Supinated Foot Pain

Overview
Children with cavus foot have arches that are much higher than usual. Often, their heels point inward, and all of their toes are flexed. Children with cavus foot have trouble finding shoes that fit. The tops and middles of their feet become sore. They may have pain, and develop thick calluses under the ball and at the outer edges of their feet. Because their high arches make their ankles roll outward slightly, children with cavus foot may feel like their ankles are about to give out. Sometimes they sprain their ankles over and over again.

Causes
There are different causes of a high-arched foot. In many cases, the cause is unknown. In other cases, the cause is a nerve disease, clubfoot or injury. Treatment ranges from changes in shoewear to surgeries, depending on the amount of deformity and related problems.

Symptoms
A high arched foot predisposes an individual to a variety of symptoms because of the manner in which this type of foot absorbs force. The excess loading on the base of the big toe can predispose people to develop sesamoiditis and sesamoid fractures. Traction forces lead to repetitive loading of the tendons on the outside of the foot and therefore predispose patients to develop peroneal tendonitis. Compression forces are increased on the inside of the ankle, which makes damage to the inside (medial) aspect of the ankle joint more common potentially leading to talar osteochondral injuries or even ankle arthritis. The structure and loading patterns of a high arch foot also make it more susceptible to: ankle sprains; fractures on the outside of the fifth metatarsal (Jones fractures); and pain directly under the great toe (sesamoiditis).

Diagnosis
Diagnosing the cause of the cavus foot position is essential prior to surgical planning. Usually, performing a laterally based calcaneal osteotomy and a distally based metatarsal osteotomy together or each procedure alone can help position the foot properly.

Non Surgical Treatment
Treatment of high arches really depends a great deal on what?s causing them. If it?s not likely the condition will worsen with time, usually the case when the cause is NOT neurological, then more conservative treatments may be effective, enabling you to live without significant pain.

Surgical Treatment
Possible operations include straightening your toes to stop them rubbing on your brooks running shoes and to take the pressure off the ball of your foot, breaking and re-shaping one or more bones in the front, middle or heel of your foot to straighten the deformity, re-shaping and stiffening one or more joints, usually in the middle or heel of your foot, to straighten the deformity and make your foot more stable, moving one or more of the tendons of your foot to another part of the foot to give more strength to a weak area, tightening the ligament of your ankle or strengthening it with another bit of tissue to stop your ankle going over. You might need more than one option from this list, and it may not be possible to do it all at once. Your surgeon will discuss the options fully with you, including the chances of success and failure, to help you make up your mind about what you want to do.