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Anurag
Anurag
Published Date28 Sept'26
Last Updated28 Sept'26
Read Time17 Minutes
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High arches, medically known as pes cavus, occur when the arch on the inside of the foot is unusually high. A high arch can be a normal variation in foot structure, but in some people it can increase pressure on parts of the foot and contribute to pain, calluses, ankle instability or difficulty finding comfortable footwear.
High arches can have several possible causes. Some are inherited or present from childhood, while others can be associated with neurological or neuromuscular conditions, previous injury or other structural problems. Because the underlying cause can influence treatment, persistent, painful or progressively changing high arches deserve professional evaluation.
The good news is that having high arches does not automatically mean that you need treatment. Treatment is generally considered when high arches cause pain, instability, difficulty walking or other functional problems.
This guide explains the causes, symptoms, diagnosis and treatment options for high arches, including when orthotics, footwear, exercises or surgery may be considered.
High arches are a foot structure in which the medial longitudinal arch is higher than usual.
The medical term commonly associated with a structurally high-arched foot is pes cavus. Depending on the underlying anatomy, the deformity may involve the forefoot, hindfoot or both.
A cavus foot can alter the way weight is distributed across the foot. Instead of pressure being distributed relatively evenly, greater loads may be concentrated around areas such as the heel, forefoot and outer border of the foot.
If you want a basic explanation of what constitutes a high foot arch, see:
What Is a High Foot Arch? Causes, Symptoms & Support Options
This article goes further into why high arches occur, the problems they can cause and how they are managed.
High arches can be a normal variation in foot structure, particularly when they are painless and do not interfere with movement or daily activities.
However, not every high arch is simply an anatomical variation.
Pes cavus can sometimes be associated with hereditary neurological conditions, neuromuscular disorders, congenital conditions or previous trauma. Clinical sources emphasize the importance of identifying the underlying cause, particularly when the deformity is progressive, severe, asymmetric or associated with neurological symptoms.
Therefore, the key question is not simply:
"Are my arches high?"
It is:
"Are my high arches causing symptoms, changing over time or associated with another condition?"
There is no single cause of high arches.
Common causes and contributing factors include:
Hereditary or genetic factors
Neurological or neuromuscular conditions
Congenital foot abnormalities
Previous trauma
Muscle imbalance
Certain spinal or neurological disorders
Structural changes affecting the forefoot or hindfoot
Idiopathic causes, where no specific underlying cause is identified
Neurological and neuromuscular disorders are particularly important causes of symptomatic cavus foot.
1. Hereditary Factors
Some people naturally have high arches because of inherited foot structure.
A family history of similar foot deformity can therefore be relevant when a clinician evaluates someone with cavus foot.
2. Neurological Conditions
High arches can sometimes develop because of muscle imbalance caused by a neurological or neuromuscular condition.
One well-known association is Charcot–Marie–Tooth disease (CMT), a group of inherited peripheral neuropathies that can cause progressive muscle weakness and foot deformity.
Other neurological conditions can also be associated with pes cavus.
This does not mean that everyone with high arches has a neurological disorder.
However, unexplained, progressive or unusual high arches—particularly when accompanied by weakness, balance problems or other neurological symptoms—should be evaluated.
3. Congenital Causes
Some high-arched feet develop as part of congenital or developmental foot abnormalities.
The shape of the foot can depend on whether the primary structural change affects the forefoot, hindfoot or both.
4. Previous Injury
Trauma can sometimes contribute to a cavus or cavovarus foot.
Examples include certain fractures, nerve injuries, muscle or tendon injuries and other post-traumatic changes.
5. Muscle Imbalance
The muscles controlling the foot and ankle work together to maintain stability during standing and walking.
When certain muscles become weak while others remain relatively strong or contracted, the resulting imbalance can contribute to progressive cavus deformity.
6. Idiopathic High Arches
Sometimes, no clear underlying cause is identified.
These cases are often described as idiopathic.
An idiopathic high arch may remain relatively stable, or it may become symptomatic because of changes in activity, footwear, body weight, age or foot mechanics.
Yes. A high-arched foot can become more noticeable or symptomatic later in life, depending on the underlying cause.
A previously stable foot that develops a progressively higher arch deserves more attention than a lifelong, painless high arch.
Particular attention is warranted when a newly developing or worsening high arch is accompanied by:
Muscle weakness
Numbness or tingling
Balance problems
Repeated ankle sprains
Increasing foot pain
Changes affecting only one foot
A sudden or progressive unilateral cavus deformity can require investigation for an underlying neurological or structural cause.
