High Arches (Pes Cavus)


Pes Cavus is the term used to describe very high-arched feet. This condition is often associated with a rigid foot structure and does not absorb shock well. Consequently, the heel and forefoot are overburdened when walking or standing.  When often combined with the tendency of the foot to roll outward, tendons and ligaments located on the outside (lateral side) of your ankle also become strained.


The most common symptoms associated with pes cavus include:

  • Pain and callousing under the ball of the foot
  • Pain through the plantar fascia, ligaments and muscles under the midfoot and within the midfoot joints.
  • Aching and fatigue in the muscles and joints of the legs and back, resulting from stiffness.

The most common causes of pes cavus include:

  • Present from birth (congenital).
  • Extreme cases can be associated with neurological conditions (such as Spina Bifida, Polio or Charcot-Marie-Tooth disease).

Orthotics (Orthoses) – Must be prescribed by a physician
Custom made orthotics support the skeleton, muscles and fascia in the correct position. Orthotics are a long-term solution to prevent reoccurrence by controlling and / or correcting the mechanics that cause the problem.

It is imperative that the orthotics match the arch height of the foot. Over the counter insoles will not correct this condition. Orthotics for Pes Cavus may include:

  • Prominent metatarsal pad or bar to lift and separate metatarsal heads.
  • Soft forefoot material to cushion metatarsal heads.
  • Hollowing out the orthotic under prominent metatarsal heads to reduce pressure as necessary.
  • A built in angulation to maintain the foot in a more suitable position.



Certified Pedorthists are trained to fit patients with appropriate footwear. BioPed offers many types of footwear into which an orthotic device may be placed or worn alone. Footwear for Pes Cavus may have any of the following characteristics:

  • Footwear with additional lateral stability is ideal for a pes cavus foot type to fit the forefoot properly and resist outward rolling of the feet.
  • Sufficient depth for high insteps and clawed toes is a necessity. Lycra and neoprene materials work well to accommodate clawed toes.
  • Rocker soles enhance forward propulsion while limiting flexing and plantar pressure of the forefoot metatarsal phalangeal joints.

Modifications to footwear are also available at the discretion of the Pedorthist.