Cavus Foot

What are the signs and symptoms of cavus foot?

Children whose feet have high arches experience a range of symptoms related to the condition. Symptoms of cavus foot may include:

• Calluses that form on the balls, heels or sides of feet
• Claw toes (tightly clenched toes)
• Hammertoes (bent toes)
• Pain under the arch of the foot
• Unstable ankles that roll easily

How do we diagnose cavus foot?

Orthopedic specialists can usually diagnose cavus foot by simply examining your child’s feet. The high arches that characterize the condition are obvious. An orthopedist will also look for other symptoms (like hammertoes, claw toes or calluses) that indicate cavus foot. In some cases, X-rays may help us make an accurate diagnosis.

If your child’s doctor suspects an underlying problem, the specialists in our Neuromuscular Program will perform additional neurological testing. This may include MRI to look for spinal cord issues, electromyography (EMG) and nerve conduction studies to assess nerve health or blood tests to detect genes associated with CMT.

How is cavus foot treated?

The best treatment depends on the underlying causes of cavus foot and the severity of the symptoms. If cavus foot is causing only mild symptoms, nonsurgical treatments may help. These include:

• Custom orthotics: An insole created specifically for your child’s foot can better support a high arch. This can help alleviate foot pain and make ankles more stable.
• Physical therapy: Muscle imbalances and weakness often result in the development of cavus foot. Working with a physical therapist can help your child strengthen weak muscles and reduce symptoms.

Most children with cavus foot — especially those with underlying neurological conditions — will eventually need surgery to correct the problem.

Cavus foot surgery

At Children’s Hospital Colorado, we perform a stepwise surgery, only using those steps your child needs. After each step, the surgeon re-evaluates your child’s arch to see if another step is necessary. We perform as many steps as your child needs during one surgery. Your child won’t need to have separate operations.

Our three-step procedure includes:

• Soft tissue release: First, our orthopedic surgeons make an incision on the inside of the foot to release tight muscles or ligaments. This can help lower the arch.
• Bone correction: If the arch is still too high after soft tissue release, the surgeon will correct the bone structure. Realigning the bones in the foot and heel helps lower the arch and stabilize the foot.
• Tendon transfer: Children with underlying neurological conditions often have tendons or muscles in the foot that aren’t working properly. We can transfer a healthy tendon from another location to substitute for the non-working one.

After surgery, your child will have a nerve-blocking catheter attached to their leg for a few days. This helps relieve pain during recovery. Your child will wear a foam-padded cast for about two weeks, a non-weight-bearing cast for two weeks and then a walking cast for four weeks. After that, they can start physical therapy.

If cavus foot affects both feet, we’ll wait about six months before repeating the surgery on the other foot.

Learn more about cavus foot surgery in this video:

Why choose us for treatment of cavus foot?

When your child comes to Children’s Colorado for treatment of cavus foot, they’ll receive the best care from our expert team. Our care includes:

• Collaborative team approach: Many children with cavus foot also have underlying neurological conditions (like CMT) or spine conditions (like spina bifida). Making sure these children get comprehensive care means that many specialists need to work together. Our orthopedic surgeons work closely with neurologists, physical and occupational therapists and other pediatric experts. Our Neuromuscular Program has a monthly CMT clinic that brings together these specialists in one place to make care more accessible.
• Advanced surgical techniques: Our orthopedic surgeons use an innovative three-step procedure for cavus foot surgery. This allows us to customize surgery to include only the steps your child needs.
• Child-friendly atmosphere: We know that medical procedures — especially surgery — can be scary for kids. We help kids understand what’s happening, carefully manage pain and make any hospital time as fun as possible.
• Targeted physical therapy: As part of your child’s treatment for cavus foot, they’ll work with a physical therapist to strengthen muscles and improve mobility. Our Center for Gait and Movement Analysis provides us with information about how your child walks — before and after surgery.