High Arched Feet/Cavus Feet: Conditions, Support Needs, and Key Differences Explained

Most people have heard about flat feet and the problems they can cause. Yet, there is another foot shape that rarely gets the attention it deserves: cavus feet, or high-arched feet. Unlike flat feet, cavus feet have an unusually high arch that changes how weight is distributed across the foot. This difference can lead to unique challenges and conditions that are often overlooked.

This post will explain what cavus feet are, the common problems associated with them, how support needs differ from flat feet, and the key distinctions between types of cavus feet. Understanding these points can help those with high arches take better care of their feet and avoid long-term issues.

High-arched foot causes a variety of foot conditions

What Are High Arched / Cavus Feet?

Cavus feet, also called pes cavus, describe a foot shape with a higher-than-normal arch. This arch is more pronounced than in typical feet, causing the foot to appear raised in the middle when viewed from the side. The high arch means less of the foot touches the ground, concentrating pressure on the heel and the ball of the foot.

Unlike flat feet, where the arch collapses and the foot flattens, cavus feet maintain a rigid, elevated arch. This rigidity can reduce the foot’s ability to absorb shock during walking or running, which leads to increased stress on other parts of the foot and leg.

Common Conditions Linked to Cavus Feet

People with cavus feet are at higher risk of several foot and ankle conditions. The unusual shape and pressure distribution can cause or worsen these conditions:

• Arthritis

The uneven pressure on joints, especially in the midfoot and ankle, can accelerate joint wear and tear. Over time, this may lead to arthritis, causing pain and stiffness.

• Neuromas

High arches can compress nerves between the toes, leading to painful nerve growths called neuromas. These often cause burning or tingling sensations in the ball of the foot.

• Ankle Instability

The raised arch and rigid foot structure can reduce ankle stability. This instability increases the risk of ankle sprains and chronic ankle problems.

• Tendon Tears

Tendons around the foot and ankle, such as the peroneal tendons, may be under more strain in cavus feet. This can lead to inflammation or tears, causing pain and difficulty walking.

• Stress Fractures

High-arch feet tend to have a more rigid structure, leading to greater stress absorption when walking or running, increasing the risk of stress fractures.

Understanding these risks helps people with cavus feet recognize symptoms early and seek appropriate care.

How Support Needs Differ for Cavus Feet

Footwear and orthotic support are crucial in managing cavus feet. However, the needs differ from those with flat feet:

• More Cushioning for Shock Absorption

Because cavus feet are rigid and do not absorb shock well, extra cushioning is essential. This helps protect the heel and ball of the foot from impact during walking or running.

• Moderate Arch Support

Unlike flat feet, which require strong arch support to lift and position the foot correctly, cavus feet benefit from lighter arch support. The goal is not to raise the arch but to provide comfort and reduce pressure points.

• Focus on Pressure Distribution

Insoles or shoes designed for cavus feet often include padding in key areas to spread out pressure more evenly, reducing pain and preventing calluses.

By contrast, people with low arches need support that lifts the arch and properly aligns the foot, while those with high arches need support that cushions and absorbs shock.

Forefoot-Driven vs. Rearfoot-Driven Cavus Feet

Not all cavus feet are the same. They can be classified based on which part of the foot drives the high arch:

• Forefoot-Driven Cavus

In this type, the high arch results mainly from the forefoot being elevated relative to the rearfoot. This causes the front part of the foot to bear more weight and can lead to pressure under the metatarsal heads (the ball of the foot), causing an outward pressure on the foot. This increases the risk for neuromas, calluses, ball of foot pain, and hammer toes. This is sometimes called "pseudo equinus".

• Rearfoot-Driven Cavus

Here, the heel is elevated compared to the forefoot, causing the rearfoot to drive the arch height. This type often leads to increased pressure on the heel and instability in the ankle.

Knowing which type of cavus foot you have helps guide treatment and footwear choices.

The Coleman Block Test: Differentiating Cavus Types

The Coleman block test is a simple clinical tool used to tell forefoot-driven cavus from rearfoot-driven cavus. It involves placing a block under the heel and lateral side of the foot, while leaving the first metatarsal (big-toe side) unsupported.

• If the heel corrects to a neutral position when the block supports the lateral foot, the cavus is forefoot-driven.

• If the heel remains elevated or inverted ("turned in"), the cavus is rearfoot-driven.

  
  

This test helps doctors determine whether treatment should focus on the forefoot or the rearfoot, improving outcomes.

Practical Tips for Managing Cavus Feet

People with cavus feet can take several steps to reduce discomfort and prevent complications:

• Choose shoes with ample cushioning in the heel and forefoot areas. Running shoes or walking shoes designed for high arches are good options.

• Use custom or over-the-counter orthotic insoles that provide moderate arch support and extra padding.

• Avoid high heels or shoes with poor shock absorption, as they increase pressure on the foot.

• Stretch and strengthen foot and ankle muscles to improve stability and reduce injury risk.

• Consult a podiatrist if you experience persistent pain, frequent ankle sprains, or signs of nerve irritation.

  
  

Summary

Cavus feet, or high-arched feet, are less talked about than flat feet but come with their own set of challenges. The elevated arch causes uneven pressure that can lead to arthritis, neuromas, ankle instability, and tendon injuries. Support needs focus on cushioning and moderate arch support to absorb shock rather than lifting the arch.

Understanding the difference between forefoot-driven and rearfoot-driven cavus feet, and using tools like the Coleman block test, can guide better treatment. With the right footwear, support, and care, people with cavus feet can reduce pain and maintain healthy, active feet.

If you have been experiencing foot or ankle pain, call us at 832-743-0508 to schedule an appointment. Or visit us at www.SelectFAS.com to schedule online.