Navigating the World of High Arches: Your Ultimate Pes Cavus Handbook
You’ve probably heard people say that they have high arches in their feet, and that it might cause them some issues. But do you know why some people have high arches and others don’t? Or the issues that high arches can cause?
That’s what we’re here to tell you in this article. Keep reading to learn about this common foot condition.
What is Pes Cavus?
Pes cavus is a condition characterised by excessively high arches in the feet. Unlike flat feet that have fallen or flatter arches, pes cavus causes the arch to elevate higher than normal. This alters mechanics in how the feet contact the ground, distribute body weight, and propel the body forward during gait.
As podiatrists can attest, achieving an accurate pes cavus diagnosis is the first step toward appropriate management. Custom tailored treatment that acknowledges the root biomechanical disturbances from high arches is key to improving comfort and mobility.
Causes and Contributing Factors
There are various possible causes underlying the development of pes cavus feet:
Inherited foot anatomy – Some cases reflect inborn structural characteristics passed genetically through the family tree.
Neurological conditions – Diseases like muscular dystrophy, Charcot-Marie-Tooth disease, cerebral palsy, paralysis or nerve damage from diabetes (neuropathy), stroke, or physical trauma can contribute to foot muscle imbalance and eventual cavus feet.
Limb length discrepancies – Significant differences in leg length alter overall body alignment and weight distribution placing more load on the longer side.
These factors lead to muscular and structural changes in how the complex network of bones, joints, ligaments, tendons, and muscles in our feet and lower legs align and interact.
Over time, imbalances and alterations in these structures can manifest into high-arched cavus feet. When the root causes are thoroughly evaluated, podiatrists can map appropriate treatment options for each patient’s unique presentation.
Common Signs and Symptoms
Though some cases may be asymptomatic for periods, common symptoms associated with pes cavus feet include:
Foot pain – Especially along the arch, ball of foot, and heel since weight is concentrated over smaller surface areas unable to adequately diffuse impact. Pain usually worsens with standing or athletic activities.
Instability and balance problems – The high arch and restricted foot mobility make maintaining equilibrium a challenge. Patients may report frequent ankle rolling and instability.
Foot fatigue and discomfort are common with excess standing or walking due to reduced shock absorption.
Calluses and foot ulcers – Extra pressure on metatarsal heads can cause painful thick calluses in these regions. In some cases, blood supply is impaired, raising risk for non-healing wounds.
Hammertoes and claw toes – With contracted toe muscles and pressure to curl toes downward to reach the ground, these conditions can develop over time.
Numbness, tingling sensation, neuroma pain – Compression or traction on plantar nerves can irritate tissue.
Limited ankle and first toe extension mobility – The foot structure can restrict typical joint range of motion.
Peroneal tendinopathy and instability
There is a heightened risk of additional secondary injuries like ankle fractures or plantar fascia strains due to poor shock absorption, rigid foot positioning, and balance challenges. Thorough evaluation helps podiatrists identify any coexisting conditions needing addressed alongside managing pes cavus.
Diagnostic Process
Skilled podiatrists are experts at diagnosing pes cavus and differentiating it from other potential foot abnormalities. Diagnosis is made through comprehensive foot structure and functional evaluation, including:
Detailed medical history review – Helps identify potential neurological conditions that may be contributing to muscular foot imbalances. Family history may reveal inherited anatomical tendencies.
Physical exam assessing stationary and moveable foot arch characteristics – The podiatrist will evaluate arch shape, height, rigidity, and range of motion.
Observation and analysis of full weight bearing footprint – Hyperpronation patterns may be revealed.
Gait evaluation – To assess step, stance stability, ankle and toe clearances, propulsion patterns.
Muscle strength and flexibility assessment – Weakness or tightness in foot and lower leg musculature impacts mechanics.
Advanced imaging like x-rays, CT scans, or MRI if needed – Further examines bony alignment and joint space integrity.
By systematically comparing findings against hallmark traits of pes cavus, podiatrists can differentiate the condition from flat feet, plantar fasciitis, arthritis, posterior tibial tendon dysfunction, ligamentous injuries, and other abnormalities. An accurate diagnosis steers the course toward suitable conservative or advanced intervention.
Non-Surgical Treatment Approaches
Most cases of pes cavus respond very well to non-operative treatment approaches. Podiatrists have an array of conservative modalities to incorporate into customised treatment plans based on the individual nuances of each case. Options include:
Prescription orthotics – Custom moulded shoe inserts help optimise arch support, alignment, shock absorption, and pressure redistribution. Orthotics can significantly reduce pain and restore functional mobility when appropriately designed.
Bracing – External structural aids like ankle-foot-orthotics provide stability and support during ambulation and athletic activities. These limit the ankle rolling and foot collapse pes cavus patients often experience.
Physical therapy – Specific strengthening exercises target weakened foot intrinsic and extrinsic musculature while stretching protocols enhance flexibility within rigid foot structures. Therapy retrains balanced gait mechanics.
