High foot arches: what they are and how to treat the problems they cause

Physiotherapist Alex Parford explains all you need to know about high foot arches, and how to manage the problems they could cause


What are high foot arches?

Pes Cavus (high foot arches) is an inherited condition in which the foot has a high medial arch. Pes Cavus doesn’t necessarily cause pain, but it does cause you to place more weight and stress on the ball and heel of the foot while standing and walking. It can be difficult to find shoes (especially cycling shoes) that have enough room for a high arch and unfortunately this could lead to plantar fasciitis and metatarsalgia (hot foot).


What are the common high arch problems?

One or more of the following symptoms may be present:

  • Foot pain when standing or walking
  • Decreased ankle stability (due to inverted heel position)
  • Hammer toes
  • Claw toes
  • Numbness in the feet (when cycling)
  • Knee pain
  • In more severe cases some people may experience a foot drop, which results in a dragging of the foot. This is usually cause by an underlying neurological condition


What causes high arches?

The causes of Pes Cavus are complex and not entirely understood. Factors considered in the development and progression are:

  • Development of a neuromuscular disease, which will create a muscular imbalance. These neuromuscular diseases include cerebral palsy, spina bifida, muscular dystrophy and stroke
  • Congenital club foot
  • Compensation following some form of foot trauma
  • Contracture of the plantar fascia
  • Shortening of the Achilles tendon
  • Lower limb stress fractures

How can you treat high arches?


  • Seek a physiotherapist’s advice for a guided rehab programme, which should include improving weight distribution of the foot and ankle, balance and ankle stability exercises.


  • Shoes with extra depth can be useful to prevent bony prominences rubbing against the shoe, while a lateral wedge can improve mechanics of the foot.


  • In cases that cannot be helped by physiotherapy or orthotics, surgery can be performed to correct the cavovarus foot.

How can you manage the problems caused by high arches when running and cycling?



  • If you have high arches and you run, your laces may irritate the top of your foot. Try not to tie your laces too tight or skip the middle two holes so that there’s less pressure on the foot.
  • Improve your ankle range of motion. Improving the weight distribution onto the medial arch will help.



  • Ensure that the ball of the foot is directly in line with the axis of the pedal.
  • Widen the pedal position.
  • Purchase a ‘metatarsal button’ which can help improve weight distribution of the foot.
  • Improve hip mobility so that your knees can track forwards and not out to the side.

Alex Parford is a physiotherapist at Six Physio Borough

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