Hollow Foot Definition and Meaning

According to abbreviationfinder, hollow foot (lat. Pes excavatus) is a congenital or acquired foot deformity. The hollow foot can be recognized by a raised arch of the foot, which makes it the exact opposite of the flat foot.

What is a hollow foot?

By increasing the longitudinal arch of the foot, the pressure that occurs when walking and standing is not evenly distributed on the foot. Depending on whether the body load from the pes cavus is more on the balls of the feet or on the heel, a distinction is made between pes cavus and pes cavus, with pes cavus occurring much less frequently.

As a result, pressure points develop on the back of the foot, balls of the foot and toes, which manifest themselves as foot pain for those affected. This foot pain in the pes cavus leads to restrictions in the movement of the foot and problems when walking. This results in an increased risk of falls and sprains.

Due to the deformation, the foot feels rather stiff and awkward, as do the toes, which also appear curved. Another problem for people who suffer from a pes cavus is the premature wear of the shoes, which is influenced by the foot position.

Causes

There are several possible causes that can be decisive for a pes cavus. The first possibility and at the same time the most common one is a congenital pes cavus, which can be detected at birth.

The foot malposition can also occur as a result of an illness. Possible causes are paralysis (especially in the small foot muscles), diseases of the nervous system, other nerve damage, muscle weakness, ligament weakness or spinal cord tumors. These diseases lead to an excessive longitudinal arch of the foot, which puts an unnatural strain on the foot.

Another cause, especially in the case of less pronounced pes cavus, is wearing tight shoes with heels that are too high. However, it can also happen that the reason for the change in shape of the foot cannot be determined. In this case one speaks of an idiopathic pes cavus (idiopathic = without recognizable cause).

Symptoms, Ailments & Signs

A hollow foot is manifested by a foot malposition, which can usually be seen from the outside. The longitudinal arch of the affected foot is greatly elevated, making the foot shorter and stockier. A hollow foot with an inward heel, hammer toes and claws is common.

The malposition of the foot also changes the way the foot steps: the heel and forefoot bear the entire weight of the body. This incorrect loading leads to the typical symptoms of a hollow foot. The excessive strain on the ball of the foot causes severe pain and, in the long term, leads to the formation of calluses. Depending on the cause, a pes cavus can change over the years.

The symptoms usually increase gradually and are often only noticed when the deformity is already well advanced. Complaints mainly occur when wearing shoes – then there are stabbing pains, feelings of pressure and gait disturbances. People with pes cavus walk unsteadily and often twist their ankles, which repeatedly leads to injuries.

If the hollow foot remains untreated, further health problems can develop from the avoidance behavior, such as premature joint wear, malposition of the ankles and nerve pain. As the deformity progresses, corns usually also form on the toes.

Diagnosis & History

Cavus foot is usually discovered during a physical examination, as it can already be seen with the naked eye in a pronounced form. But it can be determined with certainty by looking at the footprint. The severity of a pes cavus is usually determined by doctors with X-rays.

Signs for recognizing a foot deformity are, for example, an unsteady gait, twisting ankle more easily, frequent falls, sprains or corns on the toes. Due to the higher load on the forefoot and heel area, which arises from standing and walking for a long time, pain in the metatarsus can also occur if you have splayfoot at the same time. Another indication can be pain in the heel. These usually come from inflammation, which can result from the deformed position of the pes cavus.

Complications

Due to the pes cavus, the patient experiences various complaints and limitations that affect running and walking. In most cases, those affected suffer from a so-called hammer toe and corns. These complaints usually lead to severe pain, which occurs primarily when walking.

This pain leads to significant restrictions in movement, which makes everyday life even more difficult. The entire foot musculature is restricted and paralyzed by the pes cavus, so that no sporting activities are possible for the patient. Due to the permanent incorrect strain on the hollow foot, there is severe pain, which can also occur in the form of rest pain.

The rest pain can lead to sleep problems at night and trigger depression. The diagnosis of pes cavus is usually relatively simple, so that early treatment can be initiated. In most cases, the treatment takes place with the help of insoles and therapies. This can alleviate most of the symptoms and there are no further complications. In serious cases, surgical interventions can also be performed. The life expectancy is not affected by the hollow foot.

When should you go to the doctor?

A slight hollow foot does not necessarily need to be treated as long as it is not causing any problems. However, if pressure points, calluses or corns accompany the malposition and the foot hurts regularly, it is best to consult an orthopedist. Poorly developed or weakened foot muscles can be an indication of a pes cavus. In the case of a pronounced pes cavus, it is always advisable to have an examination by a specialist, preferably an orthopedic surgeon, because he or she can best decide which therapeutic measures are necessary for correction and how the symptoms caused by the deformity can be alleviated in the most sensible way.

