Cavus Foot (High-Arched Foot)

Description


The arch of the foot is a pretty important piece of your anatomy. (Of
course, all parts of the foot are pretty important. But it’s the arch
that’s the subject for the moment.) Unfortunately, arches really work best
when they’re at a nice middling height: too low, and you’ve got flat feet;
too high, and you’ve got cavus foot, or a high-arched foot. (High arches
might show up in both feet at once, or sometimes only in one foot. Feet are
kind of weird that way.)

High arches are not nearly as common as low arches. They can be caused by a
few different things. In some cases, this condition can be a symptom of a
neurological disease, such as polio, Charcot-Marie-Tooth disease, cerebral
palsy, muscular dystrophy, or even a stroke. These neurological conditions
can affect your muscle tone, causing some muscles in your foot to be
weakened or even paralyzed, while others remain just as strong as always.
It’s like some mad scientist came up with an evil muscle-weakening ray gun
that only targets certain muscles or tendons. In the case of the cavus
foot, the muscles that pull the ball of your foot towards your heel remain
strong, and the muscles that pull the foot back up become weak or
paralyzed. If your high arches are due to a neurological disorder, they’ll
probably get worse over time.

High arches aren’t always caused by neurological conditions, though. It may
just be that you’ve inherited rather high arches from your parents. Unlike
those due to neurological disorders, a high arch that’s just part of your
genetic makeup will be less likely to get worse and worse over time.
Sometimes, having extra high arches doesn’t cause too many problems (other
than making it a little bit more difficult to find shoes that fit
properly), but in other cases, the problems may be severe and painful.

Symptoms


One of the more obvious symptoms of a cavus foot is that the arch will
appear rather high, even when you’re standing on it. Your toes may curl
inward like the fingers of a fist, a condition referred to as “claw toes.”
(Be assured, your podiatrist did not come up with the name to make fun of
the way your toes look. It really is a valid symptom name.) Or, the toes
may be bent or crooked (aka “hammertoes”).

You may also notice that your heel is curling downward at the ankle, toward
the ball of your foot. Also, if you sit with your feet hanging down, the
front of your foot will hang lower than the back of your foot. (Again,
that’s due to the muscles that pull your foot inward being stronger than
the ones that pull your foot outward.) Your foot may also be shortened a
bit, and might be rather stiff.

Because so much extra weight is being placed on the ball and heel of the
foot, you may also notice calluses developing in these areas, as well as on
the side of the foot opposite the arch (the outside edge of your foot).
Walking will probably also make your foot rather sore, since pressure is
being put in all the wrong areas. Wearing shoes will probably be
uncomfortable, since most shoes aren’t designed to fit feet with very high
arches. Plus, your ankles will probably be pretty unstable because you’re
in essence balancing on your heel and the ball of your foot: not a secure
arrangement. This may mean that you sprain your ankle rather often (which
is really just the universe adding insult to injury).

Diagnosis


When your high arches are causing you pain, are making your ankle unstable,
or if you notice the arches are getting higher over time, you definitely
want to see your podiatrist about them. To diagnose your condition, your
podiatrist may ask you about your family history. (And no, this doesn’t
mean he or she is looking for stories about the amazing pies your great-
great grandmother used to make. We’re talking medical history, here.)

Your podiatrist will also likely observe your feet as you walk, and will
examine your foot up close, checking for the above symptoms, such as a
visibly high arch, hammertoes or claw toes, or calluses on your heel or on
the ball of your foot. He or she may also take a peek at your shoes to see
where they’ve become worn (and to compliment you on your excellent fashion
sense). X-rays may also be ordered to give your podiatrist an inside look
at what’s going on with your bone structure.

If a neurological condition is suspected to be at the heart of your
problem, your podiatrist will probably examine your leg as well as your
foot, and may also refer you to a neurologist, who is specially trained in
recognizing such conditions.

Treatment


Treatment of high arches really depends a great deal on what’s causing
them. If it’s not likely the condition will worsen with time (usually the
case when the cause is NOT neurological), then more conservative treatments
may be effective, enabling you to live without significant pain.

Your podiatrist may use some external devices to stabilize your foot, and
provide support for your extra-high arches. These devices may include
orthotics (which are prescription shoe inserts specially designed for
you – which should make you feel pretty special, actually), braces (worn
outside the foot, these will help keep your foot and ankle stable), and
special shoes (usually ones with high tops and wide bases to add stability
and support). The podiatrist may also treat secondary symptoms, trimming
calluses or suggesting the use of pads to reduce pressure on certain areas
of your foot.

If these treatments fail to sufficiently abolish pain, or if it’s likely
that your arches will continue to get worse over time, then surgery may be
the best option for you. For those with neurological conditions, more than
one surgery may become necessary as the arches continue to worsen. In these
cases, getting surgery is more a preventative measure, kind of like
shoveling six inches of snow off your driveway even while it’s still
snowing, just so you won’t have to shovel a full two feet off later. (In
other words, surgery now may make it a bit easier to manage your condition
later on.) Whatever the option, your podiatrist will help you decide what’s
best for you.