The term pes cavus is Latin for "hollow foot" and is synonymous with the terms talipes cavus, cavoid foot, high-arched foot, and supinated foot type. Pes cavus is a multiplanar foot deformity characterised by an abnormally high medial longitudinal arch. It also commonly features a varus (inverted) hindfoot, a plantarflexed position of the first metatarsal, an adducted forefoot, and dorsal contracture of the toes. Despite numerous anecdotal reports and hypothetical descriptions, very little rigorous scientific data exist on the assessment or treatment of pes cavus.Causes
Pes Cavus is typically a result of a fixed plantar flexion of the foot. Plantar Flexion is the movement of the ankle, pointing the toes away from the shin (think pressing a gas pedal in your car). However, a fixed plantar flexion does not guarantee that a person has pes cavus.Symptoms
Symptoms of a cavus foot type are higher arch than normal while standing. Sometimes the heel is seen to be angled inward as well as the toes appearing to be drawn inward. People with a cavus foot type also sometimes develop clawtoes as the toes will be curled up like claws. Frequent ankle sprains may also occur as the foot has a tendancy to roll over on the outside of the ankle with a higher arch. Conditions such as plantarflexed metatarsals, Haglund's deformity, and equinus may co-exist. A person with a cavus foot type typically is unable to stand as long as a normal foot structure as it does not have a good shock absorption mechanism. Some problems may be unnoticed until the person takes up heavier levels of activity, like running. In other extreme cases the deformity may not be well suited to the shoes your wearing and cause an ulcer. This is a strong reason to consult a podiatrist.Diagnosis
The diagnosis of symptoms occurs through conducting a history and physical in combination with diagnostic testing. A history of familial high arches and any muscular dystrophy type symptoms in the family Where are the femur tibia and fibula? important to consider. The type of pain and what causes the pain to begin are also important to consider. For example, patients who have pain with walking in comparison to only having pain when running may need more aggressive treatment than patients who only have pain with high impact exercises.Non Surgical Treatment
The most important thing is basic foot care as outlined above (Can I do anything about it myself?). If you have difficulty getting shoes to fit, your GP or specialist can arrange for an orthotist to get you shoes with a bit more room. These usually look like ordinary shoes, just a bit bigger. The orthotist may also be able to help with insoles to relieve aching or to spread weight away from raw skin or calluses. If your foot tilts over a lot, especially if your heel tilts too, a splint, brace or caliper may make it more stable for walking.Surgical Treatment
The surgical procedures involved with the correction of the cavus foot are varied. Theses may include correction of the bony deformity, ankle looseness and the muscle imbalances that cause the deformity. The goal is to provide a foot that evenly distributes weight along both inside and outside edges. A variety of incisions may be needed to perform the procedures related to the correction of the cavus foot.