Hi, Arch: Cavus Foot
Posted by Jenn F. on Wednesday, July 11th, 2012
Flat feet get a lot of attention–and deservedly, because they’re not uncommon, especially adult acquired flat foot. There is, however, an opposite condition that’s in the spotlight less than their flat cousins: high arches.
Now I don’t mean just a slightly higher arch than normal, the kind that makes ballet teachers smile or the kind that may cause some mild discomfort but don’t really interfere with walking (those would describe my arches–and by the way, the excitement ballet teachers felt when they saw my feet quickly disappeared when my utter lack of coordination became apparent). No, we’re talking about pes cavus, also known as cavus foot, or a foot with abnormally high arches (by the way, pes means foot and the word cavus is one of the Latin roots that make up the word concave, meaning something that has a scooped out appearance–just like a high arch! Isn’t language wonderful?).
How do I know if I have cavus foot? Most obviously, your foot will have a noticeably high arch even as it’s relaxed without any toe pointing to emphasize it. You may also notice excess pain when standing (it’s normal to feel your feet hurt if you’re standing for four hours, but not four minutes) and calluses on the ball, heel, or side of the foot. Your foot may be unstable, due to a tendency for the heel to drift inward, making you more vulnerable than usual for ankle sprains. You may develop hammertoes or claw foot due to a tendency to curl your toes to make up for the extra high arch.
What causes cavus foot? In some cases, it may just be hereditary–people in your family just have unusually high arches. However, it can also be the cause of a neurological condition, such as cerebral palsy, Charcot-Marie-Tooth disease, spina bifida, polio, muscular dystrophy, or stroke. The best way to accurately diagnose the cause of cavus foot is to see a podiatrist at The Center for Podiatric Care and Sports Medicine (212.996.1900). If it is the result of a neurological condition, then that needs to be addressed, as well as the likelihood that the arch problem will worsen. If it’s hereditary, the arch will likely stay the same and can be treated with that in mind.
What is the treatment? A podiatrist will try to treat cavus foot non-surgically. Custom-fit orthotics can help stabilize the feet and braces can add support to the ankles. Podiatrists also may recommend that you choose high top shoes that add support and wider heels for stability.
If non-surgical treatment doesn’t relieve pain and instability, then surgery may be recommended. The procedure involves a bone graft, using a small piece of bone from another part of your body (often the pelvis) and putting it into the arch. There’s an excellent description of the basics of the surgery here from Mike Uglow.
Hopefully your high arches are just high enough to give you a great ballet career, or at least a career as a foot model. If you do have a problem with your arches or any other part of your foot or ankle, contact The Center for Podiatric Care and Sports Medicine. Dr. Josef J. Geldwert, Dr. Katherine Lai, and Dr. Ryan Minara have helped thousands of people get back on their feet.
If you have any foot problems or pain, contact The Center for Podiatric Care and Sports Medicine. Dr. Josef J. Geldwert, Dr. Katherine Lai, Dr. Ryan Minara and Dr. Mariola Rivera have helped thousands of people get back on their feet. Unfortunately, we cannot give diagnoses or treatment advice online. Please make an appointment to see us if you live in the NY metropolitan area or seek out a podiatrist in your area.