The high arched foot, also described as cavus foot, is the opposite of a flatfoot condition. Many underlying causes may be directly responsible for this positioning with the most common being Charcot-Marie-Tooth disease or, the now more properly referred to as, Hereditary Sensorimotor Neuropathy. This is a strong congenital condition and can be a progressive problem with time and age. The muscles of the foot and ankle become less supportive, causing progressive weakness of the muscles. Without the efficient use of these muscles, the ankle can’t bend up, the big toe can’t bend down, the arch of the foot increases, and the heel bends inward. This leads to the high arched foot position.
In some patients with this problem and no family history is noted, this could be a new genetic problem in the individual or may be due to other disorders. Another underlying primary problem, for example, is a rupture of one of the tendons on the outside of the foot (peroneal tendons) – causing a similar muscle imbalance.
Patients with high rigid arches do have a propensity to certain types of foot problems because the foot loads differently. Within patients, there is a spectrum of normal, ranging from a flat foot, a mutually lined foot, and then a foot that’s aligned where all weight goes on the big toe, heel, and outside part of the foot. Almost like a tripod with a high arch, the weight isn’t distributed through the entire foot, but rather a very specific pressure area. The way we address this condition is dependent upon where the pain is specifically associated with that high arched foot.
The treatment for patients with this condition involves identifying the main problem (instability of the ankle, tendon pain, arthritis, callus, imbalance, etc) and planning surgery to correct the imbalance of the foot. This is often caused by osteotomies of multiple bones (cutting the bones of the foot and realigning them to rebalance the foot), most commonly of the heel bone and / or first metatarsal bone. In addition, tendon transfers (routing a tendon from one area of the foot and transferring some or all of the fibers to another part of the foot where the tendon has failed) is also used in order to rebalance the foot.
If the deformity is severe and the arthritis is too progressed, the joints cannot be saved and welding the joints (fusion), joint replacements, or a combination of both procedures may be necessary. The reconstruction of foot condition requires skillful technique and consideration for treatment with an orthopaedic foot and ankle specialist familiar with all orthopedic treatment options and reconstructive methods should be considered to maximize outcomes.
Over the counter or custom orthotics takes pressure off those focal points where the weight is being distributed on the outside part of the foot, or for example, underneath the big toe. This causes the pressure to be well distributed further, and in other areas, more universally.
All levels of foot pain can become more and more irritating if it’s left alone. To get the professional medical assistance you need, contact Dr. Vora at an orthopedic clinic in your local Chicagoland area. Discovering a customized solution to high arched feet and general foot pain is just a step away with Dr. Anand Vora.