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THE TREATMENT OF FLAT-FOOT BY MEANS OF EXERCISE

ERNST BETTMANN J Bone Joint Surg Am. 1937;19:821-825.

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THE

TREATMENT
BY ERNST

OF

FLAT-FOOT
BETTMANN, M.D.,

BY
LEIPZIG,

MEANS
GERMANY

OF

EXERCISE

The
fathers possess. and adequate is of equal supports pose muscles
anterior,

human
had Nowadays,

foot

was
for due

originally
walking to function. if not is the and flexor longus. the In of sold and

an
wearing the the more to foot

organ
of often importance cure

for
which shoes of individual

gripping.
most which of us cramp painful

Our
no the and mechanical The lifting arch,-tibialis exercise the cases.

forelonger feet in-

a capacity

climbing

walking to which of medical on tibialis and the

on perform importance

hard

pavements, its with, too

becomes flat-foot, than, the the

treatment

are inner

generally border

pur-

exercises posterior, peroneus

systematic transverse hallucis If the longus, foot

strengthening of portion flexor muscles of

digitorum functioned

longus, properly,

interossei,

they support

would would There are 1.

prevent

the

painful unnecessary. of gymnastics

lowering which

of

the may be which is be

arch,

and

mechanical to by the correct the amount the gradual wise

often be two types of by to of the foot or the means be weak

employed

flat-foot: mother,
2.

A series the nurse,

Exercises

exercises which can family doctor. of special apparatus, as much as muscles.

EXERCISES

supervised permit for

of

the

exercise

increased

necessary

strengthening

Concerning foot exercises

the which

first may

type, already

the be

author known:

suggests

the

following

simple

FIG. Exercise
VOLE

1-A
the medicine ball. 821

with

XIX

NO.

3.

JULY

1937

822

ERNST

BETTMANN

1. coarse
stubbles,
:

Walking and
and

with uneven
pebbles).

bare ground

feet (grass, improves

on

2. posture the calf the ball

sole

Jumping and muscles, Use

worn

rope;

this

breathing, and raises of

as

strengthens the arch Spitzy on

which

of

foot. 3.
and

the ball
a

so-called sewed
sandal).

(a wooden 4. Towel both In order flexion to

a straw
im-

exercises,

prove
FIG.

and make in
and

adduction. the treatments the exercises games,-foot

throwing of pine

1-B a pine cone.

Exercise

with

attractive may be
ball and the

for children, employed

gripping

gymnastics cones or

with chestnuts.

the (See

medicine Figures

1-A leg.

and

1-B.) With the

Both help

games of

strengthen imagination of exercises. and

the

musculature

of it is possible

the

entire to develop

experience,

innumerable

combinations

APPARATUS

The
carpenter 1. 2. in

following
and Fixation Pressure of of

types
mechanic, the a stable

of
have heel

apparatus,
as in correction their supination;

which
bases cushion

can
these against

be

made

by

good

corrective the

principles: weakest point.

the 3. All

foot

arch,-the

talonavicular adduction must be perpendicular. and carried

joint; pointed-toe out with the position. knee bent at right angles

Regulated exercises leg Disk of

and

the lower

The with
and

Potters It consists rough its height

a slanting

disk,

forty

centimeters

in

diameter,

covered

rubber. (See is adjustable

Figure 2.) The disk revolves by means of a screw plate. and

loosened

on four wheels On the fixed hub in

of have fixation

there is an adjustable A heel clamp, which

helps cushions maintained and of a lowering braking to fix for by the the two heel in

plate for the right can be tightened and

position. of the Both

the
by of the joint.

left
means

foot
clamp The

supination.
a screw, adjustable is

wings

redressment straps.

talonavicular

The Movement

amount of

of flexion the disk

can

be varied difficult

by

raising by means

the

disk.

is made

weight.

