Batna Journal of Medical Sciences
Volume 13, Numéro 1, Pages 63-69
2026-05-01
Pes Cavus And The Domino Effect On The Musculoskeletal System: Clinical Implications Across The Kinetic Chain From Foot To Spine
Authors : Remita Kamel . Al Fahel Mohamed Hassan . Haddad Wissem Soumia .
Abstract
In clinical practice, patients with recurrent or refractory musculoskeletal complaints that respond inadequately to standard treatments may harbour an underlying, unifying biomechanical driver. Pes cavus (high-arched foot), characterized by a rigid elevation of the medial longitudinal arch, represents one such frequently overlooked contributor. This foot morphology alters fundamental biomechanics by reducing shock absorption and redistributing plantar loads, thereby propagating compensatory stresses proximally along the kinetic chain. Although pes cavus is commonly perceived as a marker of underlying neuromuscular disease, this assumption is frequently incorrect. Only a minority of cases, typically severe and progressive, are associated with neuromuscular disorders, while the majority represent a normal anatomical variation of foot shape. Like pes planus, pes cavus should not be considered pathological per se and warrants intervention only when symptomatic. Clinically significant cavus alignment may generate a cascade of pathology ranging from forefoot overload, plantar fascia stress, Achilles and peroneal tendinopathies, and ankle instability to knee pain, sacroiliac joint dysfunction, and spinal loading abnormalities. Despite these wide-ranging effects, pes cavus remains under-recognized, often resulting in fragmented, symptom-oriented management. Early identification through targeted clinical assessment and appropriate use of orthoses can mitigate this biomechanical “domino effect,” addressing symptoms from the foot to the spine.
Keywords
Pes cavus ; High-arched foot ; Kinetic chain ; Musculoskeletal pain ; Foot orthoses ; Gait analysis
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