Методические указания к проведению упражнений для профилактики и лечения плоскостопия у детей
В целях борьбы с этой весьма распространенной деформацией предупреждать её следует с раннего детства, тем более, что стопа особенно интенсивно формируется в первые три года. Лучшим профилактическим средством является ежедневная гимнастика, массаж. В дошкольном и школьном возрасте необходимо включать как в комплексы ежедневной утренней гимнастики, так и в физкультурные занятия специальные упражнения, укрепляющие свод стопы. Однако гимнастика для детей с плоскостопием не должна состоять только из упражнений, укрепляющих мышцы ног. Такая гимнастика будет вызывать утомление мышц стопы.
Специальные упражнения для стоп должны применяться в сочетании с общеразвивающими упражнениями для мышц верхних конечностей, плечевого пояса, нижних конечностей, тем более, что плоскостопие возникает чаще у ослабленных детей. Нередко плоскостопие является спутником сколиоза или поталогической осанки.
В целях разгрузки мышечно-связочного аппарата стопы и голени необходимо проделывать специальные упражнения в положении сидя и лёжа. Основными видами упражнений при плоскостопии являются подошвенное сгибание (оттягивание носков вниз) и супинирование стоп (поворот внутрь). Следует избегать пронирования стоп: это движение усиливает патологическое состояние связочно-мышечного аппарата стоп и голеней.
Помимо систематических занятий физическими упражнениями в детском саду, школе или детской поликлинике, рекомендуются ежедневные занятия дома. Все упражнения должны выполняться босиком.
Упражнения, рекомендуемые детям с плоскостопием в виде домашних заданий
1. Упражнение "каток" — ребенок катает вперед-назад мяч, скалку , или бутылку. Упражнение выполняется сначала одной, затем другой ногой.
2. Упражнение "разбойник" — ребенок сидит на полу с согнутыми ногами. Пятки плотно прижаты к полу и не отрываются от него в течение всего периода выполнения упражнения. Движениями пальцев ноги он старается подтащить под пятку разложенное на полу полотенце (или салфетку), на котором лежит какой-нибудь груз (например, камень). Упражнение выполняется сначала одной, затем другой ногой.
3. Упражнение "маляр" — ребенок, сидя на полу с вытянутыми ногами, колени выпрямлены, большим пальцем одной ноги проводит по подъему другой ноги по направлению от большого пальца к колену. "Поглаживание" повторяется 3-4 раза. Упражнение выполняется сначала одной, затем другой ногой.
4. Упражнение "сборщик" — ребенок, сидя на полу с согнутыми коленями, собирает пальцами одной ноги различные мелкие предметы, разложенные на полу (игрушки, прищепки для белья, ёлочные шишки и др.), и складывает в кучки. Другой ногой он повторяет то же самое. Затем без помощи рук перекладывает предметы из одной кучки в другую. Следует не допускать падение предметов при переносе.
5. Упражнение "художник" — ребенок карандашом, зажатым пальцами ноги, рисует на листе бумаги различные фигуры, придерживая лист другой ногой. Упражнение выполняется сначала одной, затем другой ногой.
6. Упражнение "гусеница" — ребенок сидит на полу с согнутыми коленями, пятки прижаты к полу. Сгибая пальцы ног он подтягивает пятку вперед к пальцам, затем пальцы снова распрямляются и движение повторяется (имметация движения гусеницы). Передвижение пятки вперед за счет сгибания и выпрямления пальцев ног продолжается до тех пор, пока пальцы могут касаться пола. Упражнение выполняется обоими ногами одновременно.
7. Упражнение "кораблик" — ребенок, сидя на полу с согнутыми коленями и прижимая подошвы ног друг к другу» постепенно старается выпрямить колени до тех пор, пока пальцы и пятки ног могут быть прижаты друг к другу (старается придать ступням форму кораблика).
8. Упражнение "мельница" — ребенок, сидя на поду с выпрямленными ногами, описывает ступнями круги в двух направлениях.
