High arch (cavus foot) is a condition in which the arch on the bottom of the foot that runs from the toes to the heel is raised more than normal. Because of this high arch, excessive weight falls on the ball and heel of the foot when walking or standing causing pain and instability. Children with neurological disorders or other conditions such as cerebral palsy, spina bifida, poliomyelitis, muscular dystrophy are more likely to develop cavus foot. It may sometimes occur as an inherited abnormality.
Causes
Conditions that affect the nervous system (brain and spinal cord) can also cause the arches to fall. Over time, the muscles gradually become stiffer and weaker and lose their flexibility. Conditions where this can occur include cerebral palsy, spina bifida and muscular dystrophy. Adult-acquired flat feet often affect women over 40 years of age. It often goes undiagnosed and develops when the tendon that supports the foot arch gradually stretches over time. It's not fully understood what causes the tendon to become stretched, but some experts believe that wearing high heels and standing or walking for long periods may play a part. Obesity, high blood pressure (hypertension) and diabetes are all risk factors.
Symptoms
Flat feet don't usually cause problems, but they can put a strain on your muscles and ligaments (ligaments link two bones together at a joint). This may cause pain in your legs when you walk. If you have flat feet, you may experience pain in any of the following areas, the inside of your ankle, the arch of your foot, the outer side of your foot, the calf, the knee, hip or back, Some people with flat feet find that their weight is distributed unevenly, particularly if their foot rolls inwards too much (overpronates). If your foot overpronates, your shoes are likely to wear out quickly. Overpronation can also damage your ankle joint and Achilles tendon (the large tendon at the back of your ankle). See your GP if you or your child has flat feet and your feet are painful, even when wearing supportive, well-fitting shoes, shoes wear out very quickly, feet appear to be getting flatter, feet are weak, numb or stiff, Your GP may refer you to a podiatrist (foot specialist).
Diagnosis
The adult acquired flatfoot, secondary to posterior tibial tendon dysfunction, is diagnosed in a number of ways with no single test proven to be totally reliable. The most accurate diagnosis is made by a skilled clinician utilizing observation and hands on evaluation of the foot and ankle. Observation of the foot in a walking examination is most reliable. The affected foot appears more pronated and deformed compared to the unaffected foot. Muscle testing will show a strength deficit. An easy test to perform in the office is the single foot raise.
Non Surgical Treatment
Tight arches, overpronation and flat feet as well as tight calves all lead to inflammation of the connective tissue that forms this arch of your foot. This condition, plantar fasciitis, can be very painful, from your first step in the morning. Fortunately, treatment is easier than most. No operations, no fancy pulsed waves, no night splints necessary. Good arch supports? full length flexible (not hard) orthotics are key. Stretches of the calf relieve arch tightness as the heel bone acts like a fulcrum pulling back the arch tissues if too tight. Regularly perform the gastroc and soleus stretches that you learned at the gym. If lazy, buy "Pro-Stretch" on line which helps you stretch your calves easily. Use it often. You can't stretch too often, only too little. Finally, the magic cure is to roll a golf ball under the arch for half-hour once a day. (I know; a half-hour is a long time to perform one exercise, but that's what it takes. Once you master this exercise, it is easy to do while you work at your desk or are watching a half hour TV program.) This may hurt the first week. Keep going because by week two, after you go over the pain hump, the pain will be gone.
Surgical Treatment
A procedure that involves placing a metallic implant (most commonly) at the junction where the foot meets the ankle. This device causes the physical blockade that prevent the collapse. It is a procedure that is only indicated for mobile feet, and should not be used with rigid flat feet. Dr. Blitz finds this procedure better for younger patients with flexible flat feet where the bone alignment is still developing so that the foot can adapt to function in a better aligned position.
Prevention
Foot and ankle injuries are common in sports, especially running, tennis and soccer. But sports enthusiasts can decrease the risk of injury by taking some precautions. Lightly stretch or better yet, do a slow jog for two to three minutes to warm up the muscles. Don't force the stretch with a "bouncing motion." The amount of time spent on the activity should be increased gradually over a period of weeks to build both muscle strength and mobility. Cross training by participating in different activities can help build the muscles. People whose feet pronate or who have low arches should choose shoes that provide support in both the front of the shoe and under the arch. The heel and heel counter (back of the shoe) should be very stable. Those with a stiffer foot or high arches should choose shoes with more cushion and a softer platform. Use sport-specific shoes. Cross training shoes are an overall good choice; however, it is best to use shoes designed for the sport.
Stretching Exercises
Calf Stretching in Bed. As you may already know, the first few steps out of bed in the morning can be the worst of the day. Those first few steps can be enough to reaggravate your condition putting you into a cycle of inflammation and pain. The best way to help break that cycle is to stretch your calf before taking those first steps in the morning. When the muscles in your calf are tight, they pull on the heel bone, making your plantar fascia very taut and prone to injury. To help loosen those muscles, take a towel or belt and loop it around the ball of your foot. Keeping your leg straight, gently pull towards your body until you feel a stretch in the lower part of your leg. Hold that for 30 seconds and repeat up to 5 times before taking your first step out of bed. Plantar Fascia Stretching. Loosening up the tissues that are irritated probably makes sense to you, but you may not know how to do so. Luckily, there?s a very simple way. All you have to do is pull your toes up with your hand until you feel a stretch along the ball of your foot. You may feel the stretch anywhere from the ball of your foot to your heel. Holding this position for 30 seconds a few times can make a world of difference in your pain levels. Calf Stretching. I know, it probably seems like overkill, but stretching out the muscles in the lower leg is an integral step to recovery. There are two main muscles in the lower leg that attach to the heel, so we?ll work on stretching them both out. Stand against a wall and slide one leg back, pushing the heel down towards the floor (first picture). When you feel a stretch in the lower part of your leg, hold it for 30 seconds. After those 30 seconds are up, bend your knees until a deeper stretch is felt a bit lower in the leg (second photo). Again, hold this stretch for 30 seconds and repeat this until you?ve done it 3 times on each leg. Who doesn?t love a good massage? I suppose you could pay for someone to rub out the tissues in the bottom of your foot, but if you?re looking for a cheaper alternative, look no further than the humble tennis ball. Placing a tennis ball on the ground and gently rolling it under foot for a few minutes can help loosen up your plantar fascia, making it much less likely to become irritated. Put enough pressure on the ball to get a deep massage. You may feel some soreness, but back off if you feel any pain.Tennis Ball Massage While using the tennis ball is great for keeping things loose, sometimes it?s worth doing some icing at the same time for some inflammation control. Freezing a water bottle and rolling it under your foot for 10 minutes at the end of the day can be a very effective way to keep inflammation in check while staying loose. It might not be the most comfortable thing in the world, but ?Brrr? is better than ?Ouch? any day. One thing to keep in mind is that while these tips have been proven to work, they?re not an instant fix. It can take a few weeks of consistency with them before your pain levels begin to change. If you?re not seeing any improvement after making an honest effort, it may be time to look into some different treatment methods with your doctor such as formal PT, orthotics, a weight-loss plan, or others.