Advanced deformities such as hammer and claw toes usually require physical therapy, usually in the form of stretching exercises, to prevent the deformity from getting worse. If left untreated, a pes cavus usually gets worse over the years and gradually symptoms appear that make it increasingly difficult to wear shoes. At this point at the latest, a trip to the orthopedist can usually no longer be avoided because of the level of suffering. However, it is better to consult a doctor beforehand so that such symptoms do not arise in the first place.

Treatment & Therapy

Depending on the degree of deformity, there are different types of treatment for patients with a pes cavus. The extent to which the pes cavus is already pronounced is usually determined using X-rays. In lighter cases, modeled shoe inserts that support the foot are usually sufficient.

This distributes the pressure and relieves the heavily stressed zones, such as the ball of the foot and the heel. In addition, it is advisable to wear a so-called night splint, which fixes and stabilizes the foot during the night. In order to obtain more stability and reduce the risk of twisting, it is recommended to wear shoes with a high shaft. It is also often necessary for people with pes cavus to need orthopedic shoes specially made for them.

If the foot deformity is already advanced, it is necessary to undergo physiotherapeutic treatment. Movement and stretching exercises under supervision often have a positive effect on the course of the foot deformity. Orthopedic treatment can be perfectly complemented with gymnastics and appropriate exercises. Patients with advanced pes cavus foot also have the option of having the foot surgically corrected.

Outlook & Forecast

A hollow foot generally promises a good prognosis. If the necessary treatment steps are initiated at an early stage, the malformation can often be corrected before permanent damage to the ankles and tendons occurs. Early diagnosis and treatment is necessary to prevent further deterioration of the deformity. If the hollow foot is recognized in time, it can be corrected with surgical, orthopedic and physiotherapeutic measures. Although a pes cavus can rarely be completely corrected, the symptoms are marginal and the prognosis is correspondingly positive.

However, if left untreated, the deformity will progress, eventually leading to deformity of the toes and ankle. Then the movement restrictions and pain increase, which is always associated with a decrease in the quality of life. A congenital pes cavus foot must be treated immediately after birth to ensure a positive prognosis.

An acquired pes cavus usually develops in connection with other malpositions and physical ailments, which is why early therapy cannot guarantee a life free of symptoms. Patients usually have to do physiotherapy exercises and take pain medication for the rest of their lives. In addition, the malposition can occur again and again and cause symptoms that have to be treated surgically.

Prevention

Since a pes cavus is either congenital or the result of another disease, there is no way to prevent it. With early diagnosis and timely treatment, however, the course of the deformation can be positively influenced.

Aftercare

In most cases, those affected with a pes cavus foot have very few options for direct follow-up care. Those affected are primarily dependent on early detection and treatment so that there are no further complications or a further deterioration of the symptoms. In general, an early diagnosis has a very positive effect on the further course of the disease.

Those affected should contact a doctor as soon as the first symptoms and signs of the disease appear. In most cases, a pes cavus is compensated by wearing and using shoe inserts. Those affected should wear these insoles permanently and not leave them out. Especially with children, the parents have to control the wearing. Furthermore, the insoles must be adjusted to the foot as the child grows.

Wearing special orthopedic shoes can also relieve the symptoms of the disease. In many cases, sufferers of a pes cavus are also dependent on physiotherapy measures. Many of the exercises can also be performed at home, which speeds up the treatment. As a rule, the life expectancy of those affected is not reduced by the hollow foot.

You can do that yourself

A hollow foot should be presented to a specialist, preferably an orthopedist, even if it is not causing any symptoms. However, the patient can also help to prevent pes cavus foot or stop the progression of the condition.

In milder cases, it already helps if the person concerned consistently wears special insoles that support and relieve the foot. The insoles distribute the pressure over the entire foot so that areas that are otherwise overly stressed, such as the balls of the feet and heels, are relieved. A sleep splint that stabilizes the foot during the night can increase the positive effect of the insoles. Affected people who tend to twist their ankles due to the hollow foot can reduce this risk by wearing boots or half-height shoes with shafts. If you twist your ankle very often, you should also think about special orthopedic shoes that can be adapted to the individual degree of the disorder and can thus prevent this problem.

In addition, early physiotherapeutic treatment can prevent or at least delay the progression of the deformity. In many cases, the special physiotherapy exercises can even help to reverse the deformity. However, this requires regular training under the guidance of a physiotherapist who has experience in treating the disorder.

Blisters, pressure points, cracks and other lesions should be treated promptly, as they can otherwise trigger additional foot pain.