9. Упражнение "серп" — ребенок, сидя на поду с согнутыми коленями, ставит подошвы ног на под (расстояние между ними 20 см). Согнутые пальцы ног сначала сближаются, а затем разводятся в разные стороны, при этом пятки остаются на одном месте. Упражнение повторяется несколько раз.
10. Упражнение "барабанщик" — ребенок, сидя на полу с согнутыми коленями, не касаясь пятками пола, двигает ступнями вверх и вниз, касается пола только пальцами ног. В процессе выполнения упражнения колени постепенно выпрямляются.
11. Упражнение "окно" — ребенок, стоя на полу, разводит и сводит выпрямленные ноги, не отрывая подошв от пола.
1. И. п.: стоя, мяч на полу перед собой, руки внизу произвольно. Стать на колени, на мяч, вернуться в исходное положение (рис.32).
Усложнения: а) Опускаясь на мяч, руки поднимать вперед; б) опускаться на мяч, держа руки на поясе.
2. И. п.: стоя на коленях, мяч внизу в двух, руках. Садиться вправо и влево с мячом в руках.
3. И. п.: стоя, мяч на полу, одна нога на мяче, руки на поясе. Прыжком сменять положение ног. Чтобы мяч не откатывался, ногу ставить на мяч сверху.
Дозировка: 12—15 раз.
4. И. п.: сидя, руками опереться о пол сзади, мяч впереди. Согнуть ноги, поставить их на мяч. Выпрямляя ноги, сильно толкнуть мяч, встать, догнать его.
Усложнение: выполнять упражнение сидя парами на расстоянии 3—4 м.
5. И. п.: сидя, ноги согнуты, стоят на мяче, руками опереться о пол сзади. Выпрямить ноги и опустить их на мяч <рис.33).
6. И. п.: стоя, мяч на полу, руки на поясе. Прыжки на двух или на одной ноге вокруг мяча в правую и левую сторону.
Дозировка: 3—4 раза в каждую сторону с перерывом.
7. И. п.: стоя, мяч на полу, ноги вместе, руки слегка отведены назад. Прыжки на двух ногах через мяч. Стараться прыгать как можно дальше, а не выше.
8. И. п.: стоя, ноги врозь, руки внизу, мяч на полу. Прыгнуть через мяч, успев над мячом соединить ноги вместе и приземлиться держа ноги вместе.
10. И. п.: дети стоят в две шеренги (12—15 человек), одна из которых получает мячи и кладет на пол. Толчком одной ноги дети перекатывают мячи партнерам, те, получив мячи, возвращают их обратно.
11. И. п.: стоя, мяч на полу. Па сигналу обежать вокруг мяча, по сигналу "Хлоп!" присесть на корточки и ударить по мячу ладонями.
Необходимого эффекта от упражнений с набивными мячами можно добиться только при условии рациональной методики их применения. Комплексы упражнений составляются в соответствии с задачами разносторонней физической подготовки. Упражнения подбираются в определенной последовательности, чтобы обеспечивалось чередование работы разных групп мышц — плечевого пояса, спины, живота и ног. Следует также менять исходные положения. Упражнения с подниманием мячей хорошо чередовать с подскоками, прыжками, катанием мяча.[1]
УПРАЖНЕНИЯ ДЛЯ УКРЕПЛЕНИЯ СТОПЫ
Для правильного выполнения ходьбы, бега, прыжков необходимо укреплять мышцы, обеспечивающие подошвенное сгибание стопы. У дошкольников слабо развит связочно-мышечный аппарат стопы. Поэтому нередки случаи появления плоскостопия. При этом ребенок во время ходьбы и стояния быстро устает. Предупреждать плоскостопие надо с раннего возраста. Средства для этого различны— общее укрепление организма посредством правильного питания, длительного пребывания на свежем воздухе, физических упражнений. Могут быть и специальные упражнения, способствующие развитию и укреплению мышц голени, стопы и пальцев ног. Наибольший эффект оказывают движения, проводимые босиком и по возможности несколько раз в день: утром и после дневного сна (это время когда мышцы стопы расслаблены, не устали).
1. И. п.: стоя, ноги слегка расставлены, ступни параллельно, руки на поясе. Приподняться на носки и опуститься на всю стопу.
