Pes cavus is a medical condition in which arch of foot is raised higher than normal. This condition is also termed as high instep/high arch/talipes cavus/cavoid foot. This condition is opposite to flatfoot and occurs less commonly than flatfoot. With Pes Cavus or High Arch Foot, there is permanent plantar flexion of foot. This is a painful condition and if left untreated leads to disability. Patient has difficulty in fitting shoes. Tight calf muscles are usually present with this condition. This condition may be hereditary or acquired. The cause of this condition may be neurological, orthopedic or neuromuscular.
Types of Pes Cavus or High Arch Foot
- Pes Cavovarus: This is one of the most frequent forms of this condition. It frequently occurs in individuals with neuromuscular conditions like CMT disease.
- Pes Calcaneocavus: This commonly occurs when there is paralysis of triceps surae as a result of conditions like poliomyelitis. In this type, the calcaneus gets dorsiflexed and front part of foot plantarflexed. X-ray shows a large talocalcaneal angle.
- Pure form Pes Cavus: In this type, the front part of foot is plantarflexed on the rear part of the foot causing high arch and the position of calcaneus is not in dorsiflexion or varus.
Pes Cavus or High Arch Foot may have a combined form in which there is mix of all the above factors. Pes Cavus or High Arch Foot can also be categorized further as flexible and rigid.
Complications Due to Pes Cavus or High Arch Foot
- Running causes pain in the feet.
- Toes are very painful, are present in a flexed position and cannot be straightened.
- Chronic pain.
Signs and Symptoms of Pes Cavus or High Arch Foot
- The foot length is shortened.
- Pain upon walking, running and standing.
- Difficulty fitting into shoes.
- Gait disturbances.
- Leads to other foot problems.
Diagnosis of Pes Cavus or High Arch Foot
- X-ray of the spine
- X-ray of the feet
- Nerve conduction studies
- MRI of the spine
Treatment for Pes Cavus or High Arch Foot
- Static stretching of calf muscles and sole of the foot should be done daily, multiple times a day.
- Injury or other damage to the foot should be avoided.
- Appropriate footwear should be used.
- Strengthening and stretching exercises should be done.
- Sports specialist should be consulted who can prescribe orthotic devices.
- Specialized cushioned footwear should be used.
- If there are any calluses on the plantar surface, then they should be debrided.
- Osseous mobilization can be done.
- Massage is also beneficial.
- Chiropractic manipulation of the foot and ankle are also helpful.
- Surgery may be required if the pain is severe and is causing difficulty to the patient in performing daily activities.
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