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Nov 17

Written by: Cherri Choate, DPM

The symptoms related to the pes cavus type foot are often more complicated than the more typical flat foot.  The majority of orthotic and shoe modifications are targeted at the flat foot, but with careful consideration of the patient's activities, shoe type and symptoms, orthotics can be a very successful treatment option for the high-arched foot.  Typical symptoms, goals and modifications are listed below:

    1)   Symptom:         Lateral Ankle Instability 
          Goal:                Decreased supinatory moment arm 
          Modification:     Forefoot valgus wedge; no lateral bevel on rearfoot post; flat rearfoot post
     2)  Symptom:          Metatarsalgia
          Goal:                 Off-load metatarsal heads
          Modification:      Metatarsal pad; metatarsal bar; no bevel distal end of plate; minimal fill;  heel lift (if equinus present); shock-absorbing topcover

    3)  Symptom:           Apropulsive, unsteady gait
         Goal:                  Improve stability 
         Modification:       Wide plate; flat rearfoot post; heel lift (if equinus is present); shock-absorbing topcover

These patients often seek treatment later in life, as their fat pads become thinner and the patient's flexibility decreases.  They have usually tried multiple OTC soft insoles and many different brands of shoes, prior to seeing the physician.  It may take a few adjustments to improve their symptoms, but orthotics are a valuable component of controlling the symptoms in patients with pes cavus.

Interested in Pes Cavus research?  Read our EJournal article today by Burns (2006):
Burns J, Crosbie J, Ouvrier R, et al.  Effective orthotic therapy for the painful cavus foot: a randomized controlled trial. J Am Podiatr Med Assoc. 96(3):205-211,2006.


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