2. И. п.: то же. Делать перекаты с носка на пятку.
Усложнение: упражнение выполнять стоя на палке;
3. И. п.: сидя на стуле, ноги прямые, руки свободно. Сгибать и разгибать пальцы стопы.
4. И. п.: сидя на стуле, ноги согнуты, одна нога стоит на полу, другая на ней. Поочередно потирать одной ногой другую.
5. И. п.: сидя на стуле, ноги прямые. Поочередно или одновременно поднимать носки ног вверх и опускать в исходное положение, не отрывая пяток от пола.
6. И. и.: сидя на стуле, пятки на полу, носки вверх. Разводить носки ног в стороны и соединять их вместе, пятки при этом от пола не отрывать.
7. И. п.: сидя на полу. Захватывать пальцами ног разные мелкие предметы (палочки, шарики, карандаши), подкатывать их к себе, перекладывать вправо и влево.
8. И. п.: сидя на полу, ноги стоят на гимнастической палке. Сгибая и выпрямляя ноги, катать палку стопами ног вперед и назад.
9. И. п.: сидя парами, ноги на одной палке. Стараться пальцами ног подтянуть палку к себе.
10. И. п.: сидя на полу, веревка впереди. Поднять её пальцами ног и опустить на пол.
11. И. п.: стоя, ноги — пятки и носки вместе. Передвигаться в правую сторону, поочередно приподнимая и переставляя пятки и носки сомкнутых ног. После 6— 8 шагов сделать перерыв, затем передвигаться в левую сторону.
12. И. п.: то же. Передвигаться в сторону, поочередно смыкая вместе то носки, то пятки обеих ног.
13. И. п.: стоя, нога слегка расставлены, руки на пояce. Подниматься поочередно на носок то правой, то левой ноги (пятку от пола отрывать, носок на полу).
14. Разные виды ходьбы: на носках, на внешней стороне стопы (пальцы внутрь, ступни параллельно), по ребристой доске, положенной на пол горизонтально или с небольшим наклоном (примерно 30°).
Во время прыжка необходимо обращать внимание на отталкивание, которое должно быть энергичным, сильным, возможно более коротким. Ноги перед прыжком незначительно сгибаются в коленях и резко выпрямляются в момент толчка, снова сгибаются в завершающей фазе. При подскоках движения сгиба и разгиба, соответствующие моментам расслабления и максимального усилия, повторяются неоднократно, приобретают циклический характер, развивают мышцы ног, живота и всего туловища.
Прыжки на двух ногах:
1) продвигаясь вперед прямо;
2) продвигаясь вперед змейкой между предметами (мячами и др.)
3) через линии, начерченные на разном расстоянии— 30, 40, 50, 60 см (задача упражнения — уметь соразмерять мышечное усилие с поставленным заданием);
4) вверх и вниз по скату, положенному на 2—3-ю перекладину гимнастической стенки или башни;
5) стоя повернувшись боком (правым или левым) через линию или палку на месте и продвигаясь вперед;
6) из обруча в обруч с междускоками и без них;
7) в приседе продвигаясь вперед;
8) со скакалкой на месте и в движении.
Спрыгивание с возвышения:
2) на одну из линий, расположенных на расстоянии 10, 20, 30 см;
4) с последующим быстрым отскоком вперед или подскоком вверх.
Прыжки на двух ногах на возвышение (несколько матов, широкая банкетка):
1) с места толчком двух ног;
2) с 2—3 шагов толчком одной ноги;
3) с разбега толчком одной ноги.
Лазанье по гимнастической стенке:
1) приставным шагом;
2) переменным шагом с перекрестной координацией (правая нога и левая рука, левая нога и правая рука);
3) переменным шагом с одноименной координацией (правая нога и правая рука, левая нога и левая рука);
4) влезть на один пролет, перейти на соседний и по нему спуститься;
5) подняться на четвереньках но наклонной доске или приставной лестнице, спуститься по гимнастической стенке;[5]
Упражнения от плоскостопия – важная часть комплексного терапевтического воздействия на измененный свод ноги ребенка. Регулярное и правильное использование тренировок позволит остановить негативные процессы, а в начале патологических изменений и полностью устранить их.