High arches do not always cause symptoms.
When symptoms occur, they can result from altered pressure distribution, reduced shock absorption or instability associated with the foot structure.
Common symptoms include:
Foot pain
Arch pain
Heel pain
Ball-of-foot pain
Calluses
Ankle instability
Repeated ankle sprains
Difficulty finding comfortable shoes
Rapid or uneven shoe wear
Foot fatigue
Pain during prolonged standing or walking
Stress-related foot problems
People with cavus feet can experience increased pressure beneath particular areas of the foot, including the heel and forefoot.
Yes, high arches can contribute to foot pain in some people.
A high arch can alter how forces are distributed through the foot while standing and walking.
Pain may occur beneath:
The heel
The ball of the foot
The first metatarsal area
The outer border of the foot
The arch itself
The exact location depends on the person's foot structure and the underlying cause.
Research on pes cavus has identified abnormal plantar pressure distribution as one potential contributor to pain and disability.
They can contribute to heel pain in some people.
High-arched feet may distribute pressure differently during walking, potentially increasing stress on specific areas of the foot.
Heel pain can have many causes, however, so it should not automatically be attributed to a high arch.
Persistent heel pain should be evaluated in context rather than assuming that arch height is the only cause.
Yes. Ball-of-foot pain, also known as metatarsalgia when appropriate, can occur with symptomatic high arches.
A high-arched foot can concentrate pressure around the forefoot, particularly beneath the metatarsal heads.
This can result in:
Forefoot pain
Tenderness
Calluses
Burning or aching sensations
Pain that becomes worse with prolonged standing or walking
Clinical reviews identify forefoot pain and metatarsal overload among common problems associated with cavus foot.
Yes.
Calluses develop when repeated pressure and friction cause the skin to thicken.
Because high arches can concentrate pressure on particular parts of the foot, painful calluses may develop beneath the forefoot or around other pressure points.
Calluses beneath the first and fifth metatarsal heads are among the findings reported with pes cavus.
A callus itself does not necessarily mean that something is wrong, but recurrent painful calluses can indicate that pressure is not being distributed comfortably.
High arches can be associated with ankle instability and repeated ankle sprains.
Some cavus or cavovarus foot structures place the heel in a more inverted or varus position, which can affect lateral ankle stability.
People with symptomatic cavus feet may therefore report:
Repeated ankle sprains
A feeling that the ankle gives way
Lateral ankle pain
Difficulty on uneven surfaces
Reduced confidence during sports
Clinical reviews describe lateral ankle instability as an important potential consequence of cavovarus foot mechanics.
High arches may be associated with plantar heel pain and plantar fascia problems, but high arches are not the only possible cause.
A rigid or poorly accommodating high-arched foot can alter how forces are absorbed during walking.
However, plantar fasciitis has multiple risk factors and causes. A diagnosis should not be made solely from the appearance of the arch.
If you have both high arches and persistent heel pain, professional assessment can help determine whether the two are related.
Yes, symptomatic high arches can affect walking mechanics.
A high-arched foot may have reduced ability to adapt to the ground compared with a more flexible foot.
Changes in:
Foot position
Pressure distribution
Shock absorption
Ankle stability
Forefoot loading
can influence gait.
Cavus foot is associated with altered biomechanics and can produce gait-related problems when the deformity is significant or symptomatic.
However, having a high arch does not automatically mean that your walking pattern is abnormal.
They may contribute to altered lower-limb mechanics, but high arches should not automatically be considered the cause of knee or back pain.
Some clinical descriptions of pes cavus include knee pain associated with abnormal gait mechanics, but knee and back pain have many possible causes.
If you have persistent knee or back pain along with high arches, the entire lower-limb kinetic chain should be considered rather than focusing exclusively on arch height.
For comparison, see our article on the relationship between foot structure and movement:
Flat Feet and Walking: How Foot Mechanics Affect Movement
Not necessarily.
A high arch is not automatically a medical problem.
A painless high arch that does not interfere with walking, exercise or daily activities may simply be part of an individual's natural foot structure.
High arches become more clinically relevant when they are:
Painful
Progressive
Rigid
Associated with repeated ankle sprains
Causing recurrent calluses
Affecting walking or activity
Associated with neurological symptoms
Significantly different between the two feet
The presence of symptoms and the underlying cause are generally more important than arch height alone.
A healthcare professional may evaluate high arches using a combination of history, physical examination and, when necessary, imaging or other investigations.
Assessment can include:
Foot Shape
The clinician examines the arch, heel position and overall foot structure while the person is standing and walking.
