Х-образное и О-образное искривление ног: виды, диагностика, лечение
Виды деформации голеней:
- О-образная или варусная. При сведенных вместе стопах остается расстояние между коленями, форма ног напоминает букву О.
- Х-образная или вальгусная. При соприкосновении коленей стопы не сходятся между собой, внешне нижние конечности похожи на букву Х.
Как врач диагностирует вид деформации голеней
К сожалению, о типе искривления не всегда можно судить по внешнему виду голеней. Так жировые отложения на бедрах и коленных суставах скрывают внешние признаки деформации. Точный диагноз устанавливается только при обследовании пациента врачом.
Чтобы определить тип деформации, ортопед проводит внешний осмотр, клиническое обследование и оценивает рентгенограммы нижних конечностей с захватом коленных суставов или назначает панорамный снимок ног. Только после этой процедуры специалист выносит вердикт – ставит диагноз и выбирает оптимальный метод коррекции.
Методы исправления О-образного и Х-образного искривления ног
Детям, у которых наблюдается деформация нижних конечнойстей, не всегда требуется хирургическое вмешательство. Пока у ребенка открыты зоны роста в костях, возможна коррекция без операции. Это не относится к очень большим деформациям, которые исправляют оперативно и у детей. Обратите внимание: точные методы лечения должен назначать только квалифицированный детский ортопед.
Деформацию костей ног в зрелом возрасте лечат только с помощью операции. В зависимости от степени искривления назначается один из двух видов хирургического вмешательства:
- Классическая коррекция по методу Илизарова. Кости ног пересекаются, ставятся в правильное положение и фиксируются специальным аппаратом до полного сращения. Человек начинает ходить с костылями на следующий день после процедуры, весь срок лечения занимает около 2 месяцев.
- Коррекция без использования аппарата Илизарова. Операция проводится также, как в первом случае. Отличие заключается в способе фиксации костей – применяются накостные пластины, внутрикостные стержни или другие металлические приспособления. На ноги можно вставать через 4–6 недель.
Врач определяет оптимальный тип лечения в зависимости от степени деформации и пожеланий пациента.
Только врач поставит точный диагноз и назначит лечение
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Природная кривизна ног вовсе не является катастрофой:
- во-первых, идеальных от природы ног не так уж много;
- во-вторых, вполне возможно, вы просто преувеличиваете свой небольшой дефект.
Сегодня кардинально решить проблему кривизны ног можно либо ортопедической операцией по выпрямлению, либо пластической. Такие операции очень болезненны, долги и дороги, а самое обидное – часто разочаровывают. Но стоит ли прибегать к кардинальным мерам, когда существуют иные методы, намного проще, доступнее и безобиднее. Исправление кривизны ног можно произвести физическим и мануальным воздействием.
Исправить кривизну ног возможно при помощи физических упражнений, тренажеров и мануальных способов воздействия.
Как определить тип кривизны ног
Прежде чем приступить к исправлению ног, обязательно посетите ортопеда. Он поможет определить:
- Обладателем какой кривизны вы являетесь (истинной или ложной):
- истинная кривизна определяется отклонением костей от вертикальной оси;
- ложная – несимметричностью или недостаточным развитием мышц икр или бедра.
Ложность или истинность кривизны и форму искривления вы можете проверить и самостоятельно, выпрямив ноги до полного соприкосновения коленей и стоп.
Перед выбором способа выпрямления ног нужно определить свой тип кривизны.
Проверочный тест подробно описан в статье Операция по выпрямлению ног.
В кривизне ног природа часто оказывается ни причем:
В большинстве случаев кривизна ног – это приобретенный во время незаконченного роста костей дефект.
- Виноваты могут быть наши привычки:
- привычка стоять в позе, опираясь на одну ногу и ослабляя другую;
- поза, в которой стопы повернуты носками вовнутрь;
- привычка много кушать – в итоге большой вес приводит к искривлению ног.
Исправление ложной и истинной кривизны
Исправление ложной кривизны производится путем накачивания соответственных мышц бедра или голени при помощи физических упражнений и тренажеров – таким образом можно подкорректировать форму ног, закрыв слишком большие «проемы» между ног или сгладив наружный контур.
Однако большая степень кривизны обычно приводит к нарушению биомеханики коленных суставов.
Проверочный тест для коленных суставов:
- при О-образной форме коленная чашечка на выпрямленной ноге смещена вовнутрь;
- при Х-образной – кнаружи;
При проведении теста одну ногу подогните, а на ровной ноге определите смещение коленной чашечки.
При приседании следите, в каком направлении движутся ваши колени.
Возникает уже не ложная, а истинная кривизна, исправить которую путем разработки икроножных мышц не получится.
Истинную кривизну ног по причине смещения коленного сустава можно скорректировать при помощи мануального воздействия на коленный сустав в сочетании с комплексом упражнений для суставов и мышц.
