High Arch Foot (Pes Cavus)

Introduction

This condition is an abnormally high arch of the foot that results in an excessive amount of body weight being directed to the ball and heel of the foot. Cavus foot can be congenital or acquired, may develop at any age, and can affect one or both feet.

What is Pes Cavus?

Pes cavus foot type describes a highly arched foot whereby the longitudinal arch does not flatten on weightbearing. It's much less commonly seen in comparison to pes planus (flat or pronated foot type) and affects approximately 10% of the population.

Characteristics

Generally speaking the pes cavus foot type tends to be stiff with poor shock absorbing capacity. It can also present in a wide variety of a neurological disorders. With this foot type it is fairly common to see retracted/hammered digits, prominent forefoot/ball of foot and callosities on the 1st and 5th metatarsal heads.

Common Problems

The rearfoot may sit at an inclined angle or supinated position and this foot type tends to be pre-disposed to:

• Lateral ankle sprains

• Peroneal tendinopathy

• Stress fractures

• Plantar fasciitis

Treatment Options

Treatment options vary depending on if the deformity is flexible or rigid and if there is any paralysis from a neurological condition.

For Flexible Deformities: If the deformity is flexible or partially reducible a corrective orthotic may be used with lateral posting to increase pronatory motion.

For Rigid Deformities: If the foot type is rigid, then an accommodative type orthotic may be useful to contact the foot and help distribute weight bearing more evenly and offload and provide cushioning to the ball of the foot.

For Cases with Paralysis: If there is paralysis involved an Ankle Foot Orthosis (AFO) may be required to address the deformity and lack of ankle dorsiflexion. In very severe cases a caliper that is attached to the sole of the shoe can be used.