Managing High Arches and Calf Pain: Effective Treatment Options Explored

High arches can cause calf pain?

At the age of 25, I had an ankle sprain, and prior to that, I had no discomfort from my high arches.
I was able to engage in various intense sports such as basketball, badminton, and rock climbing without any issues.
However, after a right ankle sprain, I developed compensatory problems in my left foot.
I received PRP injections and shockwave therapy, which improved my condition by about 50%, but further progress was slow.
A doctor later suggested that I check my foot pressure to see if there were any foot-related issues, which led to the discovery of my high arches.
I found that my left foot has a higher arch compared to my right foot (a complete cavus foot), along with a collapsed transverse arch, functional leg length discrepancy due to high arches, genu varum (bow-leggedness), pelvic tilt, and scoliosis (though I was already aware of the issues outside of the arches, they were not painful before).

After using custom orthotics and undergoing stretching and physical therapy for six months, I have only maintained my condition without improvement.
Currently, my symptoms include pain in the heels and dorsum of both feet, pain on the lateral side of the metatarsals in the plantar region, joint pain around the cuboid bone, and calf pain.
However, I had no symptoms prior to the sprain.
It seems that all the doctors and physical therapists I have consulted attribute my issues to high arches, and they mostly recommend orthotics, which essentially only prevent further deterioration.

I have seen online that some traditional Chinese medicine practitioners offer osteopathic treatments and small needle knife techniques to relieve muscle spasms, and some physical therapists have exercise therapy methods that I am considering trying.
However, these seem to be non-mainstream methods without evidence-based support.
I would like to ask if you would recommend any of the aforementioned methods besides surgery?

Weu, 20~29 year old female. Ask Date: 2023/12/16

Dr. Wang Zhaomin reply Rehabilitation

The management of high arches primarily involves the use of orthotic insoles, along with physical therapy that focuses on stretching exercises and strength training.
Other options such as analgesics and injection therapies can help alleviate discomfort.
If symptoms persist or worsen, surgical intervention should be considered.
It is advisable to consult an orthopedic or rehabilitation specialist to arrange appropriate treatment.

Reply Date: 2023/12/16

More Info

Managing high arches, also known as pes cavus, can be quite challenging, especially when accompanied by calf pain and other musculoskeletal issues. Your experience of developing discomfort after an ankle sprain, which subsequently led to compensatory changes in your left foot, highlights the complex interplay between foot structure and overall biomechanics. Given your symptoms, including heel pain, discomfort in the midfoot, and calf pain, it’s essential to explore effective treatment options that can help alleviate your discomfort and improve your functional mobility.

Understanding High Arches and Associated Symptoms
High arches can lead to an uneven distribution of weight across the foot, resulting in increased pressure on certain areas, such as the heels and balls of the feet. This can cause pain in the plantar fascia, metatarsals, and even the calf muscles due to altered gait mechanics. The presence of functional leg length discrepancies, as you mentioned, can further complicate matters, leading to issues such as knee pain, hip misalignment, and even spinal curvature.

Treatment Options
1. Orthotic Devices: Custom orthotics are often recommended for individuals with high arches. These devices can help redistribute pressure, provide support, and improve alignment. While you mentioned that your current orthotics have only maintained your condition without significant improvement, it may be worth revisiting a specialist who can reassess your foot mechanics and potentially provide a more tailored solution.

2. Physical Therapy: Engaging in a structured physical therapy program can be beneficial. A physical therapist can design a program that focuses on strengthening the muscles of the foot and calf, improving flexibility, and correcting any biomechanical issues. Techniques such as manual therapy, stretching, and strengthening exercises can help alleviate pain and improve function.

3. Extracorporeal Shock Wave Therapy (ESWT): This non-invasive treatment has shown promise in treating various musculoskeletal conditions, including plantar fasciitis and Achilles tendinopathy. It may help reduce pain and promote healing in the affected areas.

4. Dry Needling and Myofascial Release: These techniques can help release muscle tension and improve blood flow to the affected areas. While they may not have extensive empirical support, many patients report subjective improvements in pain and function.

5. Alternative Therapies: You mentioned interest in acupuncture and traditional Chinese medicine approaches. While these methods may lack robust scientific backing, some individuals find relief through holistic treatments. It’s essential to consult with qualified practitioners who can provide evidence-based care.

6. Activity Modification: Given your history of engaging in high-impact sports, it may be beneficial to modify your activities temporarily. Low-impact exercises such as swimming or cycling can help maintain fitness without exacerbating your symptoms.

7. Surgical Options: While you expressed a desire to avoid surgery, it’s important to note that in cases where conservative treatments fail and pain significantly impacts quality of life, surgical intervention may be warranted. Procedures can range from tendon lengthening to realignment of the foot structure.

Conclusion
In summary, managing high arches and associated calf pain requires a multifaceted approach. While custom orthotics and physical therapy are foundational treatments, exploring additional modalities such as shock wave therapy, myofascial release, and alternative therapies may provide further relief. It’s crucial to work closely with healthcare professionals who understand your unique situation and can guide you through the available options. Regular follow-ups and reassessments will help ensure that your treatment plan evolves in response to your progress. Remember, the goal is to improve your quality of life and restore your ability to engage in the activities you enjoy.

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