Упражнения для исправления О-образной кривизны
Хорошо при этом типе кривизны помогают следующие упражнения:
Примеры упражнений для исправления кривизны ног
- Ходьба на внутренних сторонах стопы.
- Ходьба на пятках с носками наружу.
- Приседания в «балетной» позиции: носки разведены как можно больше.
- Упражнения на приводящие (внутренние) мышцы бедра и голени:
- свободное отведение ноги в сторону в положении стоя;
- отведение ноги с амортизатором – резиновым шнуром;
- подъем ноги в сторону в положении стоя боком к опоре;
- подъем ноги лежа на боку.
Виды спорта, предпочтительные при О-образных искривлениях:
- конькобежный спорт;
- бегание на лыжах коньковым методом;
- балетные танцы;
- плавание.
Упражнения для исправления Х-образной кривизны
Лучше всего реагирует на упражнения длинный тип голени, в которой камбаловидная мышца и икроножная мышцы имеют низкое расположение и крепятся на коротком ахилловом сухожилии.
Короткая голень с высоким положением мышц и длинным сухожилием хуже поддается коррекции.
Предпочтительны при Х-образной кривизне такие упражнения:
- Ходьба на внешних сторонах ступни.
- Приседания с мячом между коленями.
- Сидение «по-турецки»:
- колени разведены, пятки соединены;
- аналогичная асана в йоге – поза «лотос».
Данные упражнения выполняются три раза в неделю:
- в течение занятия делаются три подхода с 15 повторениями.
Виды спорта при Х-образных ногах.
При Х-образной деформации подойдут:
- конный и велосипедный спорт,
- плавание брассом,
- занятия йогой.
Видео: Упражнения для коррекции ног.
Выпрямление ног на тренажере
Цель занятий – тренировка четырехглавой мышцы бедра, но не на наращивание массы, а на проработку ее рельефа и формы.
Для выполнения этого упражнения потребуется простой тренажер для разгибания ног.
Цель упражнений на тренажере – коррекция рельефа и формы четырехглавой мышцы бедра.
Как выполняется упражнение:
- Сядьте на тренажер и вначале проверьте как он выставлен:
- при заведении голени под упор, он должен находиться не выше одной трети длины голени
- если упор находится выше или ниже, выставьте его по своим антропометрическим данным
В домашних условиях такое упражнения можно выполнять на стуле с утяжелителями на голенях.
Видео: Выпрямление ног сидя в тренажере.
Мануальное исправление истинной кривизны
Данная очень простая методика предложена мануальным терапевтом, костоправом Виталием Гиттом.
Для подбора способа коррекции определяется тип кривизны ног:
- Искривление из-за слишком сведенных вместе или наоборот чересчур разведенных коленей.
- Искривление голени (в основном наружное О-образное).
- Наружное искривление бедренной кости.
В соответствии с этими типами дефектов Гитт предлагает следующие способы исправления:
Восстановление биомеханики коленных суставов
- Это происходит путем расширения суставной щели и стимуляции роста внутренней или наружной части мениска (нахождение суставной щели можно определить по углублениям, расположенным на 4 см ниже центра колена, справа и слева от него).
Колено корректируется расширением суставной щели и естественным наращиванием мениска под ударным воздействием.
Устранение кривизны голени
Дефект устраняется аналогично – постепенным наращиванием ударов по проблемным зонам.
Удары – это своего рода микротравмы, благодаря которым стимулируются кровообращение и обменные процессы, и происходит наращивание мышц, чего не удается сделать при помощи физических упражнений при слишком высоком или слишком низком положении искривления.
Устранение наружного искривления бедра
Это происходит путем наращивания внутренней мышцы:
- в положении сидя на стуле между коленями помещается небольшой 20-сантиметровый мяч;
- мяч сжимается-разжимается в быстром темпе одну-две минуты.
Наращение и мениска, и мышц при таких способах минимально, но даже и несколько миллиметров производят хороший визуальный эффект.
Для получения ощутимых результатов эти процедуры необходимо выполнять самое малое полгода.
Как видите, исправление кривизны ног, полностью в ваших руках.
Видео: Стройные ноги при помощи йоги
Коррекция формы ног у взрослых в большинстве случаев носит косметический характер. Врожденная или приобретенная кривизна ног доставляет большой психологический дискомфорт: люди стесняются ходить на пляж или в бассейн, у них развиваются различные комплексы, мешающие отношениям с противоположным полом. Для исправления дефекта фигуры таким людям могут быть рекомендованы различные средства, среди которых наибольшую популярность имеют липофилинг, куропластика и специальные физические упражнения. В самых тяжелых случаях деформации конечностей может быть показана хирургическая операция по выравниванию ног с использованием аппарата Илизарова.
