Pes Cavus Causes Symptoms

Overview
In a few people with cavus feet who have weak calf muscles, the heel is also drawn down and this adds to the height of the arch. Other people, whose Achilles tendons become tight, have their heel drawn up. This tends to increase the pressure on the ankle and the ball of the foot. Other people's heels are neither drawn up or down. The heel of any cavus foot may also turn inwards because of the tilting of the rest of the foot. To start with, the heel tilting is flexible but with the passage of time the tissues and joints may become stiff and the heel tilt may become fixed.

Causes
The most frequent cause of cavus foot in children is a nerve or muscle disease. The condition usually is not present at birth but rather develops slowly during the first 10 years of life. Among cavus foot?s most common causes are Charcot-Marie-Tooth disease (CMT), Spina bifida, Polio, Muscular dystrophy, Injuries to the nerves in legs or spinal cord, Injuries to the leg muscles, Cavus foot also may be an inherited structural abnormality.

Symptoms
The foot serves as an organ of load distribution, shock absorption, balance and propulsion. Pes cavus interferes with all of these functions. Supination of the hindfoot normally results in a change of the foot from a loosely packed, flexible, energy absorbing structure to a tightly packed, stiffer lever. This change occurs naturally during the gait cycle. When the hindfoot remains supinated throughout the gait cycle, however, the reduced flexibility lessens the foot?s capability as a shock absorber and diminishes its ability to balance on uneven ground. Hindfoot varus also leads to an increased moment on the ankle, making ankle inversion injuries common. Eventually there may be dramatic varus tilting of the ankle and secondary osteoarthritis.

Diagnosis
Coleman block test helps guide treatment, evaluates flexibility of hindfoot by putting block under lateral foot you eliminate the contribution by the first ray, a first ray that is overly flexed can contribute to a varus deformity, flexible hindfoot will correct to neutral or valgus when block placed under lateral aspect of foot, a rigid hindfoot will not correct into neutral, always remove shirt and look for spinal dysraphism.

Non Surgical Treatment
Do plenty of static stretching, especially of the calf muscles and the sole of the foot. This will loosen the muscles and other structures in the foot making it more flexible and able to cope with the demands of walking. Take steps to avoid injury such as correct shoe selection, strengthening and stretching exercises. See a specialist who can fit orthotic inserts for a Pes Cavus foot. These are insoles which are worn in the shoes and help correct any biomechanical problems of the foot. They can be custom made or often bought off the shelf ready made. With a high arch it is probably best to see a professional for advice. Many off the shelf insoles are ideal for over pronation or rolling in but not so effective for supinating feet or rolling out.

Surgical Treatment
Most people with cavus feet do not need operations. However, if your cavus feet cause a lot of pain, rub badly on your shoes so that the skin breaks down, or your foot or ankle are very unstable, and simple treatment has not helped, it may be worth considering an operation to straighten your foot. Your GP can refer you to an orthopaedic foot and ankle surgeon to advise you about surgery.