Patient Education

Cavus Foot (High-Arched Foot)

Description

The arch of the foot is a pretty important piece of your anatomy. (Of course, all parts of the foot are pretty important. But it’s the arch that’s the subject for the moment.) Unfortunately, arches really work best when they’re at a nice middling height: too low, and you’ve got flat feet; too high, and you’ve got cavus foot, or a high-arched foot. (High arches might show up in both feet at once, or sometimes only in one foot. Feet are kind of weird that way.)

High arches are not nearly as common as low arches. They can be caused by a few different things. In some cases, this condition can be a symptom of a neurological disease, such as polio, Charcot-Marie-Tooth disease, cerebral palsy, muscular dystrophy, or even a stroke. These neurological conditions can affect your muscle tone, causing some muscles in your foot to be weakened or even paralyzed, while others remain just as strong as always. It’s like some mad scientist came up with an evil muscle-weakening ray gun that only targets certain muscles or tendons. In the case of the cavus foot, the muscles that pull the ball of your foot towards your heel remain strong, and the muscles that pull the foot back up become weak or paralyzed. If your high arches are due to a neurological disorder, they’ll probably get worse over time.

High arches aren’t always caused by neurological conditions, though. It may just be that you’ve inherited rather high arches from your parents. Unlike those due to neurological disorders, a high arch that’s just part of your genetic makeup will be less likely to get worse and worse over time. Sometimes, having extra high arches doesn’t cause too many problems (other than making it a little bit more difficult to find shoes that fit properly), but in other cases, the problems may be severe and painful.

Symptoms

One of the more obvious symptoms of a cavus foot is that the arch will appear rather high, even when you’re standing on it. Your toes may curl inward like the fingers of a fist, a condition referred to as “claw toes.” (Be assured, your podiatrist did not come up with the name to make fun of the way your toes look. It really is a valid symptom name.) Or, the toes may be bent or crooked (aka “hammertoes”).

You may also notice that your heel is curling downward at the ankle, toward the ball of your foot. Also, if you sit with your feet hanging down, the front of your foot will hang lower than the back of your foot. (Again, that’s due to the muscles that pull your foot inward being stronger than the ones that pull your foot outward.) Your foot may also be shortened a bit, and might be rather stiff.

Because so much extra weight is being placed on the ball and heel of the foot, you may also notice calluses developing in these areas, as well as on the side of the foot opposite the arch (the outside edge of your foot). Walking will probably also make your foot rather sore, since pressure is being put in all the wrong areas. Wearing shoes will probably be uncomfortable, since most shoes aren’t designed to fit feet with very high arches. Plus, your ankles will probably be pretty unstable because you’re in essence balancing on your heel and the ball of your foot: not a secure arrangement. This may mean that you sprain your ankle rather often (which is really just the universe adding insult to injury).

Diagnosis

When your high arches are causing you pain, are making your ankle unstable, or if you notice the arches are getting higher over time, you definitely want to see your podiatrist about them. To diagnose your condition, your podiatrist may ask you about your family history. (And no, this doesn’t mean he or she is looking for stories about the amazing pies your great- great grandmother used to make. We’re talking medical history, here.)

Your podiatrist will also likely observe your feet as you walk, and will examine your foot up close, checking for the above symptoms, such as a visibly high arch, hammertoes or claw toes, or calluses on your heel or on the ball of your foot. He or she may also take a peek at your shoes to see where they’ve become worn (and to compliment you on your excellent fashion sense). X-rays may also be ordered to give your podiatrist an inside look at what’s going on with your bone structure.

If a neurological condition is suspected to be at the heart of your problem, your podiatrist will probably examine your leg as well as your foot, and may also refer you to a neurologist, who is specially trained in recognizing such conditions.

Treatment

Treatment of high arches really depends a great deal on what’s causing them. If it’s not likely the condition will worsen with time (usually the case when the cause is NOT neurological), then more conservative treatments may be effective, enabling you to live without significant pain.

Your podiatrist may use some external devices to stabilize your foot, and provide support for your extra-high arches. These devices may include orthotics (which are prescription shoe inserts specially designed for you – which should make you feel pretty special, actually), braces (worn outside the foot, these will help keep your foot and ankle stable), and special shoes (usually ones with high tops and wide bases to add stability and support). The podiatrist may also treat secondary symptoms, trimming calluses or suggesting the use of pads to reduce pressure on certain areas of your foot.

If these treatments fail to sufficiently abolish pain, or if it’s likely that your arches will continue to get worse over time, then surgery may be the best option for you. For those with neurological conditions, more than one surgery may become necessary as the arches continue to worsen. In these cases, getting surgery is more a preventative measure, kind of like shoveling six inches of snow off your driveway even while it’s still snowing, just so you won’t have to shovel a full two feet off later. (In other words, surgery now may make it a bit easier to manage your condition later on.) Whatever the option, your podiatrist will help you decide what’s best for you.