The Sports physio - Carlisle, Cumbria

The high arch or Pes Cavus is represented by an abnormally high medial longitudinal arch.

Although less common than flat foot (Pes Planus), it is no less painful and in some cases can be more problematic.

There are Two types of high arch: Flexible and rigid.
The rigid or inflexible high arch will retain the high-arched appearance in both non weight bearing and weight bearing. This may also be referred to as a supinated foot.
The flexible high arch will appear more normal on weight bearing as the joints of the midfoot allow the foot to flex.

What causes a high arch?
There are a number of reasons why people may have high foot arches;

The condition may be inherited (congenital). Usually involving both feet (bilateral) and is evident from an early age.

In earlier years, there may be no symptoms due to the flexibility of the younger foot. However, as the body ages and joints become less flexible, these feet become painful and can also lead to pain and biomechanical problems in the lower limbs and back.

Trauma to the nerves of the foot or neuromuscular conditions such as Poliomyelitis and Charcot-Marie-Tooth disease can be some of the reasons Pes Cavus appears in later years.

Symptoms

• Heel or ball of foot (Metatarsal) pain.
• Calluses and corns may appear on the ball of the foot where undue pressure is exerted.
• Pain in ankles, knees, hips, hamstrings and low back due to poor shock absorption.
• Haglund’s Deformity – Hard lumps at the back of the heel, often known as “pump bumps”.
• Toes may appear clawed, as though they are grasping the ground.
• Pain in the mid foot due to stress on the mid tarsal joints and Plantar Fasciitis.
• Unstable ankle, resulting in frequent sprains.
• Morton’s Neuroma – damage to the plantar nerves of the foot.

Treatment

• Pes Cavus is not able to be prevented, so treatment is aimed at increasing flexibility of the midfoot where required and the use of prescriptive orthotics to support the arch and improve shock absorption by redistribution of weight.
• Off the shelf orthotics are usually unsuitable, due to the complex nature of the problem.
• Treatment of any corns and callouses to relieve pressure on the metatarsals.
• Surgical correction may be required in the case of complications such as Morton’s Neuroma.

Your shoes should always have good arch support with plenty of room in the upper for the foot to flex. A well cushioned shoe will help to absorb impact.