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Bilateral Pes Cavus

Bilateral Pes Cavus

Overview
Cavus foot pain can be a difficult and challenging problem. It is far less common to see a high arch patient with foot pain than a low arch patient with foot pain. As a result, high arch feet are less commonly treated or may be less understood than the common flatfoot. Charcot Marie Tooth muscular dystrophy has been associated with high arch feet and may lead to muscle imbalance issues that make the high arch foot more difficult to diagnose and treat.

Causes
There are many causes for a high arch foot, known as cavus. In the United States, the most common cause for a high arch foot is a form of muscular dystrophy called hereditary sensorimotor neuropathy, more commonly known as Charcot Marie Tooth disease (CMT).'Cavoid

Symptoms
Patients often complain of pain, instability, difficulty walking or running and also problems with footwear. There is often a range How do you get rid of Achilles tendonitis? other foot deformities also present eg, claw toes, increased calcaneal angle, 'cocked-up' big toe.

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 are 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
Suggested conservative management of patients with painful pes cavus typically involves strategies to reduce and redistribute plantar pressure loading with the use of foot orthoses and specialised cushioned footwear. Other non-surgical rehabilitation approaches include stretching and strengthening of tight and weak muscles, debridement of plantar callosities, osseous mobilization, massage, chiropractic manipulation of the foot and ankle and strategies to improve balance.

Surgical Treatment
Toe deformities can be effectively treated with the Jones and Hibbs procedures. These correct the cock-up deformities by fusion of the interphalangeal (IP) joints, combined with transfer of the EHL and EDL tendons to the metatarsal necks to assist with ankle dorsiflexion. The EHL and EDL transfers remove the deforming force on the MTP joint, and relax the plantar fascia.'Supinated