Common foot problems: Cavus foot and Flat foot.
Feet are a crucial part of our body, providing the balance we need to stay upright, walk, and perform all the activities and exercises we enjoy. However, sometimes, anatomical defects in the feet can turn standing into a torture or make walking, a privilege granted by our feet, into a real ordeal.
Below are two of the most common conditions affecting the feet:
Cavus foot
Cavus foot deformity is an abnormal elevation of the arch. "Cavus foot is a structural alteration that causes a higher-than-normal arch," says Javier Torralba Estellés, president of the Spanish Association of Podiatric Surgery. The toes can become cramped or flexed inward, reducing the foot's size.
This condition can develop early and vary in intensity, sometimes becoming very painful. It is characterized by limited joint flexibility and instability due to lack of support. This can lead to other issues like plantar fasciitis, sprains, or tendinitis.
Causes
In 80% of cases, the cause of cavus foot is related to a neurological condition. According to Torralba, it is likely that this condition results from neuromuscular impairment, which is why it is essential for cavus foot patients to consult a specialist to identify the exact cause of their problem. Sometimes, the cause is idiopathic, with no obvious reason for the elevated arch. Specialists also note that this condition has a high familial frequency, though no actual hereditary transmission has been identified.
This disorder typically starts with pain in the arch, heel, and forefoot area, as well as beneath the toes. "It is associated with tension and shortening of the plantar muscles of the foot and the calf," explains the expert.
Highly arched feet tend to cause pain because more tension is placed on the section of the foot between the ankle and toes. This results in a shortened foot, difficulty finding suitable shoes, and pain when walking, standing, or running.
Cavus foot causes excessive muscle tension and joint stiffness. When it develops early, it causes minimal discomfort and rarely alters gait, except in cases with a neurological origin.
There are two types of cavus feet:
- Posterior cavus or calcaneovarus: A type of cavus foot where the heel tends to fall.
- Anterior cavus: A more common condition where the metatarsals become vertical or drop, often associated with claw toes.
Cavus foot treatments
The treatment for cavus foot will depend on the age of the person, the cause, and the severity of the deformity. For example, a newborn with structural cavus foot caused by a bone position abnormality will likely require surgery and a splint to correct the abnormal bone alignment.
Cavus feet caused by neurological issues require early treatment. The sooner the deformity is addressed, the more likely it is that it can be prevented or corrected.
Additionally, the neurological condition must be controlled by a medical specialist.
Surgical intervention: Surgery for severe cavus feet requires a comprehensive approach to correct all causes of the deformity, according to David López Capapé, an orthopedic trauma specialist.
Flat foot
This results from the collapse of the foot's arch, causing most or all of the sole to touch the ground. This is common in children, who are born with flat feet, and the condition usually persists until the age of 3 or 4, when the tendons and muscles forming the foot's arch begin to strengthen. Sometimes, this process can take until adolescence to correct itself.
However, adults may also experience flat feet if the arch doesn't develop, or an adult may lose the arch due to malfunctioning parts of the arch, resulting in a loss of tension.
In people with flat feet, the instep makes contact with the ground when standing. To diagnose the issue, a healthcare provider will ask the person to stand on tiptoe. If an arch forms, the flat foot is considered flexible.
No further exams or treatment may be required. However, if the arch does not form when standing on tiptoe (referred to as rigid flat foot) or if pain occurs, further tests may be necessary, such as:
- CT scan to examine the foot bones.
- MRI to examine the tendons in the foot.
- X-ray of the foot.
Consequences
Although flat feet may seem like a minor issue, they can cause serious anatomical problems in adults. Without the arch, the foot starts to roll inward toward the "big toe," and this misalignment affects all the joints that keep us upright. If the foundation of a building is not solid, the entire structure collapses. The weight on the ankles, the first joint affected, pushes them inward, which alters posture. As a result, the knees are misaligned and start to rub against each other, leading to wear and tear, which can eventually cause injury. The back can also suffer problems, leading to an increased forward curvature due to a tendency to walk more hunched over.
Flat feet can also cause unusual fatigue, as it feels like dragging the foot when walking. This foot shape requires more energy expenditure than a normal foot.
Treatment
Flat feet do not require treatment unless they cause pain or walking problems.
A child's feet will grow and develop normally whether they wear special shoes, insoles, orthotic heel lifts, or wedges. Your child can walk barefoot, run, jump, or engage in other activities without worsening their flat feet. In older children and adults, flexible flat feet that are painless and do not interfere with walking do not require further treatment.
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