Cavus foot is a condition where the arches in the foot are significantly higher than a normal arch. This causes the heel to point inward and the toes to flex. Children with this condition typically develop it slowly from the time they begin to walk until 10 years old. Most often this condition occurs in conjunction with another musculoskeletal or nervous system disorder.
An inherited disorder called Charcot-Marie-Tooth disease (CMT) is the most common cause of cavus foot. But there is a long list of disorders that may cause the problem. Children who have muscular dystrophy (MD) Cavus foot can affect only one foot, too. Cavus foot in one foot is more common in children with injuries to the nerves in their legs or spinal cord or to the muscles in their legs. Other conditions that make it more likely a child will develop cavus foot are poliomyelitis, cerebral palsy and spinal cord tumor.
As with certain cases of flat feet, high arches may be painful due to metatarsal compression; however, high arches, particularly if they are flexible or properly cared-for-may be an asymptomatic condition. People with pes cavus sometimes though not always, have difficulty finding shoes that fit and may require support in their shoes. Children with high arches who have difficulty walking may wear specially designed insoles, which are available in various sizes and can be made to order.
Examination of the muscle groups and muscle strength is important. Furthermore, pain along the peroneal tendons may be a sign of a peroneal tendon tear. This may result in a cavus foot much like a posterior tibial tendon dysfunction may result in flatfoot. Instability of the lateral ankle may also lead to a cavus foot position as the talus deviates into a varus position due to the laxity of the lateral ankle ligaments.
Non Surgical Treatment
Careful investigation is needed to rule out any neurological condition that is causing the high arched foot. This will depend on What is the tendon at the back of your ankle? is causing the pain, if anything. For instance, flexible high arches may not need any treatment. Wear shoes with a good cushioning, depth and arch support. Control body weight to decrease load on the feet. Over-the-counter arch supports may be helpful for mild cases of pes cavus, but they are often a poor fit for persons with severe pes cavus.
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.