Flexibility
The clinician may determine whether the deformity changes with different positions or movements.
Muscle Strength
Muscle weakness or imbalance can provide clues about the underlying cause.
Neurological Examination
When appropriate, reflexes, sensation, muscle strength and coordination may be assessed.
Gait Assessment
Walking and standing mechanics can provide useful information about how the foot functions.
Family History
A family history of similar foot deformity or neurological disease may be relevant.
Imaging
X-rays or other imaging may be used when the deformity is significant, unusual, progressive or being considered for surgical treatment.
The purpose of diagnosis is not simply to confirm that the arch is high.
It is also to understand why the arch is high and whether it is causing a functional problem.
You can observe your foot shape at home, but a home test cannot determine the underlying cause of a high arch.
For example, you may notice that:
The inner arch appears pronounced
Less of the middle of the foot contacts the ground
Your shoes wear unevenly
You develop calluses at pressure points
You frequently experience ankle sprains
A footprint test can provide a rough indication of arch shape, but it cannot diagnose pes cavus or determine whether treatment is necessary.
For an introduction to checking your arch type, see:
How to Measure Your Foot Arch at Home
And for the wet-foot method:
Wet Foot Test: How to Check Your Arch Type at Home
Treatment for high arches depends on the cause, severity and symptoms.
There is no single treatment that works for every person with pes cavus.
Treatment can include:
Footwear modifications
Activity modification
Orthotic devices
Padding or pressure redistribution
Stretching and strengthening
Physical therapy
Treatment of an underlying neurological condition
Bracing in selected cases
Surgery for severe or progressive deformity
Conservative treatment is generally considered first when the deformity is flexible and symptoms can be managed without surgery.
Many people with symptomatic but manageable high arches can initially be treated conservatively.
Potential options include:
1. Supportive Footwear
Shoes with adequate cushioning and a comfortable fit may help reduce pressure on sensitive areas.
The goal is not necessarily to find a shoe with the most aggressive arch support.
Instead, the shoe should accommodate the shape of the foot while reducing uncomfortable pressure points.
2. Orthotics
Orthoses can be used to redistribute pressure and accommodate the foot.
Evidence from a randomized trial included in a Cochrane review found that custom-made orthoses reduced pain and improved function compared with sham orthoses in adults with painful pes cavus. However, the overall evidence base for pes cavus treatments remains limited, and treatment should be individualized.
3. Padding
Padding can help protect areas exposed to excessive pressure.
4. Physical Therapy
Depending on the individual, physical therapy may include:
Stretching
Strengthening
Balance exercises
Gait-related work
Mobility exercises
The appropriate program depends on the specific limitations and underlying cause.
5. Activity Modification
If a particular activity repeatedly triggers pain, temporarily modifying activity levels may help while the underlying issue is addressed.
Orthotics can help some people with painful high arches by redistributing pressure and improving foot accommodation.
Evidence is particularly supportive of custom orthoses for reducing pain in adults with symptomatic pes cavus, although the evidence base is not extensive.
Orthotics may be designed to:
Redistribute plantar pressure
Cushion sensitive areas
Accommodate the high arch
Reduce excessive pressure beneath the forefoot
Improve comfort during walking
Importantly, an orthotic for a high arch should not simply push aggressively against the arch.
The design needs to accommodate the individual's foot shape.
Custom orthoses may be useful for some people with painful or complex high-arched feet, but they are not automatically necessary for everyone.
The choice depends on:
Severity of the deformity
Foot flexibility
Pressure distribution
Symptoms
Underlying condition
Previous response to footwear or prefabricated devices
A randomized trial involving adults with painful pes cavus found better pain and function outcomes with custom orthoses than sham orthoses.
That evidence supports considering custom orthoses for selected symptomatic patients, rather than recommending them universally to anyone with a high arch.
There is no single shoe that is best for every high-arched foot.
Generally, look for footwear that provides:
Adequate cushioning
Enough room for the toes
A comfortable fit around the arch
Sufficient width
Good heel stability
Appropriate flexibility for your activity
No pressure on prominent areas
People with high arches may benefit from footwear that accommodates rather than aggressively corrects the foot.
If you experience recurrent pain or difficulty finding footwear that fits, consider professional assessment rather than repeatedly changing shoes without understanding the underlying problem.
Exercises cannot be assumed to lower a structurally high arch.
However, stretching, strengthening and balance exercises may be used as part of rehabilitation depending on the individual's symptoms and underlying mechanics.
Potential areas that may be addressed include:
Calf flexibility
Ankle mobility
Foot and ankle strength
Balance
Proprioception
Functional movement
The correct exercises depend on the person's condition.