Возрастные особенности
Высокие технологии позволяют людям совершать новые научные открытия и улучшают их жизнь. В то же время они все дальше «отодвигают» человека от его естественной «среды обитания». Наши дети уже не бегают босиком, им обязательно нужно носить обувь, ведь это «опасно» или некрасиво, по мнению родителей. Такая излишняя забота приводит к уменьшению детской физической активности, что становится причиной развития многих проблем с опорно-двигательным аппаратом. А отсутствие естественных «неровностей» на пути детских ног в виде камней, травы или песка приводит к неправильному формированию свода стопы и ослаблению мышечного аппарата.
Слабые мышцы и связки на ногах у малыша становятся причиной развития плоскостопия. Главная задача упражнений при плоскостопии у дошкольников – укрепить мышцы стопы со всех ее сторон, а также ускорить ток крови в ней.
Наиболее результативна оздоровительная гимнастика при устранении плоскостопия у детей дошкольного возраста. Хороших результатов достигают и при использовании ЛФК с 14 до 16 лет. Весь этот период стопа формируется, поэтому ее можно еще видоизменить. По истечении этого времени остановить патологию с помощью упражнений практически невозможно.
Планируя занятия с детьми младшего возраста, родители должны понимать, что принуждать малышей к тренировкам нельзя. Так можно «отбить» у них желание заниматься. Главным аспектом при планировании комплекса лечебной физкультуры для малышей 3-7 лет является игра. При возникновении неприятных ощущений или боли отдельные упражнения можно не делать до тех пор, пока дошкольник сможет их выполнить.
После 7 лет применяется другая тактика: настойчивость и упорство. Правильная мотивация позволит справиться с проблемой быстрее.
Длительность тренировок также зависит от возраста. Так, первые занятия для малышей проходят за 3 минуты. С каждым днем их продолжительность увеличивается на 2-3 минуты. Оптимальное время для тренировок после «подготовительного» этапа привыкания составляет 15 минут. Занятия для подростков начинают с 8-10 минут, ежедневно увеличивая продолжительность и интенсивность. Средняя тренировка в этом возрасте составляет 25-30 минут.
В любом возрасте тренировки должны проходить ежедневно. Регулярная проработка всех мышц – залог хорошей результативности.
Разрешенные виды физической нагрузки
Помимо лечебной физкультуры при плоскостопии детям необходима другая физическая активность. Однако родители должны четко разделять, какие виды спорта принесут дополнительную пользу, а от каких нужно воздержаться, чтобы не усугубить ситуацию.
Начнем с перечисления запрещенной при плоскостопии физической активности:
- Тяжелая атлетика;
- Пауэрлифтинг;
- Бокс;
- Легкая атлетика;
- Футбол;
- Хоккей;
- Катание на коньках.
Запрещены любые занятия, связанные с бегом и прыжками. Такие тренировки вызывают сильную нагрузку на позвоночник даже у здорового человека. А у детей, у которых выявлены нарушения амортизации стопы, эти нагрузки увеличиваются вдвое.
Справиться с проблемой помогут такие направления в спорте:
- Плавание;
- Восточные единоборства;
- Велоспорт.
Так как активная физическая нагрузка не противопоказана детям с плоскостопием, от уроков физкультуры их не освобождают. При нарушениях 2-3 степени для школьников организуют занятия в специальных группах со щадящей, правильно подобранной нагрузкой.
Комплекс упражнений для детей
Проводить гимнастику для плоскостопия у детей можно дома или в кабинетах ЛФК. Второй вариант предпочтительнее, особенно в начале тренировок. Кабинет ЛФК оборудован всеми необходимыми приспособлениями, которые показано использовать во время занятий. После нескольких тренировок под руководством опытного инструктора родители, приобретя нужные приспособления, могут «перенести» занятия домой.
Конкретный комплекс упражнений при плоскостопии врач подбирает только дошкольникам, достигшим 4-5 лет. Связано это с тем, что малыши до этого возраста не могут выполнять предложенные инструктором действия осознанно. Поэтому занятия не могут считаться качественными, а упражнения правильно выполненными.
