Cavus Foot: causes, symptoms and treatment options  

Updated 3/17/2021
Cavus Foot, high arches, University foot and ankle institute

What is a cavus foot?

A cavus foot (also called pes cavus) is one that has a very high arch.

 

The problem with having a high-arched foot is that it places too much weight on the ball and heel of the foot. This alteration in your foot’s weight-bearing surface can often lead to pain and instability.

 

Cavus foot is often present at birth, although it can develop at any age. It can affect one or both feet.

 

 

Cavus Foot Symptoms

To begin with, the arch of the foot will appear higher than usual. While not everyone with cavus feet has symptoms, over time, your metatarsals (the long bones between your ankle and toes) can start to shift, causing you to become symptomatic. In addition, one or more of the following symptoms may occur:

 

  • Hammertoes (toes with the middle joint bending upward like a tent)
  • Claw toes (toes that are claw under and appear clenched like a fist)
  • Callus formation on the ball, heel, or along the outer edge of the foot
  • Plantar fasciitis (pain along the plantar fascia tendon that runs between the heel and toes) associated with prolonged standing or walking
  • Foot instability due to an ankle that tends to roll outward (known as supination, a foot posture that predisposes you to ankle sprains)
  • Knee, hip, and low back pain can result from your body’s effort to compensate for the muscle imbalance in your midfoot
  • Foot pain

 

In severe cases, cavus foot deformity can lead to ankle arthritis, frequent tripping, and falling due to ankle instability, stress fractures around the ankle, shin splints, or Achilles tendon pain.

 

What Causes Cavus Foot?

More often than not, a cavus foot is an inherited structural problem that has no link to any medical condition. However, in some patients, cavus foot can be due to neuromuscular diseases that cause muscle contractures that draw the ball of the foot closer to the heel.

 

Neurologic conditions causing cavus foot deformity include Charcot-Marie-Tooth disease (CMT accounts for 50% of the neurologic cases), cerebral palsy, clubfoot, post-stroke paralysis, spina bifida, muscular dystrophy, and, rarely, poliomyelitis.

 

In some cases, cavus is due to a tendon tear of the peroneal tendon which results in cavus deformity.

 

Although cavus feet, no matter what their origin, can be painful, those due to a neurologic cause tend to get worse faster. As such, they require more monitoring and pro-active treatment in order to prevent progressive foot deformity.

 

How is Cavus Foot Diagnosed?

Your podiatrist will start by taking a comprehensive medical history and family history to determine if there are any possible neurologic conditions or hereditary factors at play. Your doctor may observe you walking to look for signs of ankle instability.

 

Your feet will be carefully examined to evaluate their structure as well as to look for tell-tale clues such as calluses or hammer and clawing toe deformities. Your shoes may be examined for signs of excessive wear along the outer border. X-rays may be ordered to look for signs of arch collapse or bone shifting.


Treatment for Cavus Foot

The treatment of pes cavus has a lot to do with the cause and severity of the condition.
Conservative treatment options include:

 

Modifying your shoe choices

Shoes having thick flexible soles, wide heels no more than 2 inches high, a wide toe box, and shoelaces that can be loosened to accommodate a high arch all help mitigate pain symptoms. In addition, high-topped shoes or ankle boots can provide extra hindfoot support.

 

Over the counter arch inserts

Larger drugstores often carry three-dimensional arch inserts at reasonable prices and these can help reduce plantar fascia pain.

 

Custom orthotics

These are custom-made inserts placed inside your shoe to provide cushioned arch support while correcting your foot position at the same time.

 

Ankle braces

Braces may be prescribed to provide stability and prevent excessive supination (ankle rolling out).

 

Physical therapy

PT may be ordered to teach you how to stretch your plantar fascia and Achilles tendons, and also strengthen the muscles and ligaments of your foot and ankle.

 

Whereas most hereditary cavus feet do fairly well with conservative treatment, in cases where an underlying neurologic condition exists, conservative therapy might fail to provide continued symptom relief as the disease progresses.

 

Surgery is not uncommon and is an option when other treatments aren’t successful. For surgery for cavus foot, the surgeon will realign the foot to restore function and muscle balance.

 

UFAI, the Best Choice for Your Foot Care

Our nationally recognized surgeons have decades of combined experience and helped develop the techniques used in the surgical correction of high arches. With the highest success rates in the country, our specialists work hard to get you back on your feet and back to your life with the least invasive treatment possible.

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