High Arches (Pes Cavus):
The Ultimate Guide
"High arches are often misunderstood. Unlike flat feet, which collapse, a high arch is rigid and unforgiving. This lack of shock absorption sends impact straight up your legs. The goal isn't to lower the arch, but to bring the ground up to meet it, redistributing that pressure evenly."
NPI: 1245247089
Board Certified Podiatrist
Dr. William Naughton
Board Certified Podiatrist
In This Guide:
1. What Are High Arches?
High arches, medically known as Pes Cavus (ICD-10 M21.6X), is a condition where the arch of the foot is raised more than normal. Unlike a normal foot that flattens slightly to absorb shock, a cavus foot remains rigid and locked.
While a high arch might look "strong," it is often mechanically inefficient. Because the arch doesn't lower, the foot has a significantly reduced ability to absorb impact, forcing the heel and the ball of the foot to bear an excessive amount of weight with every step.
2. Anatomy: The Problem of Rigidity
In a neutral foot, the arch acts as a spring. In a high-arched foot, that spring is too tight. The foot is typically fixed in supination (rolled outward), which places extreme stress on the outer edge of the foot and the ankle ligaments.
The Consequences: Because the midfoot doesn't touch the ground to share the load, the impact forces are concentrated on the heel and the metatarsal heads (ball of the foot). This often leads to secondary conditions like Metatarsalgia, callus formation, and chronic instability.
Conservative Management
Review articles in the NIH database state that orthotics are 92% effective for the conservative management of cavus (high arches).
Why Orthotics Work for Cavus
- Redistributes pressure evenly
- Provides missing shock absorption
- Stabilizes the ankle against sprains
3. Symptoms & Self-Diagnosis
People with high arches often have a very distinct footprint—the middle section of the print is very narrow or even missing entirely.
Instability & Pain
The most common complaint is lateral (outside) foot pain and a feeling of ankle instability. Because the foot is locked in supination, it is prone to rolling over, leading to frequent ankle sprains.
Other Key Symptoms:
- Claw Toes: The toes may curl downward (clawing) or upward (hammer toes) as tendons pull tighter to stabilize the foot.
- Calluses: Thick, painful skin forming on the ball of the foot and the heel due to focused pressure points.
- Metatarsalgia: Sharp pain or burning in the ball of the foot.
- Knee & Back Pain: Poor shock absorption transmits impact forces up the chain to the knees and lower spine.
4. Causes: Genetics & Neurology
While many cases of high arches are simply hereditary, they can sometimes indicate an underlying condition.
Common Causes
- Genetics: Most commonly, you inherit the bone structure from your parents. If it affects both feet and has been present since childhood, it is likely genetic.
- Neurological Conditions: Conditions like Charcot-Marie-Tooth disease, spina bifida, or cerebral palsy can cause muscle imbalances that pull the arch upward.
- Trauma: Severe ankle fractures or nerve damage can lead to a rigid high arch over time.
5. Comprehensive Treatment Options
Treating high arches is different from treating flat feet. Instead of "correcting" a collapse, the goal is to accommodate the shape and provide shock absorption.
Home Remedies (Cushioning)
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High-Volume Shoes:
Choose shoes with extra depth to accommodate the high instep and prevent rubbing. -
Cushioned Socks:
Thick socks can help reduce friction on the heel and ball of the foot. -
Calf Stretching:
Loosening tight calf muscles can reduce the pull on the foot structure.
Medical Therapies
-
Custom Orthotics:
The most effective treatment. Fills the void under the arch to redistribute weight. -
Debridement:
Professional trimming of painful calluses by a podiatrist. -
Surgery:
Reserved for severe cases (e.g., neurological causes) to reconstruct the foot.
3 Essential Stretches for High Arches
While you can't lower the arch through exercise, you can improve flexibility to reduce strain.
Sit down and pull your toes back towards your shin with your hand. You should feel the band on the bottom of your foot stretch. Why it works: High arches keep this ligament chronically tight.
Lean against a wall with one leg back, heel flat. Bend the front knee. Why it works: Tight calves exacerbate the rigidity of a high arch.
Use your toes to pick up a towel. Why it works: Improves the dexterity of the toes, which often become clawed in high-arched feet.
6. The Definitive Treatment: Custom Accommodation
Because the high arch doesn't lower to the ground, the ground must be brought up to the arch. This is the principle of Accommodation.
Custom Orthotics for high arches are designed differently than those for flat feet. Instead of just preventing collapse, they are designed to make total contact with the sole of your foot. By filling the high arch gap, the orthotic allows the arch to bear weight, instantly relieving pressure from the heel and ball of the foot.
Why Bilt Labs? We customize the shell flexibility to provide the shock absorption your foot is naturally missing, protecting your ankles and knees from impact.
Need Better Shock Absorption?
Don't let rigid arches cause long-term joint pain. Get custom support that fits your unique foot profile.
View Custom Orthotics7. Prevention & Footwear Guidelines
The right shoe is crucial for managing high arches. You need volume and cushioning.
What to Look for in Shoes
- Cushioning: Look for "maximalist" shoes or those with ample midsole cushioning to absorb shock.
- High Volume: The shoe should have a high instep (vertical space) so it doesn't compress the top of your foot.
- Neutral Support: Avoid "stability" or "motion control" shoes designed for flat feet, as they can push your foot further outward (supination).
The Orthotic Advantage: Placing a custom orthotic into a neutral, cushioned shoe creates the perfect environment: the shoe absorbs the shock, and the orthotic distributes the weight.
8. Frequently Asked Questions
Can high arch feet be corrected?
High arches are typically a structural or genetic trait that cannot be permanently "lowered" or corrected without complex surgery (which is rare). However, the functional problems caused by high arches—such as pain, instability, and lack of shock absorption—can be effectively managed and "corrected" mechanically using custom orthotics and proper footwear.
How do podiatrists treat high arches?
Podiatrists primarily treat high arches by addressing the pressure points and instability. The standard of care involves prescribing custom orthotics to redistribute weight across the entire foot, trimming painful calluses, and recommending high-volume, cushioned footwear. In cases involving severe claw toes or muscle weakness, physical therapy or surgical tendon releases may be considered.
What does a high foot arch indicate?
A high foot arch typically indicates a rigid foot type prone to supination (under-pronation). While often just a hereditary variance, a very severe or rapidly developing high arch can sometimes indicate an underlying neurological condition, such as Charcot-Marie-Tooth disease, spina bifida, or a spinal cord issue, warranting a medical evaluation.
What type of shoe is best for high arches?
The best shoes for high arches are "Neutral" cushioning shoes. Look for footwear with a thick, shock-absorbing midsole and a spacious toe box. It is crucial to avoid "Stability" or "Motion Control" shoes, as these often have dense foam on the inner arch that can push a high-arched foot further outward, increasing the risk of ankle sprains.
Medical Disclaimer: The information provided in this guide is for educational purposes only and is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website.