Condition Spotlight: Pes Cavus (High Arches)

What is pes cavus?

A pes cavus foot type is one with a high arch.

It is less common than a pes planus foot type (flat feet), with research suggesting that approximately 10% of the population have this foot type.

There is minimal to no collapse of the arch and can result in pain throughout the feet and ankles.

A pes cavus foot type is generally quite rigid, meaning that there is not a lot of movement through the joints of the feet.

A pes cavus foot type also generally has a plantar flexion of the big toe to allow for ground contact and stability.


What does it feel like to have high arched feet?

In some cases, a pes cavus foot type may not cause any pain or discomfort.

This is dependent on the alignment of the structures, the strength of the musculature and the footwear that is worn.

Pain associated with a pes cavus foot type is generally located on the lateral (outside) aspect of the foot and ankle, as well as in the peroneal muscle group which sit on the lateral aspect of the lower leg.

Coupled with ankle instability, those with a pes cavus foot type may also experience frequent ankle sprains.

Those with a pes cavus foot type can often experience pain in the forefoot, including corns and calluses due to the large amount of pressure applied to the area.


What causes high arches in the feet, and who does it affect?

A pes cavus foot type can be caused by a number of factors.

Sometimes the cause is referred to as idiopathic, meaning that the cause is not clearly understood.

It can be caused by a neuromuscular dysfunction, weakness of the peroneal muscles or tightness of the tibialis posterior muscle.

It may also be present in those with conditions such as metatarsus adductus or club foot (talipes equinovarus).

Those with medical conditions such as cerebral palsy, spina bifida and poliomyelitis are more likely to have a pes cavus foot type.

Over time, those with a pes cavus foot type may experience degenerative changes to the midfoot joints which often results in pain if not treated.


How is a pes cavus foot type diagnosed?

Generally, a pes cavus foot type is diagnosed with visual assessments.

We will sometimes refer you for scans to assess the alignment of the feet, however this will be following an in-depth examination to assess the areas that need to be addressed.

Our assessments usually involve testing your range of motion, strength and how your feet work when standing and sitting.


How are high arched (pes cavus) feet treated?

The treatment of a pes cavus foot type will depend on the amount of pain that is present, as well as the function and mobility of the foot.


Taping is used to support the feet and assist with alignment. In this case, it may be used to offload the lateral aspect of the foot and ankle.


Orthotics can help to support and cushion the structures that need it the most, as well as realign the foot to allow it to function effectively at each affected joint. This can help to significantly reduce pain in the feet.

Footwear advice

Footwear is very important to address as most shoes do not cater for a pes cavus foot type. Due to the high instep, it is important that you are looking at shoes that have enough depth to accommodate this, as well as avoiding shoes that have tight straps across the top of the foot.

Stretching and strengthening program

Stretching and strengthening the peroneals and the tibialis posterior in this case is extremely important. This will depend on your level of muscle strength, flexibility and range of motion and will be tailored to your specific needs.

Dry needling

Dry needling involves the use of an acupuncture needle into a trigger point within the muscle. The aim of trigger point dry needling is to relax the trigger point in order to reduce your pain. This can be performed in the peroneals to help reduce tension.


If you have high arches

If what we’ve talked about today sounds familiar to you, or you have been diagnosed with having a pes cavus foot type, why not book in to see us here at our Watsonia-based clinic? We have a team of highly skilled podiatrists who are ready to help you today.

You can book in to see us by making an appointment online here or calling us on (03) 9432 2689.





Aaron Dri