Supinated Foot Positioning

Overview
Pes cavus occurs in up to 15% of the population, of which 60% will develop foot pain (Burns 2005). Common complaints associated with pes cavus include pain under the metatarsal heads and the heel, lateral ankle sprains, and footwear issues. Custom orthoses should be designed to address the pathomechanics of problematic cavus foot based on the evidence in the literature.

Causes
Causes of a cavus foot type probably have some heredity origins making you more prone to have this type of foot. Ask your parents and siblings and see what kind of foot structure they have as well. There are multiple reasons this foot structure may cause symptoms to exist, most dealing with an imbalance of foot and leg muscles. Some neuromuscular diseases, such as Spina Bifida or muscular dystrophy can make one prone to a cavus foot type as the muscle become weaker. Having a weak calf muscle or a tight calf muscle can cause a cavus foot depending on the biomechanics involved.

Symptoms
The symptoms of a high arch foot will vary depending on the severity of the arch height, the availability of joint motion in the foot to help lower the arch and the activity levels or occupational demands placed on the high arched feet. Most people with high arches will have no pain or any other symptoms. Symptoms may vary from a mild problem with shoe fitting to significant disability.

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
In severe cases of cavus, surgical intervention is often necessary. The main consideration for surgical planning is the cause of the cavus deformity. Consider whether it is a structural deformity or one caused by an underlying traumatic event such as a peroneal tendon tear or ankle instability. Furthermore, in either a structural or traumatic case, it is important to consider if the cavus is from a plantarflexed first ray only, a calcaneal varus only or a combination of the two deformities together. After considering all the information, one can plan for surgery.