A high arch, medically known as pes cavus, is a foot structure characterized by an exaggerated elevation of the inner, longitudinal arch. This foot type is less common than a flat foot and maintains its high curve even when bearing full weight. The foot’s rigid structure often leads to an uneven distribution of pressure across the sole.
Physical Characteristics of a High Arch
The most defining visual marker of a high arch is the pronounced upward curve of the midfoot, leaving a significant gap between the floor and the center of the sole when standing. This elevated arch does not flatten when weight is applied, distinguishing it from a flexible arch. The heel often exhibits an inward tilt, known as varus deformity, which contributes to the foot’s overall instability and supinated (outward rolling) posture.
The toes frequently show an associated deformity, commonly appearing curled or clawed, resulting from muscle imbalance and excessive pressure on the forefoot. When standing, weight is concentrated on the heel and the ball of the foot (forefoot). This concentration causes calluses and thickened skin to develop prominently under the heel and the metatarsal heads, directly beneath the toes.
A simple method for self-identification is the “wet test,” involving stepping onto an absorbent surface after wetting the feet. A high arch footprint shows a distinct break in the middle, revealing only the heel, the ball of the foot, and the toes, with a very narrow or absent connection along the outer edge. This narrow strip of contact confirms that the foot is bearing weight primarily on its perimeter.
How High Arches Affect Movement and Comfort
The rigid, highly curved structure of a high arch significantly limits the foot’s natural ability to absorb impact during walking or running. While a normal foot slightly pronates to cushion shock, a high-arched foot typically under-pronates or supinates, remaining rigid and transferring stress upward. This reduced shock absorption capacity places increased strain on the ankles, knees, hips, and lower back over time.
Discomfort often manifests as pain in the ball of the foot, known as metatarsalgia, due to excessive forefoot pressure. Heel pain, including plantar fasciitis, is also common because the high arch increases tension on the plantar fascia ligament. The abnormal gait, characterized by walking on the outer edge of the foot, can destabilize the ankle joint, increasing the risk of recurrent sprains. Fitting shoes is challenging due to the high instep and toe deformities.
Why High Arches Develop
The cause of a high arch is often categorized as either inherited or acquired, with many cases being idiopathic, meaning the cause is unknown. Many people inherit the structural abnormality, resulting in a foot that functions normally but possesses a naturally elevated arch. However, the sudden development of a high arch, particularly in only one foot, can be a sign of an underlying medical issue.
High arches are frequently associated with various neurological conditions that affect muscle control in the lower leg and foot. Conditions such as Charcot-Marie-Tooth disease, cerebral palsy, and spina bifida can cause muscle imbalances that pull the foot into the exaggerated arched position. These neurological causes often result in a progressive, rigid high arch that worsens over time, requiring professional evaluation.
Options for Managing High Arches
The primary non-surgical goal in managing high arches is to improve shock absorption and redistribute pressure away from the heel and forefoot. Custom-made or specialized over-the-counter orthotic devices are a common intervention, designed to provide support for the arch and cushioning for the pressure points. These inserts help to achieve a more even weight distribution across the entire sole.
Appropriate footwear selection and regular physical therapy are also important components of management:
- Footwear should offer excellent cushioning, especially in the heel and forefoot area.
- Shoes with a deep toe box accommodate common toe deformities.
- Those with a rigid heel counter can help improve ankle stability.
- Regular physical therapy, including targeted stretching and strengthening exercises, maintains flexibility and stability in the muscles of the foot and ankle.