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 simply inherited and/pr family genetics, to birth defects and 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.
Typically, when you hear people talking about a foot type, the most common type of foot you hear is a flat foot. There are also a lot of common problems that are associated with a high arch foot as well! Today I am going to go over what exactly a high arch foot type is and some common problems associated with it.
What is a High Arche?
A high arch foot is exactly how it sounds. You will notice an arch on the bottom of your foot when your at rest or when you are standing. This is an important distinction. A high arch foot that has anarch at rest but then flattens out when you put weight on it is called a “flexible pes cavus (or high arch) foot type.” A high arch foot that has an arch when your non weight bearing, as well as weightbearing, is called an “rigid pes cavus (or high arch) foot type.” Typically, patients with the rigid foot type will develop more problems.
Problems most associated with this foot type are problems arising in the forefoot (or ball of the foot). The reason for this is because more pressure is applied to the forefoot as opposed to a more fluent distribution of weight with someone with a more average or flexible foot type. Common problems in the forefoot include neuroma, stress fracture, bursitis and tendonitis. Saying this, a high arch foot type just doesn’t cause problems in the forefoot! Pain in the bottom of the heel as well as pain on the back of the heel can arise. The two most common issues with the above pain are plantar fasciitis and Achilles tendonitis. Plantar fasciitis in a high arch foot type is caused by the stretch of the plantar fascia at an abnormal angle due to the rigidity of the foot. Tendonitis of the muscles of your foot can be caused by overuse of muscles in the anterior of your legs that have to compensate for other muscles in your foot.
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.
Where Can I get Treated for High Arches?
You can get treated for high arches at our Hillsborough location at Family Foot and Ankle Specialists or our Piscataway location. Your evaluation would include a comprehensive foot examination as well as imaging and gait studies that can help identify what your specific problem is. It is important to come in and not ignore issues surroudning your feet because the quicker you come in, the easier the treatment process will be! You can call us at our Hillsborough location at 908-874-80360 or you can call us at our Piscataway location at 732-968-0573.