correction of the costal arches is applied - pressing inward with a delay of up to 10 seconds (Fig. 6), alternating with deep, energetic strokes (Fig. 7).

Rachitic coxavar

Great attention must be paid to the lower limbs. Violations of the hip joint may also be observed. With the formation of rachitic coxsavara, the gait is disturbed (the so-called "duck"). When walking, the child seems to roll from side to side. The reason is the failure of the gluteal muscles, therefore, a stimulating, strengthening massage of the muscles of the thighs and buttocks is used, using rubbing and kneading techniques (Fig. 8-14).

O-shaped curvature of the legs

With an O-shaped curvature, an abnormal development of the knee joint occurs. The ligaments that strengthen the joint are stretched on the outside, and on the inside, on the contrary, they spasm. The external condyle increases in size (the bone appears to grow sideways).

On the outer surface of the lower leg (Fig. 15,16) and thigh (Fig. 17,18,19) make an intense, firming massage, because. the muscles there are weak, stretched.
fig.15
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fig. 23 On the inside, where the muscles are tense, the massage, on the contrary, is light (it is necessary to relieve tension), the main techniques are stroking (Fig. 20, 21), shaking (Fig. 22), longitudinal stretching of the muscles (Fig. 23). To correct the knee joint apply pressure on the outer surface of the knee joint (Fig. 24).
fig.24
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Fig. 26 With an O-shaped curvature of the legs, the formation of varus feet occurs (the foot is turned inward). The massage scheme is the same: on the outside it is strengthening (Fig.25,26), and on the inside it is relaxing (Fig.27,28) with longitudinal stretching of the foot muscles (Fig.29).
fig.27
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fig.29

X-shaped curvature of the legs

With an X-shaped curvature, the ligaments are stretched on the inside of the knee joint, and spasm on the outside. Here the internal condyle increases in size.

The X-shaped curvature is much more difficult to correct, after 3 years it is practically untreatable. Massage is done for 20-25 minutes, 15-20 times, until the condition improves or complete recovery. Between courses should take at least 2 weeks.