Перед тем как выбрать метод исправления кривизны ног, необходимо определить, к какому типу относится дефект нижней части фигуры. Для этого нужно сделать медленное приседание и посмотреть, в какую сторону раздвигаются колени. О-образное искривление будет в том случае, если колени раздвигаются в стороны. Х-образное — хотят соединиться. Если ноги ровные – они сгибаются параллельно стопам.
В зависимости от причины, которая формирует визуальную кривизну ног у девушек и у мужчин, выделяют следующие виды деформации:
- Истинная кривизна. Такая деформация нижних конечностей происходит в результате искривления костей бедра и голени. Кривые ноги визуально образуют форму дуги. Кривизна возникает чаще всего в результате приобретения наследственных признаков от родителей или является итогом перенесенного в детстве заболевания. Такими болезнями могут быть рахит или полиомиелит.
- Ложная кривизна. Данный вид деформации ног образуется в результате неравномерного распределения мышечной и жировой ткани на голени и бедре. При этом кости будут правильной формы.
Для того чтобы максимально достоверно определить тип кривизны ног, рекомендуется сделать рентгеновский снимок.
Распространенность искривления ног у девушек и мужчин примерно одинакова. Однако девушки пользуются различными способами исправления патологии гораздо чаще. Это связано с тем, что представительницы прекрасного пола больше обеспокоены эстетикой своих ног. Мужчины, как правило, обращаются к докторам лишь в тех случаях, когда деформация нижних конечностей может привести к развитию и прогрессированию различных болезненных состояний.
Исправить кривизну ног в домашних условиях можно, если делать упражнения для выпрямления ног. Их эффективно использовать, если деформация носит ложный характер. Выполнение упражнение в этом случае будет направлено на увеличение мышечной ткани на внутренней части бедра и голени.
Для того чтобы исправить кривизну в области бедер, наиболее эффективным будет выполнение следующих упражнений:
- Приседания. Выполняются следующим образом. Исходное положение – ноги на ширине плеч, стопы развернуты наружу, руки скрещены за головой. Опускание тела должно происходить медленно и подконтрольно, спина прямая. В самом низу необходимо сделать вдох и быстро выпрямить туловище в исходное положение. Количество повторов рекомендуется совершать от 8 до 12. Время для отдыха между подходами около 2,5 минут. Для того чтобы упражнение дало максимальный эффект, необходимо использовать гантели или любой другой тяжелый предмет.
- Выпады. Перед началом выполнения выпадов необходимо хорошо разогреть и растянуть мышцы задней части бедра. Нелишним будет раскрутить коленные и тазобедренный суставы. Из исходного положения – ноги на ширине плеч, руки за головой держат гимнастическую палку – производится большой шаг вперед с одновременным сгибанием передней ноги в колене. Без паузы совершается тоже движение второй ногой. Количество выпадов в одном подходе — не менее 15. Количество подходов – 4-5. Чтобы повысить эффективность упражнения, можно вместо гимнастической палки положить на плечи железный гриф (пустой или утяжеленный блинами – в зависимости от тренированности человека).
- Разгибание бедра. Осуществляются в домашних условиях так: за лодыжку цепляется эластичный бинт или тугая резинка. Второй конец снаряда закрепляется за батарею или ручку двери. После этого необходимо развернуться в обратную от батареи сторону, наклониться вперед и совершить тягу голени к ягодицам. Количество повторов в подходе – 12-14 на каждую ногу. Отдалиться от батареи или двери нужно на такое расстояние, чтобы сила сопротивления резинки позволяла выполнить около 30 повторений. Как правило, снаряд берут длиной чуть больше метра.
Для того чтобы увеличить мышечный объем внутренней части голени, рекомендуется выполнение упражнения «поднятие на носки из положения стоя». Производится оно следующим образом: необходимо подойти к стене лицом, положить ладони на ее поверхность и совершить поднятие туловища мышцами голени ног. Выпрямляться необходимо максимально высоко. Количество таких поднятий определяется степенью тренированности человека. Выполнять упражнение нужно до тех пор, пока не наступит чувство жжения в икроножных мышцах. Отдохнув 2-3 минуты, можно попробовать выполнить еще 1 или 2 подхода.
Другим эффективным упражнением для прокачки икроножных мышц является «подъем на носки из положения сидя ». Выполняется следующим образом: ноги согнуты и нагружены утяжелителями. Необходимо подняться на носки максимально высоко и опустить ноги в исходное положение. Количество повторений должно быть таким, чтобы наступило чувство жжения в икроножных мышцах. Для хорошей нагрузки достаточно будет выполнять по 2-3 подхода. Перерыв между подходами – 2 -3 минуты.
