What is Pes Cavus?
In pes cavus, the plantar longitudinal arch is abnormally high. Standing and/or walking will put too much stress on the ball and heel of the foot in people with this condition.
With pes cavus, an array of deformities is observed, including clawed toes, posterior hindfoot deformity, contractures of the plantar fascia, and cockup deformities of the great toe. Increasing weight-bearing on the metatarsal heads may result in Metatarsalgia and calluses.
Causes of Pes cavus:
- muscle weakness and imbalance in neuromuscular disease,
- residual effects of congenital clubfoot,
- post-traumatic bone malformation,
- contracture of the plantar fascia, and
- shortening of the Achilles tendon.
Symptoms of Pes cavus:
- Pain,
- Foot instability,
Difficulty walking, - Metatarsalgia (pain under the first metatarsal),
- Associated knee pain,
- Also, back pain.
Medical management:
Drug therapy:
- Analgesics for pain relief.
Surgical management:
- Surgical treatments include soft-tissue and bony procedures, tendon transfers, and osteotomies.
Physiotherapy Management.
Physiotherapy managements:
- Kinesio taping.
- Orthosis for correction of biomechanical deficit.
- Stretching exercises.
- Range of Motion exercises.
- Gait training.
- Modalities
- Manual therapies involve
- Strengthening exercises
Physiotherapy treatment post-surgery:
Weeks 1-5
- Strict non-weight-bearing
- Elevate the leg above the heart using pillows under the foot to minimize swelling.
- Cryocompression therapy.
- Hip and knee Active ROM exercise.
- Hip strengthening exercises.
- Also, isometric exercises for the ankle.
Weeks 6-12
- Scar massage.
- Joint mobilization.
- Also, stationary bike in the boot.
- Partial weight-bearing.
Weeks 12-14
- Low-level balance exercises.
- Gait training.
- Hip, Knee, and ankle strengthening exercises.
- Also, swimming and stationary bike.
Weeks 14-16
- Running.
- Single leg balancing and proprioception exercises.
- Also, Bilateral, progress to unilateral heel raise.