Pes cavus, or a high-arched foot, describes a foot with a more pronounced arch than typical, meaning the sole doesn't make as much even contact with the ground. Unlike a flat foot, a high-arched foot is generally less flexible and less effective at absorbing shock, which tends to concentrate pressure at the heel and the ball of the foot rather than spreading it evenly.
A high arch can be a simple structural variation with no associated problems, or it can be linked to an underlying neurological or muscular condition, particularly when it develops progressively, is asymmetrical, or is accompanied by other signs such as clawed toes or muscle weakness. This is why assessment of a genuinely high-arched foot includes a broader neurological and structural review, not just the foot itself.
Idiopathic (No Identified Cause)
Many people simply have a naturally higher arch as part of their normal foot shape, without any underlying condition.
Neurological Conditions
Conditions such as Charcot-Marie-Tooth disease can cause a progressive, often asymmetrical high arch due to muscle imbalance around the foot.
Muscle Imbalance
An imbalance between the muscles that support the arch can pull the foot into a more cavus position over time.
Family History
A high arch, like a flat foot, often runs in families as part of normal inherited foot shape.
Metatarsalgia and forefoot pain from concentrated pressure at the ball of the foot
Heel pain from reduced shock absorption
Lateral ankle instability and a tendency toward ankle sprains
Peroneal tendinopathy from increased lateral column loading
Callus build-up under the heel and metatarsal heads
Assessment includes examining foot structure, flexibility and muscle strength, along with in-shoe pressure and gait analysis to understand exactly where and how load is being concentrated. Where the arch is notably rigid, asymmetrical, progressive, or accompanied by muscle weakness, we'll discuss whether further neurological investigation is appropriate.
Management focuses on redistributing pressure away from overloaded areas and supporting stability, particularly at the ankle where high arches often increase the risk of sprains.
If you have a high arch alongside forefoot or heel pain, recurrent ankle sprains, or you notice the arch changing, becoming asymmetrical, or accompanied by muscle weakness, book an assessment. A progressive or asymmetrical high arch, in particular, is worth investigating rather than assuming it's simply your natural foot shape.
Is a high arch always a problem?
No — many people have a naturally high arch with no issues at all. It's worth assessing when it's associated with pain, instability, or if it appears to be changing over time, rather than because of arch height alone.
Could my high arch be a sign of something more serious?
In most cases, no — a high arch is simply a variation in foot shape. However, a progressive, asymmetrical or rapidly developing high arch, particularly alongside muscle weakness, can occasionally indicate an underlying neurological condition and is worth a thorough assessment.
Will orthotics fix my high arch?
Orthotics don't change the underlying arch shape, but they can significantly improve comfort by redistributing pressure and improving shock absorption, and are often the most effective single intervention for symptoms related to a high-arched foot.
Is this covered by insurance?
Yes — biomechanical assessment and orthotics are typically covered by most major insurers. We work with Bupa, Aviva, WPA and others. See our
insurance page for full details.
Ready to book your assessment?
We'll assess how your arch is affecting load through your foot and build the right support plan.
