Inner corridor

from Wikipedia, the free encyclopedia

When inner gear or Einwärtsdrehgang ( English walking in-toe or in-toing ) the big toe face each other while walking and the foot rolls over the outer side. This leads to increased wear and tear in the ankles, kneecaps and also in the hip bones. Besides Einwärtsgang of the feet, there is the so-called Kniebohrgang English kneeing in .

In toddlers, the inner corridor is often a temporary phenomenon that is harmless. From around the age of 10, the gait pattern should have normalized and the foot should roll straight to the point where it is turned slightly outwards . The counterpart to this phenomenon is called “outward gait” or “external rotational deformity”.

Subdivision

The inward, inner or toe inner gait is referred to in technical terms as the inner rotation gait. The feet are not parallel to each other, but are "turned inwards" (internal rotation). This gait pattern occurs especially in small children and usually has no pathological causes. The thigh is often turned inwards in toddlers, so the knees do not point exactly forward.

  • English Femoral Anteversion - twisting of the thighbone ( Latin femur ) below the hipbone, can possibly be favored by sitting too often on the floor, whereby the legs form a so-called W-position ( naiad seat ). Functional problems rarely arise. The malposition normally normalizes by the age of 13 or 14.
  • English Internal Tibial Torsion - twisted shin bones ( Latin tibia ) changes in the lower legs or knees. A form in babies and toddlers that mostly arises from its position in the uterus during pregnancy and normalizes as it grows. The malposition usually normalizes by the age of 6 or 7.
  • Latin metatarsus adductus - curved metatarsal bone , can occur in small children who mostly sleep on their stomach. For more pronounced problems, a doctor may prescribe special shoes or splints. An operation to straighten the feet is only required in very rare cases.

Psychomotor inner passage

In some cases, the interior passage is a consequence of a lowering or Knicksenkfußes , which can roll in the normal case only over the big toe and thereby rotates the foot outwards. In some people - mostly girls - this, also harmful gait, is counteracted in the subconscious in order to relieve the big toes. This is called the inner psychomotor duct . Our muscles are controlled by the brain. If the arching foot is turned inwards, it must roll over the little toes. This inevitably results in the heel and shin bones being turned inwards. The result: excessive, one-sided wear in the knee and hip joints.

The inner passage can, however, also have other growth-related or congenital reasons that make a visit to an orthopedic doctor or therapist specializing in children's feet and legs necessary.

therapy

Individual insert therapy leads to normalization of the gait pattern and stabilization of the foot muscles. This insert therapy is initiated as follows:

  • Well-defined support inserts after a plaster cast (for angled foot with heel correction)
  • Apparent gait control after 3–6 months
  • If the gait pattern and rolling process are not neutral by then, medial support strips are attached to the insoles. These ensure that the inner corridor becomes uncomfortable.

After a few weeks, the muscle control programs itself accordingly and the child walks normally. You will not be able to remedy this with soft foam inserts, but these cheap insoles are among the most prescribed insoles in Germany!

Treatment should take place from the age of 4. It must be clarified in advance whether the gait behavior is caused by a flat foot. The administration of custom-made insoles with an internal arch correction and an unwinding support wedge glued to the outside of the insoles is sufficient to normalize the gait pattern within a period of between two weeks and eight months. Of course, foot exercises are also part of this therapeutic measure.

Children and adolescents usually have no problems getting used to. In adults, insert therapy can cause tension pain from the foot to above the calves in the hips.

Before applying the insole regulation, it is important that the gait pattern is carefully checked and recorded so that the lateral wedge can be correctly positioned.

Consequences of the untreated inner passage

  • The vault can be permanently deformed in the direction of the hollow foot due to the tension during rolling.
  • Hip and knee problems often appear during or after puberty.

literature

  • H. Scheier: Inward movement and regression of the anteversion of the femoral neck . In: Archive for orthopedic and trauma surgery, with special consideration of fracture theory and orthopedic-surgical technology . tape 61 , no. 3 , September 1967, ISSN  1434-3916 , pp. 262-266 , doi : 10.1007 / BF00416439 , PMID 5590889 .
  • Inner passage of the feet: what to do if the child walks inwards with their feet In: New Osnabrück Newspaper. February 6, 2017 ( noz.de ).
  • Olga M. Morozova, Thomas F. Chang, Mackenzie E. Brown: Toe Walking: When Do We Need to Worry? In: Current Problems in Pediatric and Adolescent Health Care . tape 47 , no. 7 , July 2017, ISSN  1538-5442 , p. 156-160 , doi : 10.1016 / j.cppeds.2017.06.004 , PMID 28716514 (English).
  • Ronald Verch, Anja Hirschmüller, Juliane Müller, Heiner Baur, Frank Mayer, Steffen Müller: Is in-toing gait physiological in children? - Results of a large cohort study in 5910 healthy (pre-) school children . In: Gait & Posture . tape 66 , 2018, ISSN  0966-6362 , p. 70–75 , doi : 10.1016 / j.gaitpost.2018.08.019 , PMID 30170136 (English).
  • Sontka Tamm: Differential Diagnoses in Pediatric Osteopathy . Ed .: Torsten Liem, Christina Lenz, Cristian Ciranna-Raab. 2019th edition. Thieme Verlag, Stuttgart 2019, ISBN 978-3-13-220711-0 , 15 gait pattern, abnormalities of the - inward gear, p. 71-73 , doi : 10.1055 / b-0039-168526 .

Web links

Individual evidence

  1. ^ Engelhardt Lexicon Orthopedics and Trauma Surgery. In: Lexikon-Orthopaedie.com. Retrieved May 27, 2020 .
  2. ↑ a b c d In-toe walking - Pediatric Orthopedics. Oxford University Hospitals (OUH), accessed May 27, 2020 .
  3. ↑ Alexander Schuh, Wolfgang Hönle: She sits between her heels - is that normal? In: MMW - Advances in Medicine . tape 158 , no. 13 , 2016, ISSN  1613-3560 , p. 7 , doi : 10.1007 / s15006-016-8468-6 .
  4. ↑ Susanne Klein-Vogelbach: Knee drilling . In: Gait training on functional movement theory (=  rehabilitation and prevention . Volume 16 ). Springer-Verlag, Berlin / Heidelberg 2013, ISBN 978-3-642-50985-8 , p. 106 , doi : 10.1007 / 978-3-642-50985-8 ( books.google.de - reading sample).
  5. ^ Klaus Buckup, Lars-Christoph Linke: Children's orthopedics . 2., rework. and exp. Edition. Georg Thieme Verlag, Stuttgart / New York 2001, ISBN 3-13-697602-9 , p. 43–44 ( books.google.de - reading sample).
  6. ↑ Background knowledge of bones and muscles - everything that is normal. In: Health for Children: Prevent, Recognize, Treat Childhood Diseases. Retrieved May 27, 2020 .
  7. ↑ Femoral anteversion. hopkinsmedicine.org, accessed May 27, 2020 .
  8. ↑ Internal Tibial Torsion. hopkinsmedicine.org, accessed May 27, 2020 .
  9. ↑ metatarsus adductus. hopkinsmedicine.org, accessed May 27, 2020 .