High Arched Foot
Patient Information
A high arched foot, also known as pes cavus or cavus foot, is a condition where the arch of the foot is raised more than normal. This leads to an abnormal distribution of weight across the foot, placing excessive pressure on the heel and the ball of the foot. Mr Matthew Welck is a leading consultant foot and ankle surgeon based in London, offering expert diagnosis and treatment for high arched foot conditions at the Royal National Orthopaedic Hospital (RNOH) Stanmore, The Wellington Hospital in North London, and other private clinics across Hertfordshire and Central London.
Useful patient resources: Foot Health Facts – Cavus Foot | BOFAS – High Arched Feet
What is a High Arched Foot (Pes Cavus)?
Pes cavus describes a foot with an abnormally high arch that does not flatten when weight is placed on it. Unlike a flat foot, where the arch collapses, a high arched foot creates a rigid structure that absorbs shock poorly. This rigidity can cause pain, instability, and deformity over time if left untreated.
Causes of High Arched Foot
- Neurological disorders such as Charcot-Marie-Tooth disease, cerebral palsy, spina bifida, or Friedreich’s ataxia are the most common causes.
- Inherited structural abnormality — some patients have idiopathic pes cavus with no identifiable neurological cause.
- Previous trauma or compartment syndrome of the foot or leg may result in a cavus deformity.
- The condition can affect one or both feet and may be progressive.
Symptoms of Pes Cavus
- Visible high arch deformity, sometimes with the heel angled inward (varus)
- Callosities (hard skin) on the ball of the foot, heel, or outer border of the foot
- Pain on standing and walking, particularly in the ball and heel of the foot
- Ankle instability and recurrent ankle sprains due to poor foot mechanics
- Clawed or hammer toes resulting from muscle imbalance
- Foot drop in cases associated with neurological conditions
- Difficulty fitting footwear due to the high arch and toe deformity
GP Information
Referral and Investigation Guidelines
Diagnostics are not required prior to referral. It is important to accurately diagnose the underlying cause of pes cavus, as neurological conditions may require parallel management. A unilateral or progressive cavus foot in particular warrants referral to both a foot and ankle surgeon and a neurologist, as it may indicate an underlying neurological condition that requires investigation.
Conservative Management
In the first instance, the following conservative measures may help manage symptoms while awaiting specialist assessment:
- Analgesia – over-the-counter or prescribed pain relief to manage discomfort
- Activity modification – reducing high-impact activities that worsen symptoms
- Orthotics – custom or off-the-shelf insoles to redistribute weight across the foot and improve comfort
- Physiotherapy – strengthening and stretching exercises to improve foot mechanics and ankle stability
- Appropriate footwear – wide, deep shoes to accommodate the deformity and reduce pressure
Surgical Treatment
When conservative measures fail to adequately control symptoms, surgical intervention may be considered. Mr Matthew Welck specialises in corrective surgery for pes cavus and associated deformities. Surgery aims to correct the underlying foot deformity, redistribute weight more evenly, and improve stability. Procedures may include tendon transfers, osteotomies (bone realignment), and joint fusions, tailored to the individual patient’s anatomy and neurological status.
Book an Appointment
If you or a patient is experiencing symptoms of a high arched foot in London or North London, Mr Matthew Welck offers specialist consultations at multiple locations including the RNOH Stanmore, The Wellington Hospital, and Spire Bushey Hospital. To book an appointment, please visit the appointments page or contact the clinic directly.