High Arched Foot (Pes Cavus)

High Arched Foot (Pes Cavus)

When a person has Pes Cavus, or a high arched foot, an excessive amount of weight is placed on the ball and heel of the foot while standing or walking. Pain and instability are just two symptoms caused by a high arched foot. It can occur in either or both feet, and happen at any age.

Causes of High Arched Foot

A neurological disorder is often the cause of Pes Cavus. Cerebral palsy, spina bifida, polio, Charcot-Marie-Tooth disease, muscular dystrophy, or a stroke are other conditions that can cause Pes Cavus. And inherited structural abnormality could be another contributing factor. The underlying cause of a high arched foot determines its future course, so an accurate diagnosis is key. If the high arch is due to a neurologic disorder or other medical condition, it is very likely to worsen over time. If not a result of a neurologic disorder, Pes Cavus usually will not change in appearance.

Symptoms of High Arched Foot

The high arched foot will appear high even when standing. Additionally, one or more of these symptoms may be present:

  • Hammertoes (bent toes) or claw toes (toes clenched like a fist)
  • Calluses on the ball, side, or heel of the foot
  • Pain when standing or walking
  • An unstable foot due to the heel tilting inward, which can lead to ankle sprains

Foot drop, a weakness of the muscles in the fool and ankle, may also be experienced. This results in dragging the foot when taking a step. Foot drop is usually a sign of an underlying neurologic condition.


A review of the patient's family history is necessary in diagnosing Pes Cavus. a doctor, usually a foot and ankle surgeon, will examine the foot to look for high arches, calluses, hammertoes, and claw toes. Muscle strength and the patient's walking pattern and coordination are also observed and tested. The entire limb will be examined if a neurologic condition presents itself. The pattern of wear on the patient's shoes could also be a sign of a high arch.

Sometimes x-rays are ordered or the doctor may refer the patient to a neurologist for further examination.

Collapsed Arch

The natural upwards curvature in the foot appears in an arched foot. When the tendons do not pull the foot in properly, the arch subsides and appears as a collapsed arch or a fallen arch. Some individuals are born with their feet formed this way; others injure the tendons in the foot. Nerve injuries, broken bones or injury to the back of the foot can cause a collapsed arch to occur.

Nonsurgical High Arched Foot Treatment

Nonsurgical treatment may include one or more of the following:

  • Custom orthotic devices that fit into the shoe provide stability and cushioning to the foot.
  • High-topped shoes support the ankle while shoes with heels a little wider on the bottom add stability.
  • A brace may be recommended to help keep the foot and ankle stable. It is also useful in managing foot drop.

When Is Surgery Needed?

If all nonsurgical treatment fails to relieve the pain and improve stability, the next option may be surgery. Surgery would decrease pain, increase stability, and compensate for weakness in the foot. Depending on the individual case, the surgeon will choose the best surgical procedure which may include a combination of procedures. In some cases where the high arch is cause by neurologic problems, surgery may be needed again in the future due to the progression of the disorder.