When you hear the words “Pes Cavus”, what initially comes to your mind? For some it might be fine childhood memories of eating sugary “Pez” candies, and collecting their dispensers. Others might recall the summer exploring the local caves in the forest. The literal meaning of Pes Cavus, however, is “hollow foot” and is the term used to describe a high arched foot. A high arched foot results when the forefoot turns inward (metatarsal adductus) and the hindfoot or the heel also turns inward (rearfoot varus).
What causes a high arched foot?
The above mentioned changes are most often a result of muscle balance deficiencies. Without getting into too much detail, weakness of one muscle allows for another muscle to “take over” or gain the “advantage”, thus pulling the foot into an abnormal position. The majority of these muscles imbalances are often due to an underlying neurological condition (eg. Muscular Dystrophy, Cerebral Palsy, Charcot-Marie-Tooth disorder). Other causes may also include residual club foot, trauma, severe burns, fracture malunion, or even idiopathic or spontaneous causes with no underlying condition
Signs, Symptoms, and Complications of Pes Cavus
Signs and symptoms of a high arched foot include the following:
- pain on the outside of the ankle
- plantar fasciitis
- claw toes
- lack of shock absorption, leading to exclusion from high impact activities
Treatment is often a combination of conservative and surgical treatment. Conservative therapy often includes custom orthotics or bracing. Surgical treatment often involves both soft tissue procedures and bony procedures. Soft tissue procedures include tendon transfers and Achilles lengthening. These procedures often require extensive physical therapy both before and after the surgery.