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Tight calves cause cavus foot or vice versa

Discussion in 'General Issues and Discussion Forum' started by peter96, Apr 19, 2007.

  1. peter96

    peter96 Member

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    I recently read an abstract of a paper, in which it was suggested that equines was the cause of cavus feet. I know that the two conditions are commonly seen together, all though i have not read much about the causation of this association.

    I would think that because a cavus foot has a high arch, the calcaneus would be dorsiflexed relative to the supporting surface, to quite a large degree sometimes, this would also cause the talus to become dorsiflexed relative to the supporting surface, unless it plantar flexes on the calcaneus, which is noted to be a compensation for the lack of tibial advancement.

    This would mean that if the talus was dorsiflexed more than usual and the tibia rotates anteriorly to its normal position in the ankle mortise in mid to late stance, tibial advancement would be limited unless there was early heel rise.

    Does anyone have an opinion on this or can someone direct me to a paper that can clarify this subject, thanks.
  2. Craig Payne

    Craig Payne Moderator

    What is the reference for that?
  3. peter96

    peter96 Member

    Sorry Craig i cannot provide a reference it appears that the paper is not online anymore.

    I believe it was from a physiotherapy department at a Sydney university.
  4. Craig Payne

    Craig Payne Moderator

    The reason I asked for it, is that I have not heard of tight calf muscles causing a cavus foot and would like to know why they said that.
  5. peter96

    peter96 Member

    Found it.

    J Burns, J Crosbie, Weight bearing ankle dorsiflexion range of motion in idiopathic pes cavus compared to normal, and pes planus feet. The Foot, volume 15, issue2, june (2005)
  6. Craig Payne

    Craig Payne Moderator

    You are right, the abstract says:
    , but I do not understand the mechanism. Will see if Josh can comment as he is the cavus wizz.
  7. In the Compendium, it is stated that an "uncompensated equinus" may be associated with an adductovarus type foot with a normal arch and inverted heel. It is possible that a toe walker with an "uncompensated equinus" could develop a high-arch deformity due to continued activiation of the windlass mechanism during gait. This would be a rare cause of cavus foot but certainly could be possible.

    Still the question needs to be asked: if the forefoot could dorsiflex further on the rearfoot in the cavus foot with an "equinus deformity", then not only would the foot have a more normal arch height and may no longer possess an "equinus deformity". Because of this, it is mechanically impossible to separate ankle joint dorsiflexion stiffness from forefoot dorsiflexion stiffness.
  8. peter96

    peter96 Member

    Thank you Kevin this gives me something to think about. After further reading i have seen that the subject of my original post has already been discussed in more detail in another thread "Lunge test- normal range'' I did not mean to go over old ground. I will try and get hold of the paper on Pseudoequinus that you mentioned in the thread.
  9. podhugh

    podhugh Member

    Hi this is my first post, but I wondered if I might get some clarification on something of this nature. Been reading many threads on pes cavus as I have a patient who presents with acute forefoot pain after 60 minutes of playing football. Gradual onset of pain until he has to leave the game. He massages his foot for 10 minutes and the pain subsides. Next day he has stiffness but no symptoms.

    He also runs marathons - doesn't get the pain then.

    Has a rigid pes cavus foot with equinus. No pronation visible and no forefoot lesions. All toes are retracted, 1st's triggered but toes are not a problem for him - just the ball of his foot and ONLY when he plays football.

    Heel lift is premature, forefoot loading heavy. He wears spiked boots - already inserts gel insoles and has just bought sorbothane insoles. He also wears forefoot gel pads.

    Not sure I've asked all the right questions - and it seems it must just be the boots and the activity that's causing the pain, but I don't know what to do to relieve the pain.
    Some posts say heel raises are good - others not. I've already asked him to do stretching exercises - his gastroc, soleus are very tight.

    Any ideas where I can go from here?

  10. Hi Hugh.

    got some reading for you.

    Think bending moments.

    Read the article in the following post. It´s about the sprinters foot. At the end of the article they discuss the longer lever arm of the forefoot in spiked shoes.... should be the same for football boots.http://www.podiatry-arena.com/podiatry-forum/showthread.php?t=38588

    here another tread that there is lots of articles to read on football boots.http://www.podiatry-arena.com/podiatry-forum/showthread.php?t=38730

    Then read this one that I started on wolfs law that got nowhere but good articles on bending moments of the mets for you


    hope that helps
    happy reading

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