Footwear modifications – Properly fitted athletic shoes with ample cushioning, stability features, and arch support enhances shock absorption and realignment.
Activity modifications – Temporarily reducing high impact pursuits protects during inflammatory phases.
Pain management – Oral anti-inflammatory medication, supportive taping, or foot mobilization can relieve discomfort.
Conservative treatment is almost always successful at managing pes cavus related symptoms non-operatively when consistently implemented over time. Patients integrate podiatric recommendations into their daily lifestyle for maximal benefit.
Paediatric Care
Assessing and addressing paediatric cases deserves unique consideration given developing bone and soft tissue structures. As podiatrists, we tailor management approaches to nurture normal biomechanical development and prevent future complications:
Close monitoring of growth milestones – Intervene promptly if delays arise
Prescription orthotics and shoes – Control abnormal alignment and pronation
Stretching programs – Maintain muscle balance and joint health
Proprioceptive training – Boost balance reactions
Bracing – Reinforce stability if needed during gait.
Though preventing or fully resolving pes cavus may not be possible if an underlying condition like cerebral palsy or Charcot-Marie-Tooth disease is present, staying ahead of accelerating foot deformities through proactive paediatric podiatry fosters the best possible outcomes.
Impact on Gait and Biomechanics
Beyond isolated foot troubles, pronounced pes cavus deformity substantially impacts gait patterns, mobility, balance, and risk of associated leg injuries. Abnormal foot biomechanics from high arches can manifest in:
Excessive pressure concentrated over smaller surface areas – Most commonly the heel, ball of foot, and metatarsal heads with limited shock dissipation. This raises risk for calluses, pain, and cracking.
Muscular imbalance – Tightness results in calf, achilles, and toe flexor muscles while shin, ankle dorsiflexors, and long toe extensors stretch out and weaken.
Gait abnormalities – Foot rigidity leads to limited ankle mobility, heel strike walking patterns without typical midfoot pronation, and external rotation dominance from tight outside hip musculature.
Heightened ankle instability – The collapsed arch provides minimal stability during stance, frequently rolling the ankle.
Proprioceptive and balance deficits – Falls and instability common
Shin splints, knee/hip pain – Associated leg pains emerge from poor shock absorption.
Rehabilitating pes cavus requires a whole kinetic chain approach guided by podiatry to resolve these maladaptive movement patterns. Promoting flexibility, strength, appropriate step mechanics, tissue resilience, and postural control minimises pains and injury risk long term.
Exercises for Pes Cavus Feet
In conjunction with orthotic interventions, prescribed at-home exercises enhance recovery for those with rigid high-arched feet. Your podiatrist hand selects routines targeting:
Intrinsic foot muscle activation – Toe curls, marble pickups
Calf/Achilles/Plantar fascia – Controlled stretching
Ankle flexibility mobility – Alphabet movements
Foot & hip external rotators – Strength training
Proprioceptive challenges – Single leg standing, pillow inserts
Low impact cardio – Cycling, swimming
Routinely checking in with your podiatrist ensures exercise plans stays in tune with your changing needs and current tissue capacity across the recovery timeline. Small adjustments make big impacts toward durability.
Why See a Podiatrist?
Podiatrists complete extensive training focused exclusively on foot and ankle care. They are experts at assessing and developing personalised treatment plans for those with complex conditions like pes cavus where restoring pain-free mobility hinges on addressing foundational biomechanical disturbances.
Podiatrists seamlessly incorporate a blend of conservative therapeutic interventions in initial treatment phases including anti-inflammatory modalities, activity modifications, custom orthotic inserts, braces, and targeted exercise based rehabilitation. For recalcitrant cases unresponsive to thorough conservative care, podiatrists can then coordinate surgical collaboration to relieve discomfort.
Throughout care, podiatrists also emphasise education so patients better understand their condition and their vital role in managing it long term through strategic lifestyle adjustments. This facilitates lasting resultados.
By leveraging their specialised expertise, podiatrists like those at Hurst Podiatry bring comprehensive assessment and holistic treatment perspectives to revive comfort and stability for those with symptomatic pes cavus changes. Patients benefit through accurate diagnosis, treatment streamlining, lifestyle guidance, and enhanced quality of daily living.
When to Schedule an Exam
Consult your podiatrist promptly about an evaluation if you notice:
The sooner underlying pes cavus foot changes are identified and treated, the greater potential exists to prevent the development of secondary chronic deformities affecting gait and leg health. Schedule an appointment with your podiatrist to discuss your symptoms and get connected to solutions that get you moving confidently again.
Take care of your feet in Melbourne with Hurst Podiatry
By seamlessly blending lifestyle adjustments and advanced interventions when needed, Hurst Podiatry’s podiatrists provide complete care. Patients benefit through prompt diagnosis, treatment coordination, biomechanical re-education, and enhanced long-term outcomes.
If you’re concerned about your feet, schedule a comprehensive exam at Hurst Podiatry today. Our podiatrists specialise in realigning appropriate lower limb mechanics for cases of symptomatic pes cavus foot changes.
