Pez Cavus Foot
What is Pes Cavus (High-Arched Foot)?
Pes cavus is a foot deformity characterized by an excessively high arch, placing increased pressure on the heel and forefoot.
- May be congenital or due to neurological conditions
- Associated with metatarsalgia, heel pain, ankle instability
Overview of the Condition
High arches can be flexible or rigid, impacting weight distribution. Over time, patients may develop calluses, hammertoes, or frequent ankle sprains due to an unstable foot platform.
Symptoms
- Foot pain under the heel or forefoot
- Instability, frequent ankle rolls
- Calluses or hammertoes from altered load distribution
Causes
Hereditary factors, neurological conditions (e.g., Charcot-Marie-Tooth), and muscle imbalances can lead to high arches. Trauma or poliomyelitis can also be involved.
Diagnosis
A physical exam evaluates foot alignment, flexibility, and gait. X-rays show arch height and any deformities. Neurological assessment may be performed if indicated.
Treatment Options
- Custom orthotics for shock absorption
- Supportive footwear with cushioning
- Physical therapy for stability and balance
- Surgery for severe deformities or progressive symptoms
Conservative Management
Most high-arched feet benefit from shock-absorbing insoles, shoe modifications, and exercises targeting ankle and foot muscle balance.
Rehabilitation Exercises
- Calf and foot intrinsic strengthening
- Balance and proprioception training
- Toe stretching if hammer toes or claw toes develop
When is Surgery Needed?
Consider surgery if pain or instability is severe and not relieved by bracing or orthotics, or if there is a progressive neurological condition altering foot shape.
Surgical Procedures
- Osteotomies to adjust foot alignment
- Tendon transfers to balance muscle forces
- Fusions in severe rigid deformities
Anatomy Overview
A high arch concentrates weight on the heel and metatarsal heads. Muscle and tendon imbalances, especially in neurologic conditions, exacerbate the deformity.
Affected Areas
- Lateral foot instability from lateral shift of weight
- Forefoot with increased pressure under metatarsal heads
- Toes, which can become clawed or hammered
Frequently Asked Questions
| Question | Answer |
|---|---|
| Will orthotics fix my high arch? | Orthotics won’t change the arch height but can redistribute pressure and reduce pain or instability. |
| Is a high arch always a problem? | Not necessarily. Many people have high arches without symptoms, requiring no treatment unless issues arise. |
Prevention Strategies
- Use supportive, shock-absorbing footwear
- Strengthen foot and ankle muscles
- Monitor foot changes if there is a neurological condition