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Pes Cavus. What is Pes Cavus? Excessive Elevation of Longitudinal Arch Excessive Elevation of Longitudinal Arch High Arch High Arch Foot is relatively.

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Presentation on theme: "Pes Cavus. What is Pes Cavus? Excessive Elevation of Longitudinal Arch Excessive Elevation of Longitudinal Arch High Arch High Arch Foot is relatively."— Presentation transcript:

1 Pes Cavus

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

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

6 Excessive Supination Excessive Supination Claw Toes Claw Toes Traumatic Incidents 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 Pain during running, walking, or standing Painful toes that cant be straighten Painful toes that cant be straighten Poor shock absorption Poor shock absorption Foot length shorten Foot length shorten Callus on ball and heel of foot due to uneven weight distribution Callus on ball and heel of foot due to uneven weight distribution

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

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

11 Colman Block Test Colman Block Test –Patient is to stand on 2.5-4 cm block with heel and lateral border of the foot on the block. Bear full weight while the 1 st, 2 nd, and 3 rd metatarsal hang freely into plantarflexion and pronation. Test is looking for hindfoot flexibility.

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

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

14 Moderate 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 Severe –Calcaneos cant pronate past 5 degrees varus –Heel in varus and foot in valgus –Decrease ROM in foot

16 Classification TypeForefootHindfoot SimpleBalancedNeutral CavovarusPlantarflexuionVarus Calcaneous Fixed Equinus Calcaneous EquinovarusEquinusEquinus

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

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

19 Return to Play Arch Supports Arch Supports Correct Shoes Correct Shoes Avoid Excessive Long Runs 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. 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. 2000. 10 th ed. P464 Arneheim, D. Prentice, W. Principles of Athletic Training. McGraw Hill: Boston. 2000. 10 th ed. P464 Greene, W.B. Essentials of Musculoskeletal Car. American Academy of Orthopedic Surgery. 2001 2 nd ed. Greene, W.B. Essentials of Musculoskeletal Car. American Academy of Orthopedic Surgery. 2001 2 nd ed.

21 www.sportsinjuryclinic.net/cybertherapist/ front/foot/clawfoot.htm www.sportsinjuryclinic.net/cybertherapist/ front/foot/clawfoot.htm www.sportsinjuryclinic.net/cybertherapist/ front/foot/clawfoot.htm www.sportsinjuryclinic.net/cybertherapist/ front/foot/clawfoot.htm www.emedicine.com/orthoped/topic539.ht m www.emedicine.com/orthoped/topic539.ht m www.emedicine.com/orthoped/topic539.ht m www.emedicine.com/orthoped/topic539.ht m www.nlm.nih.gov/medlineplus/ency.article /001261.htm www.nlm.nih.gov/medlineplus/ency.article /001261.htm www.nlm.nih.gov/medlineplus/ency.article /001261.htm www.nlm.nih.gov/medlineplus/ency.article /001261.htm www.ortho-u.net/011/203.htm www.ortho-u.net/011/203.htm www.ortho-u.net/011/203.htm


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