High Arches

Pes cavus or more commonly known as “high arches” can be a very painful and debilitating condition. In its mildest form it may only cause you to cut your walk short or prevent you from attending that family outing. In its most severe presentation, it can cause intractable pain and even lead to foot ulcers and amputations.

It's causes range from simple inherited, family genetics, to birth defects, to neurological disorders.  Regardless of the cause, if it prevents you or a loved one from participating in a normal daily life it needs to be addressed evaluated and treated.

high arches

Treatment for High Arches

Treatments, of course, vary as does the condition itself. A simple, thickened callus on the bottom of the ball of the foot might only need a periodic debridement to keep the patient comfortable. Going further IE: the need to prevent this callus formation would be the addition of a simple insert into the shoe to decrease the callus formation by helping to redistribute the pressure the foot is experiencing from normal daily walking.

Orthotics for High Arches

Further along this line of making the patient more comfortable would be the use of a “functional orthotic”, which helps to balance and control the foot in more than just a cushioning mode. Functional orthotics work best for those who in addition to having callous problems are also complaining of “weak ankles” or chronically twisted ankles. Certain types of high arched feet are not as flexible as is needed for the foot to properly contact the ground and thereby absorb and redistribute the pressures that the feet must endure. This can cause the feet to be very unstable on an uneven surface or with certain sporting activities, as well as in certain kinds of shoes.

Surgical Treatment for High Arches

Further along this treatment line of reasoning would first be surgical intervention in the form of soft tissue procedures to “loosen” some of the dynamic foot muscles. This would be followed by more complex bony procedures if the condition were severe enough.

As I am sure you have noticed, there is not always one good procedure that works for all people. Each foot must be evaluated for the degree of deformity as well as the pains and limitations of activities that may accompany the condition.


Robert Kosofsky, D.P.M.
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Dr. Robert Kosofsky has over 25 years of experience treating patients in our Hillsborough & Piscataway offices