High arches, medically known as pes cavus, describe a foot structure where the arch is raised higher than average. This configuration means a smaller portion of the foot makes contact with the ground when standing. While some individuals with high arches experience no issues, for others, this foot type can lead to various challenges and discomfort. It is a common variation that can affect one or both feet.
Characteristics of High Arches
A high arch is distinguished by its elevated curve, which typically does not flatten even when full weight is placed on the foot. The foot rests primarily on the heel and ball of the foot, with the arch remaining pronounced. This differs from a typical arch, which shows a broader imprint, or a flat foot, which makes full contact with the ground.
A “wet footprint test” can help identify a high arch. To perform this, wet your foot and step onto paper or cardboard. If only the heel, the ball of the foot, and the toes leave an imprint, with a narrow or absent middle connection, it suggests a high arch. Some high arches may also feature an inward-tilting heel or a heel that flexes upward. The rigidity or flexibility of the arch can vary, influencing how the foot functions.
Underlying Causes
High arches develop for various reasons, tracing back to genetic factors. Many individuals inherit this foot structure, making it a natural anatomical trait. In these cases, the high arch may not be associated with an underlying medical condition and is idiopathic.
However, high arches are a sign of an underlying neurological disorder or other medical conditions. These include conditions like Charcot-Marie-Tooth disease, cerebral palsy, spina bifida, muscular dystrophy, and polio. Such conditions cause muscle imbalances or weakness, leading to gradual development or worsening of the deformity. High arches that result from neurological disorders are more rigid and progress over time. Trauma to the foot or ankle, like fractures or ligament injuries, contribute to high arch development.
Associated Symptoms and Conditions
The distinct structure of a high arch alters how weight is distributed across the foot, leading to potential problems. Foot pain is a common symptom, felt in the ball of the foot or in the heel. Uneven pressure leads to painful calluses and corns on the heel, ball of the foot, or outer edge.
High arches contribute to foot and ankle instability, increasing the likelihood of frequent ankle sprains. This instability occurs because the foot rolls outward excessively, rather than absorbing shock effectively. Over time, toe deformities like hammertoes or claw toes develop, where the toes bend or clench due to muscle imbalances. Reduced shock absorption from a rigid high arch transmits stress to other joints, leading to pain in the knees, hips, and lower back, or even foot stress fractures. Finding comfortable shoes is a challenge due to the elevated instep.
When to Consult a Specialist
Not all high arches cause problems, but seek professional medical advice if symptoms arise or worsen. Persistent foot pain, especially if it interferes with daily activities or walking, warrants evaluation. Other warning signs include difficulty walking, frequent tripping, or noticeable changes in foot shape.
Sensory changes like numbness or tingling in the feet indicate a need for specialist consultation. Early diagnosis of any underlying neurological condition causing high arches allows for timely management and prevents further progression. A podiatrist or orthopedic surgeon conduct a thorough examination, including reviewing family history, assessing gait, and ordering imaging or other diagnostic studies, to determine the cause and best course of action.