High Arch Feet (Pes Cavus)

The symptoms associated with high arches often relate to the altered pressure distribution and rigidity of the foot. Common signs include:

• Foot Pain: Particularly in the heel (plantar fasciitis risk) and the ball of the foot (metatarsalgia). Pain often worsens with standing, walking, or running.
• Calluses and Corns: Thickened skin developing on the ball, side, or heel of the foot due to excessive pressure.
• Ankle Instability: The foot may tend to tilt outwards (supination), increasing the risk of recurrent ankle sprains.
• Claw Toes or Hammer Toes: Toes may bend into a claw-like shape due to muscle imbalances.
• Difficulty Fitting Shoes: Finding comfortable shoes can be challenging due to the high instep.
• Balance Issues: Reduced surface area contact with the ground can sometimes affect stability.
• Achilles Tendon Tightness: The high arch can sometimes be associated with a tight calf muscle or Achilles tendon.

If you experience these symptoms, an assessment at Fine Podiatry Clinic can help determine the cause and appropriate management.

High arches can be an inherited structural trait or develop due to underlying conditions:

• Genetics: Pes cavus often runs in families, being a normal anatomical variation for some.
• Neurological Conditions: This is a common cause of acquired or worsening high arches. Conditions like Charcot-Marie-Tooth (CMT) disease, muscular dystrophy, cerebral palsy, spina bifida, polio, or stroke can affect nerve and muscle function in the foot, leading to arch height changes.
• Post-Traumatic: Injuries such as fractures of the heel bone (calcaneus) or other foot bones can sometimes lead to a high arch deformity after healing.
• Idiopathic: In some cases, the exact cause remains unknown.

Identifying the underlying cause is crucial, especially if the high arch develops or worsens over time, as it may indicate a neurological issue.

• Chronic Foot Pain: Persistent pain in the heel, ball of the foot, or midfoot.
• Recurrent Ankle Sprains: Due to instability and the tendency for the foot to roll outwards.
• Stress Fractures: Increased pressure on the metatarsal bones (long bones of the foot) can lead to stress fractures.
• Plantar Fasciitis: Excessive tension on the plantar fascia.
• Claw Toes/Hammer Toes: Progressive toe deformities can cause pain and difficulty with footwear.
• Difficulty with Activities: Pain and instability can limit participation in sports, exercise, or even daily walking.

Diagnosing high arches and determining the cause involves a thorough evaluation at our Singapore clinic:

1. Medical History: Discussing your symptoms, family history (especially of neurological conditions), onset of symptoms, and activity levels.
2. Physical Examination: Our podiatrist will observe your foot structure while sitting, standing, and walking. We assess arch height, look for calluses, claw toes, check muscle strength, test reflexes, and assess ankle stability.
3. Gait Analysis: Watching you walk helps identify supination or other biomechanical issues.
4. Neurological Assessment: If a neurological cause is suspected, further tests may be conducted or referral considered.

An accurate diagnosis is essential for developing an effective treatment plan at Fine Podiatry Clinic.

Treatment for high arches focuses on relieving pain, improving stability, and preventing complications. Many people with high arches need no treatment if they are asymptomatic.

Non-Surgical Treatments

Conservative approaches are usually the first line of treatment:

• Appropriate Footwear: Choosing shoes with good cushioning, adequate width, slightly higher heels (sometimes), and good ankle support can help accommodate the foot shape and improve shock absorption.
• Orthotic Devices: Custom-molded orthotics are often key. They can help redistribute pressure away from the heel and ball of the foot, provide cushioning, improve stability, and support the foot structure.
• Padding/Cushioning: Metatarsal pads or other cushioning can relieve pressure points.
• Bracing: In cases of significant instability or foot drop (related to neurological causes), ankle braces might be recommended.
• Stretching Exercises: For tight calf muscles or plantar fascia.
• Physical Therapy: To improve strength, balance, and flexibility.

Surgical Options

Surgery is typically considered only for severe cases with significant pain, deformity, or instability that haven’t responded to extensive non-surgical treatment, or when related to a progressive neurological condition. Surgical procedures might involve tendon transfers, bone cuts (osteotomies), or joint fusions to reshape the foot, relieve pain, and improve stability. This is decided on a case-by-case basis after thorough discussion with our podiatrists at Fine Podiatry Clinic.

Constraint Check: Treatment options outlined briefly, encouraging consultation. Clinic name included.

While you can’t change an inherited high arch, you can manage symptoms and reduce risks:

• Wear Supportive Footwear: Consistently choose shoes that fit well and accommodate your arch height. Avoid prolonged use of unsupportive shoes.
• Use Orthotics Consistently: If recommended, wear your orthotics during weight-bearing activities.
• Maintain Foot Flexibility: Regular stretching can help manage tightness.
• Monitor for Changes: Pay attention to any new pain, instability, or changes in foot shape, especially if there’s a potential underlying neurological cause. Seek prompt evaluation if changes occur.
• Choose Low-Impact Activities: If high-impact activities cause pain, consider alternatives like swimming or cycling.