Helios Bracing

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  • CMT Type 2

    CMT Type 2

    CMT Type 2

    Commonly know as Flat Foot.  The pes planus is also known as a valgus deformity or where the foot goes into the position of eversion.

    CMT-Type 2 - Helios Bracing

    Pes Planus Foot

    The pes planus foot is very familiar to me as I was born with a pes planus third degree deformity. However, the CMT2 patient with a pes planus foot, has ligamentous laxity, in contrast to a pes planus foot that has a fixed or rigid deformity, such as my own foot.

    Fortunately for CMT patients, a flexible pes planus foot is easy to correct in comparison to a fixed or rigid pes planus. The pes planus is also known as a valgus deformity or where the foot goes into the position of eversion. Most CMT patients will find it interesting to learn that a large percentage of the general population (who do not have CMT), suffer from pes planus feet. A major distinction between CMT patients and other patients who have pes planus, is that with CMT there is a foot drop or peroneal neuropathy, where the foot does not dorsiflex due to a weakness of the anterior tibialis muscle.

    The anterior tibialis muscle is a large muscle on the front of your leg which dorsiflexes or lifts your toes up. With a pes planus foot the calcaneus is usually in a valgus position and the forefoot abducts (points outward). Ideally we want to do the reverse, adduct the forefoot, elevate the arch out of the pes planus position, and maintain that new corrected alignment with stability. If this is done properly it will reduce fatigue, pain, and allow you to increase your walking time. I stress that silicone is critical when doing this kind of correction.

    As a sufferer from a pes planus birth defect,
    I have a lifetime of experience dealing with it.

    If I see you here in my office as a patient I would be glad to show you my foot, the carbon graphite device that I use to correct it, and can tell you what to expect. When I first incorporated my silicone correction system, I was the first patient to test it out. After using this for 2 to 3 months I realized the benefits and then started incorporating it into my new Helios® Orthosis. I now have many patients using the silicone and they can tell you of its benefits. 

    CMT Guide › CMT Type 2 › Helios Bracing

    Pes planus, or pes valgo planus, is a deformity producing a severe flat foot. This deformity mostly takes place at one particular joint, which is the talocalcaneal articulation. When there is a valgus deformity at this joint, there are usually three separate components that are put into effect:

    • 1
      The calcaneus has a valgus position
    • 2
      The head of the talus angulates downward
    • 3
      In relation to the hindfoot, the forefoot is totally abducted

    In addition, with this deformity the achilles tendon is normally pulled laterally. This is because of the outward rotation of the calcaneus. The outward rotation of the calcaneus displaces the line of pull of the achilles tendon. The primary muscles that plays a role in this is the gastrocnemius and soleus. The gastrocnemius and soleus muscles are the principal plantarflexors of the foot.

    Corrective bracing that takes place especially in the footplate of an orthosis can realign the joints, elevate the head of the talus, and put the calcaneus back into its appropriate position. In time this will ultimately reduce the deviated line of pull of the muscle tendons and slowly let the muscles get back to their normal line of progression. This is assuming that there is no current permanent damage.

  • CMT Type 1

    CMT Type 1

    CMT Type 1

    Commonly known as High Arch Foot. CMT type 1 is the most common subtype of CMT, accounting for roughly two-thirds of all cases.

    CMT-Type 1 - Helios Bracing

    Pes Cavus Foot

    Patients with CMT experience muscle weakness, or an imbalance of muscle strength which causes a pes cavus foot. In this type of foot the arch is raised into a position that is classified as a clinical deformity.

    The muscle that is responsible for this is the tibialis posterior. The forefoot adducts in what is an inward angulation. The back of the foot, or the hindfoot, usually goes into a varus position. This profile needs very careful analysis for proper correction because many times there is what we call a calcaneal varus contracture. Therefore, it is necessary to address the calcaneal varus contracture as a separate component. In these situations, we would like as much input from your physical therapist or physician as possible.

    The Pes Cavus foot usually has four basic characteristics:
    • 1
      An unusually high longitudinal arch
    • 2
      Toes that are clawed
    • 3
      Prominent metatarsal heads
    • 4
      Foot is shorter than normal
    CMT-Type 1 - Helios Bracing

    CMT1 is the most commonly diagnosed type. Patients are inclined to manifest a pes cavus deformity. In addition to the foot angulation if left uncorrected, the alignment will affect the knee. Many patients find as soon as they have heelstrike with the floor, they feel their foot and knee rolling outward. As such, many patients that are affected by the pes cavus foot have a very narrow walking base. Patients have told me that other practitioners have instructed them to walk with a wider gait.

    Although this sounds reasonable, it will only encourage awkwardness and more compensations by the rest of your muscles. When addressed properly, the pes cavus foot with corrected alignment will reduce fatigue, thereby allowing greater velocity and more endurance or increased walking time.

    CMT-Type 1 - Helios Bracing

    The clawing of the toes is due to a contracture of the toe extensors (4.)