High Arched Feet – Pes Cavus and Over-Supination

The expression Cavus Foot refers to a condition of the foot having a very high arch due to the ball and heel of one’s foot experiencing an excessive amount of weight, especially when walking or standing. Such a condition can occur either in one foot or in both feet and often leads to various symptoms, including pain and instability.

Do you suffer from High Arched Feet – Pes Cavus?

High Arched Feet – Pes Cavus is a condition where a person has feet with a high arch or instep when they stand. This condition is also called Pes Cavus. The high arch usually runs from your toes to the bottom of your foot under the heel. Unlike Pes Planus (flat feet), which is its opposite, Pes Cavus is less frequent. Pes Planus is also referred to as flat feet. The defect usually occurs on both feet and appears at an early age. In case it appears on one foot, or suddenly, it might have been caused by a neuromuscular disease or an injury to the foot.

In the beginning, the condition may not present any symptoms. However, as the infection progresses, it becomes more symptomatic than before. Generally, Pes Cavus presents more problems to the patient than flatfoot. The decreased plantar surface that bears the body’s weight increases pressure on the heel and the metatarsal heads.

High arched feet face the challenge of inability to absorb shock from the heel as the gait cycle progresses (as you walk). This condition then creates stress on the soft tissues of the lower leg and the foot. The shock created by the heel is then transmitted from there to the lower back, knees, and ankle. Pain is a common symptom in one or all these areas to where shock is transmitted. Painful corns may also develop on top or at the tips of the toes as a result of the development of a toe deformity called ‘clawing.’ Often, painful plantar calluses also occur under the foot.

People with Pes Cavus often face difficulties when trying to wear shoes. They may benefit from using foot orthotics. Orthotics help to offload pressure that is laid on the ankle, heel, or forefoot and will redistribute the plantar pressures.

Appearance of High Arched Feet

The instep may look hollow when you stand. Also, most of your body weight is laid on the metatarsal heads or the back.
High arches may either have the ability to move to lower levels (flexible) or they may not move at all (rigid).
If the patient sits in a position where the feet are hanging, the forefoot may drop to a lower level than that of the heel.
The heel may tilt inwards from the back or roll outwards.

Symptoms and Complications of High Arched Feet

The symptoms of this condition vary depending on the condition of the arch among other factors. These include the occupational demands that dictate the level of activity and load that is placed on the foot, the presence of joint motion which will determine whether the arch will be rigid or flexible, and the height of the arch.

The symptoms of this condition range from mild problems of fitting shoes to other problems such as:

Problems finding shoes or other footwear that are deep enough to accommodate the high arch and toes that are ‘clawed’.
The length of the foot may shorten.
Pain in the feet while walking, running, jumping, and other while performing other weight-bearing activities.
Metatarsalgia accompanied with pain, often on the first and fifth metatarsals. A corn may or may not develop.
Stiffness and pain on the medial arch or other structures along the mid-portion of the feet maybe experienced.
Morton’s neuroma accompanied with pain on the metatarsal heads and the lesser toes.
Plantar fasciitis which causes pain on the heel and arch of the feet.
Chronic ulcers of the ball of the foot or heel may be experienced in cases where the patient has compromised circulation or diabetes.
Patients also experience strain and early degenerative joint infection of the lower extremity joints.
Haglund’s deformity, also called ‘pump bumps’, at the back of the heel.
Discomfort around the ankle joint.
Lower back pain, knee pain, and hip pain.
Instability of the ankle, leading to frequent sprains.
Tight Achilles tendons.
Diminished well-being and inactivity due to lower extremity pain which may have become chronic.

Treatment for High Arched Feet

First, your consulting podiatrist will make a careful examination. This will help him/ her to rule out the possibility that your condition has been caused by any neurological problems. This decision be based on what is causing pain, in case you feel any. For instance, high arches that are flexible may not need to be treated. Treatment may involve the following:

Shoes with a good cushioning, orthotics (arch support), and proper depth may help to relieve pain and walking problems.
Corns and calluses may be debrided.
Use various silicon pads to get pressure off the affected area.
Reduce load on the foot, for example by controlling your body weight.
Physical therapy
You can manipulate the foot and joint to help in increasing the range of movement of the arch.
Custom orthotics help in distributing pressure evenly on the foot and relieve the ankle and forefoot of any excess pressure. They often have shock absorbing material on the arch. The appropriate prescription for the orthotics usually follows a careful examination, gait analysis, biomechanical examination, and running over a pressure mat if necessary.
For patients with mild Pes Cavus, our pre-made orthotics can be helpful.
Contact us on 03 9077 5915 for further assessment and treatment.