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HIGH ARCH Pes Cavus

Pes cavus is defined as foot having an abnormally high medial longitudinal arch.. These feet retain their high-arched appearance when weight bearing, this is the supinated foot type.  It  is a less common deformity than flat foot (pes planus).  Pes cavus is usually bilateral and apparent at an early age. The sudden appearance of the deformity, or its presence unilaterally, may be the result of trauma or neuro-muscular disease.
It may be initially asymptomatic, but often becomes progressively symptomatic with age.  In many respects, pes cavus is a more bothersome foot type than flatfoot.  Less of the plantar surface of the foot is weight bearing resulting in increased stress on the heel and metatarsals.  Painful plantar calluses are often present. 

The toes may develop a "clawing" deformity with painful corns on the top of the toes or at the tips.  The high arched foot is very poor at absorbing the shock of heel strike during the gait cycle.  This creates abnormal stress on the soft tissues of the heel and mid-tarsal joints (arch). The shock is transmitted up the kinetic chain to the ankle, knees, hips, and lower back.  Pain in one or more these areas is fairly common. 

Prescription Foot orthotic devices can provide support for stressed joints and soft tissues.  They are often constructed to increase shock absorption.  The redistribution of weight relieves stress on the metatarsals. Generally, custom-made semi-rigid or semi-flexible functional posted orthotics are most effective for this foot type.  They often include shock absorbing material in the arch. These devices are prescribed based on a thorough biomechanical examination by a Physical Therapist. Orthotic therapy is very effective for patients with this foot type. Over-the-counter arch supports may be helpful for mild cases, but they are often a poor fit for persons with this condition.

Symptoms
Pain and stiffness of the medial arch or anywhere along the mid-portion of the foot
There may be associated discomfort within and near the ankle joint
The knees, hips, and lower back may be the primary source of discomfort
Pain in the ball of the foot, with or without calluses
Heel pain                                                                                                                                                          

Causes
Unknown, probably a genetic predisposition
Congenital conditions (e.g. cerebral palsy, congenital club foot)                                                   
Neuro-muscular disease (e.g. poliomyelitis, Charcot-Marie-Tooth disease)
Nerve trauma

What you can do                                                                                                        
Wear shoes with a good cushioning and arch support                                                                  
Control body weight to decrease load on the feet                                                                                     
Home care of associated corns and calluses

What the Physical Therapist may do
Utilise physical therapy modalities
Recommend shoes
Prescribe functional foot orthotic devices to support the foot, redistribute weight, and absorb shock.
In some cases Surgery may be required to  correct a severe symptomatic high arched foot 

Complications of the high arched foot
Pain in the heel and sole of the foot from plantar fasciitis.
"Pump bumps" (Haglund's deformity) on the back of the heel
Tight Achilles tendons
Ankle instability with frequent sprains
Morton's neuroma with pain in the ball of the foot and lesser toes.
Strain and early degenerative joint disease (osteoarthritis) of lower extremity joints
High arched feet are are more prone to develop painful contractures of the toes and calluses.
Metatarsalgia with pain in the forefoot
Stress fractures of the metatarsals and other foot bones
In diabetics & those with compromised circulation, abnormal pressure may result in chromic ulcers of the heel & ball of the foot.
Chronic lower extremity pain my lead to inactivity and diminished well-being