Также необходимо увеличить общую физическую активность. Для этого достаточным будет поездку на работу на машине заменить общественным транспортом. Можно выйти на несколько остановок раньше и пройтись 2-3 километра пешком. В выходные дни будет полезно отправиться вместе с семьей или друзьями на длительную прогулку в парк, а традиционному пикнику с шашлыками и спиртным предпочесть активные игры.
С помощью хирургической операции исправляют истинную кривизну ног. Процедура имеет обусловленное медицинское показание — предотвращение развития артроза коленных, голеностопных и стопных суставов.
Хирургическое исправление кривизны ног с использованием аппарата Илизарова
Наиболее распространена операция, в которой используется аппарат Илизарова.
Осуществляется процедура коррекции ног следующим образом:
- В голени просверливают отверстия и проводят через них спицы, которые закрепляются кольцами.
- Рассекают кости и фиксируют спицы в нужном положении.
- Накладывают швы.
- Через 6-8 дней начинают производить коррекцию расположения костей по заранее смоделированной схеме.
Продолжительность носки аппарата Илизарова составляет около 4 месяцев, в течение которых пациент имеет возможность передвигаться. Снимают приспособление после того, как костный рубец станет прочным.
В период реабилитации пациент некоторое время должен передвигаться с помощью костылей или на ходунках.
Аппарат Илизарова используется чаще всего в операциях по исправлению варусной (О-образной) кривизны ног. Х-образные (вальгусные) искривления составляют менее 10% в ортопедической практике, и производится операция в этом случае, как правило, мужчинам, у которых дефект нижних конечностей трудно скрыть с помощью одежды.
Другими хирургическими операциями по выпрямлению ног являются:
- Куропластика. Является пластической операцией и представляет собой введение импланта во внутреннюю часть голени. Выполняется она следующим образом: врач делает разрез под коленом длиной около 4 сантиметров. В предварительно сформированное пространство помещают один или несколько имплантов. Производить данную процедуру рекомендуется в том случае, когда человек не способен добиться желанного контура ног посредством диеты, физических упражнений. Достоинством куропластики является то, что для достижения эстетического эффекта достаточно одной процедуры. Минус – это большое количество противопоказаний: беременность, лактация, гемофилия, сахарный диабет.
- Липофилинг. Суть процедуры состоит в том, что человеку пересаживаются жировые ткани из ягодиц или живота в область голени, внутренней части бедра или подколенный участок через микроразрезы. После операции не только изменяются контуры ног, но и улучшается структура кожи. Противопоказаниями к проведению липофилинга являются сахарный диабет и атеросклероз. На сегодняшний день липофилинг является самым распространенным способом для исправления кривизны ног.
Кроме хирургического вмешательства часто для того, чтобы выпрямить ноги используют другие менее эффективные, но гораздо более щадящие средства.
- Накладки. Выровнять ноги, а точнее, скрыть их кривизну можно с помощью специальных силиконовых накладок. Они производятся из материалов, которые по структуре и внешнему виду очень похожи на человеческую кожу. Закрепленные элементы в нужных областях ног хорошо закрываются свободными брюками или джинсами.
- Использование специальных ремней. Суть метода заключается в стягивании ремнями ног в нужных местах на определенное время. Главным недостатком способа является продолжительность процедуры – несколько часов за один сеанс.
Необходимость изменения рациона для коррекции формы ног возникает в тех ситуациях, когда существует неравномерное распределение жировых рецепторов на различных участках голени и бедер. Такая особенность проявляется в том, что на внешней части голени или бедра может находиться большое скопление жира при его минимальном присутствии на внутренней части. Визуально такая диспропорция проявляется в кривизне ног.
Такие проблемы в домашних условиях решаются путем уменьшения общего количества жира в организме с помощью специальной низкоуглеводной диеты при активном использовании акцентированных физических упражнений.
Суть диеты заключается в соблюдении следующих рекомендаций:
- Исключение из рациона быстроусвояемых углеводов. К ним относят все сладкое и мучное.
- Достаточное содержание ненасыщенных жирных кислот. Получать их рекомендуется из оливкового масла, орехов, морской рыбы.
- Отказ от употребления мясной продукции промышленного производства: сосисок, пельменей, сарделек, различных копченостей.
- Ограничение употребления соли. 3-4 грамма – это максимальное количество, которое допускается употреблять человеку, желающему избавиться от лишнего жира.
Важно иметь в виду, что употреблять кофе, чай и другие стимулирующие нервную систему напитки необходимо только перед физической активностью. В состоянии покоя повышенный адреналин, спровоцированный кофеином, будет приводить к увеличению массы тела и образованию холестериновых бляшек на стенках сосудов.
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На сегодняшний день существует большое множество способов изменения формы ног: от безопасных, совершаемых в домашних условиях до рискованного хирургического вмешательства. Главное, что необходимо учитывать при выборе того или иного метода — это соотношение возможных осложнений и приобретаемого положительного косметического эффекта.
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