Foot deformities in adults and childhood/custom molded orthotics

High Arches

Recently during a patient encounter the patient said to me “Doc I was told I have high arches, but aren’t having arches a good thing”. I responded that although having an arch in the foot is good there is a point when arches become too high that it turns into a problem.
An excessive high arch, also known as Pes Cavus, literally translates in Latin to a “hollow foot”.  A cavus foot type is less common that the flat foot type, with about 10% of the population having this foot type. Despite the rarity, people that have this foot type can have just as many symptoms in the foot and ankle as people with flat feet.

How does someone get a Cavus foot?

A cavus foot can either be passed down through genetics or acquired during one’s life. Genetically there are rare neurological disorders that can be represented with a high arch foot. These disorders tent to have multiple other symptoms throughout the body. A cavus foot can be acquired whether due to muscle weakness that can cause the development of the high arch or a clubfoot deformity that was not fixed correctly. There can be many causes of high arch feet and amongst the literature there is still some ambiguity as to cause in some instances.

What are the symptoms of a Cavus foot?

The symptoms of this type of foot can vary and are hard to predict. Depending on what type of shoe gear someone wears will also predict their symptoms.  Symptoms can include pain in the metatarsal region, constant ankle sprains with weak ankles, Achilles tendonitis, difficulty with shoe fitting, stress fracture, and knee pain, just to name a few.  Formation on of hammertoes is a common side effect of a long lasting cavus foot type.

How does one treat a Cavus foot?

If someone if diagnosed with this type of foot and they have minimal pain or no pain the goal is to prevent symptoms in the future. Proper fitting shoe gear is essential. That would include a shoe with a build in arch. High heel shoes will put more pressure on the toes and metatarsals and can cause more discomfort and even metatarsal stress fractures. Custom molded orthotics can be built for a high arch foot which can prevent foot pain.

If cavus feet are causing severe symptoms surgery can be performed. Before undergoing surgery your surgeon will determine where in your foot is the deformity coming from. This can be performed by a simple test, which includes standing on a block and seeing if the deformity disappears. Once surgery is decided upon there are many options of how to fix the deformity. You and your surgeon will decided what procedure is most suited for you.

Don’t ignore a high arch just because you may think it is normal. If you are having any foot discomfort please see your physician for treatment.