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Pes Cavus.

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Presentation on theme: "Pes Cavus."— Presentation transcript:

1 Pes Cavus

2 What is Pes Cavus? Excessive Elevation of Longitudinal Arch High Arch
Foot is relatively inflexible Much less common than Pes Planus Also referred to as hollow foot or claw foot



5 Causes of Pes Cavus Neurological Disorders (60% of time)
Spina Bifidia Poliomyelitis Charcot-Marie-Tooth Disease Talipses Equinovarus (Clubfoot) Muscle Imbalance Weak calf muscles Tight Plantar Fascia

6 Excessive Supination Claw Toes Traumatic Incidents
Compartment Syndrome Crushing Injury Burns Iatrogenic( overlengthing of the Achilles Tendon) Malunion of Calcaneal or Talar fracture

7 Signs and Symptoms Pain during running, walking, or standing
Painful toes that can’t be straighten Poor shock absorption Foot length shorten Callus on ball and heel of foot due to uneven weight distribution

8 Abnormal shortening of the achilles tendon
Tight plantar faciitis In frontal plane forefoot in varus and heel in valgus May experience overuse symptoms in the knees, ankles, and back


10 Examination History to determine any neurological conditions
Observation of foot and toes Examine Gait MMT and Flexibility ROM of Foot Neurological Exam

11 Colman Block Test Patient is to stand on cm block with heel and lateral border of the foot on the block. Bear full weight while the 1st, 2nd, and 3rd metatarsal hang freely into plantarflexion and pronation. Test is looking for hindfoot flexibility.

12 Two Common Patterns Calcaneocavus Cavovarus Hindfoot abnormalities
No pronation of forefoot; no varus deformity of hindfoot Dorsiflexion of calcaneum Cavovarus Forefoot abnormalities Forefoot pronated and heel in varus Claw toes

13 Classification Systems
Mild Longitudinal arch appears increased NWB Longitudinal arch appears almost normal WB Toes clawed NWB Toes normal WB Hindfoot varus

14 Moderate Longitudinal arch increases NWB and WB Claw toes NWB and WB
Calluses under prominent metatarsal head Dorsiflexion limited Forefoot plantarflexed on hindfoot

15 Severe Calcaneos can’t pronate past 5 degrees varus
Heel in varus and foot in valgus Decrease ROM in foot

16 Classification Type Forefoot Hindfoot Simple Balanced Neutral
Cavovarus Plantarflexuion Varus Calcaneous Fixed Equinus Equinovarus Equinus

17 Diagnostic Procedures
X-Ray foot X-Ray Spine Nerve Conduction Studies

18 Treatment Orthodics Corrective/Better Supporting Shoes
Stretch Achilles Tendon/Plantar Fascia Surgical Procedures in severe cases

19 Return to Play Arch Supports Correct Shoes Avoid Excessive Long Runs

20 References Gallaspy, J.B. May J.D. Signs and Symptoms of Athletic Injuries. Mosby-Year Book: St. Louis,1996. p.406. Arneheim, D. Prentice, W. Principles of Athletic Training. McGraw Hill: Boston th ed. P464 Greene, W.B. Essentials of Musculoskeletal Car. American Academy of Orthopedic Surgery nd ed.


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