Упражнения для детей 2-3 лет
Для самых маленьких пациентов разработаны не упражнения, а веселые игры. Участвуя в них, малыш весело проводит время, не подозревая, что все его действия направлены на исправление дефектов на стопах.
- Разложите перед детьми крышки от пластиковых бутылок. Попросите собрать их с помощью пальцев ног и сложить их в отдельные корзинки. Кто первый справится с заданием, тот и победитель. Крышки можно заменить любыми предметами,
- Используйте подушку, наполненную любой крупой. По правилам игры победит тот малыш, кто сможет пронести ее как можно дальше на своей голове. Упражнение помогает контролировать и формировать правильную осанку.
- Игра в «пятнашки». С помощью веселой игры, во время которой дошколята должны бегать друг за другом, можно исправить деформацию стопы.
- Упражнение, во время которого детям нужно ходить, опираясь на разные части стопы, представляют в виде походки разных зверей. Малышам предлагают походить как медвежата, пингвины или красивые балерины. Для этого они наступают на внешнюю часть стопы, а затем на внутреннюю. Также нужно ходить на носочках и на пятках.
Поощряйте малыша прыгать или ходить в указанных положениях. С помощью этих простых движений развиваются и укрепляются все группы мышц.
Комплекс упражнений для детей 4-7 лет
В этом возрасте дошкольники могут осознанно повторять предложенные им движения. Рассмотрим примерный комплекс упражнений для детей этого возраста. Помните о том, что перед тем, как приступить к основной тренировке, нужно сделать разминку.
- Малыш садится на пол и вытягивает ноги. Под счет инструктора сгибает стопу, затем разгибает. С каждым движением скорость выполнения задания нужно увеличивать. Вначале упражнение делают каждой ногой по очереди. Затем одновременно двумя ногами.
- Не меняя положения, ребенок «крутит» стопой по часовой стрелке, а затем против нее. Вначале упражнение делают каждой ногой по очереди. Затем одновременно двумя ногами.
- Стоя с прямой спиной, расположив руки вдоль тела, малыш приподнимается на носочки. Затем меняет положение, перекатываясь с носка на пятку.
- Дети идут по кругу на носочках, периодически меняя положения стопы на пятку.
- Ребенок становится на пальчики и приседает. Приседания не должны быть глубокими.
- Ходьба на искусственно созданных неровностях. Для этого упражнения используют специальные ортопедические коврики, которые имитируют камни, траву и т. д.
- Сидя на скамейке, малыш перекатывает гимнастическую палку стопами.
- Дети бегают друг за другом. По сигналу инструктора останавливаются, становятся на носочки и вытягивают вверх руки.
В комплекс включают также игры, предназначенные для детей младшего возраста. Главное, чтобы малыши не переутомлялись, получая удовольствие от проведенных занятий.
Полезное видео — комплекс упражнений при плоскостопии у детей
Профилактика плоскостопия у дошкольников
Чтобы предотвратить неправильное развитие стопы, достаточно организовать ребенку активную физическую нагрузку. Важно, чтобы большая ее часть проходила на свежем воздухе. Разрешайте летом малышу ходить босиком. Доставьте ему удовольствие бегать по теплым лужам после дождя. Мельчайшие частицы земли, камни, маленькие ветки станут естественными тренажерами, которые не позволят развиться патологическим изменениям.
Плавание, подвижные игры с использованием мяча, катание на лыжах усилят эффект и станут отличным профилактическим средством от плоскостопия.
Чтобы не «упустить момент» и вовремя выявить болезнь, малыша нужно водить на регулярные профилактические осмотры к ортопеду. Покупайте ему обувь из качественных материалов, точно соответствующую его размеру. Еще одним средством профилактики являются ортопедические коврики, с помощью которых дошкольник сможет разрабатывать и укреплять мышцы стоп.
Сбалансированное питание, в котором учтена суточная доза полезных веществ и витаминов, – важная составляющая здоровых костей и связок. Соблюдение правил питания предусматривает правильный питьевой режим. Он не позволит ребенку набрать лишний вес, который негативно скажется на состоянии стоп.
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