The person with a very high arched foot often has pain and foot problems specific to their high arch. A 2005 study of foot types showed that about 15% of the population has a higher than normal arch (also know as a pes cavus foot) and 60% of those with cavus feet have foot pain (1). Another study showed that 65% of people with cavus feet have foot pain weekly, compared with only 23% of those with normal arch height (2).
Many of the problems that people with high arched feet experience are due to the fact that they bear all of their weight on a small area of the foot (the ball-of-the-foot and the heel). This increases pressure under these areas and leads to pain. In addition, it makes the foot less stable. Some common problems that are seen in people with cavus feet include:
The goal when treating a person with problems due to a high arch is to spread the weight over a larger area of the foot and to increase the stability of the foot. This can usually be accomplished with the use of a custom orthotics. Studies in 2000 and 2006 (2, 3) indicated, however, that the orthotic must be prescribed in a very specific manner in order to provide best relief of pain and increased stability.
One of the most important factors in getting the best outcome is to ensure that orthotics conform very closely to the arch of the foot. This is demonstrated in the picture below. Note how the arch of the orthotic perfectly matches the arch of the foot. Unfortunately, many orthotics are made that do not match the arch very well and thus are not very effective at reducing pain.
Also, although we use many prefabricated orthotics in our office, studies and our experience have shown that people with high arches almost always need custom orthotics for best pain relief. Prefabricated orthotics simply do not conform close enough to the arch of the foot to provide adequate relief of pain.
Studies of pressure inside the shoe when wearing orthotics show that an orthotic that conforms closely to the arch will significantly reduce pressure. The pictures below show pressure of the same foot inside a shoe with and without an orthotic. Red indicates greater pressure. Note on the image with no orthotic, left side, there is substantially more pressure under the heel and under the ball of the foot. The picture on the right, with an orthotic, has decreased the pressure significantly.
Inside shoe pressure images. Red indicates greater pressure. Left side without orthotic and right side with orthotic.
With correctly prescribed custom orthotics most pain due to high arches can be relieved. If you have high arches and would like us to evaluate your feet, contact us to make an appointment in our Seattle office. If you already have orthotics that you would like us to evaluate, be sure to bring them to your appointment.
(1) Burns J, Crosbie J, Hunt A, Ouvrier R: The effect of pes cavus on
foot pain and plantar pressure: Clinical Biomechanics, 2005\
(2) Burns J, Crosbie J, Hunt A, Ouvrier R: The effect of pes cavus on foot pain and plantar pressure: Clinical Biomechanics, 2005
(3) Chalmers AC, et al: Metatarsalgia and RA- a randomized, single blind, sequential trial comparing 2 types of foot orthoses and supportive shoes: J Rheumatol, 2000
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Douglas Hale, DPM & Lawrence Huppin, DPM
Foot and Ankle Center of Washington, Seattle
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