The
a

Fool-Correction A wooden
round joint,

Ball ball,
which

about
makes

twenty (See screw the b,

THE

centimeters
possible its

in 3.)

diameter,
every

is mounted
direction.

on

adjustment in

The height

heel can

rests he

on

a support. ; by

Figure degree
JOURNAL

By

means

ofa, screw the is controlled;

regulated

of supination
OF BONE AND

JOINT

SURGERY

TREATMENT

OF

FLAT-FOOT

823

FIG.

2 disk. Grasping foot-correction

FIG.

3 with the

The

potters

exercise ball.

by screw
cushion

C, fixation is adjusted.

of the

heel

is guaranteed

; and

by

d, the screw and be

correction parallel by of
be

If the exercise elevation

a just right the ball.

axis of the

of the heel
the amount

ball

is horizontal can If
the of foot adduction

to the
to regulated

the ball
adduct

foot, the
vertical
in

a grasping ball order the or

and

is afforded,
angle with The

which support.
foot,

regulated the
is

moving is

by
at

axis
obliged can

to move manner
for

in

described. Stiffened

Apparatus Flat
Figure This 4.

Limbering

Feet in Adults
apparatus The foot is shown rests in on d.. a A

fixed strap
ankle the foot,

cushioned
cuff, and Another

stirrup, is laid
over to is the the laid

a.

which
passed is attached strap

around
lever

the
heel around of at

b. the a
lever straps

front pulley
at c. must

of to The the
flexion.

the the

foot other attachment

made

and end

led over of the of the

the of the

be

when

front
plantar

of is

foot
The

is with

in
axis

extreme a bar, d,

lever which

connected permits so heel the that and

manipulation a corrective front of the

toes rest
FIG. for limbering 4 stiffened flat feet

of the lever pull on the

foot
VOL.

is
XIX,

possible.
NO. 3. JULY

The
1937

Apparatus on in adults.

824

ERNST

BETTMANN

FIG.

5 wheel:

The

turbine a: grasping b: adduction

exercises exercises.

an
can

adjustable
apply

The

plate, which fixes the treatment himself. results obtained by the tendon talonavicular
part of the together heel

and use (3)

pronation

mobilizes of this of

them, apparatus

so are

that : (1)

the

patient

stretching of of
the

of the Achilles arch in the

metatarsal from toe to

and
foot

pointing joint;
into with

the calcaneum conversion of

; and of the (4) toes.

; (2) raising the position

of

the the
front

shortening

mobilization

With

the

help for a in

of this period preparing The bine

ferent muscles, parallel

apparatus, of from many

which twenty stiffened

can be used from to thirty minutes, and painful feet

two to three the author for the wearing

times daily has succeeded of arches.

Turbine To make
adjustments and wooden

Wheel foot has

it it can disks,

calisthenics been
permits be used covered

attractive (See
corrective for with
THE

for Figure

children, 5.)
of and right about
OF BONE

the By
practically the twenty
AND

so-called means
of

turall foot Two in

wheel

constructed.
the

diffoot.

exercise the rubber,

both

left

centimeters
JOINT SURGERY

JOURNAL

TREATMENT

OF

FLAT-FOOT

825 are connected is mounted movement turbine wheel heel of correction by means an axle direction is a metal remains at the grip, so of and

diameter, wooden supplied only. bar fixed

and spokes. with On the

about The an same

thirty centimeters resulting turbine brake which to carries plate

apart, wheel guarantee the

on there the

adjustable the adjustable by a bandage

in one foot cushion

to support in the rest child

heel rest. The strap and a rubber end In the foot

talonavicular that the permits spokes horizontal can

on

joint. can

At support

the upper himself.

of the bar there is a hand this form (Fig. the5, apparatus a), to grasp When the the (Fig. b),

a flexion with the to the

exercise,-the child toes and propels plate to and In the which the order turbine can

continues turbine. rest

connecting wheel is placed the5, child

is lowered

practise adduction. wheels is attached moves the animal

to encourage the and, by turning be weighted so as

child, a small animal the turbine, the child to increase the work

also done.

VOL.

XIX.

NO.

3,

JULY

1937