What Is a Cavus Foot?
A cavus foot is a condition where the arch is higher than normal. When standing, the middle portion of the foot appears lifted off the ground, creating a noticeable hollow. This arch height results from underlying deformities, including the front part of the foot being angled downward — often more on the big-toe side (first ray). As a result, the arch appears elevated, and the foot tends to tilt outward.
Some people with cavus foot develop:
- Inward-tilting heels
- Curled or claw toes
- Tightened Achilles tendon
- Pressure on the ball and ankle of the foot
With time, the foot can become stiff, and the heel tilt may turn from flexible to fixed.
Why Does Cavus Foot Occur?
1. Unknown Causes
In many individuals, no definite cause is found. These cases are often mild and may run in families.
2. Neuromuscular Conditions
Several medical problems that weaken or affect muscle coordination may lead to cavus foot, including:
- Charcot-Marie-Tooth disease
- Muscular dystrophy
- Spina bifida
- Peripheral neuropathy
Even when no diagnosis is clear, subtle nerve or muscle weakness is suspected.
Should You Be Tested for These Conditions?
If your arch is increasing, your toes are curling, your foot is tilting, or you feel weakness or numbness, you should see your doctor for evaluation. If your feet are not causing trouble, tests may not be necessary.
Is Cavus Foot Hereditary?
Possibly. Family tendency is common, but without knowing the cause, the likelihood cannot be precisely predicted.
Problems Caused by Pes Cavus
Not everyone with high arches has symptoms. However, problems may include:
- Difficulty fitting shoes
- Aching around the ankle, outer foot edge, or under the ball of the foot
- Pressure points due to clawed toes
- Stiffness and poor shock absorption
- Ankle instability from heel tilting inward
- Increased likelihood of ankle sprains (especially in neuromuscular cases)
In people with reduced foot sensation, pressure areas may rub raw — a sign to seek medical help.
Is Frequent Ankle Sprain a Sign of Cavus Foot?
Not always. Many people sprain their ankles due to an old injury. However, a high arch can worsen instability, increasing the frequency of “rolling over” the ankle.
Does Cavus Foot Cause Pain in the Ball of the Foot?
It might. High arches and claw toes can increase pressure under the ball of the foot (metatarsalgia). Still, many other causes exist, and evaluation may be needed.
Are Curled Small Toes Related to Cavus Foot?
They can be, but other causes also exist. Clawed or curled toes are common in cavus foot but may arise from unrelated issues.
What Can You Do Yourself?
While the underlying cause cannot be reversed, you can:
- Stretch and exercise your foot to reduce stiffness
- Wear roomy shoes that don’t rub
- Use shock-absorbing footwear for sports
- Use pads or insoles to reduce arch and forefoot pain
- Check your feet daily if you have reduced sensation
How Will the Doctor Diagnose It?
Your doctor will perform a full examination looking for neuromuscular signs. Tests may include:
- Blood tests
- X-rays of the feet or spine
- MRI or CT scans of the spine or brain
- Nerve conduction studies
Sometimes these tests identify a cause — sometimes they don’t.
How Is Pes Cavus Managed?
Non-Surgical Options
- Custom insoles to redistribute pressure
- Braces or splints for stability if the heel tilts excessively
- Padding to protect raw or callused areas
These measures help many people avoid surgery.
When Is Surgery Needed?
Surgery is considered when:
- Pain is severe
- The foot is unstable
- Skin breaks down from pressure
- Conservative treatments fail
Surgery is typically significant, especially in stiff or severe deformities.
Possible Surgical Procedures
- Straightening claw toes
- Cutting and reshaping bones in the front, middle, or heel of the foot
- Fusion of joints to stabilise the foot
- Tendon transfers to strengthen weak areas
- Tightening or reconstructing ankle ligaments to prevent rolling
Your foot and ankle surgeon will explain the best approach, risks, and expected outcomes.