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Pes cavus or high arch is an abnormality of the foot characterized by a very high arch. Even when someone puts full weight on the foot, the area beneath the arch is hollow, and sometimes the high arch can be quite visible, if the patient has severe pes cavus and is standing barefoot or in socks. This abnormality is not necessarily a bad thing. Some people actually benefit from slightly high arches, and others experience no ill effects. In cases where it becomes a problem, there are a number of treatment options available.
Causes of pes cavus can vary. Sometimes it is the result of an underling neurological or neuromuscular condition, or the fault of a congenital abnormality which causes problems with the development of the foot. Sometimes there are orthopedic causes, including badly healed fractures and developmental abnormalities. It can be helpful to determine the cause as this may inform treatment options or determine whether or not the pes cavus should be progressive.
For many people with slightly high arches, pes cavus does not present a problem. They may find that some shoes are more comfortable than others, and that sometimes arch support is needed to make shoes fit comfortably. For other patients, however, pes cavus can be painful. It can also limit flexibility of the foot, which can be uncomfortable and annoying, especially for people like athletes, who generally want full use of their feet so that they can compete.
If pes cavus is identified as a problem, a doctor may start by recommending supportive footwear and gentle stretching to increase flexibility in the foot and encourage the arch to flatten out. Should these measures prove ineffective, surgery can be performed to flatten the foot. Before surgery can take place, the doctor will usually order medical imaging studies to get a better idea of what is going on in the foot, for the purpose of developing an effective treatment plan.
Patients considering pes cavus surgery should meet with the surgeon to ask about what approach will be used in the operating room, and what the potential risks and complications are. These can vary, depending on the surgery, but can include nerve and muscle damage. Patients may also find it helpful to ask a surgeon about how much prior experience she or he has with the type of procedure being performed, and to inquire about the surgeon's success rate with pes cavus patients.
Which athletes are most likely to be at risk for pes cavus?