Pes Planus (Flat Feet) & Pes Cavus (Claw Foot)

Flat Foot Pes Planus & Claw foot Pes Cavus

Pes Planus is the term used when an individual has very flat feet or fallen arches. This condition is such that the foot appears entirely flat on the floor on the inside. A claw foot or Pes Cavus foot is a defect where the foot has a particularly high arch.

On this page:

  • Pes Planus (Flat feet)
  • Pes Cavus (Clawfoot)

Pes Planus (flat feet)

Pes Planus is the term used when an individual has flat feet such that the foot appears entirely flat on the floor on the inside. There are often no symptoms of a flat foot and so the individual rarely complains of problems in this area. It is more likely that they complain of other associated problems, including shin or calf pain, knee pain, and back pain.

Rigid flatfoot where the arch of the foot is very rigid, even when not weight bearing, may cause pain in the arch of the foot with stiffness. The feet may get tired easily and be tender. Low back pain is also common.

What are flat feet?

Having flat feet is different from pronation or overpronation. Pronation is a normal movement of the foot which occurs just after the heel touches the ground when walking. This means that the foot rolls inwards and arch lowers, to allow the foot to mold to the surface and to absorb shocks. Over-pronation is where too much pronation occurs, or it occurs too rapidly, which places additional stresses on the ankle, knee, hip and lower back.

A flat foot is usually evident from observing the foot, whereas someone who overpronate’s may have a normal arch when standing still, which flattens excessively whilst walking or running.

The appearance of a flat foot is normal in infants, partially due to an increase in fat in this area, and also due to the arch not yet being fully developed. In teenagers and older people, however, it is less common and can cause problems.

Pes planus may develop from childhood or may only occur later in adult life. This is known as ‘adult acquired flatfoot’ and is usually due to an injury or prolonged stress to the foot. An example includes Posterior Tibial Tendon Dysfunction (PTTD) which is a dysfunction of one of the muscles which support the arch of the foot.

Flat feet can be caused by genetic disorders, foot injury, obesity, rapid leg growth, too much exercise and traumatic injury to the arch of the foot.

Treatment for flat feet

If there is no pain caused by the flat feet then no immediate treatment is required. However, those who run or are involved in a lot of walking or being on their feet all day should ensure they have very supportive shoes or arch support insoles. This will help prevent any future injuries.

If the pain is present, orthotic shoe inserts are useful, or special shoes can be commissioned. In severe cases where the flatfoot deformity is rigid, surgery may be performed, where some of the joints are fused together to create more of an arch. This should be considered a last resort.

Pes Cavus (Claw foot)

A claw foot or Pes Cavus foot is a genetic defect in the foot with a high arch. Claw feet are relatively inflexible. This will often be associated with very tight calf muscles at the back of the lower leg. Pes Cavus of the foot can cause pain in the feet during running. The toes may be bent and cannot be straightened easily without causing pain. It is unusual for a long distance runner to have a claw foot but not unknown.

Pes cavus treatment

Do plenty of static stretching, especially of the calf muscles and the sole of the foot. This will loosen the muscles and other structures in the foot making it more flexible and able to cope with the demands of running. Take steps to avoid injuries such as correct shoe selection, strengthening, and stretching exercises.

See a specialist who can fit orthotic inserts for a Pes Cavus foot. These are insoles which are worn in the shoes and help correct any biomechanical problems of the foot. They can be custom made or often bought off the shelf ready made. With a high arch, it is probably best to see a professional for advice. Many off the shelf insoles are ideal for overpronation or rolling in but not so effective for supinating feet or rolling out which is more of an issue for high arch runners.

Neutral shoes have a midsole of constant density throughout the shoe. A motion control shoe will be harder on the inside of the shoe midsole to help prevent the foot from rolling in or pronating.

If you have the wrong running shoes you will just make any problems worse. People with high arches are often supinators and will usually want a Neutral shoe with a lot of cushioning. See a specialist shoe retailer for specialist advice.

This article has been written with reference to the bibliography.