Have you ever looked at the soles of your feet? Some people have a slightly raised, arched foot. But some people have a very high arch. When that happens, we say that the person has "High Arch Feet" or, in medical terms, a condition called "Pes Cavus". This may not be a problem for some people. But for others, it can cause a lot of discomfort. Let's talk about this in more detail today.
What is Pes Cavus?
Simply put, ``Pes Cavus`` means that the arch of your foot is higher than normal. This is the flexible part of your foot, between the heel and the ball of your foot. When we stand, it is slightly bent up, and when we walk, it bends back and forth.
However, some people have this arch higher than expected. Even if they stand with a weight on their feet, this arch does not lower and touch the ground. If you stand on wet ground and look at your footsteps, you may not be able to see the middle of the sole.
This type of heel spur can be congenital, or it can be caused by another medical condition. If it is not severe, it may not cause any problems. However, for some people it can cause problems, and the condition can be progressive.
Imagine, when the arch of your foot is raised, it puts more pressure on the other parts of your foot when you walk. This can cause discomfort and sometimes even injury. For some people, walking with their feet raised like this can even cause changes in their bones and muscles.
What are the symptoms of this `(Pes Cavus)` condition?
If you are experiencing symptoms due to your ingrown toenails, you may first notice these:
- Pain in the sole of the foot: This pain is most often felt in the ball of the foot or heel.
- Ankle pain and swelling: Your ankles may also be painful and swollen.
- Arch pain: Pain can also occur in the arch of the foot.
Over time, some more things may add up. Take a look:
- Corns or calluses can develop on the soles of your feet where there is excessive pressure.
- The ankle joint can become a little unstable. This means that the ankle may feel like it's constantly rolling, and may even sprain.
- The toes may be bent inward, like a claw. We call these ``claw toes'' or ``hammertoes'' .
Some people may experience long-term pain due to repetitive strain injuries. For example:
- Metatarsalgia: This is inflammation at the base of your foot where your toes begin.
- Plantar fasciitis: An inflammation of the ligament in your heel.
- Peroneal tendonitis: Inflammation of a tendon on the outside of your ankle.
How does Pes Cavus affect walking?
When you walk with your feet up, you're experiencing something called ``supination.'' This means you're walking more on the outside edge of your foot. This puts more pressure on the less flexible parts of your foot, such as the ball of your foot, heel, and outer toes.
When someone with a normal foot steps, the outer edge of the foot rolls inward (pronates). This helps absorb shock and adapt to different surfaces. However, when the foot is on the uphill side, this rolling doesn't happen properly. So your foot stays on the outer edge.
How does Pes Cavus affect your feet?
As the condition of `(Pes Cavus)` progresses and other changes occur in the bones and muscles of your lower leg, these changes come in two main forms. Doctors call these `(pes cavovarus)` and `(pes calcaneocavus)`.
- Pes Cavovarus: This is the most common form of Pes Cavus. In this condition, the arch is raised (cavus) and the heel is turned inward (varus). The big toe is bent downward (plantarflexed), causing the entire foot to arch. This is also called a hollow foot or a claw foot.
- Calcaneocavus Foot: This is a less common condition. In this condition, your heel (calcaneus) is dorsiflexed, while the front of your foot is bent downward. This causes the arch to be more prominent in the back. This is sometimes called posterior pes cavus.
What are the complications of inversion?
The deformity of your foot can gradually increase due to the raised soles. This can make walking increasingly painful and unsteady. In addition to the ongoing impact on the soles themselves, other secondary problems can also occur. These include:
- Knee pain
- Back pain
- Arthritis of the foot and ankle
What are the causes of `(Pes Cavus)`?
Many people are born with clubfoot. This means that there is definitely a genetic influence. However, in other cases, clubfoot can be a symptom of another medical condition. For example, conditions like spina bifida or muscular dystrophy.
Muscle imbalances in your lower body can also cause structural changes that cause your soles to bulge. When some muscles become abnormally weak, others become abnormally tight, changing the shape of your soles.
The main cause of these muscle imbalances is neuromuscular disorders . These disorders affect the way your nerves communicate with your muscles. Often, some muscles become inactive.
Many of these are genetic disorders that children are born with. But they develop very slowly. Therefore, they may not be diagnosed quickly. The soles of children's feet may be one of the first signs of such a disorder.
Examples of hereditary causes:
- Charcot-Marie-Tooth disease
- Muscular dystrophy
- Spina bifida occulta
Neuromuscular disorders can occur throughout your life. They can be caused by:
- Diabetes-related neuropathy
- Spinal tumors
- Stroke
Injuries and muscle contractures can also cause cavus foot. For example, muscle imbalances can occur due to misalignment of bones. If you don't move properly after an injury, your tissues can become tight and contracted.
