Sore orthopedics issue

The hook of the term “orthopedic shoes” includes not only parents who wish to preserve their child’s health. Communication with sellers shows that even the sales staff of children's shoe stores are often confused in terms, and under the guise of orthopedic shoes, offers the buyer something that is not and cannot be. To remove the painful issue of pediatric orthopedics, let's dot the i.

Where the legs grow

The opinion that useful children's shoes are only orthopedic shoes turned out to be surprisingly resilient. Technologies are developing, the population's awareness of the quality of goods is increasing, but the myth that orthopedic shoes would not interfere with the growing body of a child does not disappear anywhere. It would seem that how many times the world has been told that orthopedic shoes are shoes only on the recommendation of a doctor and sold in salons, parents are still looking for them in ordinary stores, and retailers helpfully offer them what they are looking for. True, under the guise of orthopedic, they sell footwear of mass production, albeit made in compliance with all the requirements for children's shoes.

Such an unethical substitution of concepts is in many ways a response to the demands of the market: customers-mothers, coming to the store, often even without a doctor's prescription require orthopedic shoes, because in their understanding, orthopedic shoes are good. Of course, the behavior of sellers in this case is a separate issue, but the root of evil still nests in the minds of caring parents. The reasons for the prevailing stereotype were voiced during the round table "Rational Children's Shoes" organized by the manufacturers of children's shoes "Zebra" and "Kotofey" in 2010. As then noted by the professor of MGUDT, Doctor of Technical Sciences Sergei Kiselev, in the current misunderstanding there is a large share of the fault of the doctors who examine children in educational institutions - they dramatize the situation by exaggerating the number of children suffering from leg diseases. The arguments of orthopedic doctors who come to school to tell about healthy shoes and advertise their salon also left their mark on the minds of parents. Finally, the picture was complemented by the prejudice against "non-orthopedic" shoes, which formed in the 90s, when an uncontrolled stream of imported children's shoes poured into the country. All this led to the fact that many parents heard about orthopedic shoes, but few of them realized that their child actually did not need them at all. “When talking about orthopedic footwear, a consumer often means comfortable footwear,” shares his observations Ivan Tatarchuk, Doctor of Technical Sciences and Deputy General Director of the Parizhskaya Kommuna factory. - He has no scientific degrees and does not know the term "rational shoes", so it is easier for him to call shoes with a comfortable insole and instep "orthopedic". But we are trying to fight this habit and position our children's shoes as preventive, which they are. "

Who needs orthopedic shoes

Orthopedic shoes are needed for people with pathological abnormalities in the structure of the foot, lower leg or thigh. Only a doctor can establish such deviations, and he, accordingly, decides whether a particular child should wear orthopedic shoes or a special insole. It is believed that orthopedic shoes should be worn to prevent flat feet. However, even here there is a whole series of "buts": firstly, in the case of children under 3 years old, flat feet cannot be discussed in principle, since the flattened shape of the foot in this case is a physiological norm, and the abundant fat layer of the children's foot is not allows you to accurately make such a diagnosis. It is also important that the child's foot is constantly developing, therefore, the allegedly discovered flat feet in most children disappears by the age of 7. Ilya Kulguleather, the leading orthopedist of the Russian Medical Orthocenter, reports that the center's specialists remove the diagnosis of flat feet in 80% of children sent to them. But according to his statistics, only 35% of parents decide to check in the center a diagnosis prescribed by a doctor who has entered a kindergarten or school, which means that all the rest go to the store for "orthopedic" shoes. Which, of course, is wrong, since a healthy child does not need orthopedic shoes: only prophylactic shoes are enough. But more about her later.

So, who, then, will benefit from orthopedic shoes and not harm? Orthopedists at the Lada-Orto Orthopedic Center in Kirov argue that children with foot disorders such as clubfoot, planovalgus and flatovarus deformities may need it. The last two disorders are characterized by a deviation of the calcaneus from the vertical axis, due to which the child's leg is tucked inward or outward. An orthopedic surgeon can make a diagnosis, and parents are required not to take the punishable initiative in buying medical shoes and just be on the lookout. When should you be alert? “If a child quickly gets tired after a short walk and asks for his arms, this may well indicate problems with the foot,” warns Anna Vinogradova, head of ORTO at the Antelope children's footwear company. - Pay attention to the child's shoes: if new shoes quickly lose their shape, trample in or out, take the child to an orthopedic doctor urgently. Children's feet are formed up to 5 years of age, so the earlier the problem is detected, the easier it is to solve it. And it is necessary to solve in a complex way - not only by wearing orthopedic insoles-instep supports in anatomical shoes, but also by massage, gymnastics, following all other doctor's recommendations. " By the way, about massage and gymnastics, which many parents needlessly neglect. The fact is that this is not just "exercise for general health", but a way to minimize the negative impact of orthopedic shoes. Yes, such an influence is present, because in medical shoes the child's foot is limited in movement and tactile sensations, which affect the development of motor skills. Therefore, in order to avoid problems with the development of the musculoskeletal system, the child must replenish the necessary muscle stimulation in other ways.

