Severe Pes Cavus


The A Quad foot type is an over-supinated or cavus foot type with the following features:

  • Also known as a Torque Foot due to rearfoot varus and forefoot valgus.
  • Largely inverted heel alignment from Uncompensated Rearfoot Varus
  • High arch (Cavus)
  • Poor shock attenuation caused by heavy loading and never seeming to pronate.
  • Excessive pronation throughout gait cycle.
  • Narrow base of support or cross over gait, like walking on a tight rope.
  • Calluses may form to the 1st metatarsal and 5th metatarsal.
  • Approximate presentation in US population is 15%.

The Quad A foot type is often diagnosed as "Pes Cavus" (High Arch) in adults and is rarely seen in young (<7 years-old) children without a neurologic etiology.

CHILD PRESETATION:  This is usually not painful in children, but can commonly lead to unstable or recurrent ankle sprains.

WALKING PATTERN: Walks similar to a tight rope walker or "shakes the chandelier" with each step.


  • Heel Pain
  • Lower Back Pain
  • Lateral Ankle Instability (Easily spraining of ankles)
  • Peroneal Tendonitis
  • 5th Metatarsal Base Pressure
  • Sesamoiditis
  • Bunions (Hallux Abductovalgus - HAV)
  • Hammer Toes
  • Knee Recurvatum

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Brandt R Gibson, DPM
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Podiatrist, Neuropathy Doctor, Father of 11 and Founder of Mountain West Foot & Ankle Institute