A high-arched foot, also known as a Cavus foot, is less common than a flatfoot, but it can cause more pain and trouble walking—particularly if it’s connected to a neurological problem. A high arch on the inside of your foot creates a “high instep.” This can make fitting shoes difficult. It can also lead to other concerns because most of your body weight is loaded on to your heels and the ball of your foot, rather than be distributed evenly over your entire foot.
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Symptoms
With time, the uneven distribution of body weight heavily concentrated on the heel and forefoot that we see with a Cavus foot, can lead to a number of symptoms. The most notable symptom is pain. The pain typically is felt in the heel, ball of the foot or on top of the foot – the instep. As a result, you may have trouble fitting into some shoes and notice redness on top of your feet after wearing shoes. Additionally, you may notice, your toes start to change shape (hammer toes/claw toes are common), and calluses/corns may appear under the feet or on the tops or tips of toes. Sometimes the foot tilts to one side, too, which destabilizes the limb and may increase the odds of spraining your ankle. Frequent ankle sprains may be related to your high arches!
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Causes
Cavus high-arched feet can be your natural foot shape that you’re born with, but often it is the result of a neurological disorder. Cerebral palsy, Charcot Marie Tooth disease, polio, muscular dystrophy, and spina bifida are all conditions that may cause your arches to develop higher than normal. Although most often hereditary, there are number of reasons why your arches may seem excessive, such as having the following shape / biomechanical pathology -
• Metatarsus adductus (“C-shaped” foot)
• Forefoot valgus
• Plantarflexed first metatarsal
• Excessive curvature of the external arch (pseudoequinus)
• Excessive inclination of the heel bone
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Treatment
A thorough biomechanical exam by a Canadian Certified Pedorthist or Registered Chiropodist is important to better understand the biomechanics of your lower limbs. Your primary care professional may also order x-rays. Treatment depends on if the arch is rigid or flexible but focuses on addressing any biomechanical pathology through functional correction or accommodation. This can be done with Orthotics and appropriate shoes. Shoes that are easy to get into and accommodate for a higher instep are ideal. However, no off-the-shelf shoe has an insole that can properly address or support an excessively high arch. This is where orthotics are key. Also, any calluses or corns need to be trimmed and offloaded by a Chiropodist or Footcare Nurse. Finally, stretching and strengthening with physical therapy can help address balance issues and some gait disturbances.
