Description: Pes cavus is a high arch that does not flatten with weightbearing. It is a genetic defect in the foot with a high arch. Feet are relatively inflexible. This will often be associated with very tight calf muscles at the back of the lower leg.

When standing with weight on the foot, the arch will appear higher. The heel often tilts inwards at the ankle (but not always). In many the toes will appeared clawed. When not standing, the front half of the foot (forefoot) will appear to be dropped below the level of the rearfoot.

High arch feet may just be a normal variant (i.e. some people just have higher arches), some may be hereditary (i.e. it runs in the family) and in some cases there may be an underlying neurological problem.

When a person with a cavus foot stands, the middle of the foot seems to be raised higher off the ground than normal. The heel may be drawn in towards the inner side, and the toes may also be drawn inwards. Some people with cavus feet also have curled-up “claw” toes.

Pes cavus is characterized by a high arched foot. In the most severe case, the patient walks on the outer edge of the foot. In a severe case, he or she is almost bow-legged, and they are walking on the lateral border.

Footwear: Selecting the proper footwear is an important and often overlooked aspect of treating the cavus foot. Uppers should be made of a soft, flexible material with long, wide lace openings to accommodate the prominent instep and forefoot. The heel should be flared and a little higher than the forefoot. The forefoot should have extra depth and an oblique toebox to reduce contact with contracted toes. It is also advisable to avoid an extended steel shank when dealing with the cavus foot. Athletic shoes provide the best combination of support and cushion. If social or business constraints dictate that the patient wear a dress shoe, lace-ups are preferred over loafers and a crepe sole over leather. A good way to give your foot high arch support is to wear shoes designed for wide and/or problem-prone feet, like adjustable shoes with Velcro.

How can orthotics help? Orthotics can provide support for stressed joints and soft tissues.  They are often constructed to increase shock absorption.  The redistribution of weight relieves stress through proper structural alignment. Orthotics function to keep the foot in a neutral position and decrease or eliminate abnormal compensatory motions.