A cavus or high-arched foot may have many foot shapes. This may range from an arch that is slightly high to a severe deformity that causes a patient to walk on the outside of the foot. Surgery is occasionally required to realign the foot. There are different causes of a high-arched foot. In many cases, the cause is unknown. In other cases, the cause is a nerve disease, clubfoot or injury. Treatment ranges from changes in shoewear to surgeries, depending on the amount of deformity and related problems.
Training on improper, hard and/or irregular surfaces as well as excessive track work in spiked shoes, or steep hill running, can stress the plantar fascia past its limits of elasticity, leading to injury. Finally, failure in the early season to warm up gradually gives the athlete insufficient time for the structures of the foot to re-acclimate and return to a proper fitness level for intensive exercise. Such unprepared and repeated trauma causes microscopic tearing, which may only be detected once full-blown plantar fasciitis and accompanying pain and debilitation have resulted.
Arch pain may have a variety of different causes. Proper evaluation and diagnosis of arch pain is essential in planning treatment. A good general guideline is to compare the injured side to the uninjured side. Injury may present itself as a distinguishable lump, a gap felt at that location, or a "crunchy" feeling on that spot caused by inflammation. The type, causes, and severity of pain are also good indicators of the severity of the injury.
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
Depending on your overall health, symptoms and severity of the the flat foot, the condition may be treated conservatively and/or with surgery. Non-surgical treatments for flat feet are centered at decreasing and/or resolving the symptoms (pain). Simple Treatments Patients Can do themselves include wear proper supportive shoes. Use an arch support. Wear shoes with a wide toe box. Modify your activities. Lose weight. Wear shoes with cushion. Non-surgical treatments a doctor might do include Prescribe an oral anti-inflammatory medication. Anti-inflammatory medication is useful to significantly reduce pain and inflammation. Prescribe physical therapy. A physical therapist may perform ultrasound and other techniques to reduce inflammation. You will also be instructed how to stretch your foot and leg properly. Keeping the joint mobile may preserve function. Strengthening weak foot and leg musculature can help prevent further collapse. Prescribe protective pads. Padding and/or cushioning of when areas of bone become prominent on the bottom of the foot, as an effective method of preventing mechanical irritation with shoes. Pads with cutouts may off-weight specific areas of concern. Prescribe custom foot orthotics. A custom foot orthotic is a doctor prescribed arch support that is made directly from a casting (mold) of your feet, and theoretically should provide superior support compared to shoe insert that you would purchase from a pharmacy. In the case of flat feet, specific modifications can be made to the orthotic device to strategically balance the foot. Prescribe custom ankle-foot orthoses. A custom ankle-foot orthotic (AFO) is a doctor prescribed molded arch and lower leg support that stabilizes both the foot and ankle. This is used when the flat foot is significant and provides more support than the simple foot only insert. Give cortisone injection. A articular cortisone injection is a powerful anti-inflammatory medication that is used to rapidly reduce the pain associated with inflammation. Cortisone shots can be extremely effective in alleviating symptoms of flat feet, but will not correct the structure.
Surgical advances have dramatically improved the ability to alleviate the pain and decreased function that millions of Americans experience due to flat feet. Nevertheless, many patients and even some physicians remain unaware of the new procedures, which are best performed by a foot and ankle specialist who has the applicable training and experience.
Stretch and strengthen important muscles in your feet, ankles and legs in order to guard against future strain. Make sure to acquire suitable arch supports and inserts if necessary, and that your shoes are shock absorbent and in good condition. Wearing tattered shoes provides no protection, and runners should replace their footwear before exceeding 500 miles of usage. Athletes new to arch supports should gradually build their training routine, allowing their feet to become accustomed to a new stance.
Below are two simple plantar fasciitis stretching exercises to help improve the flexibility of the muscles and tendons around the foot and ankle. Plantar fasciitis stretch taken from The Stretching Handbook. Kneel on one foot and place your body weight over your knee. Keep your heel on the ground and lean forward. In the photo to the left, the athlete is stretching the arch of her left foot. Kneel on one foot with your hands on the ground. Place your body weight over your knee and slowly move your knee forward. Keep your toes on the ground and arch your foot. In the photo to the right, the athlete is stretching the arch of his right foot.