Bilateral Talipes Cavus Foot
Although medical knowledge regarding pes cavus exists, the research and treatment options, as well as any theories or hypotheses as to why humans develop this deformity, are quite limited. Traditionally, we have considered pes cavus a neuro?muscular problem with a surgical answer. By combining what is known with what we can hypothesize, perhaps we can establish a new and more successful approach to pes cavus.
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 may vary from a mild problem with shoe fitting to significant disability such as difficulty finding proper fitting footwear because the shoes are not deep enough due to high arch and the clawed toes. Shortened foot length. Foot pain with walking, standing, and running. Metatarsalgia with pain in the forefoot/ ball of the foot (usually 1st and 5th metatarsal heads), with or without calluses/corns. Pain and stiffness of the medial arch or anywhere along the mid-portion of the foot. Morton's neuroma with pain in the ball of the foot and lesser toes. Pain in the heel and sole of the foot from plantar fasciitis. Stress fractures of the metatarsals and other foot bones. Particularly in diabetics and those with compromised circulation, abnormal pressure may result in chromic ulcers of the heel and ball of the foot. Strain and early degenerative joint disease (osteoarthritis) of lower extremity joints. ?Pump bumps" (Haglund's deformity) on the back of the heel. Associated discomfort within and near the ankle joint. Ankle instability with frequent sprains. Tight Achilles tendons. The knees, hips, and lower back may be the primary source of discomfort. Chronic lower extremity pain my lead to inactivity and diminished well-being.
You will be asked about your symptoms and medical history. A physical exam will be done. You will also be asked about your family medical history. Your foot will be examined closely. Your doctor may move it around to assess range of motion. You may be referred to a specialist. An orthopedist specializes in bones. Podiatrists specialize in feet. The condition may be caused by a nervous system condition. In this case your doctor may refer you to a neurologist. Images may need to be taken of your foot. This can be done with x-rays.
Non Surgical Treatment
Conservative care is highly successful in the cavus high arch foot. An orthotic with a high lateral heel flange, a valgus post and a sub-first metatarsal cutout can balance the foot. Often, the first ray is plantarflexed and a cutout of the first metatarsal head is essential for forefoot balancing. In severe ankle instability cases, an over the counter ankle-foot orthotic or a custom ankle-foot orthotic can be beneficial in balancing the foot and ankle. Consideration of a first ray cutout should also be part of the bracing process.
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.