Pes cavus is accompanied by supination of which joints and is commonly treated with what insert?

Pes cavus is accompanied by supination of which joints and is commonly treated with what insert?

• A. Pronation of ankle; corrected with medial wedge
• B. No deformity; corrected with heel lift
• C. Supination of talocalcaneonavicular, subtalar, and transverse tarsal joints; corrected with viscoelastic shoe insert with forefoot lateral wedge
• D. Supination of talocalcaneonavicular, subtalar, and transverse tarsal joints; corrected with arch support only

Answer: (C)

Pes cavus features a high, rigid arch that tends to stay in supination during stance. The joints that typically show this supination are the talocalcaneonavicular, subtalar, and transverse tarsal joints. Because the foot is stiff, weight-bearing forces concentrate on the lateral column, leading to discomfort and calluses. The orthotic approach aims to cushion the foot and encourage a small amount of pronation to redistribute pressures more evenly. A viscoelastic shoe insert provides shock absorption and supportive cushioning, while a forefoot lateral wedge helps bias the forefoot toward a more neutral or slightly pronated position, counteracting the excessive supination at those joints. Arch support alone or a heel lift doesn’t directly correct the specific biomechanics of pes cavus, so the combination described best addresses the problem.

Pes cavus features a high, rigid arch that tends to stay in supination during stance. The joints that typically show this supination are the talocalcaneonavicular, subtalar, and transverse tarsal joints. Because the foot is stiff, weight-bearing forces concentrate on the lateral column, leading to discomfort and calluses. The orthotic approach aims to cushion the foot and encourage a small amount of pronation to redistribute pressures more evenly. A viscoelastic shoe insert provides shock absorption and supportive cushioning, while a forefoot lateral wedge helps bias the forefoot toward a more neutral or slightly pronated position, counteracting the excessive supination at those joints. Arch support alone or a heel lift doesn’t directly correct the specific biomechanics of pes cavus, so the combination described best addresses the problem.