So, the child was taken to the doctor and received a disappointing diagnosis. What to do next? “After the orthopedic surgeon has decided whether the child needs to wear orthopedic shoes, he either prescribes the manufacture of shoes using an individual last or a plaster cast, or recommends buying mass-produced shoes with additional intra-shoe space where individual corrective insoles can be inserted,” says Marina Kiseleva, Ph.D. in technical sciences and specialist of the Zebra children's footwear company. "In any case, the recommended footwear must meet medical requirements: a rigid heel counter is required to securely fix the heel, and sufficient space inside the shoe."

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What does a healthy child need?

Healthy children, whose feet did not arouse suspicion by the orthopedic surgeon, orthopedic shoes will only harm, because they will limit the foot in natural movement. That is why it is enough for children without health problems to wear so-called rational anatomical or preventive shoes. This shoe differs from orthopedic in that it is made not to order, but in series, but at the same time it meets all the basic requirements of GOST and the recommendations of specialists regarding the design of shoes and the materials from which it is made. These are the requirements and recommendations:

- The back should be rigid and high enough to fix the heel and ankle joint. This is necessary for the correct installation of the foot of the child and the uniform distribution of load on the foot

- the toe part is round, free and closed, so that the walls of the shoe do not press and deform the child's toes

- fastener - laces or Velcro, which securely fix the foot at different fullness and, if necessary, allow you to wear shoes with an individual orthopedic insole

- there must be a small heel (5-7 mm), which is involved in the formation of the gait and does not allow the child to fall back

- the sole of the shoe should not be stiff

- in children's shoes of all age groups there should be a layout of the longitudinal arch of the foot, but it should not be too rigid and high so as not to immobilize the arch and allow it to perform a spring function.

“If a child is healthy, then there is no reason to order orthopedic shoes for him,” Marina Kiseleva is sure. - As for insoles and arches, they can be used in preventive children's shoes. Their main task is to create a comfortable bed in the shoe that ensures correct heel fit and contributes to the correct formation of arches. Unfortunately, in some brands of footwear, the underwater area is overstated, has the wrong location and is made of rigid materials, which is why it does not fit when pressed. "

National characteristics

As a rule, such shortcomings as an overestimated calculation of the underwater area are manifested in foreign-made shoes, because the foot of Russian children is different from the feet of Spanish, Portuguese, German or Turkish children. In addition, as Ivan Tatarchuk notes, in Europe there are no special requirements for children's shoes, and manufacturers are guided only by general recommendations. Moreover, even within Russia, anthropometric characteristics differ: for children living in the northwestern region of the country, they are more similar to Scandinavian features, and in children living in the south, they are more like Spanish ones. But in general, the difference with foreign parameters is significant, and this is an argument in favor of domestic-made footwear. Moreover, not so long ago, Sergey and Marina Kiselev conducted a large-scale study of children's feet at the Department of Artistic Modeling, Design and Technology of Leather Products at MGUDT, which made it possible to update the data on anthropometric characteristics and to manufacture the client company for the study "Zebra" and other manufacturers of children's shoes. suitable for modern kids. This was necessary if only because the last such research was carried out in the 80s: that is, in fact, until recent years, children's shoes were manufactured using stocks of 30 years ago. The term is long, and the pads of the past are outdated: “Over the past decades, the parameters of children's feet have changed,” states Professor Kiselev. “The average lengths of children's feet in individual age groups have increased, while their girth has remained virtually unchanged.” Today the situation with children's shoes has been corrected, and the companies "Zebra", "Antelope", "Kotofey", "Paris Commune" and other domestic manufacturers offer fit rational footwear and serial preventive footwear. It is this that should be recommended to buyers who want to keep their children healthy.