High Arches / Cavus Feet
Foot & Ankle Care of Colorado
Cavus foot is characterized by an unusually high arch, which causes an excessive distribution of weight on the ball and heel of the foot during walking or standing. This condition can result in various symptoms, including pain and instability. Cavus foot can develop at any age and may affect one or both feet.
Causes of Cavus Feet
Cavus foot is frequently associated with a neurologic disorder or other medical conditions such as cerebral palsy, Charcot-Marie-Tooth disease, spina bifida, polio, muscular dystrophy, or stroke. In some instances, the high arch may stem from an inherited structural anomaly. An accurate diagnosis is crucial as the underlying cause largely dictates the condition’s progression. If the high arch results from a neurologic disorder or medical condition, it often deteriorates over time. Conversely, cases of cavus foot unrelated to neurologic disorders typically do not undergo visual changes.
Cavus Feet Symptoms
The arch of a cavus foot will appear high even when standing. In addition, one or more of the following symptoms may be present:
- Hammertoes (bent toes) or claw toes (toes clenched like a fist)
- Calluses on the ball, side or heel of the foot
- Pain when standing or walking
- An unstable foot due to the heel tilting inward, which can lead to ankle sprains
Some people with cavus foot may also experience foot drop, a weakness of the muscles in the foot and ankle that results in dragging the foot when taking a step. Foot drop is usually a sign of an underlying neurologic condition.
Cavus Feet Diagnoses
Diagnosis of cavus foot includes a review of the patient’s family history. The foot and ankle surgeon examines the foot, looking for a high arch and possible calluses, hammertoes and claw toes. The foot is tested for muscle strength, and the patient’s walking pattern and coordination are observed. If a neurologic condition appears to be present, the entire limb may be examined. The surgeon may also study the pattern of wear on the patient’s shoes.
X-rays are sometimes ordered to further assess the condition. In addition, the surgeon may refer the patient to a neurologist for a complete neurologic evaluation.
Nonsurgical Treatments
Nonsurgical treatment of cavus foot may include one or more of the following options:
- Orthotic devices. Custom orthotic devices that fit into the shoe can be beneficial because they provide stability and cushioning to the foot.
- Shoe modifications. High-topped shoes support the ankle, and shoes with heels a little wider on the bottom add stability.
- Bracing. The surgeon may recommend a brace to help keep the foot and ankle stable. Bracing is also useful in managing foot drop.
When Is Surgery Needed?
If nonsurgical treatment fails to adequately relieve pain and improve stability, surgery may be needed to decrease pain, increase stability and compensate for weakness in the foot. The surgeon will choose the best surgical procedure or combination of procedures based on the patient’s individual case. In some cases where an underlying neurologic problem exists, surgery may be needed again in the future due to the progression of the disorder.
