The Pes Cavus foot is commonly known as the high arched foot that typically does not flatten with weight bearing. The structure of this foot type mimics a tripod in that the individual’s weight is mostly supported by the heel, ball of the foot (1st metatarsophalangeal joint) and just under the pinky toe (5th metatarsophalangeal joint.) These 3 points and/or others can be bony prominences and can also develop thick plantar calluses. Pes Cavus foot is less common than the opposite-a Pes Planus, or flat, foot. Most inherit their foot condition from their parents, where as some may develop a Pes Cavus foot due to an underlying neurological condition such as Charcor-Marie-Tooth disease.



The Pes Cavus foot does not typically have the ability to pronate (inward roll of the foot) enough to absorb shock. This foot type can be, or can become, inflexible or rigid. As a result, stress fractures to the smaller bones in athletic individuals with this foot type are common. Due to the high arched nature, the Pes Cavus foot tends to have claw toes associated with the foot type. With the inability to pronate comes the susceptibility to supinate (outward roll of the foot) which can lead to increased injuries on the lateral (outer) side of the foot or ankle-such as ankle sprains. The Pes Cavus foot can also affect the Achilles tendon and calf muscle causing either, or both, to be tight and reduce dorsiflexion (upwards movement of the foot) at the ankle causing pain and or ankle equinus (inability to dorsiflex at the foot at the ankle joint.) Due to reduced pressure absorbing capability, there may be increased areas of pressure on the bottom of the foot such as the metatarsal heads causing calluses and corns. Pain in the heel, knee, hip, and lower back have also been linked to a Pes Cavus foot.


Pedorthic Management

  • Can be hard to fit shoes-vamp height is an important factor-increased lateral support due to supination tendancies.
  • Extra EVA cushion in the heel and forefoot to absorb shock
  • Rocker soles and full steel or carbon shanks
  • Lateral sole flares or wedges
  • Custom made functional or accommodative orthotics to support foot laterally and add cushioning.