High Arches (Pes Cavus):
Dr. Naughton’s Ultimate Guide to Relief & Support
"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."
Dr. William Naughton
Board Certified Podiatrist
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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 mechanically inefficient. Because it doesn't lower, your foot loses its natural shock absorption, sending impact forces straight into your ankles and knees.
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.
Pressure Overload
The midfoot doesn't touch the ground. All your body weight is concentrated on just two points: the heel and the ball of the foot.
Ankle Instability
Because the foot leans outward (supination), high-arched runners are notoriously prone to chronic ankle sprains.
Conservative Management
Review articles in the NIH database state that orthotics are 92% effective for the conservative management of cavus (high arches).
Source: NIH / Sage JournalsWhy Orthotics Work for Cavus
- Redistributes pressure evenly
- Provides missing shock absorption
- Stabilizes ankle against sprains
3. Symptoms & Diagnosis
High arches are easy to spot: the middle of your footprint is missing.
Claw Toes
Toes curl downward to grip the ground for stability.
Lateral Pain
Pain along the outer edge of the foot from walking on the side.
Calluses
Thick skin under the ball of the foot and heel.
Metatarsalgia
Sharp pain/burning in the ball of the foot.
Home Diagnosis: The "Split" Print
Step on paper with wet feet to confirm your arch type.
High Arch
Only the heel and ball of foot are visible. They may not even connect.
Normal Arch
Band connects heel and toe, about half the foot width.
Flat Foot
Entire sole touches the ground.
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4. Causes: Genetics & Neurology
Primary Causes
- Genetics: Most common. Inherited bone structure.
- Neurological: CMT disease, Spina Bifida, or CP.
- Trauma: History of severe ankle fractures.
Risk Factors
- Ankle Sprains: Chronic instability worsens the supination.
- Hard Surfaces: Concrete floors punish rigid feet.
5. Comprehensive Treatments
Home Remedies
- High-Volume Shoes: Extra depth prevents top-of-foot pain.
- Cushioned Socks: Reduces friction on the heel/ball.
- Calf Stretching: Loosens the pull on the foot structure.
Medical Therapies
- Custom Orthotics: "Accommodative" style to fill the arch void.
- Debridement: Professional trimming of painful calluses.
- Surgery: Reserved for severe deformity (reconstruction).
3 Essential Stretches for High Arches
Pull toes back towards shin.
Why it works: Releases the chronically tight arch ligament.
Lean against wall, leg back.
Why it works: Tight calves worsen arch rigidity.
Pick up towel with toes.
Why it works: Improves dexterity in clawed toes.
6. The Definitive Treatment: Custom Accommodation
Why Bilt Labs Is The Superior Choice
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 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.
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 Insoles7. Prevention & Footwear Guidelines
The right shoe is crucial for managing high arches.
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.
Cushioning
Maximalist midsoles are best.
High Volume
Deep shoe for high instep.
Neutral Only
Avoid "Stability" shoes.
Clinical Insight
With custom orthotics, you aren't limited to "orthopedic" shoes. You can add structural stability to your favorite sneakers or work boots instantly.
8. Frequently Asked Questions
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.
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