High Arches (Pes Cavus): Causes, Symptoms, and Treatment

What Are High Arches?

Pes cavus occurs when the arch of the foot is higher than normal, leading to an uneven distribution of weight during walking or standing. Unlike flat feet, high arches place excessive pressure on the heel and ball of the foot.

High arches can be:

• Flexible: The arch changes shape slightly under weight.

• Rigid: The arch remains high regardless of weight-bearing.

Causes of High Arches

Neurological Conditions

• Charcot-Marie-Tooth Disease: A genetic condition affecting nerve and muscle function.

• Cerebral Palsy: Impacts muscle tone and alignment.

• Spina Bifida: Alters foot structure due to nerve abnormalities.

Structural or Acquired Factors

• Genetics: Inherited high arch foot structure.

• Trauma: Injuries leading to abnormal foot alignment.

• Imbalance of Foot Muscles: Weak muscles in the front of the leg and overactive muscles in the back can elevate the arch.

Symptoms of High Arches

• Pain: In the heel, arch, or forefoot due to uneven pressure.

• Calluses: On the ball of the foot or heel caused by high pressure.

• Instability: Increased risk of ankle sprains due to poor foot support.

• Toe Deformities: Such as claw toes or hammer toes.

• Foot Fatigue: Particularly after prolonged standing or walking.

Diagnosis of High Arches

Clinical Examination

• Visual Inspection: Assessing the height of the arch and toe alignment.

• Gait Analysis: Observing walking or running for signs of instability or pain.

Imaging

• X-rays: Provide a clear view of foot structure and alignment.

• MRI or CT Scans: Evaluate soft tissue and potential nerve involvement in neurological cases.

Treatment for High Arches

Non-Surgical Management

1. Footwear Adjustments

   • Shoes with good arch support and cushioning.

   • Avoid stiff or narrow footwear.

2. Orthotic Devices

   • Custom-made insoles to distribute weight more evenly.

   • Heel pads or metatarsal pads to relieve pressure points.

3. Physiotherapy

   • Stretching: Focused on the plantar fascia and calf muscles to improve flexibility.

   • Strengthening: Targeting weak muscles, such as the anterior tibialis, to enhance stability.

   • Balance Training: Reducing the risk of falls and ankle sprains.

4. Pain Management

   • Ice or heat therapy to alleviate pain and inflammation.

   • Non-steroidal anti-inflammatory drugs (NSAIDs) under medical guidance.

Surgical Options

Surgery may be necessary for severe cases where non-surgical methods fail. Procedures can include:

• Soft Tissue Release: Relieves tightness in muscles or tendons.

• Osteotomy: Realigns bones in the foot to lower the arch.

• Fusion Surgery: Stabilizes the foot by fusing problematic joints.

Living with High Arches

With appropriate treatment and support, most individuals with high arches can enjoy an active, pain-free lifestyle. Early intervention can:

• Prevent complications like chronic pain or deformities.

• Enhance foot stability and reduce injury risk.

• Improve overall comfort during daily activities.

At Palms Physiotherapy & Allied Health, we specialize in managing high arches through personalized, evidence-based care. Contact us today to learn how we can help support your foot health and improve your quality of life.