Someone with a neurological cause of pes cavus, for example, may need a different rehabilitation approach from someone with an uncomplicated structural high arch.
The answer depends on what is meant by "corrected."
Conservative treatment can often improve:
Pain
Pressure distribution
Foot comfort
Stability
Function
But an insole or shoe should not be assumed to permanently change the underlying bone structure of a high-arched foot.
For significant structural deformity, surgical correction may sometimes be considered.
The treatment objective should therefore be based on the individual's symptoms, function and underlying cause rather than simply trying to make the arch look lower.
Surgery may be considered when a high-arched or cavovarus foot is severe, progressive, rigid or remains significantly symptomatic despite appropriate non-surgical treatment.
Surgical treatment is highly individualized.
Depending on the deformity, procedures can include:
Soft-tissue releases
Tendon transfers
Osteotomies
Procedures to correct the forefoot
Procedures to correct the hindfoot
Joint fusion procedures in selected severe cases
Modern reviews emphasize that cavus foot surgery needs to be tailored to the underlying deformity, including whether the forefoot, hindfoot or both are involved.
Surgery is therefore not a routine treatment for simply having high arches.
They can become more symptomatic or progressively deform in some people, depending on the underlying cause.
Progression is particularly important when high arches are associated with neurological or neuromuscular disease.
The natural history can vary substantially depending on the cause, severity and age at presentation.
Signs that deserve evaluation include:
Increasing arch height
Increasing foot stiffness
More frequent ankle sprains
New weakness
New balance problems
Increasing pain
Increasing difficulty finding shoes
Changes affecting only one foot
When Should You See a Doctor About High Arches?
Consider professional evaluation if you have:
Persistent foot pain
Recurrent ankle sprains
Progressive changes in foot shape
Significant calluses
Difficulty walking
Increasing difficulty with exercise
New muscle weakness
Numbness or altered sensation
Balance problems
A newly developed high arch
A high arch affecting only one foot
A particularly important point is that progressive or unexplained cavus foot should not automatically be treated as a footwear problem.
The underlying cause may need to be investigated.
| Finding | Usually less concerning | Worth Evaluating |
|---|---|---|
| Arch height | Naturally high | Increasing over time |
| Pain | None | Persistent or activity-related |
| Walking | Normal | Difficulty or altered gait |
| Ankle | Stable | Repeated sprains or instability |
| Foot Shape | Similar on both sides | Significant asymmetry |
| Strength | Normal | New Weakness |
This table is not a diagnostic tool. It simply illustrates why symptoms, progression and function matter more than arch height alone.
The foot normally works as a dynamic structure that adapts to the ground while also providing stability during push-off.
With cavus foot, changes in the relationship between the forefoot and hindfoot can alter the normal distribution of forces.
The foot may behave more like a rigid lever, while pressure can become concentrated around specific areas.
This can contribute to:
Forefoot overload
Heel pressure
Lateral foot stress
Reduced shock absorption
Ankle instability
Callus formation
The exact mechanics vary according to the type and severity of cavus deformity.
People with high arches may sometimes find it difficult to find shoes that feel comfortable.
Common complaints include:
Pressure over the top of the foot
Excessive pressure under the forefoot
Tightness around the arch
Rapid or uneven shoe wear
Difficulty finding shoes with sufficient cushioning
Discomfort after prolonged walking
These problems do not necessarily mean that a particular shoe is unsuitable forever. Fit, activity and foot structure all influence comfort.
High arches are not automatically a medical problem.
The most important points are:
High arches are also called pes cavus.
A high arch can be a normal variation in foot structure.
Some cases are hereditary or idiopathic.
Neurological and neuromuscular conditions can also cause cavus foot.
High arches can concentrate pressure on the heel, forefoot or other parts of the foot.
Symptoms can include pain, calluses, ankle instability and difficulty with footwear.
Orthotics may help some people with symptomatic high arches by redistributing pressure.
Custom orthoses have evidence for reducing pain in adults with painful pes cavus, although the overall evidence base remains limited.
Exercises may form part of rehabilitation but are not guaranteed to structurally lower a high arch.
Severe, rigid, progressive or neurologically associated cavus foot may require specialist evaluation.
Surgery is reserved for selected cases and is tailored to the individual's deformity and underlying cause.
The presence of a high arch alone does not determine whether treatment is necessary.
FAQs
| Sensation | Normal | Numbness or altered sensation |
| Calluses | Minimal | Recurrent painful calluses |
| Activity | Normal participation | Increasing activity limitation |