Sometimes, babies are born with muscle spasms. This is not due to a neurological disorder or injury, but rather because it happens in the womb. Clubfoot is also a congenital spasm that can cause Pes Cavus.
How do you recognize the one that came up on the soles?
An orthopedist can diagnose cavus foot with a simple physical examination. He or she will observe how you stand and walk. He or she may also ask you to move your foot in different ways to see where your foot is flexible and where it is stiff.
To learn more about your condition, he may order imaging tests. For example, an X-ray of your leg or an MRI. If a neuromuscular disorder is suspected, he may recommend an EMG test or a nerve conduction study.
How do doctors treat `(Pes Cavus)`?
Treatment depends on how severe your condition is and whether it is likely to get worse. If your condition and symptoms are not too severe, treatment will primarily focus on physical therapy and pain relief.
There are several possible treatments:
- Special shoes or orthotics: Specially designed shoes or shoe inserts can help keep your feet in a better position when you walk. You can buy these orthotics at a pharmacy, or you can have them custom-made for you by an orthotist.
- Braces, splints or casts: Wearing a brace, splint or cast on the leg can help to gradually stretch the tight tissue. Some people wear it only at night, while others wear it continuously for several weeks.
- Physical therapy: A physical therapist can prescribe exercises for you to do at home or with their help. This can help improve the strength and flexibility of the affected muscles.
- Pain relievers: Nonsteroidal anti-inflammatory drugs (NSAIDs) can be purchased at the pharmacy to help reduce pain and swelling after walking. Applying ice can also help.
Can Pes Cavus be completely cured?
If your feet are severely deformed, or if your doctor thinks they will get worse, you may need surgery. The goal of surgery is to help your feet bear more weight and reduce pain.
Surgeries for Pes Cavus may include:
- Osteotomy: Reshaping and changing the shape of bones.
- Soft tissue release: Making small incisions in the soft tissues to reduce stiffness.
- Tendon transfer: The replacement of a non-functional tendon with a functional tendon.
- Joint fusion: The fusing together of two bones at a joint.
Will ingrown toenails get worse if left untreated?
In general, bunions associated with neuromuscular disorders tend to get worse over time. If you have a condition like ``Pes Cavus'', you may need treatment sooner rather than later. Also, early treatment may be better.
If you have a hereditary condition called cavus foot, with no family history of the condition, it probably won't get worse. Cavus foot caused by an injury is usually permanent. Your podiatrist can tell you what to expect based on your specific condition.
What can you expect after Pes Cavus treatment?
If you have a condition that is likely to get worse over time, early treatment is the best way to achieve results. This is especially true for children, as their bodies are still developing and flexible.
Timely surgery can help prevent the deformities caused by ``Pes Cavus'' from getting worse and the soles from becoming stiff. Once the condition becomes severe, major surgery is required to correct it, and even that doesn't completely fix everything.
Rehabilitation after surgery is crucial to long-term success. This means following your doctor's instructions on when and how to start using your leg, and continuing with physical therapy.
Depending on your condition, you may need to continue physical therapy or home exercises indefinitely. People with progressive disabilities may need more treatment in the future.
Can the risk of ingrown toenails be reduced?
Because bunions can be genetic or caused by an underlying medical condition, there is no way to prevent this condition from occurring. However, with proper monitoring and treatment, the pain caused by bunions can be successfully managed.
High arches don't always cause problems. But if they do, you should see a qualified doctor. High arches that cause symptoms are often a sign of an underlying medical condition.
Children who show gait abnormalities and gradual changes in their feet may have an undiagnosed neuromuscular disorder. Early treatment is the best way to achieve the best results.
Things you need to remember (Take-Home Message)
Okay, so I hope you now have a better understanding of the ``Pes Cavus'' or the instep that we talked about.
- High arches are not a problem for everyone: for some, it's just a matter of positioning.
- Be careful if you have symptoms: If you have pain, difficulty walking, or ankle sprains, be sure to seek medical advice.
- There may be an underlying cause: If you see this condition, especially in children, it could be a sign of another neuromuscular disorder.
- Early treatment is important: Early treatment can reduce complications, especially if the condition worsens.
- There are many different treatment options: from physical therapy to surgery. Your doctor will decide what is best for you.
So, if you or someone you know is experiencing this discomfort, don't hesitate to see a doctor and get advice. Then you too can walk comfortably and pain-free!
` Pes Cavus, high arch feet, pronation, leg pain, ankle pain, physical therapy, bone diseases
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